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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?

#261
This will get buried but as far as ssris having "really bad side-effects for most people that take them", I think thats not true. I see lots of people on SSRIs, most deny having any side effects, some have minor side effects that tend to resolve with discontinuation, rarely do I see a "really bad" or persistent side effect.

It's like plane crashes, rare events get lots of focus and thus some people are terrified of flying, but really it's quite safe.

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

#262
I've been on an off anti-depressants for about 10 years, and every time I go off it's pretty difficult.

So for me, it's a combination of things that work, the bare minimum being a low-dose of an anti-depressant. At my worst states, this is usually enough to lift me up to take care of my other basic needs like exercising, eating right, sleep, etc.

Once I'm at this point, therapy usually changes from crisis mode, to more exploration into what I want out of life, so out of the basic needs from maslow's hierarchy and into the psychological needs. Now, I haven't come to this realization on my own, but through years of therapy (and now multiple therapists).

I'd recommend sticking with therapy, and if you don't find your current therapist or their style to be meeting your needs, try investigating other therapists or therapeutic modalities.

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

#263
post #181
post #168

Earlier quoted context omitted.

> Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing. And you think a random stranger knows any better? I know firsthand that the medical profession has serious limitations in its understanding of and ability to treat depression, but no way in hell am I taking some rando's advice over that of any of the many doctor's I've seen.

That makes no sense to me, if you're trying to deal with mental health problems and struggling you're going to be looking for new ideas from any source. Doctors are good at giving garden-variety medical advice that's validated by studies, but there's so many other ideas out there that they're not going to know about. Their background gives them expertise on what medicine says about mental health, not about the human…

> Doctors are good at giving garden-variety medical advice that's validated by studies

I've found they're more often than not ignorant of the latest studies, as well. Doctors are put on a pedestal in our society that very few of them deserve. A solid 2/3s of the ones I've seen are over-confident, dismissive, and often peddling out of date information. The rare ones that truly focus on their field and put their patients above their egos are difficult to find and even harder to get to with average US insurance.

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

#264

Earlier quoted context omitted.

> 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 depre…

In the beginning of SSRI consumption, it causes initial 5HT2C upregulation and activation, which can directly cause feelings of anxiety, dread, hopelessness, and restlessness/akathisia[1]. Over time, however, the body down regulates 5HT2C in response to its activation, and those symptoms tend to dissipate. In a way, yes, there can be feelings induced that can provide the motivation and energy to go through with suici…

I didnt find any info on 5HT2C in the linked source above, not saying what you've said isn't true, just that I was interested and didn't find much info.

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

#266
post #129

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…

This is really weird advice. Yea it's mainstream and to be expected under legaleeze circumstances. But it's not the kind of advice I would give to a friend whom I'm genuinely concerned about. Have you known anyone who was depressed and managed to get better by following the advice of a generic "profressional"? I haven't. Quite the opposite. I've seen people get worse in one dimension or another by taking medication o…

I would wager you know many people who have gotten better after seeing a "professional". Mental health isn't often discussed openly so you would probably be shocked at how many high functioning people are on SSRIs (doctors, lawyers, engineers, etc).

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

#267

Earlier quoted context omitted.

50% of doctors are by definition below the average. In reality, roughly 3-10% are good, the rest just go by standard guidelines only and/or punt you off to someone else.

50% are below the median.

Grades are normalized on a gaussian curve.

What's the difference between mean and median in a Gaussian distribution?

Looking forward to your contributions to mathematics.

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

#268
post #260

Earlier quoted context omitted.

> I think the reason you are getting so many "I disagree" responses is because many of us have had awful experiences when it comes to medical professionals and mental health. > I've heard it said that giving antidepressants to a depressed person, without any therapy, is like giving amphetamines to a tired person: yes, they may temporarily cure your "tiredness", but what you really need is to go to sleep. I don't even…

I had a horrible experience with a psychiatrist. Then a great experience with another psychiatrist who managed to get me to function just enough for me to go see a psychologist who not only "cured" me but gave me a superpower of being resilient against life's wraths. So your mileage may vary. To whom might be reading this: don't give up. It sucks but sometimes we get unlucky and need to change doctors.

>superpower of being resilient against life's wraths.

how?

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

#270
post #134

Earlier quoted context omitted.

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)?

Not OP. Fair point, but also "people with the same medication" is not the same as "strangers on the Internet".
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