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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

#181

Post by techdragon »

JamesBarney wrote: post #163
techdragon wrote: post #140

Earlier quoted context omitted.

Or like many practicing medical professionals in many specialties where the patient demand is high enough to fill their week ... they don't have time to keep abreast of current research in their field and since they aren't required to, they just don't. There is usually some required ongoing professional development but that is in no way designed to ensure they keep up with current research consensus, more that they d…

This psychiatrist is either an lazy, an idiot or using shorthand. Anyone who spent even in a couple hours reading about depression (one of the most common ailments) in the last decade knows that low serotonin is not the cause of depression.

I’d agree with your assessment. It was just an opportune time to mention that they may not be familiar with recent research results. But you’re absolutely right, they should know this one.

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

#182

Post by klodolph »

patmorgan23 wrote: post #11
nvrspyx wrote: post #6

Earlier quoted context omitted.

My guess, without digging into the study itself since I'm on mobile, is that there is no singular cause for depression. Rather, depression is simply a symptom of a wide range of causes, with one possible cause being low serotonin (or a reduced sensitivity to it). Or even, low serotonin is a symptom of the depression. Not all patients with depression find relief from SSRIs, or medications in general, but some certainl…

It could even be that increasing serotonin is helps improve the patients mood and break thought patterns/cycles than kept them in their depression.

The mechanism of SSRIs is not well-described as "increase serotonin".

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

#183

Post by emodendroket »

tptacek wrote: post #178
emodendroket wrote: post #171

Earlier quoted context omitted.

How would you "medically disprove" the notion that some people are unhappy because the circumstances of their lives are bad rather than biological defects?

Nobody needs to disprove the notion that some people are happy for reasons having nothing to do with clinical depression.

OK. And the notion that psychiatry has been used to simply stamp anyone agitating for political change as insane is also attested (see https://en.wikipedia.org/wiki/The_Protest_Psychosis for instance). So what's your objection to this line of inquiry?

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

#184

Post by refurb »

chx wrote: post #104
refurb wrote: post #96

Earlier quoted context omitted.

There's no such thing as good / bad cholesterol. This is untrue. There is lots of data to suggest elevated LDL is a risk of cardiovascular disease and that high HDL lower risk. Pfizer's drug failed because of safety issues, not because "There's no such thing as good / bad cholesterol".

> there is lots of data to suggest elevated LDL is a risk of cardiovascular disease Elevated LDL is a symptom of inflammation. It is not a cause and lowering it doesn't help. The research mixed up cause vs correlation.

I love reading medical advice on HN.

Genetic errors which cause high LDL levels result in significant cardiovascular disease. It's a very strong cause and effect.

I won't argue that inflammation doesn't play some role (it seems to play a role in many diseases), but I wouldn't dismiss current medical opinion on LDL.

https://en.wikipedia.org/wiki/Familial_hypercholesterolemia

Familial hypercholesterolemia (FH) is a genetic disorder characterized by high cholesterol levels, specifically very high levels of low-density lipoprotein (LDL cholesterol), in the blood and early cardiovascular disease.

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

#185

Post by biohacker85 »

eyelidlessness wrote: post #127
tuxie_ wrote: post #75

Earlier quoted context omitted.

Don't take it personal. Both things can be true, you can have adhd and adhd can be overdiagnosed, doesn't mean that none of those diagnostics are valid. I'm sure you must be tired of people telling you about how overdiagnosed adhd is, I'm sorry about that, but don't take it personal, it's just a person on the internet.

> Don't take it personal Oh I take it personally. I’m alive today because I sought diagnosis and treatment. I very nearly wasn’t alive from the consequences of being undiagnosed and untreated. I very probably would be dead today if I had taken this “just person on the internet” more seriously than I already had. I’m more than tired of people offering their ignorant opinions about stuff they don’t understand.

No post body was provided.

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

#186

Post by wpietri »

eyelidlessness wrote: post #127
tuxie_ wrote: post #75

Earlier quoted context omitted.

Don't take it personal. Both things can be true, you can have adhd and adhd can be overdiagnosed, doesn't mean that none of those diagnostics are valid. I'm sure you must be tired of people telling you about how overdiagnosed adhd is, I'm sorry about that, but don't take it personal, it's just a person on the internet.

> Don't take it personal Oh I take it personally. I’m alive today because I sought diagnosis and treatment. I very nearly wasn’t alive from the consequences of being undiagnosed and untreated. I very probably would be dead today if I had taken this “just person on the internet” more seriously than I already had. I’m more than tired of people offering their ignorant opinions about stuff they don’t understand.

I see people downvoting this and I think that's a mistake. There's a fair bit of stigma for all sorts of mental health treatment, and I think that's a reasonable thing to be angry about. It's possible that some people are over-treated and also that some people are under-treated. People who have suffered from either end of that are allowed to be angry about their suffering.

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

#187

Post by tptacek »

emodendroket wrote: post #183
tptacek wrote: post #178

Earlier quoted context omitted.

Nobody needs to disprove the notion that some people are happy for reasons having nothing to do with clinical depression.

OK. And the notion that psychiatry has been used to simply stamp anyone agitating for political change as insane is also attested (see https://en.wikipedia.org/wiki/The_Protest_Psychosis for instance). So what's your objection to this line of inquiry?

I don't know what you're trying to argue here, but it doesn't seem to have anything to do with the claim at the root of the thread, and I apologize but I'm not interested in the tangent.

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

#188

Post by kortex »

frazbin wrote: post #73
biophysboy wrote: post #25

Earlier quoted context omitted.

Depression has no common cause or common set of symptoms. I read a paper that likened it to a watershed, with tributaries feeding into a general pool of malaise. The watershed varies from person to person, and affects their internal “ecosystem” differently. Maybe it’s a bit cute, but with this understanding, I think the headline is not shocking. We will never find the one cause of depression because there isn’t one.…

The test to see how depressed a lab mouse is, is to put it in a bucket of water and see how long it struggles. True story.

One of them is, yes. There are several, and basically all of them are some variant of "how resistant to giving into despair are you? (as a rat)". Forced swim, tail suspension, light/dark exploration activity. Kinda dark, but this research saves lives, and depression is notoriously hard to study objectively.

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

#189

Post by emodendroket »

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.

Plenty of people are very unhealthy despite ample access to fluids. Nevertheless, it is very difficult to be healthy if you don't have enough water.

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

#190

Post by ggm »

tptacek wrote: post #159
ggm wrote: post #60

Earlier quoted context omitted.

I think the gap between GPs, Psychologists and Psychiatrists lies at the heart of this. GPs can (and do) prescribe psychoactive drugs. What they do subsequently is subject to the constraints of the health economics which apply: In the UK (I am told) the delay to be seen by anyone other than your GP can be measured in YEARS because of the backlog in patents presenting. Many of these patients are young people. The GP h…

This is for the most part a thread about SSRIs. Xanax is a benzodiazapine. There are no controversies on this thread, or really any ordinary place, about the dangers of benzodiazapines; they're scary drugs.

To stick to SSRI's I know one person who reacted badly to a change of meds, predicated on her personal dislike of the effects of the prior, but finding the replacement had extremely strong negative effect. I think had she been absent any support, this could have ended tragically, the effect was so strong and so sudden.

This, coupled with the emerging reports of longterm sexual dysfunction in young women, I think represent pretty severe concerns. Obviously anecdata is not science, but this is what informs my own sense of place here. I am not anti drug in the wider sense. I think drugs of all kinds have been and are and will be beneficial. I am concerned with how SSRIs are being used in practice, with what longterm consequences, and short-term risks.

There's a strong vibe of "butt out, stick to your knowledge" in responses to my posting here. I will take that advice. I'm off-piste, this isn't my area of work.

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