[jamestnz]

>The root cause of depression is chemical

I wonder if you were speaking generally here, or if you were referring specifically to the Chemical Imbalance theory of depression/anxiety.

Often espoused by the marketing departments of Big Pharma, and by now firmly lodged in the public consciousness, the idea that abnormal monoamine levels (e.g. serotonin, noradrenaline) in the brain causes depression, is (to say the least) highly controversial. Some might even call it "debunked". Or, more charitably perhaps, just a highly persistent meme that's never really had much to do with science from the get-go.

BTW, I say this as someone who saw successful results using SSRIs (Citalopram) as a treatment for depression some years ago. Given that the relationship between serotonin and depression seems subtle, indirect, and poorly understood at best, I don't pretend to be able to explain why SSRI treatment "worked" for me! Placebo? Coincidence? Genuine effect which empirically exists but we do not yet understand the mechanism (a bit like lithium)?

[static_noise]

The problem with those cures might be that they modify one measurable imbalance but there may be many more and that imbalance might only be a symptom of something else. Also, people differ in the ways and rates they process chemicals. Using those poorly understood pills is akin to hitting it with a hammer and hoping it starts working again.

[jamestnz]

I agree with you - from a theoretical perspective, it seems pretty crazy to be taking pills that alter the brain chemistry when we don't fully understand the effects those changes might have.

But the strange fact is that SSRI therapy does seem to help with depression in many people, just as lithium seems to help with mood even though we don't completely understand why.

With the example of serotonin, even though the SSRI effects serotonin levels almost immediately, it can take several weeks for depressive symptoms to improve. Therefore it is unlikely that inhibiting serotonin transport alone accounts for the anti-depressive effect. It has more recently been theorised that the strong anti-inflammatory effect of SSRIs may be involved, as depression is increasingly known to be related to chronic inflammation.

Lastly I'm pretty skeptical about "imbalances" altogether (though I took it for granted at the time). For example, when I and others have been prescribed SSRIs, there have generally been no medical tests given first which might detect or confirm any such imbalance. In fact I'm not even sure such a test is possible. Instead, they give the pills out solely on the basis of a personal report from the patient, which the physician interprets to indicate depression.