From the Research
Yes, serotonin can help offset some of the negative effects of cortisol on mood, as evidenced by the most recent and highest quality study, which suggests that combining selective serotonin reuptake inhibitors (SSRIs) with cognitive behavioral therapy (CBT) can be an effective approach for treating anxiety and depression in youth 1.
Key Points to Consider
- Serotonin is a neurotransmitter that regulates mood, happiness, and anxiety, while cortisol is a stress hormone that can contribute to feelings of anxiety and depression when chronically elevated.
- Increasing serotonin levels through various means, such as SSRIs or natural approaches like regular exercise, exposure to bright light, and consuming foods rich in tryptophan, can help counterbalance cortisol's mood-lowering effects.
- The combination of SSRI and CBT has been shown to be superior to either treatment alone in reducing symptoms of anxiety and depression in youth, with the added value of CBT becoming more significant later in treatment 1.
- The relationship between serotonin and cortisol works because serotonin activates brain pathways associated with positive mood and can dampen the stress response system, helping to lower cortisol production and reducing its impact on mood regulation centers in the brain.
Treatment Approaches
- SSRIs like fluoxetine, sertraline, or escitalopram are commonly prescribed at starting doses of 10-20mg daily for fluoxetine, 25-50mg for sertraline, or 5-10mg for escitalopram, typically taken for at least 4-6 weeks before full effects are realized.
- Natural approaches to boost serotonin include regular exercise, exposure to bright light, consuming foods rich in tryptophan, and stress-reduction practices like meditation or deep breathing exercises.
- CBT can be an effective adjunct to SSRI treatment, particularly in cases where patients have comorbid psychiatric conditions or are resistant to SSRI treatment alone 2, 3, 4.
Important Considerations
- The effectiveness of SSRI and CBT treatment can vary depending on individual patient characteristics, such as age, severity of symptoms, and presence of comorbidities 1, 5.
- Clinicians should carefully consider these factors when selecting a treatment approach and monitor patients closely for response to treatment and potential side effects.