Serotonin is a neurotransmitter and hormone that is involved in the functioning of multiple organ systems in the body. Commonly, it is known as the happy chemical. There is a strong correlation between low levels of serotonin and depression. This is a simple enough explanation and if that is in fact the case, then medication should do the trick. And indeed, medication can help ease the most severe symptoms of depression such as fatigue, decreased concentration and focus, sadness, feeling as if one is in a fog, and general apathy. Notice that I used the word “ease” when explaining how anti-depressant medication can address symptoms of depression. I use this word because anti-depressants are not a cure-all and because depression is a complicated condition. We know that serotonin is implicated in depression, but it is a chicken or the egg argument. Does depression happen because of an insufficient amount of serotonin, or is the production of serotonin impacted by depression?This is an important question because it tells us that managing depression requires a multi-modal approach. Think about it. If you are someone reading this blog right now that has suffered from depression, whether it is infrequent or chronic, what things made it bearable? Was it the great feeling you got from exercise? Or a lovely lunch with a dear friend? A successful presentation at work? Or being selected for a prized opportunity at school? And maybe it was as simple as a walk or eating your favorite ice cream. These events create pleasure,contentment, or a sense of accomplishment which in turn boosts our mood. And those momentary feelings are just that, momentary, when you have depression. Why is that? There are a couple of explanations. One being that people who are depressed are often extrinsically motivated. One who is extrinsically motivated seeks affirmation and approval from the outside world. Success and happiness are determined by the approval of others whether that is in the form of praise, admiration, or the number of followers/likes/retweets on social media. On the other hand, a person who is intrinsically motivated experiences satisfaction with knowing they have done a good job or are a good person without lots of validation from the outside world.By itself, there is nothing wrong with being extrinsically motivated. Nor is it necessarily sufficient to only be intrinsically motivated. The reality is we need both. We need to know our worth without excessive amounts of validation, and yet it sure is nice when someone notices when we have done a good job. In my opinion, it all comes down to connection. Real, meaningful, life giving connection to others and to a life with purpose. People are healthiest when they know they matter and that what they do matters. People are healthiest when they enjoy relationships where they can be themselves in all of their multifaceted and complex wonderfulness. Do you have people in your life that help you to know you matter and are you engaged in activities or work that give you a sense of purpose? If the answer is no, and you are feeling depressed or anxious, perhaps it is time to re-evaluate and seek new experiences and relationships. Psychotherapy is a great place to begin that exploration and uncover what might be holding you back. More to come on the relationship between connection, depression, and anxiety.