Since the rise of pharmaceutical commercials in the late 1990s, it’s been widely accepted that depression likely has something to do with serotonin, a tiny neurotransmitter and hormone that’s now seen as the secret ingredient for a good mood. And while this is still debated by scientists, given the complexity of the brain and variables involved in studying it, experts generally agree that serotonin is beneficial and can be boosted with the help of selective serotonin reuptake inhibitors (SSRIs) — at least for some of the 37 million Americans who take antidepressants.
But what the Zoloft Blob won’t tell you is that it’s entirely possible to have too much serotonin, which can result in “sudden irritable or angry moods, neuromuscular hyperactivity like tremors and shivering and autonomic hyperactivity in the form of rapid heartbeat, sweating and fevers,” psychiatrist Bryan Bruno tells me. Moreover, since about 90 percent of our serotonin is produced in the gut, too much of it can cause nausea, vomiting and diarrhea.
In other words, too much serotonin is like depression, plus rage and the runs.
Otherwise known as “serotonin syndrome,” this occurs when the amount of the chemical reaches toxic levels, typically as a result of medication mismanagement. Though this is unusual when meds are taken as prescribed, levels of serotonin can increase too much when patients up their dosages without consulting their doctors in a misguided, DIY attempt to elevate serotonin. Likewise, serotonin syndrome can happen when antidepressants are taken with other drugs such as ecstasy and psychedelics, psychiatrist Yalda Safai explains. “Some dietary supplements such as St. John’s wort are also associated with serotonin syndrome.”
In very rare instances, too much serotonin can occur from natural causes. For example, carcinoid syndrome happens when cancerous tumors cause excess serotonin, “which can lead to diarrhea, flushing, wheezing, fibrosis and carcinoid heart disease,” Bruno says. “This typically happens when the tumors become advanced, and the only way to treat the syndrome is to treat the cancer.” For its part, serotonin syndrome is curable with immediate medical attention, but can be fatal without it.
Safai stresses, however, that none of this should discourage those struggling with depression from considering SSRIs because again, “if a medication is taken as prescribed, serotonin syndrome is incredibly rare.” Moreover, both she and Bruno agree that it’s pretty much impossible to give yourself serotonin syndrome with whole foods, physical activity, meditation, therapy and other wellness practices that have been found to naturally boost the brain chemical.
So for most people, the idea of too much serotonin merely serves as a reminder to always talk to your doctor before adjusting your meds, combining them with supplements or messing around with molly. Unfortunately, however, it’s not an excuse to skip your workout.