Jim had a steady girlfriend, was witty, sceptical and popular as well as a bit of a looker. After a minor event he suddenly experienced a feeling of intense panic. He couldn’t sleep or do anything. When the author met him Jim had been thinking and talking not only of suicide but about specific methods, a strong predictor that a real attempt is on the cards. The author gave him a fast-acting drug (Largactil) and left. At his next visit he found Jim sitting hunched up with his arms around his knees. “It hasn’t worked” he said angrily, “Nothing works and nothing ever will.” When he described how he tried to eat or sleep it sounded like picking a scab off an infected wound.

  The obvious way to look at Jim’s predicament, says the author, is chemistry. The neurotransmitters which make up our thoughts vary from person to person. It has been proven that when one of these chemicals is very low there are predictable mental consequences. Thus, people with low serotonin levels are more likely to be depressed than those with normal levels. When they are given antidepressants the serotonin level rises and the depression lifts.

  Knowing nothing about Jims parents, the author asked what sort of people they were. His parents, it turned out, had had difficult childhoods. There were plenty of skeletons in the cupboard. As a child Jim had been accorded the role of the successful, responsible child among his three siblings. Jim was his parents’ embodiment, and the idea of telling his parents about his current problems made him visibly shudder.

  As he talked Jim’s lucidity returned in snatches. He became able, for the first time, to really feel angry with his parents for having made him a ‘goody-goody’. As he continued to talk he realised that his career was actually less meaningful to him than he’d always believed, and that pleasing others was a central preoccupation. He had spent his life comparing himself with others and had never had much opportunity to ask what he himself actually wanted.

  In addition, if he allowed the pills to work he would, in a sense, be no longer acknowledging his distress at how things were for him - which he desperately needed to challenge, however frightening the experience.

  His girlfriend was alarmed at the authors subsequent line of questioning. It did not seem to her the right moment for Jim to be having blinding realisations about his childhood. In many cases she would be right: when people lose the plot it is often a bad idea to start debating the finer points of their psychic script; it can be confusing and distressing. In Jim’s case it was his wish to talk about it, and because Jim was fragile, with his confidence shot away, the author thought such talking was crucial in giving recognition to real, deep-seated problems which had come to the surface. Jim was insisting that these be acknowledged and not just drugged away. 

  As the days passed, his girlfriend realised that Jim had regressed into a child and that she must ‘mother’ him. The author reassured her it would not last long. During the next week Jim was even more depressed, and suicidal. Jim was then given Prozac which kicked in after a couple of weeks and from then on Jim stopped being depressed. However, he did not simply blank out the whole episode and return to being a machine for pleasing his parents. He began therapy, to build on what he had learned about himself.

  The therapist helped him identify irrational thoughts and how to develop mental strategems as an antidote. Jim thought he could do this himself – and did – so he stopped going and at the same time changed antidepressants, to Lustral, similar to Prozac but which can be taken in small amounts and with no side-effects. After 18 months of annoying his girlfriend by banging on about himself, and still taking the small doses of Lustral, he returned to therapy to talk about the childhood origins of his problems. The new therapy was a great success, so much so that he’s glad the crisis happened because without it he would “still be in the grip of my past.” Today he has a much more balanced view of his life, less concerned with what everyone else thinks or wants of him, more concerned to find what’s important to him – and his chemical balance is better as a result.



There have always been low-serotonin individuals, and doubtless there always will be. But compared with someone like Jim in 1950, a great many fundamental changes have occurred which place a 1990s Jim at higher risk of having low serotonin.

  From a very young age Jim was under constant pressure to compare himself, in all spheres of life, with others – so much so that his self-confidence was extremely brittle. Even though he was fine, Jim felt subordinated by these comparisons. He was constantly under the impression that he was lousy compared to the high standards of others.
  Since 1950, expectations have risen dramatically for personal and professional fulfilment. Likewise, demands for individualism have inflated. The media, particularly TV, make us obsessively preoccupied with how we are doing compared to others and whether we are individual enough. Filled with these new needs, Jim was exhausted and dispirited before his crisis. Until then, like most people of his generation,  he had used alcohol and cigarettes to keep his spirits up, to stave off discontent and stifle a nagging unease.

  Equally typical were the solutions to Jim’s crisis. Pills which raise serotonin levels are already widely prescribed. There were 5.6 million presrcriptions for antidepressants in Britain in 1995, and as these drugs become increasingly side-effect free, it is probably that they will become widespread amoung members of low-serotonin societies.

  Likewise, therapy is increasingly popular, and will continue to be so. That the combination of both drugs and therapy eventually helped Jim out of his pit of despair is a common experience. They are not the solution to the low-serotonin society, but for the low-serotonin individual they are the best we have.