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

bmj.com

321–330 of 625 posts

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

#321

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.

It's not that anti-depressants shouldn't be an available choice.

It's that natural remedies such as psilocybin and LSD which have proven their worth for a very, very long time are still being blocked by you-know-which industry.

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

#322
post #256

Earlier quoted context omitted.

Also a happy customer of that one. It worked great for me even with a low dosage and didn’t otherwise negatively impact anything else.

How long were you on and what made you go off it? Four months in I’m feeling better now but I don’t think I want to take it forever

Not comment OP but I got off recently after about 1.5 years - still very happy :) Although admittedly I did have some infrequent spouts of rebound symptoms for a few weeks, but those were pretty manageable.

Also, kind of happy to be off it right now honestly, heat is something that doesn’t go along well at all with SSRIs.

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

#324
post #306

Earlier quoted context omitted.

> We know that a group of people who suffer from depression have lower serotonin levels when compared to someone who is considered... not depressed. I thought the whole point of the article was that there is no solid evidence of a relationship between serotonin levels and depression?

The article seems to say that lower levels of serotonin is not the /cause/ of the depression. But it doesn't change the fact that most studies seem to conclude that one of the things we can determine in people who suffer from depression is that they have lower levels of serotonin, and in some of those cases SSRIs help. Not all forms of depression are caused by serotonin, and anti-depressants may not always be the sol…

This.

I wonder if a big part of the problem is that depression and other mental illnesses are slightly unusual in that they are categorised based on symptoms rather than underlying biology, which are poorly understood. As a diagnosis it’s about as useful as ‘chest pains’

Maybe (I am not a clinical psychiatrist) there are 1, 10, or 100 very different underlying causes which would indicate different treatment if only they were better understood. But nonetheless the existing classification / ontology is established and will be hard to displace.

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

#325

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.

Doctors aren't some magical people who know everything. They read the same books and studies available to you. They have their own biases, not much time for an individual patient. They often stopped educating themselves once reality of long work hours set in.

Just talk to you doctor might the worst popular advice on the Internet. My experience is the opposite: until you take matters in your own hands, experiment with various treatments and preferably find an open minded doctor who is willing to help you along the way (not only with advice but mainly with providing access to medication) it will not work. It might work if your problem is simple and typical but it won't otherwise.

The reason is obvious: you are likely as smart as your doctor. They might have more experience and general knowledge but they have an hour (if you're very lucky) for you and you have all the time in the world to catch up and figure it out.

Yeah, talk to doctors if you're the kind of person who drifts to homeopathy or other shamanism but please don't solely rely on them when it comes to your health of you have a bit of a brain.

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

#326
post #320

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.

HN is only really great on technical issues. Everything else suffers from Engineer's Disease, where a person who has read half a dozen articles suddenly imagines they know a complete discipline. This thread is a prime example of "my googling trumps your life experience". That said, in countries where pharmaceutical manufacturers are allowed to market prescription medicines, and one was recently convicted for pushing…

I think this 'Engineer's disease' is just what society is now. Everyone thinks they know about everything, because they read something online/have access to google. Everyone is an expert.

You have people arguing very strongly about things they know nothing about and sometimes if you actually know anything about it, it's painful to read just how bad some of the things people are saying, being a logical person, I try to point out what they are saying doesn't make sense, but it's wasted because that person just doubles down on whatever it is that they believe.

The most powerful lesson from noticing this effect and the hardest thing to do, is not actually taking that step back and just not getting involved, it's also in realising that i'm likely doing that too, so it's better to try and step back and approach such comments with a more curious and open mind, rather than one of thinking i'm an expert.

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

#327
The book lost connections is a really good read on this.

It points out the problems in modern society and our lives that lead to depression rather than it just being something that can be solved with a pill.

Things like our lack of connection to meaningful work, our lack of connection to each other and our lack of connection to nature all play a big part.

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

#328

Earlier quoted context omitted.

The idea that a terrible life can cause depression is not the limb he's going out on. It's the idea that somehow depression is caused by being way more exploited than our ancestors in the 1700's who were working on someone else's farms and factories as children is the limb he's going out on.

OK, well, that's an easy rhetorical maneuver but one that can be met with equally facile ripostes, such as "how do you determine that people weren't just as if not more depressed in the 18th Century when the concept was less familiar?" or "perhaps having the gulf between themselves and the wealthy rubbed in their faces every day is what causes the distress, since there can be little sense of exploitation if one is su…

Didn't people in the olden days also see the castles and mansions of the rich on a daily basis?

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

#329

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.

For every successful case as yours, there are many people suffering due to side effects that might include suicide. Therefore, your anecdotal evidence is of limited value, even though - gladly! - your treatment worked for you.

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

#330

Earlier quoted context omitted.

The idea that a terrible life can cause depression is not the limb he's going out on. It's the idea that somehow depression is caused by being way more exploited than our ancestors in the 1700's who were working on someone else's farms and factories as children is the limb he's going out on.

Fair criticism as usual and maybe I should have been more specific, but I didn't say anything about the 1700s or prior specifically. If we talk about trends in the lifespan of people alive today (which represents a huge number of people) the picture is much different.

My grandma (alive today) grew up with no indoor plumbing in the United States. They had to use an outhouse.

> In 1940 nearly half of houses lacked hot piped water, a bathtub or shower, or a flush toilet. Over a third of houses didn't have a flush toilet.

https://www.aceee.org/files/proceedings/2004/data/papers/SS0...

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