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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

#231

Post by dogcomplex »

smolder wrote: post #122

I'm going to go out on a limb and guess the prominence of depression is largely caused by a broken interface with the world at large. The traps created by modern society wherein you struggle for other people's benefit are better designed than ever before. What our social machine procedurally treats as progress is advances in subjugation. Depression may often be an artifact of "efficiency" with respect to extracting v…

Gonna attempt to short circuit the "you think WE have it bad? Whatabout 1700s?" argument by adding that the "broken interface" theory may be much more about the patient's perception and confidence of the trap we're in than the actual truth of relative conditions. There also might now be a greater philosophical understanding of the global picture than the average person back in the day. Back then we didn't have an internet to give us rigorous detail on both the widespread extent the human race is trapped in a broken system and the futility of the common man's attempts to change it. Even if this wasn't true (I'm hard pressed to find a more optimistic take, though I'm always searching and fighting for it - technology is the best hope imo), it is an easy perception to fall into, especially for anyone already a few steps into depression. It's a reasonable bet that even if people in the past were just as likely to get beaten down and depressed about their own lives, they still might have been able to look at the world around them and the future of humanity and see optimism and hope that the next day might be better/luckier. The world was also much more malleable at the local level - both politically and individually (i.e. go outside and chop a tree down) and less of a complex leviathan of laws and exploitations which immediately instills a feeling of being trapped in the jaws of something that you can't even explain or understand.

Alternatively - or just, adjacently - with the internet (and big business, and widespread university education) we are culture-shocking vastly more people into a medium that can barely be understood from a detached intellectual and philosophical perspective, and is almost impossible to fathom from historical, traditional, ancestral or biological ways of understanding (the way humans operated for vast majority of our existence). We have little history to compare this new way of life to, and it's unsurprising if it's doomed to breed mental disease by its very nature. We have awakened far more people to an absurd reality, and "what is meaning?" is no longer just a question for a tiny group of overintellectual philosophers. Some of those philosophers say that one must walk through the valley of the shadow of death before we can find that answer for ourselves - but even they're gonna admit that a whole lot of people are gonna get stuck in that valley for a while if you just throw the masses in like we have. Hopefully that's just a temporary growing pain of our society as we gather our strength and do better but - time will tell!

(P.S. rich people are just as trapped in this malaise of meaninglessness. They have more agency, sure, but they're also still part of the systemic trap and unlikely to have much better answer on how to change anything than the common man. Only so long even a rich person can hide in hedonism before the depression catches up - or they just embrace the cold reality and adopt the "I got mine" attitude which said system is naturally inclined to. Depression may very well be due to our moralistic social being nature chafing with a cruel capitalist system which has won by almost every measure possible)

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

#232

Post by can16358p »

ornornor wrote: post #223

When you look into the studies for antidepressants, the track record is abysmal. They’re not innocuous, trigger serious side effects, some are hard to quit, but more importantly they only make a difference in people with extremely severe depression. And doctors often downplay or don’t mention side effects honestly because they don’t want patients to not take them. The studies justifying antidepressants as effective t…

Any links to the Reddit threads if handy? I'm interested for personal issues and Reddit always comes much more useful than actual psychiatry in my case (not sarcasm, I frankly mean it).

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

#233

Post by carabiner »

tsimionescu wrote: post #221
carabiner wrote: post #43

Earlier quoted context omitted.

IOW: Are you ready for me to diagnose your totally normal reaction to our shitty society as mental illness so I can get you addicted to mind altering drugs for the rest of your life? https://imgur.com/Jb1mJyx Or as the Unabomber said, "Imagine a society that subjects people to conditions that make them terribly unhappy then gives them the drugs to take away their unhappiness. Science fiction? It is already happening…

It's very funny to describe SSRIs or SNRIs essentially as "happy pills". They are very unpleasant drugs to take, especially in the first month or so when starting to use them, and no one would be using them if they didn't feel there is a serious problem in their lives. Not to mention, depression takes several forms, and not all of them are related to unhappiness. A common form is related to anxiety, with people exper…

Would you rather be safe in prison for 100 years, or free in a world for 1 day where you could die?

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

#234

Post by telchior »

bowsamic wrote: post #212
sigg3 wrote: post #208

Earlier quoted context omitted.

Tom Cruise is a leading member in the fascist cult Church of Scientology, who is on record saying they can bring back people from the dead and levitate.

And? People also listen to Buddhists about depression, and Buddhists believe that enlightened people can fly! EDIT: I'm rate limited so I can't reply to the child comments: I think a majority of Buddhists believe that Buddhas and bodhisattvas have special powers. It is in a majority of the traditional scriptures, from both Mahayana and before. I don't think the authoritarian nature of scientology changes the situatio…

"Buddhists" represents many sects, and many more individuals who aren't beholden to anyone. The majority of these assuredly don't believe anyone can fly, enlightened or not.

Scientology is a rigidly hierarchical, authoritarian cult that speaks with a single voice: that of a handful of leaders.

There is a slight difference between these two things.

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

#235

Post by neonate »

ok_dad wrote: post #216
bowsamic wrote: post #212

Earlier quoted context omitted.

And? People also listen to Buddhists about depression, and Buddhists believe that enlightened people can fly! EDIT: I'm rate limited so I can't reply to the child comments: I think a majority of Buddhists believe that Buddhas and bodhisattvas have special powers. It is in a majority of the traditional scriptures, from both Mahayana and before. I don't think the authoritarian nature of scientology changes the situatio…

What do Buddhists have to do with Tom Cruise? Is he a leading member of a Buddhist organization?

I assume bowsamic's point is that people can be wrong about some things and right about others.

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

#237

Post by padolsey »

mathgladiator wrote: post #77
PragmaticPulp wrote: post #58

Earlier quoted context omitted.

Ketamine treatment is interesting, but it's not really a replacement for SSRIs. The anti-depressant effects of Ketamine are unfortunately relatively short-lived. Tolerance also seems to develop to the effects over time. There are some adventurous providers experimenting with frequent ketamine dosing over long periods of time, but the results haven't really been great from what I've seen. Also, a psychedelic experienc…

I'm finding the biggest impact from the psychedelic experience as a spiritual awakening, and the biggest thing I feel is that I'm no longer in the nihilism trap.

Can you articulate how your brain allowed you to escape from that trap? Did K affect you on some low-level inarticulable level? Sincerely curious. Nihilism is a struggle for me!

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

#238

Post by jmcgough »

ggm wrote: post #23

My psychologist tells me that in his profession there is a significant gulf emerging between the ones who feel the prescribing is justified, and the ones (like him) with significant concerns: 1. they prescribe both boosters, and inhibitors, to treat the same symptoms. This suggests the aetiology of disease here, is not well defined by a single behaviour because the same symptom (depression, anxiety) is responsive in…

> they prescribe both boosters, and inhibitors, to treat the same symptoms

So here's the interesting thing - there's evidence that 5-HT2a receptors are way too dense in people with depression. Antagonists obviously have a blocking effect, but increasing serotonin at the synapse counterintuitively has a similar effect - your body responds to it by paradoxically downregulating 5-HT2a receptors. Two totally opposite approaches with a similar outcome.

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

#239

Post by padolsey »

sidcool wrote: post #222

I am torn between two schools of thought on depression and anxiety. Some say it is a purely biochemical issue. Others say it's more of a psychological one and can be addressed with therapy and exercise alone.

Why not both? We always seem to try to dichotomize and categorize incredibly complex systems for some reason. Surely there are many components to the symptom clusters of depression and anxiety. Life circumstances can matter, exercise can matter, neurological dispositions can matter. All at once.

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

#240

Post by tsimionescu »

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…

> Unfortunately, the pop-culture misunderstandings about "low serotonin" can mislead a lot of people into thinking that research like this debunks SSRIs. It doesn't. As I said above, we've known for decades that something else is going on. This isn't actually a surprise to anyone in the field.

The article itself quotes one of the authors of the study, who is attending medical school in psychiatry, as starting that his training explicitly made this claim, that his textbooks make this claim, and that he himself was later passing it down to other students.

Other sources quoted by the news article are similar to your own claims. Overall, it sounds like there are camps in psychiatry that have indeed long abandoned this theory, but others who still hold onto it.

Furthermore, the meta analysis being talked about in the article does make the additional claim that SSRIs are perhaps not necessary for the treatment of depression. I don't believe they are right, but it's also misleading to suggest that theur research is entirely in line with psychiatric orthodoxy.

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