Serotonin is a neurotransmitter, a chemical messenger that acts upon blood vessels and pain control pathways in the brain. Serotonin is responsible for regulating (WebMD, 2020; Medical News Today, 2020): mood, attention, memory, sleep, pain, social behavior, appetite and digestion as well as sexual desire and function. Our current working theory related to depression and anxiety is one of serotonin Deficiency.
Genetics and Serotonin Deficiency
Depression does have a genetic predisposition (Levinson & Nichols, 2020). Major depression runs in families. If you have a family members with depression, then you are at a two to three (2 or 3) times greater risk of developing depression compared with the average person (or around 20-30% instead of 10%).
Epigenetics and Serotonin Deficiency
Moreover, epigenetics plays a major role in serotonin deficiency as susceptible genes and environmental influence. With a combination of life stressors and a potentially dysfunctional serotonin (5-HT) system (Jacobsen, Medvedev, & Caron, 2012), the serotonin transporter serves in the reuptake of serotonin at the synapse and may moderate the serotonergic response to stress is damaged.
Agonists are drugs used to increases the effect of a neurotransmitter. Selective Serotonin Reuptake Inhibitors (SSRIs) are agonists for serotonin, which increase the amount of serotonin available to the brain. SSRI’s are commonly prescribed for both depression and anxiety. Essentially, SSRI’s prevent the axon terminals from engaging in the re-uptake of serotonins. Commonly prescribed SSRI’s include
• Celexa
• Paxil
• Prozac
• Zoloft
• Lexapro
Newer drugs, like serotonin norepinephrine reuptake inhibitors (SNRIs) increase the amount of serotonin and norepinephrine in the brain (U.S. Food and Drug Administration, 2007). Commonly prescribed SNRI’s include:
• Cymbalta
• Effexor
• Pristiq
Serotonin is not found in foods, it is synthesized from the amino acid tryptophan (Canada's Natural Health & Wellness Magazine, 2019) and because tryptophan is not produced by the bod, tryptophan must be taken in through diet. However, consuming tryptophan-rich foods does not necessarily increase brain serotonin because tryptophan-rich foods also contain many other amino acids, which compete for transport across the blood brain barrier (Young, 2007; Jenkins, Nguyen, Polglaze, & Bertrand, 2019). Consuming complex carbohydrates increases serotonin levels by increasing the transport of tryptophan into the brain (Fernstrom, 1998; Wurtman, 1984). Complex carbohydrates include a) whole fruits and vegetables, b) legumes, and c) nuts.
How to Increase Serotonin Levels Naturally
There several actions and activities that we can engage in to increase our serotonin levels naturally. It is important to note that we can positively increase our serotonin levels. All of the suggestions below have been well researched.
Counseling
Talking with a trained therapist is powerful. In a study of 23 patients with depression who participated in psychotherapy for 4 months, therapy significantly increased serotonin activity and improved symptoms of depression Karlsson et al., 2010). Counseling helps clients problem solve, obtain perspective, and lead a higher quality of life among other things.
Light
People have higher serotonin levels in the summer compared to winter (Lambert, Reid, Kaye, & Esler, 2002; Carlsson, Svennerholmn, & Winblad, 2002) and when sun exposure is not possible, bright light therapy helps increase serotonin levels (Magalhães, Núñez, Kato, & Ribeiro, 2015). Young (2007) suggested full-spectrum lights or light therapy lamps to use indoors at your desk, in your living room, or other places where you normally spend time. At least 10,000 lux to help boost serotonin levels.
Exercise
Young (2007) suggested that working out temporarily boosts feel-good chemicals called endorphins and that regular exercise can “rewire” the brain to think more positively. To increase serotonin through exercise, two elements are necessary. First, fatigue, as a result of exercise, increases the amount of tryptophan that can cross the blood-brain barrier and thereby boosts serotonin production (Pardridge, 1986). Second, consistent aerobic exercise (Davis, Alderson, & Welsh, 2000; Salmon, 2001; Simon, 2007). Dance movement therapy has also been found to increase blood serotonin levels compared to the control group (Jeong, Hong, Lee, Park, Kim, & Suh, 2005)
Diet
The Standard American Diet (SAD) is highly processed, contains high levels or sugars, toxins, and preservatives. In an effort to increase serotonin, increasing the consumption of foods high in tryptophan is recommended. Foods high in tryptophan included: • chicken
• eggs
• cheese
• fish
• peanuts
• pumpkin and sesame seeds
• milk
• turkey
• tofu and soy
• chocolate
Increased complex carbohydrates along with the consumption of foods high in tryptophan will increase the absorption of tryptophan over the blood brain barrier. In addition, SSRI’s drugs were augmented with a probiotic strain (Lactobacillus plantarum) (Yong, Tong, Chew, & Lim, 2019). Foods high with Lactobacillus plantarum include foods that are fermented (e.g., Sauerkraut and Kim Chi).
Massage Therapy and Acupuncture
Massage therapy decreases cortisol levels, but is also raises serotonin and dopamine (Field, Hernandez-Reif, Diego, Schanberg, & Huhn, 2005). Moreover, acupuncture has been show to increase serotonin levels as well. For women with fibromyalgia, acupuncture increased levels of serotonin- compared to placebo (randomized trial) (Karatay, Okur, Uzkeser, Yildirim, & Akcay, 2018)
Sleep
Sleep is necessary for our bodies to heal and remove toxins from the brain. Sleep also increases serotonin levels (Young, 2007). To increase the amount of sleep per night, try the following suggestions:
• Avoiding distractions in the bedroom (TV, computer, phone, etc.)
• Eat healthy
• Regular exercising
• Shower before bed
• Read
• Pink lightbulb for lamp
• Block out bright lights (street lights)
• Smells (lavender)
There are so many activities available to us to increase serotonin production. If we make taking care of ourselves a priority through utilizing healing practices (e.g., counseling, massage, and acupuncture), eat a healthy diet rich in foods with tryptophan and complex carbohydrates, go outside, exercise, and ensure adequate amounts of sleep, we can certainly increase our health and wellbeing. Many of my students ask me what my thoughts are related to taking medication for mental illness. My answer is that I am a fan of utilizing all wellbeing strategies and when symptoms of depression and anxiety enter into the moderate to severe dimensions and disrupt our ability to function, yes, I am an advocate for SSRI’s.
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