Feeling blue? Chemicals in our brains, and controversial new drugs, can change our moods and emotions

Science World, Oct 6, 1997 by Maria L. Chang

Chemicals in our brains, and controversial new drugs, can change our moods and emotions.

At 13, Jennifer Gibbs had been active all her life. "Hyper," her mom called her. She was an honor student at her school in Dallas and captain of the soccer team.

But when Jennifer turned 14, her life changed. Most days, she didn't want to get out of bed and stared at the TV. She skipped classes and missed soccer practice. And she frequently thought about death. "It's not that I wanted to die," Jennifer now recalls. "I'd just wish I'd never been born."

Jennifer is not alone. One in 20 children and teenagers suffers from depression, according to the American Academy of Child and Adolescent Psychiatry. Doctors and scientists don't always know why some people become depressed, but they have made great progress in treating the condition.

In particular, they have discovered that the root of depression--whether it's genetic or a passing emotion--lies in chemical imbalances in the brain. Armed with this knowledge, scientists have formulated a new class of antidepressants--drugs that target specific chemicals in the brain to help people feel more like their normal selves.

CHEMICAL THERAPY

Clinically depressed people feel overwhelming sadness for no apparent reason. (Being sad about the loss of a loved one, or experiencing anxiety about problems at school, is normal.) Other symptoms of depression include loss of interest in activities previously enjoyed, feelings of helplessness, and fatigue. When depressed, some people sleep and eat more than usual; others sleep an,d eat less. Some teens may drink or abuse drugs. Others think about death or suicide.

Psychiatrists have traditionally used psychotherapy and other types of "talking cures" to help patients overcome emotional problems. But recently, more doctors are prescribing drugs. Jennifer, for example, took Prozac, a popular antidepressant, for one Year under the supervision of a psychiatrist.

Physicians prescribed Prozac, Paxil, and Zoloft to more than half a million youths last year. But drug manufacturers do not yet have the approval of the Food and Drug Administration to advertise antidepressants as safe for children and teens. This is important, because critics of drug treatment think advertising influences people to take drugs they don't really need.

Many doctors, however, think antidepressants are an invaluable tool to treat depression. "When a kid suffers from severe depression--has stopped going to school, has cut off all his friends, and is thinking about suicide--we don't have the luxury of saying, `let's try therapy and see what happens in three months,'" says Glenn Hirsch, a psychiatrist at the New York University Medical Center in New York City. In such cases, Hirsch immediately prescribes antidepressants in addition to therapy.

IT'S ALL IN THE BRAIN

Antidepressants restore the brain's natural chemical balance. To function, the brain relies on chemicals, called neurotransmitters, that allow communication between neurons, or nerve cells (see illustration, left).

To transmit an electrical signal, a neuron produces neurotransmitters and releases them into the synapse, the microscopic gap between nerve cells. The neurotransmitters cross the gap and lock in on receptors in the neighboring neuron. The signal passes on and triggers thoughts or emotions. Once the chemical messengers have done their job, the transmitting neuron reabsorbs them.

Too many or too few of specific neurotransmitters circulating in the brain can cause emotional, mental, or behavioral disorders. Depression, for example, results from a short supply of the neurotransmitter serotonin, which is associated with moods and emotions. Depression may occur when neurons reabsorb too much serotonin too quickly.

Older antidepressants acted on several neurotransmitters at once, which led to dangerous side effects. But the new antidepressants, including Prozac, target only serotonin, blocking its reabsorption. Serotonin accumulates in the synapse and continually stimulates the receptors. This makes people feel better emotionally.

TOO GOOD TO BE TRUE?

While Prozac can help ease the blues, it has a few side effects, like headaches, nausea, and weight loss. Jennifer claims the drug turned her into a shallow person. Prozac stopped me from feeling deeply," she says. "I think that's how it helps you, by making you really shallow so your problems don't seem so deep."

No one knows what long-term effects antidepressants might have on growing kids and teens. So far, only one study has been conducted to see how children react to Prozac. A psychiatrist in Dallas compared the effects of Prozac and a placebo (a "dummy" pill that contains no active ingredients) on 96 children, ages 8 to 18. About half of the kids on Prozac showed improvement. But 33 percent of those on the placebo improved as well.

Results like this worry some critics. If the FDA approves antidepressants for children, would doctors prescribe the drugs unnecessarily? Some argue this has happened with Ritalin, another brain drug that's used to treat ADD, or attention deficit disorder, a form of hyperactivity. Between 1989 and 1994, the rate of Ritalin consumption--mostly by boys--increased 400 percent.