🎙️Sanity readers speak up on the Great Serotonin Wars

Listen to my voice letter

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Couple of weeks ago I'd asked you to weigh in on the current kerfuffle around the 'chemical imbalance' theory of depression. To sum up:

• If depression is emphatically not the result of a chemical imbalance in the brain involving serotonin, as a recent paper by UCL researchers Joanna Moncrieff and Mark Horowitz argues, well then how do we make sense of our discontents?
• Does the death at long last of the chemical imbalance model signal a radical new opportunity to push for greater space for the social determinants of depression?
• And what does all of this mean for those of us who do take pills but are nonetheless critical of psychiatry's tendency to medicalise everything?

You have spoken, on Twitter and via your thoughtful emails to me. Today's edition is entirely dedicated to your voice and your stories.

A quick note on the interesting results from my (admittedly small and unscientific) Twitter poll: Most people said they were either confused by or indifferent to this latest culture war.

I understand the confusion – my own head has been swimming with all the frenzied headlines proclaiming a new mental health revolution. I wonder whether the indifference comes from the fact that these 'new' findings are not exactly new, in that the chemical imbalance model was already under severe attack, including within psychiatry's progressive quarters.

Or is the indifference the outcome, more worryingly, of a fatalism that despite these quaint academic battles, the lived reality of persons with mental health conditions is unlikely to change much, or at all?

The third option in the poll – validation – received the lowest percentage of votes. But in your emails to me, many of you expressed that feeling of being proven right after a lifetime of being medicated without improvement, or worse, with severe side effects and loss of autonomy.

Each comment below, lightly edited for brevity, is astounding in its nuance and authenticity. Thank you so much, friends of Sanity, for your wisdom and generosity of spirit. I believe we haven't heard the last of this debate, but for now, I really hope people in positions of power in the mental health establishment pay attention to what you have to say.