OPEN LETTER: The Public Deserve the Truth about the Real Causes of and Treatments for Depression.
Dear Lynne Neagle, MS Deputy Minister for Mental Health and Wellbeing,
As you are probably aware a new umbrella review by Joanna Moncrieff and colleagues was published July this year on the serotonin theory of depression. It found that the serotonin hypothesis is still highly influential. In fact, 90% of the population believe depression is caused by a chemical imbalance. But what the study also found was there is no evidence to support this hypothesis. Instead, they found evidence to suggest that long-term antidepressant use could potentially reduce serotonin levels.
We know that this information will be hard to reconcile. It will cause a lot of us distress, including for healthcare professionals, like us, who either take antidepressants or who have suggested others do. Many medical professionals routinely tell patients that their depression is due to a chemical problem in their brain in good faith because they thought that the evidence base supported this theory.
What this review does not mean is that antidepressants aren't help to some people. Their usefulness should be decided on an individual basis and no one should be made to feel shame about finding them helpful. At the same time lots of people find antidepressants unhelpful and even harmful. It is paramount we acknowledge all of these experiences respectfully in this discussion. Careful not to further silence voices that already feel excluded, ignored and unheard. What is important is that people are able to make informed decisions and provide informed consent in whatever medical treatment and intervention they are pursing or being offered.
What the evidence base does suggests is that depression is complex. It is largely caused by our circumstances and the resulting impact on our bodies and psychosocial health.
In view of this, we would like the Deputy Minister for Mental Health and Wellbeing to do two things;
1) Work with Welsh Government, the Royal College of Psychiatry Cymru, the Royal College of General Practitioners Cymru, the Royal College of Nursing Cymru, the British Psychological Society and other key professional bodies, mental health providers and other stakeholders to correct this misinformation and ensure the respective professional training curriculums reflect this amendment too.
2) To work with Public Health Wales and other relevant bodies to provide the Welsh public with accurate health information about depression and how best to support people who have these experiences.
This will be a shared effort and we all have a role in ensuring evidence-based health information is accessible to the public.
Yours sincerely,
1) Dr Jen Daffin, Co-Chair, Psychologists for Social Change Cymru
2) Dr Carly Jackson, Co-Chair, Psychologists for Social Change Cymru
3) Ewan Hilton, CEO Platfform
4) Dr Elanor Maybury, Consultant Clinical Psychologist, BPS DCP Wales Co-Chair
5) Sam Austin, Deputy CEO, Llamau
6) Hannah Wedge, Clinical Psychologist in Training
7) Dr Kellie Turner, Clinical Psychologist
8) Claire-Marie Heaney
9) Dr Kat Rayson, Clinical Psychologist
10) Dr Matthew Yates, Clinical Psychologist
11) Dr Kiran Sidhu, Clinical Psychologist
12) Zoe
13) Danielle Shaw, Trainee Clinical Psychologist
14) Daniel Harris
15) Carol Jeffreys
16) William Jeffreys
17) Jarrad Kendal
18) Cobi Kendal
19) Kathryn Bragg
20) Pol Vorozhtsova, Senior Support Worker, Social Care
21) Carol Kay, Counsellor
22) Helen Davis
23) Mariel Godejohann
24) Sami Timimi, Consultant Child and Adolescent Psychiatrist
25) Anne Darcy, Psychologist
26) Matthew Vaughan, Trainee Clinical Psychologist
27) Dr Anita Marsden, Clinical Psychologist
28) Dr Cheyann Heap DClinPsy
29) Georgina Wilkinson Trainee Clinical Psychologist
30) Rebecca Jackson
31) Sarah Scire, Deputy Director of Business Development - Platfform
32) Prof Sam Cartwright-Hatton. Professor of Clinical Child Psychology
33) Lesley Phoenix
34) Dr Sameen Malik, Clinical Psychologist
35) Mohamad Miah Teacher and Arts professional
36) Dr Lucy Johnstone, Consultant Clinical Psychologist
37) James Moore - Person with Lived Experience
38) Dr Liz Andrew, Consultant Clinical Psychologist
39) Liz Mander, Director of Operations, Platfform
40) James Barnes, Psychotherapist
41) Bernadette Byrne
42) Vicky Bamber, trainee clinical psychologist
43) Dr Siwan Roberts, Senior Clinical Psychologist
44) Jo Watson, Psychotherapist
45) Muhammad Rizkillah, Fellow Sufferer
46) Keir Harding, Clinical Lead Beam Consultancy
47) Sam Atwell, Research Scientist
48) Oliver Townsend, Third Sector Employee
49) Lasse Mattila, social worker, author and publisher
50) Dr Hayley Griffiths, Clinical Psychologist
51) Dr Emma Lloyd, Clinical Psychologist
52) Maisy Stockdale, Trainee Clinical Psychologist
53) Dr Iona Tynewydd, Senior Clinical Psychologist
54) Dr Miriam Dyberg-Tengroth, Forensic Psychologist
55) Dr Nick Horn, Clinical Psychologist
56) Alexandra Dumitru, Assistant Psychologist
57) Ewelina Freitag, MSc Abnormal & Clinical Psych graduate, Mental Health Support Professional and Person with Lived Experience
58) Anna Dyson Trainee Clinical Psychologist
updated 27/10/22
As you are probably aware a new umbrella review by Joanna Moncrieff and colleagues was published July this year on the serotonin theory of depression. It found that the serotonin hypothesis is still highly influential. In fact, 90% of the population believe depression is caused by a chemical imbalance. But what the study also found was there is no evidence to support this hypothesis. Instead, they found evidence to suggest that long-term antidepressant use could potentially reduce serotonin levels.
We know that this information will be hard to reconcile. It will cause a lot of us distress, including for healthcare professionals, like us, who either take antidepressants or who have suggested others do. Many medical professionals routinely tell patients that their depression is due to a chemical problem in their brain in good faith because they thought that the evidence base supported this theory.
What this review does not mean is that antidepressants aren't help to some people. Their usefulness should be decided on an individual basis and no one should be made to feel shame about finding them helpful. At the same time lots of people find antidepressants unhelpful and even harmful. It is paramount we acknowledge all of these experiences respectfully in this discussion. Careful not to further silence voices that already feel excluded, ignored and unheard. What is important is that people are able to make informed decisions and provide informed consent in whatever medical treatment and intervention they are pursing or being offered.
What the evidence base does suggests is that depression is complex. It is largely caused by our circumstances and the resulting impact on our bodies and psychosocial health.
In view of this, we would like the Deputy Minister for Mental Health and Wellbeing to do two things;
1) Work with Welsh Government, the Royal College of Psychiatry Cymru, the Royal College of General Practitioners Cymru, the Royal College of Nursing Cymru, the British Psychological Society and other key professional bodies, mental health providers and other stakeholders to correct this misinformation and ensure the respective professional training curriculums reflect this amendment too.
2) To work with Public Health Wales and other relevant bodies to provide the Welsh public with accurate health information about depression and how best to support people who have these experiences.
This will be a shared effort and we all have a role in ensuring evidence-based health information is accessible to the public.
Yours sincerely,
1) Dr Jen Daffin, Co-Chair, Psychologists for Social Change Cymru
2) Dr Carly Jackson, Co-Chair, Psychologists for Social Change Cymru
3) Ewan Hilton, CEO Platfform
4) Dr Elanor Maybury, Consultant Clinical Psychologist, BPS DCP Wales Co-Chair
5) Sam Austin, Deputy CEO, Llamau
6) Hannah Wedge, Clinical Psychologist in Training
7) Dr Kellie Turner, Clinical Psychologist
8) Claire-Marie Heaney
9) Dr Kat Rayson, Clinical Psychologist
10) Dr Matthew Yates, Clinical Psychologist
11) Dr Kiran Sidhu, Clinical Psychologist
12) Zoe
13) Danielle Shaw, Trainee Clinical Psychologist
14) Daniel Harris
15) Carol Jeffreys
16) William Jeffreys
17) Jarrad Kendal
18) Cobi Kendal
19) Kathryn Bragg
20) Pol Vorozhtsova, Senior Support Worker, Social Care
21) Carol Kay, Counsellor
22) Helen Davis
23) Mariel Godejohann
24) Sami Timimi, Consultant Child and Adolescent Psychiatrist
25) Anne Darcy, Psychologist
26) Matthew Vaughan, Trainee Clinical Psychologist
27) Dr Anita Marsden, Clinical Psychologist
28) Dr Cheyann Heap DClinPsy
29) Georgina Wilkinson Trainee Clinical Psychologist
30) Rebecca Jackson
31) Sarah Scire, Deputy Director of Business Development - Platfform
32) Prof Sam Cartwright-Hatton. Professor of Clinical Child Psychology
33) Lesley Phoenix
34) Dr Sameen Malik, Clinical Psychologist
35) Mohamad Miah Teacher and Arts professional
36) Dr Lucy Johnstone, Consultant Clinical Psychologist
37) James Moore - Person with Lived Experience
38) Dr Liz Andrew, Consultant Clinical Psychologist
39) Liz Mander, Director of Operations, Platfform
40) James Barnes, Psychotherapist
41) Bernadette Byrne
42) Vicky Bamber, trainee clinical psychologist
43) Dr Siwan Roberts, Senior Clinical Psychologist
44) Jo Watson, Psychotherapist
45) Muhammad Rizkillah, Fellow Sufferer
46) Keir Harding, Clinical Lead Beam Consultancy
47) Sam Atwell, Research Scientist
48) Oliver Townsend, Third Sector Employee
49) Lasse Mattila, social worker, author and publisher
50) Dr Hayley Griffiths, Clinical Psychologist
51) Dr Emma Lloyd, Clinical Psychologist
52) Maisy Stockdale, Trainee Clinical Psychologist
53) Dr Iona Tynewydd, Senior Clinical Psychologist
54) Dr Miriam Dyberg-Tengroth, Forensic Psychologist
55) Dr Nick Horn, Clinical Psychologist
56) Alexandra Dumitru, Assistant Psychologist
57) Ewelina Freitag, MSc Abnormal & Clinical Psych graduate, Mental Health Support Professional and Person with Lived Experience
58) Anna Dyson Trainee Clinical Psychologist
updated 27/10/22
Reference: https://www.nature.com/articles/s41380-022-01661-0
