3.1 Selective Serotonin Reuptake Inhibitors
You may have heard the acronym SSRI, which stands for Selective Serotonin Reuptake Inhibitor. Fluoxetine is a type of SSRI, and it works by raising the levels of serotonin in the brain. According to the NHS (2018):
Serotonin is a neurotransmitter (a messenger chemical that carries signals between nerve cells in the brain). It’s thought to have a good influence on mood, emotion and sleep.
After carrying a message, serotonin is usually reabsorbed by the nerve cells (known as ‘reuptake’). SSRIs work by blocking (‘inhibiting’) reuptake, meaning more serotonin is available to pass further messages between nearby nerve cells.
It would be too simplistic to say that depression and related mental health conditions are caused by low serotonin levels, but a rise in serotonin levels can improve symptoms and make people more responsive to other types of treatment, such as CBT.
You can see that the use of SSRIs is firmly based in the biomedical approach introduced in Session 4, drawing on knowledge of neuroscience and finding a drug that has the potential to ‘fix’ a problem in the body. The NHS information extract also pointed out that the situation is not as simple as saying low serotonin is a cause of mental health problems. Mental health is the product of a complex interaction of biological, psychological and social influences, and serotonin is one small part of a big jigsaw.
In most areas of health, and particularly mental health, it is rare to identify a single ‘cause’ of illness. It is important to appreciate this complexity and not to jump to conclusions about the source of a problem, nor what should be done to help. Anti-depressants can be a big taboo and you will learn more about their benefits in the next activity.
Activity 7: Hannah’s mental health story
It is important to know when anti-depressants may be useful for some young people. Watch this video and consider the reasons that Hannah describes that underpinned her decision to take anti-depressants.
Hannah talks a lot in her video, initially about all the efforts she made to improve her mental health. She described getting exercise, sleep and eating right as helpful and her engagement with professionals who provided talking therapy. But she also points out that this had a limited impact and that eventually she became aware that therapy wasn’t enough – she came to accept that she needed anti-depressants. It was a huge step for her to take them and she felt it was taboo to say she needed to take them. She shares the story because she wants people to know that it has changed how she feels about how she wakes up in the morning. In summary her message is that if you have tried everything else and if your mood is not getting better, then medication might provide some additional help.