As a quick survey, do the people who believe that SSRIs have only a placebo effect also disbelieve any biological source of depression?
Since the plural of anecdote is data, I'll share my story. I struggle with depression. I've kept it at bay for a long time now, but I had a big wave this year. It turns out that was ~1wk after a Rx refill and I realized the pharmacist refilled at half the dosage. Fixing the dosage got me on track in a couple of days.
I know I'm not above a placebo effect. The placebo theory could explain my recovery, but I'm not sure how it could explain regressing when my dosage was messed up.
Zoloft helps me live a normalish life. I'm not on a high dose and don't experience any emotional numbing. Every year or so I try dropping the dose or quitting and have a massive relapse. It seems to be a genetic issue in my maternal line.
These type of articles follow a couple of archetypes:
1. I beat depression by (insert value-signaling method here). These people are usually in denial and/or in the initial positive rush of a life change. The latter produces transient changes that are far outlasted by internet posts.
2. SSRI's don't work and have horrible side-effects. The side-effects trash-talk causes a nocebo effect. Sexual or sleep related side effects are produced in the general population by gusts of wind, and now you read mainstream papers talking about them. The meds work as well as therapy for far less money and opportunity cost. Poor and even middle income people don't have therapy as an option for mental illness. Check out: http://slatestarcodex.com/2014/07/07/ssris-much-more-than-yo...
The current canon of legal psychiatric drugs won't ever cure the underlying issue that causes the symptoms. The only things that come close to that are the psychedelics -- psilocybin, MDMA, LSD, etc. They have been outlawed but of course, the underground therapy community has been keeping them alive and we should see legalization for the treatment of things like PTSD within the next 5 years.
They talk about these uses on almost every episode of the Joe Rogan Experience. He has a lot of researchers on who describe their usage of psychedelics to treat depression in particular. They describe it as "brain reset" or more like a chance for people to stick their head out of the fog, giving them the opportunity to see how they're stuck in a negative cycle. I just wonder if it's like a Tony Robbins seminar, super…
Ayahuasca literally turned my entire life around. I was negative, weak willed, and had a perspective that I was incompetent and my life was pointless and leading nowhere. The self the drug let me see was beautiful and powerful, it showed me that all I had to do was basically stand up and claim that persona. Fast forward a few years, I'm hyper successful in basically every area of my life, I'm on a rocket upward trajectory, and I'm totally happy/fulfilled. I put a lot of work in to change, but I needed that peek behind the veil to get "unstuck."
Heh, as someone who was on SSRIs for a long time at high dosages, they definitely do something, but the issue is less whether the drugs do anything and more what you do during that time. Personal experience with Sertraline - it doesn't make you happy or feel better or anything. It just numbs you, and you're really susceptible during this time. It's part of the reason why therapy is also really important in addition t…
> In the case of true chemical imbalances like it's suspected I have, during this time you help find non-drug related coping mechanisms. Finding ways to help create a strong positive part of your life so the imbalances are offset and don't hit as hard. A lot of this comes just through therapy or at least a counselor while you work. We wouldn't say the same if it was your arm was broken... "You can just come up with n…
Well keeping with your analogy we also wouldn't just sit there feeding the person pain killers and hope it works either, which is pretty much what SSRIs would be.
Brain chemistry and "fixing" it is more voodoo than science right now. There are many underlying causes of depression and it's pretty unlikely there's going to be a fix that's surgically precise and accounts for even a large number of cases with one solution.
My point wasn't that SSRIs are bad or don't work, but it does usually take more than just popping pills to mitigate and help depression. Pills aren't the full solution. They're part of a working solution but not the entirety of it.
I know these things from a friend who is a doctor and works with these neurotransmitter tests since about 10 years. I asked her how accurate these tests were and she said that, while you can't read everything off a sheet, there are patients, where she can already guess the result of the tests from the bodily symptoms the patient is describing (energy level at which times of the day, feeling of hunger, insomnia etc.).…
I think you should both stop here.
No way! Having MDs or MD like people on HN is a joy! We talk about the inanities of compsci jargon all the time on this site. Hearing the debates in Bio and the Medical field on here is a rare joy!
I know these things from a friend who is a doctor and works with these neurotransmitter tests since about 10 years. I asked her how accurate these tests were and she said that, while you can't read everything off a sheet, there are patients, where she can already guess the result of the tests from the bodily symptoms the patient is describing (energy level at which times of the day, feeling of hunger, insomnia etc.).…
I think you should both stop here.
I don't. This sort of discussion from people in the field and what their friends see is helpful because it can change how other laypeople see the issue. Furthermore, I like seeing these sorts of discussions because I feel they make me more intelligent through gaining a different perspective.
The problem with "curing depression" as a whole is that it's a complex syndrome with multiple causes, and our understanding of the brain is very primitive at this point. I kind of think that many recreational psychedelics are both over-hyped by advocates and over-demonized by naysayers. Recreational experiences are fine and dandy, but I haven't seen much evidence so far that serotonergics do anything for depression.…
This is an excellent comment and reflects the current state of research. There is good evidence for the efficacy of ketamine in treatment resistant depression. The psychedelics are not well studied. SSRIs are not useful and may be harmful. ECT works but causes amnesia. Most depression gets better on its own.
I suffered from depression pretty much my entire 20's, and looking back it felt like the long line of anti-depressants I was prescribed exacerbated the situation. Eventually I changed how I live my life and started making baby steps towards improving myself. And I magically stopped being depressed. I have no doubt there are people out there that need help with medication. But I think the only thing that could have helped me was someone reaching out and showing me how to get out of my rut. But even then it would have been on me to make some changes and find out what makes me happy.
> If you think that SSRIs don't affect serotonin I didn't say that, I said that "increasing serotonin" is not why these drugs sometimes help people feel better. > Honestly, her coke habit is the lede here, Yes. In the long term, cocaine use wrecks the mitochondia, which contributes to exhaustion. The proper therapy in this case is to restore the mitochondria density. Etiology (" a branch of medical science concerned…
> In the long term, cocaine use wrecks the mitochondia, which contributes to exhaustion. The proper therapy in this case is to restore the mitochondria density. In mice, when given super high doses. The data for humans is much shakier and the effects of this are unknown, or if there are any, or if it even matters. AFAIK, none of the long term studies from reputable sources have shown long term effects on wakefulness…
Going on my observations, cocaine is a much safer drug than meth amphetamine. She recovers quickly from cocaine, but it takes 3-4 days for her to recover from meth amphetamine use.
>Many meds have extreme side-effects in part of the population My daughter was given Montelucast/singulair for treatment of asthma; now it turns out that it can have severe side effects with kids - anxiety and suicidal behavior [1]. The funny thing is that these side effects are not listed on the medication guide, as these are supposed to be 'known risks'. What exactly were they thinking when they omitted this inform…
Is there other medications she could take instead of these? Asthma is scary enough for children, I couldn't imagine having to worry about the effects of the medication as well.
there are inhalations if it comes to it, we do take care of her.
Singulair is a preventive treatment, it is supposed to prevent asthma attacks before they happen, however the side effects of induced anxiety made it too costly for us.
The problem with "curing depression" as a whole is that it's a complex syndrome with multiple causes, and our understanding of the brain is very primitive at this point. I kind of think that many recreational psychedelics are both over-hyped by advocates and over-demonized by naysayers. Recreational experiences are fine and dandy, but I haven't seen much evidence so far that serotonergics do anything for depression.…
This is an excellent comment and reflects the current state of research. There is good evidence for the efficacy of ketamine in treatment resistant depression. The psychedelics are not well studied. SSRIs are not useful and may be harmful. ECT works but causes amnesia. Most depression gets better on its own.
Tianeptine has done wonders for me, but is a weird-ass tricyclic that may not work in any of the usual ways.
The side effect profile is sufficiently minimal that if it turns out I'm just a lucky beneficiary of a placebo effect, I really don't mind.