Chemical imbalances and depression: What’s the connection?

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated March 5, 2024by BetterHelp Editorial Team

Depression, or major depressive disorder (MDD), is a common but serious mental illness that’s estimated to affect around 5% of adults worldwide. Researchers haven’t isolated a single cause of depression that’s applicable in every case. Instead, it’s thought to be caused by any of various combinations of factors such as environment, stressful experiences, genetics, and balances of certain brain chemicals. To find out how brain chemicals in particular may lead to a person developing depression, see below for recent research and information on the topic.

Facing mental health challenges?

Depression, defined

Depression is a type of mood disorder that can affect virtually anyone of any age, gender, race, or background. Signs of this mental illness can appear after a person has gone through a difficult life experience, such as a divorce or the loss of a loved one, or seemingly without a clear external cause. Either way, symptoms usually include things like:

  • A loss of interest in activities once enjoyed
  • Persistent feelings of sadness
  • Feelings of hopelessness and/or worthlessness
  • Significant changes in appetite
  • Significant changes in sleep patterns
  • Irritability
  • Social isolation
  • Fatigue
  • Excessive crying
  • Thoughts of self-harm and/or suicide

If you or someone you know is experiencing suicidal thoughts or behaviors, seek help immediately. The National Suicide Prevention Lifeline can be reached 24/7 by dialing 988.

Note that signs of depression in children and teens may differ somewhat from those seen in adults. If you or your child are experiencing symptoms of a mental illness like depression, it’s generally recommended that you seek the support of a qualified healthcare professional.

The potential link between neurotransmitters and depression

Our emotions are, at least in part, the result of biological reactions to external stimuli. In other words, our bodies react to things that happen on a chemical level, and those reactions can affect our emotions. Key components of this process are chemicals called neurotransmitters. They impact processes that occur in our bodies and emotions that we feel. That’s why emotions often come with recognizable, physical symptoms, like an increased heart rate when we’re scared or an increased body temperature when we’re angry.

Serotonin seems to be an important chemical messenger when it comes to depression. It appears to impact mood and to control a number of physical functions, including sleep patterns and digestion. A key theory on the cause of depression states that this may be why depression—which some theorize is caused by an issue with serotonin levels—can leave a person with persistent feelings of sadness and hopelessness in addition to physical symptoms like significant changes in appetite and/or sleeping patterns. 

The theory that a serotonin imbalance can cause depression is still accepted by many. However, it is important to note that there’s been increased debate on this theory more recently as new research has been done.

Some studies have failed to find a link between serotonin and incidences of depression. Research on other potential causes is ongoing.

What causes low serotonin levels?

Researchers are still aiming to understand exactly what might cause low levels of serotonin, but various theories have gained significant support. One is that not getting enough sunshine could result in lower levels. Another is that exercise can trigger the release of certain brain chemicals, including serotonin, so those that live sedentary lifestyles may be at risk of low levels of this chemical and therefore of depression. Research findings that suggest that frequent exercise can be an effective treatment for the condition in some cases would seem to support this theory.

Lifestyle factors may not be the only ones that could cause lower levels of serotonin than may be healthy. Some people may have genetic abnormalities or health conditions that could cause issues with the release and reception of this chemical. For example, some individuals seem to simply not produce enough serotonin, while others might lack adequate receptors to receive the molecules and put them to use. Still others may use serotonin too slowly, meaning that the rest gets absorbed through other channels before it can be used to positively affect mood.

Getty/Vadym Pastukh

Medication for serotonin levels

The theory that depression may be caused by issues with serotonin levels has led to the now relatively common prescription of selective serotonin reuptake inhibitors (SSRIs) for those with this mental illness. These medications aren’t designed to simply increase serotonin levels in the body, since serotonin receptors can gradually become immune to the molecule if bombarded by it. Instead, they’re meant to help make the most of the serotonin that is available already by preventing the body from absorbing the chemical before the brain has a chance to use it. 

Note that SSRIs are typically not recommended as a standalone treatment for depression. Instead, they’re often intended to help a person manage their symptoms enough to be receptive to other types of treatment, such as talk therapy—which is the first-line treatment for depression in most cases. Keep in mind as well that while SSRIs can be very helpful for some people, they’re not necessarily right for everyone in every situation. Some individuals may not be able to take them due to interactions with other medications, while others may experience undesirable side effects from them. Still others may prefer to explore non-pharmacological treatment options first before turning to a treatment like SSRIs. If you’re curious about starting, stopping, or changing medication for depression, it’s always recommended that you talk to your doctor first to avoid potentially dangerous effects.

Facing mental health challenges?

Other treatments for depression

As mentioned, talk therapy is usually the first suggested treatment for someone who has been diagnosed with depression. Cognitive behavioral therapy (CBT) is one of the most common modalities, because it aims to help clients learn how to recognize and then shift distorted thought patterns that may be causing distress. Your doctor, psychiatrist, or therapist may also recommend certain lifestyle changes that could help you manage your symptoms. Exercise, as mentioned above, seems to be effective in decreasing symptoms of depression for many. Eating a nutritious diet may help too, as may getting enough sleep and cultivating strong social connections. 

If you’re interested in speaking to a therapist about your symptoms and/or engaging in talk therapy treatment, you can typically choose between online and in-person care. For those who have a busy schedule or simply prefer attending sessions from the comfort of home, online therapy can be a more convenient way to receive this type of treatment. With a platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging to address the challenges you may be facing. Research suggests that online therapy can help reduce depression symptoms in many cases, so it may be worth considering if this format is more convenient or comfortable for you.

Takeaway

Research about what exactly causes depression is ongoing. Most experts have come to believe that it’s typically some combination of genetics, environment, experiences, and/or brain chemistry. The theory about brain chemistry has to do with serotonin levels, which is why SSRIs are sometimes prescribed for those experiencing this mental illness. If you’re living with symptoms of depression, it’s typically recommended that you meet with your doctor or therapist for evaluation and treatment advice.
Depression is treatable, and you're not alone
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
You don't have to face depression aloneGet started