How do antidepressants work? More specifically SSRIs
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Brain cells are called neurons. They signal from one to the next using chemicals called neurotransmitters, over a small gap. There’s lots of different neurotransmitters, but one called called serotonin has a bunch of roles related to everything from digestion and sleep to mood and learning. So that you can reuse the neurotransmitters you release, those cells also have pumps that snatch them back from the gap. SSRIs mess with that pump temporarily, ensuring that serotonin stays in the gap longer, strengthening its signal.
What does that do, and why does it have antidepressant effect? Very complicated answer that we only partly understand. Potential explanations have included effects on neuroplasticity (making brain cells more able to grow and build connections), perception of positive vs negative stimuli, effects on REM sleep at night, decreased inflammation, and much more. There are probably multiple components that can be reasonably approached at different levels from molecule and cell to brain regions, and given how little in common two people diagnosed with “depression” can have, there’s no guarantee one answer will cover most cases.
The fact that many antidepressants act on serotonin doesn’t mean that there’s a deficiency to begin with, though there’s plenty of evidence serotonin plays some sort of role in the big picture of what depression is.
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