By Paul Sinclair, Managing Director of Mind Matters. One of fewer than 200 Compassionate Inquiry practitioners certified by Dr Gabor Maté, working primarily with high achievers on trauma, addiction, and the patterns beneath both.
In this piece: why depression is better understood as suppressed emotion than chemical imbalance, what the SSRI research actually says and what it does not, why magnesium keeps showing up in the clinical literature, the gut-brain axis and why your bacteria matter, and what healing looks like when the goal is not to feel less.
Table Of Contents:
- What Is Depression Really? (Hint: It Isn’t Caused By An Imbalance of Neurotransmitters)
- Childhood: The Original Crime Scene
- What Am I Actually Pushing Down?
- SSRIs: Because Who Needs Feelings Anyway?
- Presence, Acceptance, and Surrender: The Tools No One Puts on a Motivational Mug.
- Magnesium: The Mineral Big Pharma Would Rather You Forgot
- The Gut Microbiome: The Tiny Critters Pulling the Strings
- Sobriety: When the Anaesthetic Wears Off
- Gratitude Culture: Why Smiling at the Apocalypse Doesn’t Work.
- Forgiveness: The Surprisingly Undramatic Part
- Depression Is a Wound, Not a Disease
- Frequently Asked Questions About Depression
What Is Depression Really? (Hint: It Isn’t Caused By An Imbalance of Neurotransmitters)
Depression. That word they slap on every shitty day, every miserable Monday. Every period of sustained sadness.
But what is it?
From where I stand, and I have stood deep in the thick, stinking bog of it, depression isn’t some divine punishment or tragic Shakespearean flaw. It’s a grim masterpiece of survival, stitched together from panic, shame, and a total absence of hugs.
From a young age, I learned survival tricks. Some kids threw tantrums. Some kids became golden children, shining bright enough to blind their parents into loving them. Me? I learned to push it all down: the anger, the loneliness, the unbearable grief of being raised by emotionally unavailable, stress-soused parents who had the emotional intelligence of a house brick. Depression, quite literally, means “to press something down.” It wasn’t random; it was a spectacularly tragic work of art.
Childhood: The Original Crime Scene
They tell us childhood is meant to be a golden age of innocence. For me, it was more like an underfunded horror film. My caregivers couldn’t offer emotional support any more than a cinder block could offer a cuddle. Home felt like a battleground where emotions went to die of frostbite.
I couldn’t rage at Mum for giving me the emotional equivalent of a tax audit. I couldn’t sob endlessly because Dad, bless him, was a man who’d had all the love beaten out of him by nuns and priests back in Ireland, those fine, upstanding citizens who could find God in a damp church pew but lose a child faster than you can say “Amen.”
Dad treated me like a punching bag that never hit back, an easy target for the kind of rage only priests and nuns could manufacture with a crucifix in one hand and a belt in the other.
If the Pope ever came on the TV (no pun intended), although with that lot you never could be sure, that was everyone’s cue to scatter like mice under the kitchen table. Dad didn’t just turn it off or hurl the remote; he pulverised the telly with his bare hands, reducing it to a tragic pile of glass and plastic as if he were auditioning for the World’s Angriest Man. His hatred for the Catholic Church wasn’t just loud; it was apocalyptic.
A trauma response stitched together from emotional, psychological, and physical abuse so vile it could make a demon cringe. And the venom in his voice hinted that somewhere deep in that horror show, the abuse had a sexual chapter too.
There’s a special place in hell reserved for the priests and nuns who manage to weaponise God himself, preferably one involving eternal karaoke nights where the only songs on repeat are by Gary Glitter and Rolf Harris, and Satan’s the DJ. Word up!
What Am I Actually Pushing Down?
There are observable changes in the brain with depression, but that’s not the cause of it. The brain changes are the consequences, not the culprit.
Depression is like a highly sophisticated storage unit for emotions. One that’s so full it eventually collapses under the weight of its contents. But unlike my local storage unit, I couldn’t hire some bloke with a van to clean it out.
Emotions. The whole grotesque carnival. Rage, terror, sorrow, grief, the lot. Raw, unedited, piling up inside me like bin bags at Christmas.
Years later. I became a fully grown adult who felt like a steamroller had flattened my soul.
Cheers, childhood. Epic.
SSRIs: Because Who Needs Feelings Anyway?
Selective Serotonin Reuptake Inhibitors, or, as I like to call them, Still Sad, Relatively Indifferent, are medications designed to “lift your mood.” They essentially bludgeon your emotions with a chemical sledgehammer until you can’t tell if you are miserable or just flat-lining.
The science is unequivocal: SSRI’s work as well as a sugar pill. Yet still dished out like Smarties. Harvard placebo researcher Irving Kirsch and his team demonstrated this in 2008, when their meta-analysis of FDA-submitted clinical trials found that the benefits of antidepressants over placebo were, for most patients, clinically negligible. A much larger 2022 analysis conducted by Marc Stone and colleagues at the FDA reviewed 232 placebo-controlled trials covering 73,388 patients and reached an even starker conclusion: antidepressants beat the sugar pill in only 15 percent of patients, almost entirely those with the most severe depression.
They address the symptom, allegedly, numbing the unbearable feelings, but ignore the underlying cause. It’s like slapping a plaster over a fire alarm while watching your kitchen burn.
And the side effects. Weight gain, sexual dysfunction, emotional zombification. But the real horror show begins when you try to come off them.
SSRI’s can take months to clear out of your system. Withdrawal symptoms are brutal, far worse than anyone warns you. A 2019 review in Lancet Psychiatry by Mark Horowitz and David Taylor documented that withdrawal symptoms are frequent, severe, and can last weeks or months for a meaningful minority of patients, yet most clinical guidelines still understate the problem.
Coming off SSRI’s was the worst detox I ever endured, even worse than coming off 10 lorazepam a day, which took seven long months of careful reduction to stop me from having seizures.
And the worst part?
I couldn’t sleep for more than ninety minutes at a time for eight relentless months. That’s not healing. That’s chemical warfare dressed up as healthcare. Because nothing says “symptom management” like being dead inside and unable to orgasm. Big Pharma’s crowning, morning glory.
Presence, Acceptance, and Surrender: The Tools No One Puts on a Motivational Mug.
Healing wasn’t about slapping sticky notes with affirmations on my bathroom mirror. It wasn’t about “choosing happiness” like a Netflix show. (If I had heard “just be grateful” again, I’d have topped myself with a glitter pen to make a point.)
Healing, at least in the real world where emotions had the decency to hurt, was about presence. It was the slow, awkward, gut-wrenching process of facing the feelings I spent decades professionally avoiding. It was like cracking open a crypt, expecting treasure, and finding a gaping hole and a note that said, “Nice try.”
It was about acceptance.
Finally admitting that my sadness, anger, and grief weren’t some glitch in the matrix. They weren’t signs that I was broken. They were the original settings I had before life handed me a shotgun and told me to “crack on, cupcake.”
It was about surrender.
Giving up the exhausting, endless war to outsmart my feelings, and letting them run riot across my nervous system like drunk toddlers with permanent markers. Spoiler alert.
They didn’t kill me. They made me wish they had for six months.
And most of all, it was about compassion.
Not the unicorn-and-rainbows Instagram kind. But the sort of compassion that’s more like standing in front of a burning building, pointing at the smouldering ruins of my life, and saying. “Yeah. That sucks. Let’s rebuild it anyway, stronger this time.”
Magnesium: The Mineral Big Pharma Would Rather You Forgot
Here’s a plot twist worthy of an M. Night Shyamalan film. In clinical studies, humble magnesium outperforms antidepressants for treating depression.
Researchers from the University of Vermont ran a randomised clinical trial in 2017, published in PLOS One by Tarleton and colleagues, which found that six weeks of magnesium chloride supplementation produced clinically significant reductions in depression scores among 126 adults with mild-to-moderate symptoms, with effects visible within two weeks. A 2023 meta-analysis in Frontiers in Psychiatry by Moabedi and colleagues pooled seven such randomised trials and found a large, statistically significant effect in favour of magnesium. It works quickly, is well-tolerated, and doesn’t turn you into Boris Johnson. Why?
Magnesium supports over 300 enzymatic reactions in the body, including many involved in neurotransmitter regulation. In other words, it isn’t magic, it’s basic biochemistry.
But you won’t see Big Pharma slinging magnesium supplements, because you can’t slap a £300 price tag on a bottle of minerals from the health food shop.
If SSRI’s are a dodgy life raft, magnesium is a proper lifeboat that floats.
The Gut Microbiome: The Tiny Critters Pulling the Strings
Feeling down. Bloated. Gassy. Turns out it might not have been “all in my head.” It was all in my gut.
The gut-brain axis is real, revolutionising how we understand mental health. Studies show that an unhealthy gut microbiome, filled with the microbial equivalent of drunken football hooligans, can directly contribute to depression and anxiety. No shit!
Healthy gut bacteria produce neurotransmitters like serotonin and dopamine. They regulate inflammation and modulate the stress response. Screw up the microbiome, and the brain goes down with the ship. See ya!
Fermented foods, probiotics, and fibre. They aren’t just for hipsters. They are the authentic MVP of emotional intelligence.
If the gut is a nightclub run by cockroaches, you shouldn’t be surprised when the brain calls in sick.
Sobriety: When the Anaesthetic Wears Off
After I clawed my way out of addiction, I thought the worst was over. Oh, sweet summer child. What followed was a more profound depression than I had ever known. Why?
Because substances, heroin, booze, and Charlie, were my anaesthetics. They were how I coped with a reality I never learned to face. Sobriety stripped away my crutches and dumped me, naked and shivering, into the icy pool of my own suppressed emotions.
Recovery wasn’t just “putting down the drink or giving up the brown.” It was learning to feel the things I never dared feel. It was mourning a childhood I never had. It was grieving parents who never knew how to love properly because they weren’t either.
It was being handed all the grief I had dodged in a neat little package marked “Welcome to sobriety, you sad bastard.”
Gratitude Culture: Why Smiling at the Apocalypse Doesn’t Work.
Gratitude culture. That magical thinking where if I just said “thank you” enough times, I’d wake up cured instead of drowning in existential dread. I didn’t have trauma, addiction, grief, or forty years of suppressed rage. I just had a poor attitude.
According to the cult of gratitude, I didn’t need therapy, compassion, or actual healing. I needed a gratitude journal and a pastel highlighter. Trauma? Abuse? Systemic neglect? No, mate. I forgot to list “warm socks” and “the smell of coffee” ten times daily while sobbing into my cereal.
The worst part? I tried. I sat there, scribbling down platitudes about sunsets and birdsong, wondering why my soul felt like hammered dog shit.
Turns out you can’t gratitude your way out of depression or grief any more than you can knit yourself a parachute during a plane crash.
Forgiveness: The Surprisingly Undramatic Part
Despite everything, the chaos, the silence, the rage, the crushing weight of unspoken trauma, I love and forgive my parents for it all. They did their best with the emotional toolkits life handed them. I am forever grateful that they tried, even when trying looked like a slow-motion car crash.
If I could turn back the clock, I’d show them how much I miss them now they’re gone. I’d probably still get a few emotional black eyes, but I’d take it. Grief has a funny way of handing you clarity, usually wrapped in sandpaper and barbed wire.
Regret is a cruel mistress.
Depression Is a Wound, Not a Disease
Depression isn’t a disease. It’s a wound. It isn’t a sign you’re broken. It’s a sign you’re trying to survive.
The real cure isn’t a pill. It’s presence, facing the pain, and trusting that inside all the darkness, there’s a small, stubborn flame that never quits.
And after enough brutal honesty, feral compassion, magnesium supplements, and a gut full of decent bacteria, that flame will grow.
If any of this resonates, and you are ready to do the work that actually moves the weather, book a conversation with me. We will not start with a pill. We will start with what you have been pushing down.
I don’t suffer from depression anymore.
Why. Because at some point, I stopped trying to fix what wasn’t broken and just started living like the gloriously dysfunctional miracle I am. It turns out that surviving a psychological house fire gives you a hell of a sense of humour.
And I realise now, I was never broken.
Just human.
Frequently Asked Questions About Depression
Is depression really caused by a chemical imbalance?
Probably not, or at least not primarily. The chemical imbalance theory of depression has been steadily dismantled by researchers over the past two decades. Brain chemistry changes with depression, yes, but as a consequence rather than a cause. The more useful question is what a person is responding to, and what they are pushing down to cope. If you want to explore the story beneath the symptoms, get in touch. We can start with a conversation.
Do SSRIs actually work?
For most patients, the difference between SSRIs and a placebo is small. A 2022 FDA-affiliated analysis found a meaningful effect in only 15 percent of patients. That analysis, by Stone and colleagues, examined 232 trials covering 73,388 patients. It supports earlier work by Harvard researcher Irving Kirsch on the same question. Severe depression shows larger effects. Always discuss medication changes with your prescribing clinician. Do not come off SSRIs alone.
Can magnesium help with depression?
The clinical evidence is encouraging. Randomised trials show magnesium supplementation reduces depression scores in adults with mild-to-moderate symptoms, with effects visible within two weeks. A 2017 University of Vermont trial and a 2023 meta-analysis of seven RCTs both reached the same conclusion. Magnesium is well-tolerated, inexpensive, and supports hundreds of enzymatic reactions in the body. Speak to your GP before adding supplements, especially if you have kidney issues or take medication.
Is SSRI withdrawal dangerous?
SSRI withdrawal can be severe, prolonged, and is more common than patients are often warned about. Tapering slowly under medical supervision is essential. A 2019 Lancet Psychiatry review by Horowitz and Taylor documented withdrawal symptoms lasting weeks or months for a meaningful minority of patients. Shorter half-life SSRIs carry higher withdrawal risk. Never stop SSRIs abruptly. Work with your prescribing clinician on a tapering plan.
Why does depression often get worse after getting sober?
Because substances were doing the emotional work. When the anaesthetic wears off, everything you were drinking or using to avoid comes up for air. I went through this myself. Sobriety is not a finish line, it is the start of the harder work, learning to feel what you spent years chemically not feeling. If you are in early recovery and this sounds familiar, get in touch. This is the work I do.
References
- Horowitz, M. A., & Taylor, D. (2019). Tapering of SSRI treatment to mitigate withdrawal symptoms. The Lancet Psychiatry, 6(6), 538-546. https://doi.org/10.1016/S2215-0366(19)30032-X
- Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008). Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. PLOS Medicine, 5(2), e45. https://doi.org/10.1371/journal.pmed.0050045
- Moabedi, M., Aliakbari, M., Erfanian, S., & Milajerdi, A. (2023). Magnesium supplementation beneficially affects depression in adults with depressive disorder: A systematic review and meta-analysis of randomized clinical trials. Frontiers in Psychiatry, 14, 1333261. https://doi.org/10.3389/fpsyt.2023.1333261
- Stone, M. B., Yaseen, Z. S., Miller, B. J., Richardville, K., Kalaria, S. N., & Kirsch, I. (2022). Response to acute monotherapy for major depressive disorder in randomized, placebo controlled trials submitted to the US Food and Drug Administration: Individual participant data analysis. BMJ, 378, e067606. https://doi.org/10.1136/bmj-2021-067606
- Tarleton, E. K., Littenberg, B., MacLean, C. D., Kennedy, A. G., & Daley, C. (2017). Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PLOS One, 12(6), e0180067. https://doi.org/10.1371/journal.pone.0180067
Paul Sinclair
Paul, Managing Director at Mind Matters, specialises in mental health, trauma, and psychedelic-assisted therapy. He has trained under Dr. Gabor Maté, a renowned expert in trauma and addiction, and has also undergone extensive training in psychedelic-assisted therapy. Paul's diverse background as an elite military unit member, top athlete, and successful entrepreneur informs his unique approach to transforming ingrained patterns of thought and behaviour. He has trained thousands of individuals, and over 20,000 development and mental health professionals follow his teachings on LinkedIn. Paul believes in the power of resilience and personal transformation, drawing from his journey to inspire and guide his clients.
