Antidepressants could work by changing our expectations

 The connection between happiness and low expectations is an age-old wisdom. Our neuroscientific research confirms this and shows that expectations have a strong influence on happiness, which is reflected at the level of brain activity.

We also examine the relationship between happiness and expectations. The Happiness Project is a citizen science project that features a series of mini-games inspired by classic neuroscientific experiments to investigate the underlying mechanisms of happiness. Thousands of people have played along and helped our team of scientists develop mathematical equations that can predict how feelings of happiness will change from minute to minute in a variety of situations.

Perhaps you can see the importance of happiness in your own life. You might get a big bonus at work or have lots of possessions, but if they don't turn out to be what you hoped for, you can still be unhappy.

Of course, when we learn, our expectations change. People have a tendency to return to stable levels of happiness (the "hedonic treadmill") despite major changes in life. This effect could be partly due to the changed expectations. Suddenly, when one is amply rewarded, one is ecstatic for a while. Over time, expectations adjust to this new normal and the feeling of happiness levels off to a normal level. This ability to learn about our surroundings is both good and bad. We can recover from even the most desperate setbacks, but we must also face the fact that nothing can make us happy forever.

SSRIs and learning

What if you could tweak your learning mechanism a little - could that have a permanent impact on your happiness? Could you get used to positive events more slowly and adapt to negative events faster? So if you received a big raise, the positive events that followed could still be rewarding. If a negative event did occur, you would lower your expectations to lower levels faster so that future events would not cause even more damage.

In a recent study, a group of neuroscientists at University College London, led by Jochen Michely, suggested that antidepressants could do just that (Michely et al., 2020). Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used antidepressants (e.g. Celexa, Lexapro, Prozac). These drugs increase serotonin levels and reduce depression in many people. SSRIs are characterized by being slow to act and gradually improving mood over many weeks.

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Based on this advice, the researchers investigated the effects of a standard clinical dose of 20 mg of the SSRI citalopram. Sixty-six healthy volunteers took a daily oral dose of citalopram or a placebo for seven consecutive days. Participants played a computerized card game that allowed them to decide which risks to take.

The subjects were presented with one of three decks of cards. Little did participants know that it was a high card game (higher odds), a low card game (lower odds), and a third card game with balanced odds. Participants decided whether to pull a card from the deck or toss a coin instead. After many such decisions and their outcomes, participants learned through trial and error which decks to play and which to avoid.