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

bmj.com

261–270 of 625 posts

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

#261

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.

Yeah, nobody can afford a house.

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

#262
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…

Agree that the system is a bit fucked, in pretty much every country (as far as I can tell). Unless you are involuntarily committed, you won't be put on the drug path if you don't want to. Psychiatric medications like SSRIs are generally awful. What I mean when I say "awful" is that the experience of taking them is awful. You may end up with symptoms that are under control, but you may still experience symptoms, or th…

I would add the caveat that low doses of SSRI do seem to be quite effective for issues like compulsiveness and anxiety without much in the way of negative side-effects.

I'm not sure what the scientific support for this is, but at least anecdotally I know 5+ people who take an low-dose SSRIs and claim it works.

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

#264
post #245

So maybe low serotonin levels are caused by depression? My naive understanding is that these amines play a critical role in our emotional response, social interactions and other complex psyche, so as a consequence, depressed person suffers decline in these functions, as well as a whole higher nervous system suffers regression. I always had a feeling that SSRIs are treating consequence, not the cause. Maybe I'm too na…

As we're dealing in analogies...

Better think the serotonin/ monoamine hypothesis of depression is akin to saying a server load balancing failure is because of "electricity imbalance". Whilst electrons are undeniably involved, the explanation is not useful, and distracts from better truths.

We have such a scarcity of safe and effective tools to probe and influence the human brain. Herein lies the hope that the diseases we invent might be treated neatly by the tools we posses. Yet, given the origin of disease and the tools are sparsely interlinked, it is too often just a fantasy.

Yet to "do nothing" is usually not acceptable and so we persist, and iteration or invention become the next hope.

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

#265

Earlier quoted context omitted.

Sure it does. It's strange to argue that it wouldn't. Kaczynski is a madman, and perhaps the only person in the history of the United States whose quality of life was drastically improved by incarceration in a Supermax prison.

He lived out in the fresh air and sunlight.

So do rats.

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

#266

Earlier quoted context omitted.

You wish to vilify him. That's fine. It's extremely uncomfortable to find that this mathematician was right about something. I respect your feelings. But that doesn't alter the substance of his social critiques.

Sure it does. It's strange to argue that it wouldn't. Kaczynski is a madman, and perhaps the only person in the history of the United States whose quality of life was drastically improved by incarceration in a Supermax prison.

I doubt he would agree with that, just like depression has many forms so does the concept of quality of life

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

#267

Earlier quoted context omitted.

Yeah an unregulated and uncontrolled consumption of a poorly dosed hallucinogenic is totally better than a double-blind study of SSRI/SNRI. I swear, I do not reject the possibility that hallucinogenics can cure depression better than existing meds, but the almost religious enthusiasm for such a poorly studied chemical is deeply concerning. And yes, before you accuse me of being a pharma shill, I know that the lack of…

You do you of course. You can grow your own mushrooms at home fairly easily and then you have more control over quality/contamination etc.

Correct, in theory. However, if you are just starting out growing you won't have the knowledge to assess quality or control contamination.

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

#268
There’s no convincing evidence that discussing medical aspects of mental health is productive on HN. Currently my comment that I’m alive has been downvoted at least half a dozen times because I had the temerity to still be alive, be glad to say so, be grateful for my psychiatric care, and reject that any of that is “suspect”. This isn’t the place to discuss psychiatry. Talk to your doctor.

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

#269

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…

I'm pretty sure I'm hell banned, but forget about all the chemicals of the brain.

Read anything by Irving Kirsch.

He used The Freedom of Information Act to study All the antidepressants studies that were sent to the FDA by the pill pushers, Not just the cherry picked studies, but All.

He found they basically don't work better than Placebo.

Personally, I think the "Happy" drugs have been the biggest con job the American suffering have ever endured. At least we know opioids work--for awhile. Antidepesssnts just make Dr. Wealthy more wealthy.

My hope is most of these wonder drugs are sued into history, along with those mandatory doctor office visits.

Ask yourself this--why do Psychiatrists have the highest rate of suicide if these drugs work?

I'm glad we have residents whom picked an easy speciality upon graduation, but these drugs have such low efficy rates they should be illegal, or over the counter, with the exception of a few. Trazadone can be nasty. A bad reaction is cured by a needle to the middle part of the brain.

Most are easy on the body, but don't do anything besides make an Artist (Medicine is an art, and Psychiatrists are the milking to the bone.) wealthy.

God help our suffering Americans.

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

#270

Earlier quoted context omitted.

I'm puzzled by those who disagree with this statement. How is it surprising that depressing circumstances would lead to depression?

Major depressive disorder isn't the same thing as feeling sad about your job.

That is an incredibly dismissive and reductive argument to make. "Feeling sad about your job" isn't limited to burnt out software engineers with a safety net. It can also apply to, for example, someone stuck in a shitty, low paying job with few, if any, prospects for better employment. The lack of a path to a decent future can, in itself, be incredibly demoralizing, even if your present circumstances might be decent. After all, what's the point in continuing if I can see that it's all downhill from here?
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