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Ask HN: Beating depression with or without anti-depressants?

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Re: Ask HN: Beating depression with or without anti-depressants?

#81

Honestly: go and talk to a doctor you trust. My opinion (not a doctor): What is wrong in your life? Are you: + Working too hard + Commuting + Not exercising and taking care of yourself + Eating a diet with lots of processed foods + Using drugs and alcohol as a crutch + Overweight + Not resting regularly + Sleeping poorly + Have other health issues not addressed + Without genuine friends + Without a good partner + A c…

As another person who has struggled with depressive issues at various points in my life, I really like your list. I have ticked every one of those boxes at one time or another; all of them brought me down, took effort to fix, and improved my well-being when fixed.

Re: Ask HN: Beating depression with or without anti-depressants?

#82

> For these reasons I am completely shit-scared of them. I see them as my option of last resort but increasingly I feel my options running out. I was in the same boat. Don't listen to the haters. Anti-depressants are amazing. Most of the people who 'cured' their depression through some kind of cheap trick turn out to have been self-diagnosed. Anti-depressants, if dosed and chosen properly, have basically no side effe…

Dangerous advice. Anti-depressants are band-aid solutions. Depression isn't an imbalance of "chemicals", it has been marketed that way for decades to sell pills. As soon as you are off them, you will likely relapse back into depression. While it can help someone that is in immediate risk, it does not solve the core issue of what depression is which requires a holistic, non-conventional view that Western medicine shun…

Everyone experiences depression differently. SSRIs made a tremendous difference to me and my mom where therapy and various other treatments did not.

Please be careful; this attitude places the blame on the person experiencing depression, and feeling guilty about being depressed is a vicious cycle that can have catastrophic effects.

There are some for whom depression is a product of their environment. For some of those, a "tough love" approach may work. But there are also those for whom depression is a physical condition that requires medical treatment

Re: Ask HN: Beating depression with or without anti-depressants?

#83

> For these reasons I am completely shit-scared of them. I see them as my option of last resort but increasingly I feel my options running out. I was in the same boat. Don't listen to the haters. Anti-depressants are amazing. Most of the people who 'cured' their depression through some kind of cheap trick turn out to have been self-diagnosed. Anti-depressants, if dosed and chosen properly, have basically no side effe…

I was averse to anti-depressants as well. Ended up depressed and started self-medicating myself for a few years with weed and alcohol. Finally gave in and started taking the minimum dose of Celexa and, holy fuck, do I wish I had started taking them sooner. They changed my life. I took them for about 7 years and then went off them when I didn't need them anymore. Side effects were very minimal. Dampened sexual pleasure slightly. But it also made me more effective at work and better to get things done in my life.

My advice is try it. Talk to a psychiatrist and go on a minimal dose for a few months. Get therapy while you're going. If it doesn't work, it doesn't work. But it really could change your life.

Re: Ask HN: Beating depression with or without anti-depressants?

#84
Of course ask for professional advice first. But in my personal experience one SSRI helped me through a tough part of puberty a bit, but also made me feel like I wasn't really living anymore; like I was in a bubble with all of the pain but also the real joy splatting up against it and dripping down. In my more recent bout of depression after trying numerous therapies I tried several SSRIs (along with therapy) but ended up worse off. Most side effects went away after a month or so, but years later I'm still not sleeping like I used to before taking them, but I've gotten used to that; it's not that bad. I feel like Americans think of them like some kind of miracle drug/candy which I'm pretty sure it isn't for most. From what I've read so far they haven't been able to scientifically prove effectiveness above placebo level. Still, if you're out of other options and with a therapist you feel good about to guide you then I'd give it a go. One way or another I wish you all the best! Remember we're all just pretending to know what we're doing while we're really just winging it and that's fine

Re: Ask HN: Beating depression with or without anti-depressants?

#85

Earlier quoted context omitted.

You may be correct about not trusting mental health with strangers. But at the and taking anti depressant or not taking it up to you. Doctor cannot weight pros and cons of taking anti depressant for you.

A doctor can definitely weigh it for you, that is practically the whole job... A doctor can (most of the time) not "make" you take medicine, but again, that is not the point either.

You can't know that. By listening you he will be trusting you with his mental health.

Re: Ask HN: Beating depression with or without anti-depressants?

#86

PLEASE do not read any of these people's advice. Talk to a MEDICAL PROFESSIONAL, preferably a DOCTOR. DO NOT trust your mental health to strangers on the internet, be it reddit, or hacker news, or whatever. If you are based in the US and live nearby a university they usually have good counseling services and the infrastructure to refer people even if you're not attending the school. Search "{school} counseling servic…

Am I the only one scratching my head over people, who are themselves giving advice on this website, saying not to take advice from people on this website? Seems self-defeating.

Re: Ask HN: Beating depression with or without anti-depressants?

#87
Former counselor here: I think it's important to differentiate between short term anti-depressant use and long term use. Short term use can be effective for motivating you to do all the non-medication things that have evidence of working (particularly together).

Long term use is typically associated with the worst side effects - both the well known things as well as how some may (edit: at least partially) block one's ability to develop and change/grow (1). Further, long term use is not associated with any meaningful enhancement of quality of life (2) and can often be a crutch - because while it alters mood it does nothing about the underlying cognitive patterns which are so ruinous for one's social life.

(1) Through antagonism of 5-HT2AR - see the "cognitive flexibility" section of https://www.frontiersin.org/articles/10.3389/fpsyt.2021.6612... - and more generally through inhibiting natural regenerative processes https://www.amazon.com/Myth-Chemical-Cure-Psychiatric-Treatm...

(2) https://www.sciencedirect.com/science/article/abs/pii/S01650... and https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1399-5618....

Re: Ask HN: Beating depression with or without anti-depressants?

#88

Earlier quoted context omitted.

Dangerous advice. Anti-depressants are band-aid solutions. Depression isn't an imbalance of "chemicals", it has been marketed that way for decades to sell pills. As soon as you are off them, you will likely relapse back into depression. While it can help someone that is in immediate risk, it does not solve the core issue of what depression is which requires a holistic, non-conventional view that Western medicine shun…

Everyone experiences depression differently. SSRIs made a tremendous difference to me and my mom where therapy and various other treatments did not. Please be careful; this attitude places the blame on the person experiencing depression, and feeling guilty about being depressed is a vicious cycle that can have catastrophic effects. There are some for whom depression is a product of their environment. For some of thos…

I'm glad it is working for you but my point is that because SSRI and Western medicine largely addresses the observed biomechanical process, it is never going to be a complete solution, and hence I use the term band-aid. Addressing why through therapy can work but obviously if that was true we wouldn't need SSRIs in the first place. My point was that the Western approach to mental health has largely been the opposite of holistic and trauma-phobic. How do we know the wounds heal with SSRI and whatever popular politically correct therapy methodology is approved by academics at the time?

I did not put blame the person experiencing depression, like OP described, he finds SSRI questionable and is open to be without it and he is justified in doing so. He is completely in his right to question and trust his intuition by seeking second advice on here, most of which I'm appalled to say reads more like logical, academic explanations.

I simply described an alternative that has been increasingly viewed positively by the scientific community lately and there is nothing in that suggests I am guilt tripping them for being depressed.

Coming from SSRIs, I can tell you that the alternative I suggested that has already been downvoted into oblivion created a lasting change and it is consistent with other people who have previously been exposed to SSRI.

If depression was the product of their environment then there really is no need for any SSRI, the external situation can be changed. Doctors would be prescribing plane tickets to Bangkok but instead they hand you out pills. It does not appear to be what OP is describing and your argument is shaky at best.

Finally I will add, go ahead and try SSRI but it is not something you go on and off on without paying penalties for it. You don't know what you will be like weeks, months, years after it. You don't know what habits, lasting side effects you might develop during and after. It's not the job of the drug to know or care, it does what it is described as.

Just remember at the end of the day, your doctor is more than happy to prescribe you whatever anti-depressants sales rep incentivize them to. It's not his job to care nor is he is trained to by profession.

Re: Ask HN: Beating depression with or without anti-depressants?

#89

PLEASE do not read any of these people's advice. Talk to a MEDICAL PROFESSIONAL, preferably a DOCTOR. DO NOT trust your mental health to strangers on the internet, be it reddit, or hacker news, or whatever. If you are based in the US and live nearby a university they usually have good counseling services and the infrastructure to refer people even if you're not attending the school. Search "{school} counseling servic…

Doctors aren't always effective at treating depression. Especially if they use a therapy modality or medication that doesn't work for you. That doesn't mean you shouldn't talk to them, but it's also helpful to read experiences from from other people.

My opinion, doing both is good. Consult a professional and read about other people's experiences.

At the very least maybe somebody mentions a form of therapy that you've never heard of that you can ask your doctor about, or find a therapist that specializes in. If you ignored everyone's advice online you'd never even hear about that.

Personally, I'm starting Internal Family Systems therapy, which has seemed more promising for my psyche than many other modalities. But there are countless others. CBT is a good place to start, but doesn't work for everyone.

Re: Ask HN: Beating depression with or without anti-depressants?

#90

PLEASE do not read any of these people's advice. Talk to a MEDICAL PROFESSIONAL, preferably a DOCTOR. DO NOT trust your mental health to strangers on the internet, be it reddit, or hacker news, or whatever. If you are based in the US and live nearby a university they usually have good counseling services and the infrastructure to refer people even if you're not attending the school. Search "{school} counseling servic…

I DISAGREE. For this reason: I was given antipressants by my (former) doctor for a moderate anxiety "phase". It was escitalopram. And it did well for me - within a day! When it came to end the medication, I was told to just stop taking it. Which I did. But I should not have - I had anxietiy "echoes" over the following YEAR, really weird stuff. So I started to read about the medication: Studies have shown the longer y…

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