Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

news.ycombinator.com

Post reply on HN
Print view View original

151–160 of 388 posts

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

#151

Post by heavyset_go »

Your best bet is to have a discussion with a doctor about this. In my opinion, there's nothing wrong with taking medication that improves your quality of life, but only your doctor can help you make such decisions.

> 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.

You don't have to take an SSRI. There are plenty of other medications out there, like mirtazapine or bupropion that don't have the same side effects that SSRIs have. Buspirone, as well, although it is indicated for anxiety, selectively targets receptor sites that mediate antidepressant effects compared to the shotgun blast approach of SSRIs.

There are now what are being marketed as SARI[1] and SMS[2] drugs, which often target the same sites as buspirone, but also have serotonin reuptake properties, as well, while blocking receptor sites that seem to induce undesired side effects. They seem to sidestep typical SSRI side effects, like sexual side effects and emotional blunting. Two drugs in this class are the only SSRI-like drugs that are allowed by the FDA to be advertised as having lower incidences of sexual side effects compared to SSRIs. Vilazadone and vortioxetine are those drugs. Trazodone can also be thought to be in the SARI class.

Then there are tricyclics and tetracyclics that are not necessarily like SSRIs, but have antidepressant effects. There's also agomelatine and low doses of atypical antipsychotics.

SSRIs are good at what they do, though. You might not experience the side effects that you're afraid of, either.

[1] https://en.wikipedia.org/wiki/Serotonin_antagonist_and_reupt...

[2] https://en.wikipedia.org/wiki/Serotonin_modulator_and_stimul...

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

#152

Post by strofcon »

Standard disclaimers - don't take my advice, I'm not a doctor, be smarter than "hey strofcon said...". :-)

Ketamine's been working wonders for me, though it's only been a month. That said, the research on it has proven fascinating, and it really is helping me to fundamentally reevaluate some beliefs that, evidently, were in need of reevaluation.

Still a loooooong road I suspect, but it's the only thing that's ever helped me.

Normal meds never touched it, lifestyle changes are a nice platitude to make neurotypicals feel smugly helpful, and while societal structures definitely play a larger role than we care to admit, they're absolutely not going to change in our favor.

Anyway, something to read up on and ask your psychiatrist about. :-)

Happy to answer questions if you have any, though again - I are not doctor.

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

#153

Post by Strom »

grp000 wrote: post #134
TameAntelope wrote: post #90

Earlier quoted context omitted.

Quoted post unavailable.

Doctors aren't infallible, and most are probably not reading research papers. That's aside from the fact that psychiatric drugs aren't even that well understood by how they actually work. If you understand basic stats and read white papers on drug efficacy that are looking for correlations with your personal attributes, that's probably really useful info to know, and much more in depth research than your doctor will…

It's funny isn't it. Nobody goes around threads screaming DON'T LISTEN TO POLITICAL ADVICE, go talk to your local POLITICAL PROFESSIONAL. Yet it is not that different. The best local politicians will obviously have amazing insight. On the flip side, just like with local politicans, most local medical professionals will just be following flow charts that they vaguely remember and won't actually give you any personalized or up-to-date insight.

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

#154

Post by TameAntelope »

grp000 wrote: post #134
TameAntelope wrote: post #90

Earlier quoted context omitted.

Quoted post unavailable.

Doctors aren't infallible, and most are probably not reading research papers. That's aside from the fact that psychiatric drugs aren't even that well understood by how they actually work. If you understand basic stats and read white papers on drug efficacy that are looking for correlations with your personal attributes, that's probably really useful info to know, and much more in depth research than your doctor will…

So you think, "Don't take medical advice from strangers on the Internet" (what I said) is equivalent to, "Don't obtain any second opinions or question you doctor" (what you seem to think I said)?

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

#155

Post by hsn915 »

TameAntelope wrote: post #90
kappuchino wrote: post #65

Earlier quoted context omitted.

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…

Quoted post unavailable.

You literally want HN to censor people like big tech social media companies do?

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

#156

Post by strofcon »

opwieurposiu wrote: post #14

If you want to avoid SSRIs, you can try ketamine treatment. Should be able to find it in most major cities now. In my city the cash price is about $400/a session and you probably need 2-3 sessions. Pros: if it works you will start to feel better in just a few days, and you only have to get a few 2-4 hour treatments a year. Cons: hard to get insurance to pay for it, SSRI are cheaper. https://www.health.harvard.edu/blo…

Fortunately there are compounded racemic ketamine options in a lot of places, whether troches (lozenges) or nasal spray (that's the one I use).

I pay out of pocket fully, and it's $60/month.

Clearly YMMV, but worth looking into if the infusions are prohibitively expensive.

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

#158

Post by alienalp »

I think you can try anti-depressant for short term. But before trying antidepressant i suggest you doing a comprehensive check up in case your depression caused by other health issue. If that is not the case and you have persistent major depression despite having every reason to be happy you should research about fasting. If it is too hard for you can try antidepressant for few months to make fasting easier and later stop using antidepressants. By fasting your brain will remember more primitive motivation so you will do without more complex motivations. Depression is pretty normal. When they sterilize cats they live rest of their life in depression. Only way of fixing it stop watching porn and fasting. So your brain will motivate you to have those.

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

#159

Post by SkyPuncher »

dimal wrote: post #106
frankincense wrote: post #56

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…

Sorry, you are very very wrong about this. Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing. Medical professionals only have one tool in their arsenal for depression: antidepressants. So a medical doctor will likely prescribe them, whether that's appropriate or not. Antidepressants are no joke. Sometimes they can help, but they…

> Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide

FWIW, my understanding is this has little to do with the drugs and mostly to do with the recovery process.

In a deep depression, you might have suicidal thoughts, but lack the will to take action on those thoughts (because depression takes away your motivation). As you a person comes out of depression, they tend to recover their motivation before their suicidal thoughts dissipate. This creates a situation where a person with suicidal thoughts now has motivation - which means they have the potential motivation to take action on their suicidal thoughts.

The important nuance of this is anti-depressants don't necessarily make your suicidal thoughts _more_ suicidal. In fact, it's likely, anti-depressants are making your suicidal thoughts _less_ severe. However, they do increase your motivation before they can fully eliminate suicidal thoughts.

I'm not saying you should take an anti-dpressant willy-nilly. It's just BS to be fear mongering like this without considering why this situation happens.

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

#160

Post by ceasesurthinko »

Had generalized anxiety and mild depression since middle school. 10mg Lexapro/escitalopram (SSRI) has done wonders for my anxiety and subsequently helped my depression. I tried CBT alone for some years and it helps a bit but the medication was really what helped me get out of my head and start living life. CBT while on medication was even better which I highly recommend you do both together. I personally didn't have any side effects on Lexapro after the first month. First month was some mild headaches and significantly reduced libido. Remember that millions take Lexapro daily, vast majority without significant issues- of course there's going to be a selection bias online towards exclaiming side effects and negativity. People who are enjoying life aren't posting about their side effects of their medication online. Getting online folks opinion's is great and all but ultimately you just gotta talk to your doc and try it and see for yourself, you can always come off if you hate it, or stay on if it changes your life.

Legal disclaimer: This is not medical advice- just my personal anecdote to encourage you to seek an opinion from a psychiatrist or your primary care doctor and discuss whether medication is/isn't right for you.

Post reply on HN