How are the messenger substance serotonin and the illness of depression connected? Learn about the current state of research, the best path for treatment, and how you can support serotonin in your daily life.
Serotonin & Depression: Key Takeaways
- What Serotonin Is: Serotonin is a messenger substance in the brain—a so-called neurotransmitter—that influences sleep, appetite, digestion, and mood.
- What Depression Is: Depression is an illness characterized by persistent low mood, loss of joy, ruminating, and physical symptoms. It is diagnosed by a doctor or a psychotherapist based on medical criteria.
- The Role of Serotonin Deficiency: A serotonin deficiency as the sole cause of depression has not been proven. To date, research has not confirmed that a deficiency or imbalance leads to depression.
- Serotonin as a Cure: Serotonin itself is not suitable as a remedy for depression. Medical guidelines recommend talk therapy, combined with medication if necessary, alongside active self-help measures in daily life.
- Digital Support: Daily life support is offered by the online program deprexis. This Digital Health Application provides helpful information, individualized dialogues, and effective exercises.
- Risks of Excess: Taking too much serotonin must be avoided, as it can trigger restlessness, tremors, sweating, and fever. In severe cases, this is referred to as "serotonin syndrome."
Measuring Serotonin
Now the question naturally arises: "Can you measure serotonin levels?" Short answer: yes, you can measure serotonin (or its breakdown products). Laboratories can either measure serotonin directly in the blood or its main breakdown product (5-HIAA) in urine. For depression, however, this is generally of no use.
Why? Serotonin acts primarily in the brain, and blood values do not accurately reflect what is happening there. Furthermore, serotonin levels fluctuate depending on the time of day, diet, and medications. When dealing with depression, these tests rarely help with making medical decisions. Much more important than numbers are the symptoms themselves, their duration and severity, and potential triggers. Even more crucial is their treatment.
Treatment: Psychotherapy, Medication, and Self-Help
Depression is highly treatable, and the effectiveness of treatment options is thoroughly researched.
The diagnosis is made by doctors or psychotherapists. Making a diagnosis means carefully evaluating what is going on. This takes place during a calm conversation where you share how you are feeling, how long you have felt this way, and how severely it impacts your daily life. The specialists then evaluate the depression based on medical criteria and propose a treatment plan.
Psychotherapy
Talk therapies are proven to be highly effective for depression. Cognitive Behavioral Therapy (CBT) is particularly well-researched. In CBT, you learn to recognize unhelpful thought patterns, take step-by-step action, and regulate difficult emotions. Many people quickly experience an increase in drive and self-efficacy.
Medication
For severe and long-lasting depression, medication—specifically an antidepressant—is prescribed in addition to psychotherapy to help lift the mood. Antidepressants do not contain serotonin themselves, but they alter how nerve cells handle serotonin in the brain.
For those who want to know more precisely how different types of antidepressants alter the way nerve cells interact with serotonin:
- SSRIs (e.g., sertraline, citalopram): Block the reuptake of serotonin into the nerve cell, allowing more serotonin to remain available between the cells.
- SNRIs (e.g., venlafaxine, duloxetine): Act in a similar manner.
- NaSSAs (e.g., mirtazapine): Block specific binding sites (receptors) and thereby indirectly enhance the effect of serotonin.
Self-Help with deprexis
deprexis is a recognized online program that offers people with depression helpful information, individualized dialogues, and effective exercises. The content of this Digital Health Application (DiGA) is based on Cognitive Behavioral Therapy (CBT). Your family doctor can prescribe deprexis for you, and your health insurance covers the costs. The best part: it can be used easily at any time and in any place.
Serotonin in Daily Life
Daily life tips do not replace professional treatment. However, they do help strengthen your daily routine. The following tips are scientifically proven and easy to implement:
Sleep: Rhythm is Medicine
Regular bedtimes help you find your inner rhythm. Go to bed at the same time whenever possible and wake up at a similar time in the morning. Air out your room, keep it dark, and place your phone out of reach. Morning light signals to the brain: "The day is here." This is a natural way to increase serotonin, as good sleep supports the regulatory circuits in the brain.
