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“No convincing evidence” that depression is caused by low serotonin levels

bmj.com

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Re: “No convincing evidence” that depression is caused by low serotonin levels

#111

Post by amanaplanacanal »

lettergram wrote: post #80
klodolph wrote: post #38

Earlier quoted context omitted.

Bolts of lightning can be factually wrong, it sounds.

No doubt, but this article is about how the SSRIs don’t seem to be effective. To be clear a disorder (ie depression disorder) can be caused by a variety of factors, including (but not limited to): genetics, environment, trauma, illness, etc. Given that’s the case, some drugs may help ease symptoms (depression being the symptom), but finding and correcting the root cause (if possible) is important. Unfortunately, the…

> this article is about how the SSRIs don’t seem to be effective.

I believe they can be effective in reducing depression, it just has nothing to do with serotonin.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#112

Post by taylorius »

pcmoney wrote: post #33
walrus01 wrote: post #19

I have a completely unscientific, subjective theory that some significant portion of depression in the population as a whole is caused by the economic circumstances that some people live in. Things like being trapped in a dead end job to keep healthcare benefits in the USA, living in a never ending treadmill of debt.

We have it way better than almost any period in history and are profoundly unhappy. Also, we always like to think we will be happy “once I have…X” and then we get X and say well actually what I need is Y. Most unhappiness is driven by vanity and desire (a bargain you make with yourself where you chose to be unhappy until you get something) to be better than our peers. Until you can be content with nothing you wont be…

How are we measuring "better"? If suicide rates have risen significantly, then perhaps there are ways in which our modern paradise is worse than the past.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#113

Post by SamoyedFurFluff »

ggm wrote: post #76
asveikau wrote: post #67

Earlier quoted context omitted.

> It doesn't make sense to make blanket statements about "the drugs" when psychiatric drugs differ widely in this regard. > I'd be cautious of taking advice from anyone who makes blanket statements about "the drugs". This is bordering on uninformed anti-psychiatry. Yeah, as someone who has been close to people who need antipsychotics, I sometimes feel the anti-antidepressant crowd extrapolates to all psychiatric drug…

I am not anti-antidepressant, or drugs in general. Bipolar people get huge benefit from their medications. And their families! The ones I know also say there are times they miss the emotional highs. It's probably why they (and schizophrenics) go non-compliant.

I think you might want to do some research as to why schizophrenics might end up non-compliant. Antipsychotics are serious drugs that, historically, have had severe side effects. Additionally, they’re rarely a complete solution (people can still have delusions and hallucinations while taking medication). Additionally, like other psychiatric medication, not all antipsychotics will work for people, sometimes they’ll stop working, etc.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#114

Post by asdff »

walrus01 wrote: post #19

I have a completely unscientific, subjective theory that some significant portion of depression in the population as a whole is caused by the economic circumstances that some people live in. Things like being trapped in a dead end job to keep healthcare benefits in the USA, living in a never ending treadmill of debt.

You don't even have to be broke to be trapped in the stranglehold of modern society and feel like shit about it. Just because you are paid well doesn't mean the work you are doing is remotely engaging or interesting or doesn't want to make you hate yourself. Being rich doesn't insulate you from toxic coworkers, in fact probably the higher you end up marching up the economic ladder the more of these narcissistic and toxic personalities you are liable to run into.

At the end of the day we are probably happiest when we are foraging for berries or mushrooms. This whole abstract 'society' crap we put upon ourselves leads to a lot of self directed scorn, embarassment, disrespect, and no doubt depression. How many billions of calories have been burned to fuel thoughts of worry about an outfit choice around the world? How many grey hairs have sprung up as a result of fretting about appearance? The stress society tries to shovel on you is such a waste of energy and does nothing to help you.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#115

Post by quacked »

_yoqn wrote: post #59
quacked wrote: post #39

Earlier quoted context omitted.

Completely agree with you, although I think that "going outside and taking a multivitamin" is an inadequate substitute for "live inside a prosperous, functional human-shaped society".

It's not society. It actually starts with the individual. In order to have nay kind of decent society, each individual needs to recognize that they are responsible for themselves and their own society. Going outside, exercising and consuming nourishing foods are the literal starting place. Then seek to find things you like doing and become competent in them. Find a good wife or husband. Don't cheat on them. Don't tak…

I completely disagree with that. If you are a westerner with a 50th percentile mind and follow every rule set up for you, you end up on a console for 8-10 hours per day, struggling with bills and health insurance and watching the land and culture around you be slowly eroded into a formless mass of concrete and advertisements.

"Depression" is a natural response to living an alienating modern lifestyle. The people who can appropriately "deal" with it (like myself) all have something extra going for then, like deep family structures or unusual minds.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#116

Post by actually_a_dog »

missedthecue wrote: post #100
walrus01 wrote: post #19

I have a completely unscientific, subjective theory that some significant portion of depression in the population as a whole is caused by the economic circumstances that some people live in. Things like being trapped in a dead end job to keep healthcare benefits in the USA, living in a never ending treadmill of debt.

All quintiles of the US population make more money (inflation adjusted) than they did 20, 40 or 60 years ago. Yet there are more depressives around than ever.

Now look at what it gets spent on. Specifically, take a closer look at housing, healthcare and higher education. All three of those have risen far, far faster than inflation for many years.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#117

Post by cpncrunch »

pddpro wrote: post #106

Anecdote but I always noticed change in sleep patterns after starting antidepressants. Actually, terminal insomnia (you wake up and then are unable to fall asleep) are characteristic of chronic depression. Add to this that SSRI causes increase in sleep hours (maybe even quality?) and then you have a theory about how it might just have been due to lack of sleep after all?

Given the placebo effect is 75% of the effect of antidepressants, and placebos have a large effect on sleep, I would say that the placebo effect is the first thing that should be considered.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#118

Post by mccorrinall »

locusofself wrote: post #45

Anecdata, but I was often depressed for most of my adjust life. Around 5-6 years ago (age 33 at the time), I started taking 20mg Citalopram. I have experienced almost no depression since I started taking this medication, I'm far more focused and productive than I have ever been. It could be a factor of age and getting married as well, and just settling into my life. But my depression felt like something out of my con…

Same here, but with Fluoxetine (Prozac). However, I don’t think exactly that fluoxetine made me less depressed. It only made me more „aggressive“ and more risk taking, and the antidepressing effect came from the positive results of taking such risks. I just „don’t care“ about failures as much as I used to.

E.g. I finally started talking to girls, because I wouldn’t care about rejection that much. => Got into my first relationship and was happy.

Also, I started working on my passion project full time and I recently registered a company for it. Two years ago I would have not thought about doing this, as working for an employer is way „safer“.

But I don’t care about failing anymore.

Re: “No convincing evidence” that depression is caused by low serotonin levels

#119

Post by [deleted] »

sn0w_crash wrote: post #32
walrus01 wrote: post #19

I have a completely unscientific, subjective theory that some significant portion of depression in the population as a whole is caused by the economic circumstances that some people live in. Things like being trapped in a dead end job to keep healthcare benefits in the USA, living in a never ending treadmill of debt.

I know plenty of depressed rich people. I understand your theory but spend a week in the Hampton’s and you’ll see some real sad souls.

[deleted]

Re: “No convincing evidence” that depression is caused by low serotonin levels

#120

Post by dymk »

petesergeant wrote: post #84
PragmaticPulp wrote: post #18

SSRIs raise extra-synaptic serotonin levels within the first hour of taking them. However, their efficacy against depression takes weeks or even months to manifest. We've known this for decades, and as a result the "chemical imbalance" theory of depression hasn't been a real contender in depression research for a long, long time. The key thing to understand is that serotonin levels don't have to be low for SSRIs to i…

> the pop-culture misunderstandings about "low serotonin" Let’s be clear though, I had an actual licensed psychiatrist say this to me last week. It’s not like people are getting this “pop-culture” information via blog articles…

It's possible the psychiatrist is using "low serotonin" as a simple shorthand meant for the layperson
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