{"id":10956,"date":"2025-05-09T11:56:00","date_gmt":"2025-05-09T08:56:00","guid":{"rendered":"https:\/\/belarus.fm\/?p=10956"},"modified":"2025-09-17T15:09:48","modified_gmt":"2025-09-17T12:09:48","slug":"brief-03","status":"publish","type":"post","link":"https:\/\/belarus.fm\/en\/health\/brief-03\/","title":{"rendered":"How do antidepressants work \u2014 in simple terms? Why does our brain worry?"},"content":{"rendered":"\n<div class=\"podcastplayer\"><figure class=\"wp-block-audio podcastplayer\"><audio controls src=\"https:\/\/anchor.fm\/s\/1046d7c48\/podcast\/play\/103069308\/https%3A%2F%2Fd3ctxlq1ktw2nl.cloudfront.net%2Fstaging%2F2025-4-22%2F400828151-44100-2-22ad6d9e41642.m4a\" preload=\"none\"><\/audio><\/figure><\/div>\n\n\n<h5 class=\"wp-block-heading\"><span class=\"mks_dropcap_letter\" style=\"font-size: 72px; color: #dd3c7a; \">I<\/span>magine yourself on a massive highway, surrounded by a billion cars. That\u2019s how all the internal processes in our body operate. Each individual signal is like a separate car on the road. One side of the highway leads to the brain, the other \u2014 sends signals back to the rest of the body. And even if every driver follows the rules, the traffic light can still become a bottleneck. Because if there\u2019s a power outage, it can trigger a chain reaction of chaos. That\u2019s what the beginning of an anxiety disorder might look like \u2014 in cases where it\u2019s caused by a serotonin imbalance in the body.<\/h5>\n\n\n\n<p>In this episode of the Misery Shared Podcast, Slava explains how antidepressants work \u2014 what you shouldn\u2019t expect from them, and where it\u2019s important to approach the decision with caution. The episode is dedicated to how brain biochemistry functions \u2014 explained in very simple terms. You\u2019ll also learn why there\u2019s still no universal medical solution for OCD \u2014 but there\u2019s every chance to overcome anxiety.<\/p>\n\n\n\n<p><strong>Disclaimer<\/strong>: the author makes it clear that he is not a psychologist or a psychotherapist. He strongly opposes any form of online diagnosis. This podcast is not intended for self-diagnosis or self-treatment. Its purpose is to explain things in simple terms and to encourage people to seek help from a therapist \u2014 even if it feels like a waste of time. It also aims to help listeners choose a good mental health professional.<\/p>\n\n\n\n<p>At the root of anxiety, there\u2019s often a serotonin imbalance \u2014 a kind of \u201celectricity\u201d in the \u201ctraffic lights\u201d. Of course, that\u2019s a big simplification. It\u2019s not really electricity \u2014 it\u2019s a chemical. This comparison is just meant to help convey the scale of the issue. You could also compare serotonin to a national currency: When the supply is stable, your \u201csalary\u201d allows you to \u201cpay for\u201d joy, restful sleep, and clear thoughts.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Serotonin is synthesized in the gut (for digestion) and in the brain (for mood), but only brain serotonin affects emotions. And the brain can\u2019t receive serotonin from external sources. That\u2019s why serotonin-related problems aren\u2019t corrected by adding more of it \u2014 but by interfering with the process of how it\u2019s \u201ccleared away\u201d.<\/p>\n<\/blockquote>\n\n\n\n<p>Here\u2019s the thing: after a signal is transmitted (now a bit of science without metaphors), serotonin remains in what\u2019s called the synaptic cleft. If it stayed there permanently, it would start sending false signals \u2014 ones that no longer match the real situation. Like a messenger app that keeps sending endless notifications about a message you\u2019ve already read. That\u2019s why, after the signal is delivered, serotonin is taken back in by the SERT transporter \u2014 a kind of special \u201cvacuum cleaner\u201d for serotonin.<\/p>\n\n\n\n<p>So, if there\u2019s too little serotonin, or if the receptors\u2019 sensitivity to it has changed \u2014 then by contrast, the work of a \u201cvacuum cleaner\u201d seems too dynamic. The signals disappear too quickly. This means that the message doesn&#8217;t have time to be \u201cread\u201d. Or, going back to the national currency analogy \u2014 it seems like you aren&#8217;t seeing the full amount that you earned because your salary (serotonin) was heavily taxed, in a country with high inflation.<\/p>\n\n\n\n<p>Other \u201chappiness hormones\u201d (scientifically, they\u2019re different substances, but they all contribute to feelings of pleasure and motivation) \u2014 like dopamine, oxytocin, and endorphins \u2014 could be compared to discounts, coupons, or free samples, if our body were a store. Of course, that\u2019s a major simplification. But in this example, without the national currency (serotonin), all those \u201coffers\u201d would lose their meaning.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Just like no discount can bring peace of mind if you don\u2019t have any money \u2014 without serotonin, dopamine becomes useless. So trying to regulate dopamine in this case is like trying to set off fireworks in a burning shed. Dopamine won\u2019t feel like a reward \u2014 it\u2019ll just be noise.<\/p>\n<\/blockquote>\n\n\n\n<p>When serotonin is out of balance over the long term, both the braking and accelerating systems of the body begin to suffer: GABA (the main \u201cbrake\u201d) and glutamate (the main \u201cgas\u201d). Of course, their balance is also regulated by many other systems \u2014 but serotonin plays a significant role. And when GABA is lacking, the nervous system stays \u201con the gas\u201d, even when there\u2019s nowhere left to rush. Over time, the body becomes less sensitive to GABA \u2014 the brakes don\u2019t respond in time, they squeak, and the \u201cvehicle\u201d becomes harder and harder to control.<\/p>\n\n\n\n<p>Returning to the topic of serotonin reuptake, Slava explains how the medications typically prescribed for anxiety disorders work. These are selective serotonin reuptake inhibitors (SSRIs), and they act like HR managers \u2014 extending the shift of the \u201cconductor\u201d serotonin, so that messages are delivered more accurately, and other systems don\u2019t suffer from a \u201ccurrency\u201d shortage.<\/p>\n\n\n\n<p>The effects of the medication usually take a few weeks to develop. It\u2019s important to understand that during the initial period, your condition might actually get worse \u2014 you may experience insomnia, nausea, or dizziness. But this is a natural part of the body\u2019s \u201creadjustment\u201d process.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>And although benzodiazepines exist for emergency situations \u2014 capable of instantly \u201cputting out the fire\u201d of anxiety like a fire extinguisher \u2014 they don\u2019t address the root cause. With long-term use, they can lead to dependence, impair memory and concentration. And unlike antidepressants, suddenly stopping them can cause serious consequences.<\/p>\n<\/blockquote>\n\n\n\n<p>That\u2019s why, even though the effects of selective serotonin reuptake inhibitors don\u2019t happen instantly \u2014 and they need to be taken for at least six months \u2014 they\u2019re prescribed to correct the imbalance in the long term.<\/p>\n\n\n\n<p>Slava emphasizes that in cases of OCD and anxiety disorders, teamwork between a psychologist and a psychiatrist is crucial. Because antidepressants don\u2019t rewrite ingrained behavioral patterns \u2014 they only adjust the brain\u2019s \u201cchemistry.\u201d With OCD, habitual cycles can remain in place like the \u201ccontrol system of the old regime\u201d: Unless a psychologist conducts a kind of \u201cinventory audit\u201d and reprograms the responses, they\u2019ll return \u2014 deeply embedded in the body over many years. That\u2019s why only a combination of \u201crewiring the system\u201d and \u201cretraining the autopilot\u201d offers a real chance to maintain inner balance for the long term.<\/p>\n\n\n\n<p>The <a href=\"https:\/\/belarus.fm\/en\/health\/brief-04\/\">next episode<\/a> of the Misery Shared Podcast will focus on panic attacks \u2014 how they work on a biochemical level (explained in simple terms), and what techniques you can use if you don\u2019t have immediate access to a psychologist.<\/p>\n\n\n\n<p>If you want to contact us but are afraid to use comments, you can send us an e-mail. After that it will be enough to delete your letter from the \u201cSent\u201d folder.<br>Our e-mail address is: <a href=\"mailto:help@belarus.fm\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">help@belarus.fm<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In this episode of the Misery Shared Podcast, Slava explains how antidepressants work \u2014 what you shouldn\u2019t expect from them, and where it\u2019s important to approach the decision with caution. The episode is dedicated to how brain biochemistry functions \u2014 explained in very simple terms. You\u2019ll also learn why there\u2019s still no universal medical solution [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":10554,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[394],"tags":[352],"class_list":["post-10956","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-audio-in-russian"],"_links":{"self":[{"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/posts\/10956","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/comments?post=10956"}],"version-history":[{"count":0,"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/posts\/10956\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/media\/10554"}],"wp:attachment":[{"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/media?parent=10956"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/categories?post=10956"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/belarus.fm\/en\/wp-json\/wp\/v2\/tags?post=10956"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}