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

Turns out most doctors prescribe what is recommended by the professional organization they’re a member or the CDC.

I can’t count the number of times I’ve been at my daughter’s pediatrician’s office and the doctor either hands me a print out of the CDC website or actively googles something in front of me during a visit.

Sometimes I’ll ask her “what do you think about…” and she’ll parrot back “well the American Academy of Pediatrics recommends…”

And guess what? These clowns are fine with it. They jump through ridiculous hoops in school to get cushy high paying jobs, and their professional organizations work very hard to keep any competition out.

My brother just got prescribed anti-depressants this week. All the doctor did was give him the standard DSM “are you depressed” test. His score was barely on the depressed spectrum and so the doctor gave the standard dose. “See you a month from now, call me if you feel like killing yourself.”

No probing questions about why he might be depressed. No questions about past his past experiences with seasonal depression in Michigan where he lives. No other alternative remedies. Just a prescription, next patient please.

These doctors are just very highly credentialed monkies. They have vast knowledge of when to prescribe what and at the recommended dose. But ask them any kind of thought provoking question and inevitably you’ll get “the [trade organization I belong to] recommends…”

When my wife was in labor with my firstborn, the doctor and I were hanging out chatting. I asked him what the machine that printed out the intensity of her contractions was measuring. I kid you not: “well… it measures… it’s like how tight her uterus is… like, the intensity of her contractions.” No doc, what physical phenomenon is it measuring. It sits on her belly. What is it doing? Crickets. Guy couldn’t even tell me what the units were on the chart.

Try it sometime. Ask them a knowledge check question. Something simple, like “why do you administer this vaccine at four months old instead of, say, six months old?” or “what do these SSRIs do to my brain chemistry that helps manage my depression symptoms?” Watch them squirm.

Almost as interesting is the fact that none of them have ever admitted “you know, that’s a great question, I’m not sure, let me go research it and get back with you,” a completely valid answer. The hubris among these folks is something.

I’ll warn you though, if you try this you’re going to lose a lot respect for these medical “professionals”, I guarantee it.

I've had one bout of anxiety that I went on medication for. Normally I have other ways to cope with depressive/anxious times, but in this case, there was nothing to cope with; everything was going well for me by every metric. When it started to seriously interfere with my life, I decided to give SSRIs a try. For the first week, I woke up a few times in the middle of the night, but other than that, I didn't experience any side effects. It addressed my anxiety and I was on them for about 5 months. The side effects could have been quite a bit worse and it still would have been better for my health than the constant anxiety. I know people that have had issues with antidepressants, but nobody I know has ended up completely fried because of them.

Talk to a doctor about what's best for you, but don't write off medication because of the possible (they are not guaranteed) side effects. If you are depressed to the point you are struggling to function in absence of anything actually going wrong in your life, the risks of continuing with that could very well be worse than the side effects of medication.