Brody annotates Evans thus:-
"4) There is discord between #2 and #3. For example, serotonin has at least 15 different receptors identified and is involved in temperature regulation, digestion, eating, sleep, sex, and self esteem. Are all of these to be considered part of a "serotonergic spectrum disorder"? A client taking an SSRI "feels better" but may also be less attentive to their family. Current practice is to inquire about mood but not about all the ancillary activities that are also tied to SSRIs."
I think that taking neurophysiology off the two dimensional page can be misleading.
The brain has evolved the precise abilities to use single transmitter chemicals for many purposes without creating interference. Life would be impossible it systems such as vision or balance were grossly affected by large amounts of shared transmitter or modulator chemical being produced in adjacent brain areas. Many systems are necessarily subservient to emotional activity. Respiratory and cardiac functions are notable examples. It is the very detachability of mood or emotion from the routine of homeostatic regulation that makes pharmacological definition possible.
A quotation which I think helps is reproduced from Rolls, A Theory of Emotion, Cognition and Emotion, 1990, 4, p 166.
... (Many brain systems use lateral inhibition in order to maintain sensitivity to contrast constant, but this is not possible in the emotion system in which absolute levels of reinforcer must be reflected over moderately long time spans). The difficulty of maintaining a constant absolute level of firing in neurones such as these may contribute to "spontaneous mood swings, depression which occurs without a clear external cause, and the multiplicity of hormonal and transmitter systems which seem to be involved in the control of mood......
Secondly "A client taking an SSRI 'feels better' but may also be less attentive to their family."
Quite so. Is this not predictable and consistent? An SSRI may make a person "better" in the sense of experiencing greater "resting contentment" or "a sense of getting a result or reward from life". Can we not allow that a person who is more self contented may be less in need of feedback from trading contact with others? Might it be the case that the idealised examples of maternal and social "groomers and carers" are to some extent the more needy individuals? (With some difficulties in adjusting to the loss or escape of their care objects !). Such a fuss is made about the individual who is so self fulfilled and hence preoccupied as to appear chilly and ungiving to the emotional craver. Since the latter writes the noisiest books and creates the greatest outcry (s)he tends to demonise folk who might simply be envied as rather complete.
We always seem to want it both ways.
Robin (Your average overneeder)