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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

#271

Post by valec »

heavyset_go wrote: post #249
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…

To add to this, SSRI onset efficacy corresponds with the downregulation of serotonin receptors in the brain. "Low serotonin" isn't what's being treated or changed, but the number of receptors and their activation rates. SSRIs can reduce emotional lability, which makes sense when you figure that downregulation and increased activation of serotonin receptors is a relatively stable system compared to an unmedicated brai…

i think it corresponds most exactly with the desensitization of dendritic autoreceptors

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

#273

Post by mellavora »

ornornor wrote: post #257
PraetorianGourd wrote: post #244

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.

Ok, so you have some control over quality. I'll also be generous and assume you have good estimate of dosages and/or some way to maintain consistency of dosages (anyone else reading this, the standard advice is to take less than you think you want and wait 45 min or so, then take more if needed to reach planned cruising altitude. This works if you have enough prior experience to calibrate by, otherwise is very difficult).

How do you know which dosage is best for treating depression?

Assuming the best treatment is a series of sessions, how do you know the optimal spacing of sessions, and the optimal dosing per session?

You are correct that the trips should be intentional. Who sets these intentions, which intentions are the most helpful, how do you guide the session along the lines of the intentions (recalling that the session might include full ego death and conviction that both your mind and reality are distinct and permanently broken) and most importantly how do you structure the post-session therapy to integrate the learnings and actually get some personal growth out of this?

Are there age-related differences in this? What is the protocol for a early 20s vs a mid-50s vs 70s/80?

Also, to look at your own advice ("if you have anything else than extreme depression and no other mental health conditions") how do you actively screen for this?

These are concerns which are well addressed within shamanic circles-- so I'm not speaking with the voice of pharma here.

Psychedelics are powerful tools. Like any other power tool, they can be a great help and also fairly risky if not used carefully. Insert your own woodshop analogies here.

And if you are going to use them anyway, without working with someone who knows what they are doing, please please please:

1) start with small doses

2) do some reading BEFORE. Minimal list: Hudson Smith, "Cleansing the Doors of Perception" and James Fadiman The Psychedelic Explorer's Guide: Safe, Therapeutic, and Sacred Journeys

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

#274

Post by nl »

dr_dshiv wrote: post #213
nl wrote: post #193

Earlier quoted context omitted.

Unhappy is dramatically, completely different to depression. I've been both and they don't even feel that similar.

Sadness or distress vs not feeling anything and not having motivation?

Yes, this is roughly in the right area.

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

#275

Post by marincounty »

makeitdouble wrote: post #201
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…

I had the same feedback talking to a few professionals. There is doubt about the exact effect of the prescription and the science behind it, and they regularly have patients that get no clear effect from commonly prescribed treatments. But they also see other patients showing measurable improvement, and trying different prescriptions until finding one that seem to have an effect is a common practice. All in all, this…

No post body was provided.

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

#276

Post by malf »

neuroma wrote: post #264
gloosx wrote: 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 diseas…

“electricity imbalance” may be a myth, but a short electricity “fast” (HYTTIOAOA) is still a useful fix for many problems.

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

#277

Post by nl »

emodendroket wrote: post #220
nl wrote: post #193

Earlier quoted context omitted.

Unhappy is dramatically, completely different to depression. I've been both and they don't even feel that similar.

If we change the word "unhappy" to "despairing" does it make sense?

I don't know - it's your argument.

If it helps, unhappiness/despair seem like different degrees of the same feeling. Depression is a different feeling.

The closest analogy I can think of is that "amused" and "satisfied" are both positive feelings, but they are different and you can't treat the cause the same even if some of the symptoms are similar.

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

#278

Post by padolsey »

mathgladiator wrote: post #247
padolsey wrote: post #237

Earlier quoted context omitted.

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!

So, what I can surmise is that I felt a deep connection to the universe. You _feel_ the ramifications of not only being a part of the universe, but also the part of the universe trying to understand it. I'd say I was an atheist before, but now I feel there is something and that something is curious. It's like consciousness is independent of the universe, and didn't create the universe. Instead, it's trying to figure…

That's beautiful. Thank you.

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

#279

Post by NavinF »

emodendroket wrote: post #220
nl wrote: post #193

Earlier quoted context omitted.

Unhappy is dramatically, completely different to depression. I've been both and they don't even feel that similar.

If we change the word "unhappy" to "despairing" does it make sense?

No
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