No, it’s not your imagination: Mass shootings have become much more common in recent years.
The Gun Violence Archive (GVA) defines a mass shooting as an act of gun violence with four or more victims shot. According to the GVA, the annual number of mass shootings in the United States:
- was already growing steadily before the pandemic. The number of mass shootings rose from 269 in 2014 to 417 in 2019.
- rose dramatically in the last 2 years. There were 610 mass shootings in 2020 and 692 in 2021.
- remains high in 2022. As of May 31, 230 mass shootings have taken place, with the Uvalde shooting being the deadliest this year.
Newspapers, TV stations, and social media offer a constant stream of coverage on these shootings, which happen nearly every day.
Humanity only recently gained the ability to stay informed in real-time of tragedies taking place across the globe. But evidence suggests repeated media exposure to mass shootings leads many people to feel dread, despair, and deep alienation from society at large — perhaps in part because the human brain lacks the emotional capacity to process all this pain and death.
While modern media allows people to share vital information and support with one another, it has a downside, too. A barrage of bad or tragic news can quickly take a toll on your mental health.
It’s often challenging to find a healthy middle ground between staying informed and protecting yourself from information overload. These seven tips can help you protect your mental health in the aftermath of a mass shooting, or any large-scale tragedy.
After a mass shooting, you might experience many emotions. Sadness is a common reaction when the news first comes out and people begin to mourn the victims. As time passes,
The more removed you are from an incident, the more you tend to focus on the bigger picture of why gun violence happens. You may:
- grow anxious as you try to predict whether a similar shooting could happen in your hometown
- feel angry at the shooter
- become frustrated with politicians who don’t seem to treat the U.S. gun crisis with the urgency it deserves
Your emotions can serve as a useful barometer to help determine when you’ve had too much media exposure. As you move through the news, take advantage of commercial breaks or ad spaces to check in with yourself.
- What feelings does this piece of media trigger?
- Can you calm down without too much effort?
- Do you feel “trapped” in a particular mood, or unable to stop reading?
- Do you notice physical symptoms, like muscle tension, a pounding heart, or difficulty catching your breath?
It’s absolutely natural to feel upset, but you can take strong distress as a sign you likely need a break.
For example, maybe you watch a video of the shooting and notice your muscles are tense and your thoughts are racing with what ifs. In that case, it could help to step away from the news for a while, or at least shift to less graphic forms of coverage.
Even if you feel fine emotionally, you’ll typically still want to take frequent breaks from the news. Mass shootings can trigger stress, whether you notice it right away or not. If you let that stress build up too high, it can overwhelm you at a later, more vulnerable moment.
During these breaks, try to stick to calming activities. While you may enjoy murder mysteries or multiplayer combat games, it won’t hurt to avoid any hobbies that remind you of the violence.
Instead, consider stress-relieving activities like:
- Crafts. This could include cooking, gardening, drawing, origami, and other art.
- Light exercise. You could take a quick stroll around the block or a brief stretch break at your desk.
- Meditation. You might try yoga, mantras, or deep breathing.
- Slow-paced games. Think Wordle or Animal Crossing, not Call of Duty.
- Conversation. Chat with a coworker over coffee or trade knock-knock jokes with your kids (or roommates).
Of course, taking breaks is often easier said than done, especially when it comes to social media. After a mass shooting, you may find yourself “doomscrolling” through content related to the tragedy, feeling stressed and upset but still unable to look away.
Doomscrolling can happen for a few reasons:
Platforms like Tiktok and Twitter are designed to keep you perpetually scrolling through content so you stay on their app. If unwanted emotions like fear and anger keep you clicking, the algorithm will only keep feeding you more emotionally charged content.
You can temporarily cleanse your timeline of upsetting posts by filtering out hashtags like #gunviolence and #massshooting.
This tells the app not to show you posts with those tags. If someone doesn’t tag a post, it may show up, but the filter should catch most of them.
Doomscrolling can be a form of hypervigilance. You may search through shooting-related posts to gauge how big the threat is and how much danger you’re in. While scrolling can make you feel prepared, staring at your phone for an hour probably won’t do much to make you tangibly safer.
Instead, try putting down your phone and ground yourself by observing the world around you. Take note of things like:
- ambient noise
- the smell in the air
- the texture of the ground under your feet
It can also help to remind yourself that you’re safe. The shooting has already happened elsewhere, so you’re not in any immediate danger.
On social media, many people treat silence as a statement in itself. You may worry that if you fail to comment on a particular shooting, you’ll appear to lack compassion for the victims. You may also feel you have a civic duty to stay informed on each and every update.
But remember, you don’t owe your followers (or anyone at all) a live performance of your pain and distress. If you find the news too upsetting to keep up with, tell people you’re taking a break (and why, if you like). Most people will understand.
Those who criticize you may simply want an outlet to ease their own worry and distress. Even so, you’re under no obligation to read or respond to their remarks.
After a mass shooting, a lot of information can come out at once, but not everything you read is necessarily true. In fact, it’s fairly common for online trolls to pose as local witnesses and spread rumors. Sometimes, these rumors attack a specific person or group of people.
For example, after the Uvalde shooting, a false rumor originating from the message board 4chan suggested the shooter was a transgender person. The conspiracy spread quickly and even reached Congressman Paul Gosar’s Twitter feed before fact-checkers caught up with the hoax and debunked it.
Trolls often design their posts to get attention by making them as upsetting as possible. If a post has the perfect recipe of outrageous language to get your blood pumping, that’s a cue to press the pause button. Before you let yourself get emotionally worked up, take a minute to make sure the claims are actually true.
A few signs you’ve encountered a troll post:
- The original account got banned or deleted shortly after making the post.
- The original account has very few followers. The followers they do have share each other’s posts and no one else’s.
- The post is vague about where its information came from.
- The post uses memes popular among hate groups, such as Pepe the Frog.
Mass shootings often prompt a lot of debate online about topics like gun control, mental health, and policing. These arguments can range from tense disagreements to outright digital warfare.
Needless to say, you’ll do your mental and emotional well-being a favor by sticking to the more civil corners of debate. “Civil,” in this case, refers to discussions where those involved trade ideas rather than insults.
- “We need to f***ing pass X law already” could be considered a civil line even though it contains a cuss word. That’s because you’re commenting on a specific policy, not a person.
- “You’re an idiot for opposing X law” wouldn’t be considered civil, even though you might consider the term “idiot” less taboo than the F-word. (It’s ableist language, though.) You’ve derailed the focus of debate from the merits of a certain law to the other person’s intelligence.
It may feel cathartic at first to “roast” an opponent online. But after an hour of exchanging insults, you’ll probably feel more emotionally drained than triumphant.
In short, you’re more likely to enact some political change by contacting your state representatives than bickering with a digital stranger.
If you’re a parent, teacher, or caregiver, don’t be surprised when your children ask about the shooting. Kids have a knack for picking up tidbits of news, no matter how much you try to shield them from violence.
You may feel tempted to shut down the conversation or temporarily ban social media to protect your child. But hiding the truth may backfire and make your child more anxious. They likely need comfort during this scary time. Cutting off social support may push them to express fear and anger in unhealthy ways, like disruptive behavior at school.
When you talk about the shooting, the National Center for School Crisis and Bereavement recommends letting your child lead the conversation.
It may help to:
- Ask what they know so far.
- Correct any misconceptions they have.
- Answer their questions as honestly as you can.
You’ll likely need to tailor the discussion to your child’s maturity level. A young child may only need a simple explanation such as, “Someone hurt some people with a gun today, and the grown-ups are sad about that.” Older kids and teenagers may need a longer, more nuanced conversation to soothe their anxieties.
You don’t need to be directly involved in a mass shooting for it to affect you emotionally. Every shooting becomes part of a larger pattern of gun violence, a national crisis that affects everyone. Simply living in an environment with such widespread, unpredictable violence can be traumatic.
How do you know if your stress around mass shootings has become something more serious?
You may want to consider connecting with a professional for more support if you experience:
- Hypervigilance. Maybe you startle whenever you hear loud noises, like a door slam or distant fireworks.
- Obsessions. You constantly check the news, to the extent that you can’t focus on anything else.
- Anger. You have intrusive thoughts about “punishing” the people you blame for the violence.
- Sleep issues. Maybe images of the shooting linger in your head, making it hard to relax.
- Hopelessness. Maybe you have trouble motivating yourself to do anything since you feel you could be killed at any time.
A therapist can’t prevent mass shootings, it’s true. But they can help you manage your fears around gun violence and grieve the current state of the country.
Keep in mind, too, that therapy can help at any time. You don’t need to wait until your mental health reaches a low point before getting support.
Start your search for a therapist here.
The recent spike in gun violence in the U.S. has many people fearing for their survival, the safety of their loved ones, and the fate of the country as a whole. During this stressful time, it can be easy to lose yourself in the media storm of panic, anger, and dread.
While staying informed is important, so is protecting your mental health. Try to take regular breaks from the news, and take care with the types of media you engage with.
Above all, remember that although tragedies happen, good still exists in the world. Plenty of people out there continue to work tirelessly to solve this crisis and build a more peaceful society. If enough people work together, change is possible.
Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.
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5 Best Sunscreens for People with Psoriasis
For many people, warm weather means outdoor activities like swimming and backyard barbecues.
But sunlight can be a friend — or foe — for those living with psoriasis. Making sure you choose the right sunblock for your sensitive skin can mean the difference between an amazing day outside, and one that’s worthy of nightmares.
Proper sun protection during outdoor activities is important for everyone. But people with psoriasis need to be particularly careful.
If you have psoriasis, you may have heard that exposure to ultraviolet B (UVB) rays has actually been shown to help with the autoimmune skin condition.
“UVB rays are actually good for people with psoriasis,” says Jacqueline Schaffer, MD, founder of Schique Skincare. UVB rays help slow the skin growth and shedding that happens with psoriasis.
But too much sun exposure — of both UVA and UVB rays — can be a problem. “If people with psoriasis are overexposed, it can actually worsen the skin,” Schaffer says. “They’re extra sensitive versus someone who doesn’t have psoriasis.”
Psoriasis also mostly affects people with lighter skin tones who are already more prone to sunburn.
Plus, certain medications used to treat psoriasis can cause increased photosensitivity. This makes a person sunburn more easily.
For all these reasons, wearing sunblock when you have psoriasis is crucial. It’s important to choose wisely since skin may already be irritated and sensitive.
Make sure there are no parabens, no formaldehyde, and no other really strong preservatives.
— Jacqueline Schaffer, MD
Follow these expert tips next time you’re shopping for sunblock.
1. Make sure you’re buying sunblock, not sunscreen
“Sunscreen is known to be absorbed into your skin, whereas sunblock actually sits on top of your skin and reflects the UV rays,” Schaffer says.
Many products are a mixture of both, so a product labeled “sunscreen” can still have enough protection if it also contains sunblock. Common sunblock ingredients include zinc oxide and titanium dioxide.
2. Avoid preservatives and chemicals
“Make sure there are no parabens, no formaldehyde, and no other really strong preservatives that can be damaging to the skin,” Schaffer says. These ingredients can irritate psoriasis patches.
3. If you’re shopping for a child, don’t buy sunblock with added color
Some companies now offer colored or “disappearing color” sunblocks. Parents should avoid buying these for children with psoriasis, Schaffer says, as they can irritate skin.
4. Don’t buy sunblocks with added scents
Added fragrances can aggravate the skin in people with psoriasis.
5. Buy SPF 30 or above
People with psoriasis need just as much sun protection as everybody else. This is especially true if they’re on medications that can increase their sensitivity to the sun.
SPF 15 doesn’t provide enough protection throughout the day. “A lot of studies from the American Academy of Dermatology have shown that SPF 30 is more effective for longer use as a sunblock,” Schaffer notes.
6. Look for the label ‘broad spectrum’
This meansthe product will protect against both UVA and UVB rays. Even though UVB rays can be beneficial in treating psoriasis, people with the condition should still have sunblock on to protect against too much exposure to both types of rays.
The sunblocks on our list were carefully chosen and vetted. Following the advice from our expert, Schaffer, we looked for:
- sunblocks that don’t include potential irritants like parabens, formaldehyde, potent preservatives, added color, or fragrances
- sunblocks that include the mineral ingredients zinc oxide and titanium dioxide
- sunblocks that are broad spectrum and provide SPF 30 or higher protection
We also carefully considered customer reviews, the prices of products, and selected products only from trusted brands.
Sunscreen can become costly, as it’s something you regularly use that sometimes comes in small bottles. We considered options from different brands at a range of prices, to bring the best possible selection.
Sunscreens in this article are broken down on a price per ounce basis according to the following key:
- $ = under $6 per ounce
- $$ = $7-12 per ounce
- $$$ = more than $12 per ounce
If you have psoriasis, try one of the following products that made it through the above checklist and past the experts.
Best sunblock for psoriasis for the face and body
Badger Sunscreen Cream
- Price: $
- Size: 2.9-ounce (oz.) bottle
Schaffer recommends this SPF 40 mineral-based cream because it’s unscented and doesn’t have dyes or chemicals. It uses four ingredients, and 98 percent of them are organic. You can use this sunscreen on both your face and body.
The certified non-GMO formula includes uncoated zinc oxide at 22.5 percent, and it adds organic sunflower oil, organic beeswax, and sunflower vitamin E for a moisturizing boost. The brand also says it’s hypoallergenic and gluten-free.
The product is designed to resist water for 80 minutes, but you’ll want to be mindful and reapply every 2 hours.
Coral reef safety is a big concern for many sunblock users. The company says this product is reef-safe. Even the manufacturing is eco-friendly — the company says it’s made with 100 percent solar power.
Amazon reviewers are impressed with the quality, especially given its reasonable price. A number mentioned that the formula is thick, so it may take some elbow grease to squeeze the product out of the tube. You may also need some extra time to rub it into your skin completely.
Best tinted sunblock for psoriasis
La Roche-Posay Anthelios 50 Mineral Ultra-Light Sunscreen Fluid
- Price: $$$
- Size: 1.7-oz. bottle
This water-resistant product, which is free of dyes, fragrances, oil, and chemicals, is one of Schaffer’s go-to recommendations. It’s a 100 percent mineral sunscreen that’s safe for sensitive skin, and it’s noncomedogenic, so it won’t clog your pores.
This sunscreen is tinted with a matte finish, which some may prefer. For those who’d rather skip the tinted glow, there’s an untinted version available on the company’s website.
The sunscreen is lightweight, nonwhitening, and nongreasy, according to the company. The majority of Amazon reviewers seem to agree it checks those boxes.
One complaint from Amazon reviewers about the tinted version is that there’s only one shade available. The tinted version doesn’t include zinc oxide, using instead titanium dioxide, which may be a drawback for some.
Best sunblock for psoriasis with vitamin C
Derma E Sun Defense Clear Zinc Mineral Oil-Free Sunscreen SPF 30
- Price: $$
- Size: 2-oz. bottle
This broad spectrum, oil-free sunblock is chemical-free and contains vitamin C and green tea, which can help skin recover after sun exposure. It also contains soothing aloe vera. To protect you from UVA and UVB rays, this sunblock uses non-nano mineral zinc oxide.
The brand says this pick checks a number of other boxes, as it’s:
Keep in mind that some reviewers mention pilling or peeling and a white cast — a common, but still bothersome, factor in mineral sunscreens.
Best sheer sunblock for psoriasis
Drunk Elephant Umbra SheerPhysical Daily Defense SPF 30
- Price: $$
- Size: 3-oz. bottle
This SPF 30 broad spectrum sunscreen contains 20 percent zinc oxide, as well as algae and sunflower sprout extracts for additional antioxidant protection. Aloe vera is tossed in to soothe and moisturize.
It doesn’t use sunblocking chemicals (it’s mineral-based), essential oils, silicones, and fragrances. Plus it’s cruelty-free.
The brand suggests applying this sunscreen to the face, neck, chest, and backs of hands. So, it’s not considered an all-over sunscreen, but it works for more than just your face. The company also says it’s safe for daily use and sensitive skin types.
Reviews in Google are split. Some users call it their favorite, noting how effective it is for sensitive and acne-prone skin. Others were underwhelmed — one said they wished it felt more moisturizing, while another pointed out a white cast (but again, it’s tough to find mineral sunscreens that completely leave out a white cast).
Best value sunblock for psoriasis
All Good SPF 30 Sport Mineral Sunscreen Lotion
- Price: $
- Size: 3-oz. bottle
This certified organic sunscreen is made with sensitive skin in mind, leaving out harsh chemicals.
The non-GMO formula uses 16 percent non-nano particle zinc oxide to block UVA and UVB rays (as well as blue light from screens). The exclusion of chemical sunscreen ingredients also makes this sunscreen coral reef-friendly.
The sunblock is also:
This pick gets high marks among Google reviewers, who mention it’s kind to their sensitive skin and doesn’t leave them feeling sticky or greasy.
It’s intended for use on the face and body, which makes it a pretty convenient go-to for all uses. Plus, there’s a 16-oz. family-size version with a pump top available.
The only complaints we found on this one say that it has a thick consistency, and may leave a white cast behind if it’s not fully rubbed in.
What type of sunscreen is best for psoriasis?
People with psoriasis should look for mineral (physical) sunscreens that include zinc oxide and titanium dioxide. The sunscreens they use should have an SPF of 30 or higher.
Should people with psoriasis wear sunscreen every day?
Most people — those with psoriasis and those without — should wear SPF daily. If you believe your symptoms improve with some sun exposure, limit your time in the sun without sunblock to just about 5- or 10-minute periods. Keep in mind that too much exposure could potentially worsen your symptoms.
What ingredients should I avoid when selecting a sunscreen?
It’s a good idea to avoid potentially irritating ingredients like intense preservatives, parabens, formaldehyde, and added color or fragrances.
Some companies will advertise that their sunblock doesn’t contain these ingredients. But it’s always good to double-check the label on products that say they’re good for sensitive skin, and don’t call out certain ingredients their formula excludes.
Can sunshine help with psoriasis?
Some sun exposure can benefit people with psoriasis. But when people with psoriasis are overexposed to the sun, they may see worsened symptoms.
People with psoriasis should wear sunblock in the sun, even when using the sun as treatment for their condition. Look for broad spectrum, fragrance- and preservative-free sunblocks that are at least SPF 30.
If you have psoriasis and are planning on being in the sun, experts recommend starting with 10 minutes of exposure at noon, then increasing exposure by 30 seconds to 1 minute each day.
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8 Healthy Ways to Use White Rice, According to a Dietitian
Rice is a staple food in many cultures.
Compared to brown rice, white rice offers fewer nutrients, including minerals, vitamins, and dietary fiber. This disparity has led many in the West to
However, white rice remains more widely consumed than brown rice, potentially due to cultural practices, its faster cooking time, and
Plus, it is more cost-effective and can be purchased in bulk.
For example, a bag containing 320 ounces of white rice (more than 200 standard servings) costs less than $9 USD at Walmart. A similarly-sized bag of brown rice is not available at the retailer. Instead, a 32-ounce bag (about 20 servings) costs $1.37 USD.
To buy the same amount of brown rice as offered in the bulk bag of white rice, you’d need to purchase 10 32-ounce bags for more than $13, plus tax.
Therefore, it’s important that we acknowledge the roles and benefits of white rice as a cultural staple in several dietary patterns and as an affordable alternative to other grains.
We need to develop a deeper understanding of ways to use this staple food as part of a healthy diet and lifestyle.
This article explains the benefits of white rice and ways to enjoy it through balanced nutrition.
The scientific research on white rice’s association with various health outcomes has been inconsistent.
This occurred because cooking the white rice then refrigerating it for 24 hours before reheating activated its resistant starch — a type of non-digestible carbohydrate that
Here is how 1 cup (158 grams) of cooked parboiled
White rice offers fewer calories, fewer grams of carbs, fat, and dietary fiber, and less of the mineral phosphorus, but comparable protein and selenium compared with brown rice.
However, it is richer in the B vitamin
This data shows that white rice offers some nutritional benefits. Consider pairing it with foods rich in dietary fiber and minerals to boost the nutritional profile of your meal.
Learn more about the differences between white and brown rice here.
White rice is not inherently inferior to brown rice, despite myths. It offers nutritional benefits, including some minerals. It’s low in fiber, fat, and calories, and can be paired with fiber-rich foods to boost a meal’s nutritional profile.
Here are 8 healthy ways to enjoy white rice.
1. With peas and beans
Peas and beans are rich in dietary
Furthermore, when peas and beans are paired with rice — including white rice — a
This is an especially important food combination for people who follow a vegetarian or vegan dietary pattern, since most complete proteins are animal-based foods.
Enjoy white rice with stewed lentil peas, dhal (split peas), or a black bean chili.
Learn more about complete protein sources for people who eat plant-based here.
2. Vegetable rice
Like peas and beans, non-starchy vegetables are rich in dietary fiber. When included in a vegetable rice dish, they can help make up for the lower fiber content of white rice.
Vegetables also contain nutrients like calcium, vitamin C, iron, and folate that
Examples include carrot rice, spinach rice, and pumpkin rice.
3. Balanced with veggies and meat
A great way to build a meal using white rice is following the balanced MyPlate method recommended by the United States Department of Agriculture (USDA).
Under this guideline, about half your plate should be filled with non-starchy vegetables and fruit, a quarter of your plate with protein like meat, fish or poultry, and a quarter with grains like white rice.
This method encourages flexibility and a diversity of nutrients to be enjoyed while also helping you eat mindful servings of white rice.
Serve a quarter-plate of white rice with a half-plate of cooked spinach and a quarter-plate of grilled fish for a quick, balanced dinner meal.
4. In a one-pot dish
It is impractical to enjoy all meals in the MyPlate method recommended above, as is the case with one-pot meals.
However, these can still be a nutritious and healthy way to eat white rice.
Pair one-pot dishes like pelau — a Caribbean dish made with caramelized chicken, rice, pigeon peas, herbs, spices, and vegetables — with an additional side of non-starchy vegetables like carrot coleslaw or tossed salad.
Other rice-based one-pot dishes, such as casseroles or South Indian recipes like sambar rice, can also be accompanied with a side of non-starchy vegetables for a boost of filling dietary fiber.
5. Vegetarian rice bowls
Rice bowls are quite popular in Asian, Persian, and Spanish cultures.
The rice may be topped with beans, vegetables like lettuce, onions, and olives, avocados for healthy fats, and sauces or gravies for flavor.
Because rice bowls use so many ingredients, that often means you’ll use smaller portions of each food, including rice, to create room for a variety of other food groups.
The inclusion of fats like
6. Lean meat burrito bowl
In some cultures, rice bowls are also called burrito bowls.
Popular burrito toppings include lettuce, red onions, celery, or a combination of other non-starchy vegetables, corn, black beans, and cooked chicken, beef, pork, or plant-based proteins like tofu and tempeh.
If you’re making a burrito bowl that uses meat, choose lean cuts to reduce saturated fat intake.
Try topping your rice bowl with a Mongolian beef or smoked pork recipe for a burst of flavor.
7. With fish
Consuming fish at least twice per week
In addition, fish is an
Try curry fish, blackened creole fish with white rice, or a tuna fish and rice casserole. Don’t forget to include a fresh or cooked non-starchy vegetable side dish for fiber and health-promoting added nutrients.
8. Stuffed in bell peppers
A clever way to enjoy white rice and vegetables in a nutritious and filling yet simple dish is by making stuffed bell peppers.
Bell peppers contain capsaicin, which is a phytochemical compound with potential
This active compound in bell peppers has also
Pair white rice with peas and beans, lean cuts of meat, fish, and vegetables to make balanced and nutritious dishes. White rice can also be enjoyed in one-pot meals like pelau and sambar rice or in rice bowls and stuffed bell peppers.
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Depression May Not Be Linked to Low Serotonin, New Analysis Finds
- A new analysis finds that depression may not be caused by lower levels of serotinin in the brain.
- Researchers say the chemical and neurological underpinnings of depression are complex.
- Additionally, researchers say this does not mean that anti-depressants don’t work, only that they may not understand why they work.
There is no evidence that depression is caused by lower levels or reduced activity of serotonin in the brain, according to a recent analysis of 17 previous studies.
This suggests that depression is not caused by a chemical imbalance of this brain-signaling molecule, say the authors of the review. It also raises questions about how antidepressants that supposedly target serotonin work, they add.
However, other researchers say the chemical and neurological underpinnings of depression are complex, so to completely rule out serotonin is an oversimplification of the research.
They also caution against making decisions about how to treat depression based on this review, saying antidepressants have been shown to be moderately effective for certain people.
The most common antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), are thought to make serotonin more available in the brain by
However, in their recent analysis, Joanna Moncrieff, MD, a professor of psychiatry at University College London, and her colleagues found that there is no “consistent evidence” that serotonin is involved in depression.
Their findings, which were published July 20 in
- Research on serotonin and its breakdown products in the blood and brain fluids found that the level of these chemicals was similar in people with and without depression.
- Research on serotonin receptors and the serotonin transporter, a protein targeted by many antidepressants, offered “weak and inconsistent” evidence that people with depression had higher levels of serotonin activity.
- Studies in which healthy people’s serotonin levels were artificially lowered through a special diet found that this did not increase their risk of developing depression.
- Genetic studies found no difference in serotonin-related genes between people with depression and healthy participants.
“After a vast amount of research conducted over several decades, there is no convincing evidence that depression is caused by serotonin abnormalities, particularly by lower levels or reduced activity of serotonin,” Moncrieff said in a news release.
Anthony King, PhD, a neuroscientist and licensed psychologist and psychotherapist at The Ohio State University’s College of Medicine, who was not involved in the new review, agrees that the role of serotonin in depression has been overblown.
“The idea that depression is a chemical imbalance characterized by a deficit or a lower level of serotonin in the synapses is just not correct,” he said. “It never was, and it’s not now.”
However, “I’m not saying serotonin is not involved and I’m not saying SSRIs don’t help,” he added.
Serotonin is likely involved in some way, he said, but the relationship between depression and other brain chemicals is complex. Likewise, he said SSRIs can help some people — just not everyone.
King also noted that stress can play a role in the development of depression
Dr. Srijan Sen, a professor of depression and neurosciences and director of the Frances and Kenneth Eisenberg and Family Depression Center at the University of Michigan, said he doesn’t think the new review entirely eliminates serotonin from the picture.
“Whether serotonin plays a role in depression in some way is an open question,” he said. “The brain is so complicated and complex, it would be surprising if serotonin wasn’t involved at all.”
He pointed to a recent
In that study, researchers found that people who carry a certain serotonin-related gene variant are at higher risk of developing depression in response to a stressful life event. However, this was only true for chronic stress and for depression assessed within a year of the stressor.
This meta-analysis was published this month, so it was not included in the review by Moncrieff and her colleagues.
There is, however, one thing that Sen agrees with Moncrieff and her colleagues on: “[Chemical imbalance] is not an accurate representation of our understanding of what happens in the brain,” he said.
“It’s probably more likely that there are certain circuits and loops of connections in the brain that are changed that are important,” he said. “But we don’t know exactly what is happening.”
King said there are other ways to think about depression that can help people break free of the downward spiral that often accompanies this condition.
“[Stressful life events] can lead to emotional upset and a big change,” he said. “That can be accompanied by a sort of pessimism and a certain habit of behavior and thinking.”
Basically, “people get into a rut — they get into a rut mentally and behaviorally,” he said. “And a sense of inertia sets in.”
While this may sound like a hard cycle to get out of, King said several types of treatment can help people get moving again, including cognitive behavioral therapy, behavioral activation, and mindfulness.
The new review also challenged whether it’s helpful to talk about SSRIs as fixing a chemical imbalance.
“Many people take antidepressants because they have been led to believe their depression has a biochemical cause, but this new research suggests this belief is not grounded in evidence,” said Moncrieff.
Sen, though, cautioned against making decisions about depression treatments based on this review.
“We generally don’t make clinical decisions about treatments based on the molecular and biological understanding of what the treatments do,” said Sen. “It’s much more based on the results of clinical trials.”
Scientists use rigorous clinical trials to see if a treatment works, as well as under what conditions and for which people. These trials can produce useful results even without a good understanding of how a treatment works, said Sen.
That said, “understanding the biology in the long term, I hope, will help us develop better medications and advancements in personalized treatments,” he added.
For people who don’t benefit from SSRIs, he said there are other potential treatments for depression, such as improved sleep routines, regular exercise, and stronger social connections. Recently using psychedelic drugs like
“With all these things, there is observational and clinical trial evidence showing that they really help with depression,” he said.
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Ashton Kutcher Reveals Battle With Rare Disease That ‘Knocked Out’ His Vision and Hearing
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