Calling for a new approach to depression • Hacker News Board

Re: Calling for a new approach to depression

#81

Post by skybrian » Mon, Jan 08, 2018, 2:05 AM UTC

justasitsounds wrote: post #70

dsego wrote: post #51

Earlier quoted context omitted.

Almost all antidepressants list the increase of suicide risk as a side effect, which is frightening. Zoloft for example [1]: > An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs. [1] https://www.drugs.com/sfx/zoloft-side-ef…

Like all side-effect warnings I'm pretty sure the warnings about increased suicide risk are only added after the drugs have been on the market for a while (and having accumulated a few lawsuits). As with the generic 'this product may contain nuts' warnings on food these smack of post-hoc ass-covering to me. While my scepticism of 'alternative' medicine, magical thinking and general woo-woo is as strong as ever, my ex…

That sounds like a class in reverse ethics. Is it widespread? I wonder if that sort of thing contributes to the reproducability crisis?

Re: Calling for a new approach to depression

#82

Post by SubiculumCode » Mon, Jan 08, 2018, 2:07 AM UTC

marian_ge wrote: post #47

Dismissing the scientific trials as flawed by cherry picking and then choosing an anecdotal cow to make a point seems ironic to me. The only thing I can get from this is that we may not have the whole picture regarding depression and focusing only on medication is the wrong thing. But as far as I know from people battling with this is that even in my country the doctors strongly recommend lifestyle changes and hours…

Thanks for writing this. Saved me some time, and you did it better.

Re: Calling for a new approach to depression

#83

Post by SubiculumCode » Mon, Jan 08, 2018, 2:13 AM UTC

ekwelio399 wrote: post #77

drumhead wrote: post #21

I'd like to think that medical professionals and academics in the mental health field have probably been thorough enough in their research to have looked at these finding over the years. I somehow doubt a person whose graduated in Social and Political Science and has no medical or scientific background might actually know what they're talking about in relation to this. Interesting thing about the author. He was a ris…

Tenured professor of psychiatry here. I'll give you the summary of research on depression: 1. Emotional state is like blood pressure. It's a continuously varying thing. There is no discrete depressive disease state, just an extreme end of a continuum. 2. Just like blood pressure, though, very high blood pressure (or low) represents an illness state, a potentially very serious one. The etiology is a different matter.…

Thank you for your informed summary.

What are your thoughts about about the relative efficacy of cardiovascular exercise compared to anti-depressants (not that they are mutually exclusive). Thanks.

Re: Calling for a new approach to depression

#84

Post by dsego » Mon, Jan 08, 2018, 2:14 AM UTC

wu-ikkyu wrote: post #31

drumhead wrote: post #21

I'd like to think that medical professionals and academics in the mental health field have probably been thorough enough in their research to have looked at these finding over the years. I somehow doubt a person whose graduated in Social and Political Science and has no medical or scientific background might actually know what they're talking about in relation to this. Interesting thing about the author. He was a ris…

>I'd like to think that medical professionals and academics in the mental health field have probably been thorough enough in their research to have looked at these finding over the years. You might like to read up on the short history of modern psychiatry. You'll find a great deal of mistakes, pseudoscience, and human rights atrocities.

No need to go back in history. Visit a psychiatric hospital, see those poor souls on first generation antipsychotics still in use. They walk around like zombies, slowly, with a parkinsonian gait. Staring vacantly or grimacing, some have their mouths constantly open and drooling (look up tardive dyskinesia). But hey, as long as they are docile, right?

Re: Calling for a new approach to depression

#85

Post by taurath » Mon, Jan 08, 2018, 2:32 AM UTC

justasitsounds wrote: post #35

There seems to be an increasing number of non-academic articles, essays and books that are expressing the idea that the Serotonin hypothesis of depression is flawed. It seems like the drug industry just picked up this idea in the 70s and has been running with it (to the bank) ever since Anecdotally, I have come to believe that SSRIs have a temporary mood-altering effect, possibly combined with a placebo effect that w…

I have at different points in my life had major depressive episodes where an ssri does nothing whatsoever, and others when the same ssri same dose completely knocked it out.

I’ve never seen a single study that shows altnernative efficacies in the same person, but it happened to me. Just one data point though.

Re: Calling for a new approach to depression

#86

Post by blurbleblurble » Mon, Jan 08, 2018, 2:32 AM UTC

TheSpiceIsLife wrote: post #27

nixpulvis wrote: post #17

I've been depressed, and I'll tell you this straight up. If a doctor gave me a cow instead of the pills, I would have been way better off... ignoring all the actual problems the cow solved for the rice farmer in the article, just the honesty of the doctors recognizing the real issue in the right spirit would have made me laugh, and prolly "cure" me, at least for a little while.

Getting two (sibling, Border Collie x Foxhound) puppies, and taking a boatload of magnesium and Vitamin D, a fair bit of rock climbing, skiing, jogging, and weight training, seems to have alleviated me of all my anxiety and depression. I obtained a prescription for an SSRI from a doctor, sat in the car outside the pharmacy for an hour staring at the prescription, then drove home. No way, fuck that those drugs. I've a…

YES to magnesium & vitamin D... they must be taken together and work wonders.

Re: Calling for a new approach to depression

#87

Post by milankragujevic » Mon, Jan 08, 2018, 2:46 AM UTC

I am disenhearted by the apparent pseudo-scientific thinking in the comments on this article, and how it'll "be better if you just go workout and eat better", which might work for some people, but not for everyone. If there was a scientific study about changing life habits to stop depression, I'd bet that it would have the same amount of effectiveness or even less than SSRIs. I myself have been "miraculously" cured from depression by the most ridiculed profession in modern medicine, psychiatry, and with "poison" that was supposed to ruin my life and make me kill myself. Basically, aripiprazole and fluoxetine helped me, and help me live life, work and be happy. There was nothing wrong with my life until one day I tried to kill myself, and I was very resistant to treatment because of years of people's anecdotes how psychiatrists were crazy, were "out to get them" and "chemically lobotomize" them. This is bullshit, and we all know it, during my stay in a hospital I have seen many cases of teenagers who were "beyond repair" get "fixed" with medications, and would you look at that, 3-4 years on, they haven't regressed (I kept in contact). Neither have I. It's dangerous to spread conspiracy theories to impressionable and vulnerable minds, and you should think twice before dismissing the whole modern science of psychiatry, just because you fell that hippie life and smoking pot is the way to fix anyone's life. I don't care about the downvotes, but had to get this off my chest.

Re: Calling for a new approach to depression

#88

Post by dragonsky67 » Mon, Jan 08, 2018, 2:49 AM UTC

ekwelio399 wrote: post #77

drumhead wrote: post #21

I'd like to think that medical professionals and academics in the mental health field have probably been thorough enough in their research to have looked at these finding over the years. I somehow doubt a person whose graduated in Social and Political Science and has no medical or scientific background might actually know what they're talking about in relation to this. Interesting thing about the author. He was a ris…

Tenured professor of psychiatry here. I'll give you the summary of research on depression: 1. Emotional state is like blood pressure. It's a continuously varying thing. There is no discrete depressive disease state, just an extreme end of a continuum. 2. Just like blood pressure, though, very high blood pressure (or low) represents an illness state, a potentially very serious one. The etiology is a different matter.…

Not to diminish the discussion, but you remind me of the skit from The Life of Brian..

Brian: You've got to think for yourselves, your all individuals.

Crowd: Yes we are all individuals.

It seems to me that medicine (and patients) seem to want a nice neat label to put on what is affecting them, then they can look up the label and fit it to a nice neat solution.

Unfortunately as you describe we are all individuals, especially when it comes to perception of feelings and experience and even those are not static, something as simple as a disturbed night sleep can dramatically impact somebodies mood. How the heck is medicine supposed to deal with all those variables and come up with a definitive "this works" when presented with a mental health issue.

Society expects simple solutions to problems. Dark -> turn on light. Broken leg -> apply traction, apply cast, prescribe pain killers. Patient depressed -> ????

Your average GP has about 15 minutes to provide a solution to the patient, how in that amount of time can they discover that:

the patient has recently had a messy break up,

haven't been sleeping or eating properly,

the cat was run over by the neighbour and

they have been working far too much.

Oh, and the patient would like to be prescribed a pill that will just fix it all.

Good luck with that.

Re: Calling for a new approach to depression

#89

Post by [deleted] » Mon, Jan 08, 2018, 3:01 AM UTC

erkose wrote: post #69

dsego wrote: post #51

Earlier quoted context omitted.

Almost all antidepressants list the increase of suicide risk as a side effect, which is frightening. Zoloft for example [1]: > An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs. [1] https://www.drugs.com/sfx/zoloft-side-ef…

I'd like to see some controlled studies with marijuana.

[deleted]

Re: Calling for a new approach to depression

#90

Post by stephengillie » Mon, Jan 08, 2018, 3:08 AM UTC

milankragujevic wrote: post #87

I am disenhearted by the apparent pseudo-scientific thinking in the comments on this article, and how it'll "be better if you just go workout and eat better", which might work for some people, but not for everyone. If there was a scientific study about changing life habits to stop depression, I'd bet that it would have the same amount of effectiveness or even less than SSRIs. I myself have been "miraculously" cured f…

Being rich won't solve all of your problems. But wealth/funding does solve some problems, and reduces most of the rest by orders of magnitude.

In the same way, being in good physical shape, eating healthful foods, sleeping well every night, and not being stressed won't solve every medical problem. But a dependable and healthy body does solve some problems directly, and reduces most of the rest by orders of magnitude.