[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.