I know in theory that sounds logical, but it doesn't work like that.
It is the reuptake of Serotonin in the brain that can cause depression, not the actual level or amount in the brain.
For example you could have perfectly normal levels of Serotonin in your brain, but if the receptors in your brain are performing the reuptake (a kind of absorbsion) of that Serotonin too rapidly then much less Serotonin is left in between the receptors and this inhibits the brains ability to function normally, which can result in a depressed brain.
Not to mention that Serotonin reuptake is not the only contributing factor related to depression. many other neurotransmitting chemicles also play a big part in brain function. Sush as Neurephineferine, Doapamine, and Triptafane, just to name a few.
It's important to remember that SSRI drugs such as Prozac, Zoloft, Paxil, Lexapro, Ect.... Do not raise the level of Serotonin in the brain. Rather they work by Inhibiting the reuptake of Serotonin that already exists in the brain, Thus resulting in a slightly higher build up of Serotonin to remain in stasis between the billions of receptors in the brain. this inhabition of reuptake allows for improved brain fuctioning as it relates to mood and well being because more Serotonin is left in stasis between the receptors of the brain that rely on this presense of Serotonin to properly fire. Think of it like a tiny bit of fuel in between two slightly spaced apart receptors. The receptors need this Serotonin as a kind of bridge to fire data back and forth. When the Serotonin is artifically (with meds) prevented from being absorbed by the brain, more of it can stay in the little places between the receptors to do what it does best, act as a bridge for firing data to different parts of the brain.
To take any drug that is designed to increase the amount of Serotonin in the brain is very dangerous. These drugs do exist. For example the drug Ecstacy does this very well.
The problem with taking a drug that directly pumps Extra Serotonin into the brain is that eventually your body will do what it does best..... It will stop naturally producing Serotonin because it is getting it artifically. For this to happen would be a nightmare scenario and could result in eventual brain damage.
There have been some huge advances toward a working test that can give doctors a better idea of which antidepressant will work best for each individual. This would take a lot of the guess work out of finding the right AD medication for your individual biology.
It's still the the testing phases, but I realy think we will see this test approved by the FDA in the next few years. The accuracy of the test is whats going to be the big determining factor in it's success.
Well if the amount of serotonin in your brain is already low why would a drug that helps reuptake like SSRI's make much of a difference? Could this be why people get rebound effects or suddenly a med will stop working because the brain adjusts to the extra serotonin in the brain unable to be absorbed and stops producing enough to even fill those gaps. Much like Alzheimer's patients who take L-dopa "synthetic dopamine" they keep having to up the dose because the body will adapt over time. Maybe if you could trick the brain into keep releasing the current amount of serotonin and take synthetic serotonin maybe that could prevent the rebound cycle.
SSRI's don't help reuptake of Serotonin, they do just the opposite, they inhibit the reuptake of Serotonin. It's this inhibition effect that slowes the reuptake process, which in turn allows for higher levels of Serotonin to build up in the brain.
It's kind of like finding a back door to raising Serotonin levels without introducing a chemical to the system that directly forces a flood of serotonin to be produced artifically.
Scientists could easily make a drug that simply and directly raises levels of Serotonin in the brain. The problem with that approach is that to do so would have very serious long term effects on proper brain function.
For example, if I were to inject you with an artifical hormone that your body already produces naturally and I did this for several months, the end result would be that your body would say, "well, I'm getting plenty so I can shut down making anymore."
Then if the injections were stopped, there is a good chance your body may not start producing that hormone again. At least not in sufficient levels to keep you well.
The same thing could happen if pure Serotonin were taken. The results could be devistating.
This action is much different than our bodies ability to build resistance to drugs and alcohol. SSRI meds and other AD medications often poop out in time.
This is why you see so many people having to change meds that once worked well for them.
Our bodies are amazing machines and they are very good at learning how to destroy any Chemicle or drug that is not native to it. Some peoples bodys do this very fast and others are slower at it. My body happens to be very good at building resistance to any medication I put in it. I get maybe 1 year on any one AD medication before my body renders it usless.
I am frustrated and confused, maybe you can shed some light please.
I had an anxiety attack that landed me in the hospital for 24 hours. First time in my life and didn't know what it was, thought I was having a severe allergic reaction or heart attack. That was back in July and I'm just "slightly" feeling better since then. I've been taking Buspar and feel anxious, tense, weepy every day and have HOT/BURNING spots in different areas of my body sporadically. The heat build up in my body drives me crazy, is that too much serotonin or what could it be? Have you ever heard of that ? My email is ***@**** if you could please respond. I cant get any answers from doctors. Thank you !
Buspar or "buspirone hydrochloride." is an anti-anxiety agent. It's not a Benzodiazaphine like Xanax or Valum. Thus it is considered better for the "long term" treatment of anxiety dissorder.
That is if all you suffer from is anxiety dissorder. About 60% of people that suffer from Anxiety dissorder also suffer from Major cronic (chronic) depression. About 85% of people that suffer from Severe Depression also suffer from Anxiety dissorder.
So now you see how common it is for the two dissorders to play together.
Depression and anxiety are like two little peas in a pod. They both need each other to survive. Alone they are less powerful and they know this very well. That's not to say that both don't need to be treated.
You may not have been properly disagnosed, and as such you may not be getting the proper medication which can = trouble for you and your condition.
Not sure if your doctor is an expert in Mental health, but if he isn't may I suggest you find a Psychiatrist ASAP so that you can get proplerly treated and feel better.
Please refer to the post I just made on the boards about Regular doctors & Psychiatrists. There is a huge difference.
I agree 100% and there are very brilliant Psychiatrists and Psychopharmocologists contuing to work on more exacting test that are accurate enough to make a determination between situaltional depression and the type of cronic (chronic) depression that is caused by actual brain malfuction in the mood receptors of our brains.
The main and most difficult part about the development of such tests is the sheer complexity of the human brain.
My Psychiatrist once told me that current treatment with psycotropic meds is more of an art, rather than an exact science.
He alos told me that current top notch Psychiatry only understands about 10% of how the disease of cronic (chronic) depression and anxiety manifest in the brain. He also mentioned that currently there are about 4 known chemical neurotransmitters in the brain that they know of which effect mood regulation. He also stated that there are many more, in fact dozens more of these mood regulating neurotransmitters that have yet to be discovered.
My P-doc also told me that in the next 10 years there will be an absolute revolution regarding the treatment of very severe uni-polor and bi-polor types of depression. He said that science is just on the cusp of cracking the code to why depression effects so may people and this will result in better medications and better treatments.
Hensley u have alot of valuable medical knowledge, is this from personal experience or r u in the medical field?
I have never had that question answered for me before....I too can only take an antidepressant for approx a year than it no longer works...I never knew why b4. I always assumed I was just atypical.
Over the years my psych has trialed many meds and now I am on lamotrigene although I can say I sure didn't have any faith in the dx of bi-polar...but the drug has worked good,(so far)its been almost 16 months now and thats long for me.
Interesting and I would appreciate any material u may have on info regarding expanding beyond BP 1&2 to 3&4.
I really don't feel I fit into the symtoms (symptoms) of either BP 1or2...so I would be most interested in reading more on this.
Where do you obtain all this information?
My Psychiatrist happens to be a standing member of the center for Psychpharmocology.
He provides me with the absolute latest studies regarding new advaces in the treatment of medication resistant people such as you and I are.
Him and his coleges have a theroy that there may be more undiscovered types of Bi-polor depression that result in a lot of patient mis-diagnosis.
I was always diagnosed as Unipolar, but this new psychiatrist had a theory that perhaps I was not as medication resistant as once thought, but rather was suffering from what is now being called Bi-Polor (NOS) as in Not Otherwise Specified.
This type of depression can often mimic Uni-polor depression because it does not include bouts of Mania or Hypo-mania as with Bi-polor 1 & 2
My P-doc said that in the next year these new forms of Bi-polor will be broken down into 3 & 4 type. There is still a lot of studies being conducted to better help diagnose if these factors may contribute to why people like us are so medication resistant. We may just be getting the wrong meds.
This new P-doc currently has me on Lamictal, Pristiq, and Lithium.
He also explained that for me to get relief we may have to go as high as 600Mgs a day on the lithium and up to 250Mgs a day on the Lamictal. Accoring to him he explained that just 150Mgs a day of Lamictal is the lowest amount possible to effect change and 300Mgs of Lithium is the lowest amout to effect change.
So these dosages are not as shocking high as many may think.
As for Lithium, it is a very old drug, but do not underestimate it's amazing ability to add more punch to the antidepressant your already taking.
Lithium is also one of the only drugs proven to reduce suicidal thoughts.
Down side of Lithium is that you have to drink lots of fluids becuase it will make you sweat like a pig and you also have to get your blood lithium levels checked every 6 months to ensure your Kidneys are dealing with the drug ok.
I think your on the right track with adding Lamictal to your antidepressant, but if your depression is still not being fully kicked, then you may want to try also adding Lithium.
I have been taking some form of anti-depressant steadily for 21 years. I am pretty much stable. I take 20 mg. of Celexa and 300 mg of Wellbutrin XL. This seems to be a good combination for me. I have taken others before 1988 (when I started taking it steadily), but never for a long period of time. It was the old ones such as Endep and Elavil and I took it for about six weeks and then slowly weaned off. I can remember having bouts of depression since I was a young child. I have had two severe "Post-traumatic Stress" incidents in my life that required intensive treatment to bring me out of them. I have never been hospitalized, however. My question is what would happen if I weaned off the medication at this point? Would it harm me? What happens if I stay on it the rest of my life? the only side effect I have is weight gain, and I am starting to get that in control.
I guess the only way to know for sure is to try. I might add one good possability (others may disagree) but maybe your depression is not that severe to begin with. There is a rating scale that measures a persons level of depression.
Mine happens to be at the extreem high end and very cronic (chronic). It's also nearly impossible to treat and I must take massive amounts of medication to produce theraputic response.
Then you have Moderate depression. These sufferers also need medication, but there symptoms are a bit less severe.
Then you have Mild Depression. It can still be cronic (chronic), but it's not "OMG put me in the hospital depression!" These sufferers can sometimes get by without medication,but many times choose to use a low dosage antidepressant.
Don't get me wrong, for the sufferer even Mild depression is very uncomfortable.
Maybe you fall into a milder form of depression that could be controled without meds.
I have seen less severe people do it before.
I would just be careful and if you do then tell your doctor that you plan to taper off.
I tried one time to taper off my meds and I put myself in the Psych ward for 3 weeks.
Then again your probably not as screwed up as I am.
Good luck, just be careful and watch for warning signs.
It least a test that show all the amino acid levels for the building block of Serotonin. If any of the building blocks is low you are in trouble for low serotonin....I took the test and showed many low levels of important amino acids...I have OCD Pure O.........
I also agree it's not entirely the amount of serotonin that effects mental illness. In fact we do not know all the actions of SSRIs. We do know this. tryptophan (amino acid) converts to 5-Hydroxytryptophan (amino acid) which converts to serotonin. Whats this mean? I know there has been a study of people with Celiac Disease and mental illness. With Celiac Disease you cant absorb vital nutrients or very little. Without basic vitamins minerals you can't assimilate amino acids which are vital for brain function.This has an effect of not only serotonin but also other mood altering compounds as well.
Some people have said taking 5-HTP alone will help with depression and or anxiety. It sounds good in theory but if you don't have other vitamins and other organic compounds you won't be able to metabolize it into serotonin. You could make things worse by have 5-HTP compete for room cross over the blood brain barrier. You could block other amino acids and compounds from from crossing the bridge that are just as important for anxiety and depression.
In fact if you are low in those amino acids from nutrition and or autoimmune or a bad gene, than synthetic drugs will only work with the little amount of serotonin you have...Its like fighting a fire with a small bucket of water,and refilling the bucket with the water you just used. Synthetic drugs do not cure, they only help. I am not saying they are bad.
I see that most of people here are med oriented. As far as I know if you rely only on meds you not gonna be ever cured, you will always fear that when you stop taking them it will hit you back. This is psychological game played by drug industry whihc is worth $12 billion a year. Do you think that they just gonna stop drugging people, not gonna happen it is grate businesses. You just have to remember that when taking antidepressants the goal is to one day get off of them completely. There are natural ways of boosting neurotransmitters, but it is much slower then drugs and requires more effort. Also ADs are effective in 50-60% and side effects can be worst then original symptoms. In addition taking them is like playing Russian roulette, you never know what gonna happen next.
Yeah, I've been on meds for darn near ten years and I am sick of it. Not that ppl should feel lesser if they are on meds - I just think meds should be used as a tool to help one deal with the problems that cause the depression, so that they can learn to deal with it naturally.
I am at the point where I want off the meds. I am ready to try dealing with my problem naturally - with regular therapy, if needed. I feel "drugged" all the time, disoriented, malcontent, my memory is shot. I want to try. Try hard.
Apart from exercise what other treatments or methods do you know of - or have tried?
I have a bipolar 2 friend who is a psychiatric nurse, and he swears by "true hope" which he has been taking and has been off his meds for about 4 years. I like this idea of providing the nutrients that science has proven our brain needs to produce serotonin and other stuff that helps the receptors in the brain.
Hi, I came across this thread researching Serotonin levels and how to measure them and how to raise them. I have very low levels as per a blood test. The serum blood test is, I believe, as mentioned, measured indirectly. The doctors and psychiatrists I've spoken with don't seem to have any answers to any of my questions, but it doesn't surprise me. They usually aren't the best at pharmacological issues.
Serotonin is found in the pineal gland, the lining of the GI tract, the platelets, and the brain. It cannot cross the blood-brain barrier as serotonin - only as its precursor tryptophan. Raising levels of tryptophan isn't a very straight forward, simple process either. After all my research up til now, I think going the "natural way" is probably the best. I don't mean not taking meds at all - I take many - due to having multiple medical conditions. I have MS, Systemic Sclerosis, Interstitial Cystitis, Osteoporosis, Hypothyroid, Lung problems, Gastroparesis, Scleroderma Esophagus, and on and on. Doctors don't know what to do at this point to help me.
The things I've read so far - to raise serotonin levels - are 1. Getting sunlight - especially morning sun, 2. exercise, 3. diet rich in complex carbs and protein - salmon, turkey, walnuts, etc. (you can find lists) 4. meditation - prayer - whatever you can do to think about positive pleasant thoughts. Serotonin greatly effects our sleep cycle, which of course greatly effects mood.
I had planned to try 5-HTP until I discovered all the possible repercussions. I've learned the hard way that meds cause many many side effects, and as much as we at times need them - they can create havoc. Another problem is that since we don't know how to dose these supplements nor do we know how to keep a close eye on levels, serotonin syndrome could develop (too much serotonin), which can really be damaging. COMPLICATED MESS!
I have been on prozac then effexor and over the last 2yrs switched to celexa for depression. Have recently as 2/2009 lost my husband of 19yrs and in April 2010 decided to try and get off meds... Working out/exercising 5days a week, tanning, church/praying and reading good books for grieving and letting go. But I have been a weepy a lot and snappy bit*hy and donot like it, trying to change on my own, with the help of weekly therapist sessions. I would love to not take the meds, feel like it may be my only way to maintain. Need other ways to help during this transition time... any and all suggestions accepted. thanks
L-Tryptophan is an essential amino acid and the precursor to serotonin. In North America you should take L-Tryptophan rather than 5-HTP to avoid high and potentially dangerous levels of serotonin in the blood (all to do with passage through the blood brain barrier).
There are many pathways in the metabolism of L-Tryptophan, and each step in a pathway is controlled by an enzyme. These enzymes are the product of your individual genetic expression and can vary greatly from one person to another. Unlike digestive enzymes, though, you cannot simply take cellular enzymes in a capsule. Furthermore, cellular enzymes cannot work alone. Enzymes are as useless as a car without wheels if they lack critical coenzymes and cofactors that make them run. Coenzymes typically are the enzymatic-forms of vitamins, such as pyridoxal 5-phosphate (the true form of vitamin B6), but sometimes coenzymes are biochemicals few people have even heard of. Yet, they are essential to life.
L-Tryptophan to create serotonin for snappy, etc.,
Melatonin for sleep and, last,
Tyrosine for your weepy moods(Tyrosine is the precursor of three most essential Neurotransmitters during stressful conditions, and they are Dopamine, Epinephrine and Nor Epinephrine. These are the basis of elevating mood and concentration.)
Whilst your pineal gland needs serotonin with which to create melatonin, research suggests taking both serotonin and melatonin is helpful when you have depression, moods, trouble sleeping, etc.
I have been taking L-Tryptophan for some time and recently added melatonin and believe it has made a difference with regards to sleep and how I feel.
BTW, there is research that indicates a link between low levels of serotonin and migraine headaches. Three years ago, my 17 year old son started taking one (1) L-Tryptophan tablet every Sunday and has not had a migraine since. Prior to that he had at least one severe headache/migraine a week.
Thank you, I will look at the info you suggested and talk to my doc's... what you stated makes sense. WOW! I must be having a good day.
ANd will suggest to cousin who is having migranes (migraines)- Again Thank you.
I have been off lexapro for about 1 month, after having been on it for about 12 years. I don't really have any specific reason why I chose to go off except that I just didn't like the thought of being on it for the rest of my life, and I thought it was keeping me from feeling "real"... It has been a real struggle for me... I am very sad and irritable and wonder if I should just go back to 20mg of lexapro...
Hi I once spoke to the wife of a psychiatrist when I was ill coming off effexor. She told me that erewhen they treat depression they do not know which part of the brain is depressed and what tablets will work it is all just a stab in the dark. In other words it is quite scary because these professionals or so called do not know what they are doing really yet they are giving out chemical altering drugs like smarties. These tablets are highly addictive
and are not easy to get off. So my question is if we went for talking therapy and got it all out of our system would we need these drugs. Also in the long run they make you more depressed and anxious than you already were. They are obviously not working !!!!
I remeber being so anxious when i was on venlafluxine i am not saying its a walk in the park but i am not in bed all day and i don't lie in bed worrying.
You sound pretty well informed about chronic depression and the function of psychotrophic drugs. I recently started reading a book by Stephen Stahl called depression and bipolar: Stahl's Essential Psychopharmacology. It goes into great detail while being clear, sometimes humorous, and has a lot of diagrams to help explain concepts.
hi, here I completely disagree with u.1st of all its not all in dark its evidence based medicine means large no of trials on many no of pts were conducted and conclusion are made. only thing tat is that not known is exactly how all medication works and tats why huge research is going on to search answers.2nd thing antidepressants are not at all addictive,some pts just have to take for ling time because their brain receptors not working properly. To give analogy if u diabetes and ur not able to get off medication tat dose not mean ur dependent on medications, u need because ur body dose not produce insulin. plz go through FDA and NICE guidelines for fur
It's spelled "colleagues". You're just regurgitating your version of what one practitioner has told you. 5-HTP has been proven at least as effective as prescription anti-depressants. I experienced no effects from Prozac or Zoloft, and spectacular relief within weeks of beginning to take L-glutamine and L-phenylalanine.Tibia Is the first time I've heard it suggested that depression can exist in spite of normal neurotransmitter levels. The theory of SSRIs is analogous to "fooling" your vehicles engine into thinking that the oil has been changed.
bullsh*t what you saying, maybe that's what doctors say following 'guidelines of best practice' but since 95% serotonin is in the bowels they should concentrate on bowel disorders, someone is trying to be smarter than he is and it doesn't work or they have purpose to pretend stupid. Maybe thats the effect if government does not invest in science
Thanks for the info. I've been suffering from depression/anxiety for years and diag with ADD as an adult. We thought my son had ADHD due to severe bouts of being hyper, crying, picking on sister, etc., but the Dr. doesn't think the stimulant is helping due to him and myself punching, choking each other even though we had this issue before we went to her. His therapist had mentioned Oppositional Defiant Disorder so I have been reading about it and the other personality disorders, but the lines of these overlap so much to me. I do have traits of BPD which may be an inherited dysfunction in the limbic system. Anyway, while reading over those it said may be cause from low serotonin so I'm going to try to get my son to take the Tryptophan (if he will with the ODD-lol)to see if it works. We have to do something because there are no psychiatrists here that take Medicaid. It makes sense. It's weird because I used to take L-Tyrosine because it was supposed to be good for polysystic ovarian disease/insulin resistance.
Hi, just wondering if anyone has had their serotonin, epinefrine and norepinefrine levels tested in connection with SSRI meds?
I know it may not be directly useful because of the re-uptake thing already discussed here. What I'm wondering is whether too much serotonin may present as bipolar or other type of depression, and get mistreated because of this statistical guesswork diagnosing that gets done a lot.
If the problem is actually in the MAO-A gene, monoamine oxidase doesn't work as it's supposed to, and the result is too much sero, epi and norepi. Which, presumably, should be treated with a MAOI (monoamine-oxidase inhibitor), not SSRI (selective serotonin re-uptake inhibitor). Although I'm not totally clear on this bit yet... might be more complex than that. Anyway, the MAO-A levels can be tested with a PET scan. Since those are expensive, preliminary bloodwork might be a good idea. But I have no idea if this is common practise in the medical field yet.
Also, any practical experience with SNRI's? They're some newer stuff that works on both serotonin and norepinefrine. According to Wikipedia, some types can even affect dopamine re-uptake. The stuff has been on the market for long enough to have actual users out there. Anyone care to share?
The fundamental problem with "testing" for epinephrine, norepinephrine is that not only is there no easy and straight forward way to do so, but also, MUCH of psychiatry is based primarily on THEORY. It has never been PROVEN that a chemical imbalance causes depression, and even if it does (which it could), the cause of depression would likely vary from person to person. This is true of all psychiatric disorders. There is still so much that the experts don't understand, as the brain is a complex machine....and a lot of factors are thought to affect mental health.
This is why treating mood disorders IS largely trial and error, based on those theories.
I would encourage you to start a new thread, as this one is very old, and the older threads tend to get passed up by most.
Were you getting your lithium level check more frequently in the beginning than every 6 months? When I was on it with every increase and on a schedule I had blood levels checked to make sure that I was in the therapeutic range without becoming toxic. As far as blood tests every six months, I have my glucose and cholesterol checked every six months.
One thing to be aware of is that with each episode of depression you have, your chance of having another episode increases. Since you have had several episodes it is almost a given that you will have more episodes.
I have been on meds and therapy since 2002. Therapy helps with coping skills and general support but it isn't a cure any more than the meds are a cure. Antidepressants may be hard to get off, but they are NOT addictive. To be addictive, it would mean that you had to take more and more to get the same effect. Not addictive. However, you have changed brain chemistry so it is no surprise that when you remove the chemicals it is a shock to your brain and you have negative responses.
In response to your question about too much serotonin causing symptoms that were misdiagnosed as anxiety and hypomania , it happened to me.
Since approx. 1997 , I have been put onto Prozac , Zoloft , Effexor (snri), Lexapro then Cymbalta (snri). Each of these seemed to help the severe depression initially , then I developed a range of adverse reactions that were interpreted as a "worsening of my condition" , and doses were increased.
The psychiatrist I was seeing then supplemented the Lexapro with Epilim (mood stabiliser for mania) , and eventually Largactil then Zyprexa - anti-psychotics. Over these years my life totally fell apart and nothing I did was able to make it better.
I recently started seeing a psychiatrist who recognized serotonin syndrome , and suggested I have a cheek-swab test to see if I had ever been able to metabolize ssri or snri's. And ,guess what ? Out of the six genes that metabolize these medications , I have genetic variations in three of them. So for all the years I trusted my doctors and took what was recommended , I now find out it was those very meds and a lack of understanding of them by my doctors that made me so extremely ill that I became a hermit living in a world filled with intolerable pain.
I'm currently coming off the Cymbalta , and am absolutely furious that these doctors totally ****** up the past 16 years of my life.
How much serotonin is too much? How much is too little? What is the average amount of serotonin present in samples of non psychiatric patients within the population? How are samples obtained from brains of depressed members of the population and compared with the non depressed? Who originated the theory that depression was a result of a serotonin imbalance? What role does serotonin play in other areas of the body? How does excess serotonin impact the endocrine system as a whole? How many studies and tests have been done to inarguably answer these questions based on pure measurable untainted scientific data? If blood tests or brain tissue tests for serotonin levels are not performed, assessment of whether or not there is excess or deficiency of serotonin cannot be logically determined.
That's not completely accurate-- Blood tests for serotonin are relatively new, decently pricey, and it's a challenge to find someone to do them. (There's also urine and saliva tests, but they're not known to be accurate) Serotonin reuptake is not the only reason people have depression. In fact, most types of depression are not caused by issues with reuptake inhibitors. (Only one specific kind is, can't currently remember the name)
In fact, if the only issue is a low level of serotonin, there's two simple solutions, eat more whole wheat foods, and take HTP-5 supplements. (And these are not dangerous!) If your problem is a Reuptake problem, then St.John's wart works well.
(In actuality, reuptake inhibitors cause more issues--they affect the rate at which your brain recycles the serotonin compounds. Some people need this, but more often than not, a person's brain will stop creating sufficient amounts of serotonin because it thinks it has enough. That's why people often fluctuate in their depressive moods (even moreso) when taking SSRI's. (or SNRI, NRI's...) Typically it create a downward spiral every 1-3 months until the patient's brain readjusts and creates more serotonin (if it can create enough.)
But yes, there are a cocktail of neurotransmitters, such as... serotonin, GABA, PEA, norepinephrine, epinephrine, and histamine that can cause these issues. There are tests for specific types of depression, which, are very new, and I'd guess insanely expensive.
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