Understanding Serotonin and Its Roles in Mental and Physical Health - Serotonin’s Role in the Brain and Body

 Dr. Wesley Sassaman, DNP, MSN-NE, MPH, MBA, FNP-C, CARN-AP

Introduction

Serotonin, often called the "feel-good" chemical, is a vital neurotransmitter that helps regulate mood, emotions, and cognitive functions like learning and memory. Its impact extends beyond the brain, influencing gastrointestinal health, cardiovascular function, pain regulation, and even bone density. Serotonin achieves this through interactions with receptors and proteins, like the serotonin transporter (SERT), which recycles serotonin to maintain balance in the brain and body. This process is crucial for emotional stability and the management of mood disorders such as anxiety and depression.

SERT plays a pivotal role by controlling the amount of serotonin available in synapses, the spaces between neurons where signaling happens. Medications like selective serotonin reuptake inhibitors (SSRIs) target SERT to block serotonin reabsorption, thereby increasing serotonin availability and improving mood over time (Higa et al., 2024; Huang et al., 2023). This balance is essential not only for emotional resilience but also for physical processes. For instance, disruptions in serotonin activity can influence synaptic plasticity, which affects a teen or young adult's ability to adapt, learn, and even manage stress (Melo et al., 2024).

Serotonin also affects broader systems like the gut, where it regulates digestion, and the cardiovascular system, where it influences blood vessel dynamics and heart rate. For example, serotonin’s role in pain perception means variations in its signaling can alter sensitivity to pain (Huang et al., 2023). This multi-dimensional reach underscores serotonin’s importance across all major systems in the body.

How Serotonin-Based Medications Work

Serotonin-modulating medications, specifically SSRIs, enhance serotonin levels by targeting SERT, preventing serotonin's reabsorption into neurons. This increases serotonin availability and prolongs its mood-regulating effects. Common SSRIs, like fluoxetine and sertraline, are extensively used to treat depression and anxiety in teens or young adults, with clear mental health benefits (Bremshey et al., 2024). However, these medications can also have systemic effects because serotonin interacts with other bodily systems.

Cardiovascular health is one example. Serotonin in the bloodstream helps regulate blood vessel function. However, altered serotonin signaling can lead to vascular issues, like arterial stiffness or changes in heart rhythm (Chen et al., 2023). Athletes have unique concerns, as their physical activity places higher demands on their cardiovascular systems. For teens or young adults with anxiety or depression, SSRIs can significantly enhance emotional well-being while requiring close monitoring for potential cardiovascular side effects, such as changes in heart rate or blood pressure (Edmonston et al., 2023).

SSRIs can also impact sleep, focus, and gut health, areas often interconnected with mental health. For instance, the gut stores the majority of the body’s serotonin, and disruptions in this system can contribute to digestive conditions like irritable bowel syndrome (Guzel & Mirowska-Guzel, 2022). Understanding these broader impacts is key to managing side effects and achieving the right balance in treatment.

Beyond the Brain: Serotonin’s Role in Growth and Cardiovascular Health

While serotonin-based medications are designed to focus on mood regulation, their scope frequently reaches other areas, such as bone health and cardiovascular function. Young adult growth depends heavily on hormone regulation, and serotonin impacts bone density and growth by interacting with critical cellular processes. Young adults who are on SSRIs benefit from routine screenings and a diet rich in calcium and vitamin D to maintain healthy bones during treatment (Shultz, 2022).

The cardiovascular system is heavily influenced by serotonin’s activity. High serotonin levels in the bloodstream can lead to thickened artery walls, a process called vascular remodeling, which impacts flexibility and blood flow. A heightened risk of conditions like pulmonary hypertension or left ventricular hypertrophy (an overgrowth of heart muscle) underscores the need for cardiovascular assessments in young individuals on serotonin-modulating treatments (MacLean et al., 2022).

For athletic teens or young adults, these risks are compounded by the demands of regular physical activity. Support from healthcare providers through echocardiograms or heart monitoring ensures early detection of potential issues. Parents of teens or young adults with cardiovascular or metabolic risks, such as pre-existing conditions, should consider additional lifestyle strategies like nutrient-rich diets and consistent exercise tailored to minimize strain on the body (Cao et al., 2025).

Making Sense of Future Treatments and Holistic Care

While SSRIs remain a trusted component of mental health care, ongoing research in serotonin-based therapies offers exciting possibilities for personalized treatment. For example, GLP-1 receptor agonists, initially developed for diabetes management, show potential in modulating neurotransmitters like serotonin, dopamine, and glutamate, which influence mood and stress responses. However, these new treatments require careful study to understand risks like pulmonary hypertension linked to serotonin signaling (Archambault & Delaney, 2023).

Holistic care strategies can help parents and young adults manage the complexities of mental health treatment. Encouraging open communication about symptoms, recording side effects, and maintaining regular medical check-ups ensure both mental and physical health are monitored. Additionally, advocating for personalized treatment plans that consider a young adult’s unique lifestyle and health history enables better management of mental health conditions alongside physical well-being.

Ultimately, staying informed about serotonin's multifaceted role empowers parents to support their teen or young adult’s mental health effectively. While challenges related to serotonin-modulating treatments may arise, thoughtful planning and collaboration with healthcare professionals provide a foundation for resilience and recovery.

Recap and Action Steps for Parents

Throughout this article, parents have gained a comprehensive look at serotonin’s role in the brain and body, the effects of serotonin-modulating medications, and the importance of holistic care. Key takeaways include:

• Understanding the science behind serotonin’s role in mood regulation, cognitive function, and physical health systems like the gut, cardiovascular, and skeletal systems

• Recognizing medication benefits in treating anxiety and depression, while monitoring their potential side effects

• Acknowledging the interconnectedness of mental and physical health, and how SSRIs affect both

Parents can take the following action steps to better support their child:

Encourage open communication Foster a safe environment where your teen or young adult feels comfortable sharing how they’re doing emotionally and physically

Keep track of symptoms Maintain a journal to document potential medication side effects or noteworthy changes

Consult healthcare providers regularly Tailor treatment to your child’s personal and family health history, and don’t hesitate to ask about screenings or lifestyle recommendations

Promote healthy habits Encourage nutrient-rich meals, regular exercise, and stress-management techniques to complement their mental health treatment

 Stay informed Read up on emerging medication options or scientific studies, and partner with your healthcare team for the best outcomes. Empower yourself with knowledge and a proactive approach to ensure your teen or young adult thrives both mentally and physically. 

References

• Archambault, J., & Delaney, C. A. (2023). A review of serotonin in the developing lung and neonatal pulmonary hypertension. Biomedicines.

• Bremshey, S., Groß, J., Kim, R., & Masseck, O. A. (2024). The role of serotonin in depression: A historical roundup and future directions. Journal of Neurochemistry.

• Cao, J., et al. (2025). Overweight and glucose/lipid metabolism abnormality associated with SSRIs. Frontiers in Pharmacology, 15.

• Chen, Y., et al. (2023). Cardiovascular toxicity induced by SSRIs. Psychiatry Research.

• Edmonston, D. L., Isakova, T., & Wolf, M. (2023). Plasma serotonin and cardiovascular outcomes in chronic kidney disease. Journal of the American Heart Association, 12.

• Guzel, T., & Mirowska-Guzel, D. (2022). The role of serotonin neurotransmission in gastrointestinal tract and pharmacotherapy. Molecules, 27.

• Higa, G. S. V., et al. (2024). Serotonergic neuromodulation of synaptic plasticity. Neuropharmacology, 257.

• Huang, C., et al. (2023). Serotonin transporter and sodium-dependent reuptake inhibitors as modulators of pain behaviors. The Journal of Pain.

• MacLean, M. R., et al. (2022). Serotonin and pulmonary hypertension. Comprehensive Physiology, 12.

• Melo, L., et al. (2024). Neurochemical mechanisms underlying serotonergic modulation of neuroplasticity in humans. Brain Stimulation, 17.

• Shultz, E. (2022). Do genetic variants moderate side effects of SSRIs? Journal of the American Academy of Child and Adolescent Psychiatry, 61(10).

About the Author: Wesley Sassaman, DNP, is a medical professional with years of experience in addiction and mental health. Working on the front lines of the fentanyl epidemic, Dr. Sassaman is dedicated to empowering families affected by fentanyl addiction by providing them with the knowledge and resources to navigate the difficult road to recovery. With a deep understanding of the biopsychosocial model of addiction, Dr. Sassaman combines expert insights with compassionate guidance, offering hope to those struggling with the devastating effects of street-based fentanyl addiction.

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