You're a nurse. You speak the language of biology. You've sat in on rounds, you've read the charts, you've probably even heard the words "chemical imbalance" used as a neat, tidy explanation for a patient's profound, messy pain.
It's a clean diagnosis. It's simple. It's biological. It fits on a chart.
And now, as you navigate the crushing, complicated weight of your own burnout and grief, you find yourself applying that same diagnosis to yourself. My brain must be broken. My serotonin must be low. This exhaustion, this sadness… it's a chemical defect. I just need the right medication to fix it.
The lie you've been sold — in your medical training and by the culture at large — is that your suffering is a simple, biochemical manufacturing error. That your story — the burnout from being a full-time caregiver, the grief for the partner you thought you had, the chronic stress of co-regulating a dysregulated nervous system — is secondary to the "chemical problem."
What if the diagnosis itself is the sickness? What if it's not a scientific fact, but a brilliant marketing slogan that has been holding millions of us hostage for decades?
The Takedown: A Scientific Reckoning
For over 30 years, the "serotonin theory of depression" has been treated as gospel. And for over 30 years, there has been a profound lack of definitive evidence to support it.
Then came the reckoning.
In 2022, a team of researchers led by Dr. Joanna Moncrieff published a massive "umbrella review" in the journal Molecular Psychiatry — one of the most prestigious psychiatric journals on the planet. This wasn't just another study. It was a comprehensive review of decades of research involving hundreds of thousands of participants. It is the most definitive, evidence-based takedown of the chemical imbalance myth ever produced.
Their findings were an earthquake:
No difference in serotonin levels between depressed and non-depressed people.
Artificially lowering serotonin in healthy volunteers did not cause depression.
Even studies looking at gene variations, including the serotonin transporter gene (5-HTTLPR), showed no consistent link to depression.
The central, foundational idea that you have been sold about your own brain — that your sadness is a serotonin deficit — is not supported by the science. It was a hypothesis that failed to stand up to scrutiny, but it was kept alive by a multi-billion dollar pharmaceutical industry because it was a simple, profitable story.
But Wait — Serotonin Does Something, Right?
Yes. And this is where lazy science becomes dangerous. Serotonin is a real neurotransmitter that does many real things. Our research knowledge base documents the complexity:
Different serotonin receptor subtypes (5-HT2A, 5-HT1A, 5-HT2C) have distinct and sometimes opposing roles in behavior. One subtype might increase social adaptation. Another might increase impulsivity.
Individual genetics matter. Polymorphisms like 5-HTTLPR moderate how serotonin affects your social behavior — but this is light-years away from "your serotonin is low, take this pill."
Serotonin enhances social suggestibility — but only when conflict is low. It's not a "happy chemical." It's a social-context chemical, and context is everything.
The problem was never "serotonin doesn't matter." The problem is that the entire mythology was built on a single, cartoonishly simple narrative — "low serotonin = sad" — when the real neuroscience is incomprehensibly more complex.
The Real Story: Your Body is Keeping Score
So if it's not a chemical imbalance, what is it?
The truth is infinitely more complex, validating, and hopeful. Your brain and body are not a faulty machine making random chemical errors. They are a perfectly logical system that is responding to the data of your life.
The burnout you feel isn't a random serotonin dip. It's the predictable, biological consequence of the chronic, sustained stress you are under. It is a full-system response:
Your Nervous System: Your body is likely stuck in chronic fight-or-flight or freeze — a state our work in trauma recovery is specifically designed to address.
Your Hormonal System: Your adrenal glands are pumping out cortisol, which profoundly impacts your mood, energy, and sleep — and chronic cortisol exposure dysregulates the entire HPA axis through epigenetic changes.
Your Immune System: Here's the finding that should change everything: inflammation can cause depression in healthy people. The research shows a specific molecular pathway — the IDO enzyme, activated by inflammation from chronic stress, directly depletes serotonin. So yes, your serotonin may be low. But it's low because you are inflamed from stress. Your body isn't making a chemical error. It's making a chemical response to an impossible life.
Your body is not making a mistake. It is keeping an accurate score of the impossible load you have been forced to carry.
The Rebellion: Demand a Therapy That Honors Your Story
This is the rebellion. It is a rebellion against a lazy, pathologizing system that prefers to give you a simplistic label and a prescription rather than engage with the beautiful, messy complexity of your life.
I'm not anti-medication. I need to say that clearly. Medication can be a life-saving tool, and for many people, SSRIs work — not necessarily because they "fix a chemical imbalance," but possibly through other, more complex mechanisms we're still understanding. The crime is not the medication. The crime is telling you that the medication is treating a "disease" that doesn't exist, while ignoring the lived experience that does.
Your mission: stop seeing yourself as a walking chemical imbalance and start seeing yourself as a human being with a story. You are not a faulty machine. You are a person whose nervous system is responding logically to an impossible situation.
Demand a form of therapy that is interested in your story, not just your symptoms. Demand a clinician who will help you audit the sources of your burnout — not just write you a prescription to mute the alarm.
When you're ready to be heard, not just diagnosed: Start here →
Part of: The Science Library → | Related: Your Anxiety Has a Biological Fingerprint · The Burnout No One Warned You About
