Doctor Ellen Leibenluft explains that neurotransmitters and neuromodulators in the brain are heavily inter-connected and work together as a system.
One important thing to understand in the brain is that to a certain extent it’s all about communication. It’s all about communication between neurons and between brain regions, and that’s why there’s been increased recent interest in not just brain regions that might be involved in bipolar disorder but brain circuits. So functionally, what’s the communication that’s going on for example between the amygdala and the ventral prefrontal cortex? Or between the amygdala and parts of the brain that processes emotional stimuli such as faces? In the same way, there’s increased appreciation that these various neurotransmitter systems, neuromodulator systems, work together. So dopamine and serotonin, for example, interact with each other and influence each other's levels, so a lot of this has to do with putting together a very complex system and understanding how both different brain regions and different brain chemicals work together to create the symptoms that we ultimately see.