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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

#421

Post by raducu »

locusofself wrote: post #45

Anecdata, but I was often depressed for most of my adjust life. Around 5-6 years ago (age 33 at the time), I started taking 20mg Citalopram. I have experienced almost no depression since I started taking this medication, I'm far more focused and productive than I have ever been. It could be a factor of age and getting married as well, and just settling into my life. But my depression felt like something out of my con…

It's not just anecdotal evidence, the whole anti-antidepressant hype seems to re-emerge every few years, like a plague. After trying a few different anti-depressant the vast majority of people do improve. And the people bashing antidepressants fail to come up with any proven alternatives.

Is there a conspiracy shutting down depression curing alternatives all around the world?

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

#422

Post by wpietri »

imtringued wrote: post #303
wpietri wrote: post #180

Earlier quoted context omitted.

As somebody who was diagnosed with ADHD in my youth and who has tried various medications, I've reached the point of suspecting that the disease model is just a poor fit here. Does my brain work differently than other people? Yes. Would this have been a problem for me in any pre-industrial society? (Which, to be clear, is most of human history?) I don't think so. Is it a problem for me when I have a fair bit of contr…

I find the idea that we are born defective to be inherently suspect. It is quite illogical but very popular because well adapted people can just talk about superior genes and how everyone else has inferior genes and they can never change anything about that except with extensive medical treatment.

For sure. I've read some really interesting stuff under the "medicalization of deviance" label. A classic example being how homosexuality was treated as a psychological illness because the dominant group saw it as a societal offense.

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

#423

Post by ornornor »

raducu wrote: post #417
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…

The track record is not abysmal: https://slatestarcodex.com/2014/07/07/ssris-much-more-than-y...

> more importantly they only make a difference in people with extremely severe depression

Which your link confirms. And your link also states that antidepressants were oversold, especially to people with mild depression, a level for which antidepressants aren’t particularly good at treating especially in light of the side effects and difficulty to quit.

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

#424

Post by hutzlibu »

Workaccount2 wrote: post #397
nth_order wrote: post #335

Yeah, but thats hardly news, we have known that for decades. Otherwise direct serotonin releasers would be the most useful ADs. But these mostly give people nausea and serotonin syndrome. ADs work mostly by being FIASMAs, reducing inflammation and oxidative stress, increasing neurogenesis and neuroplasticity, increasing the activity of other monoaminergic systems, and the serotonergic portion is mostly explained by d…

Anytime I learn about bodily functions I become more and more aware of how shit it's engineering is. Works amazing, sure, but try and fix or debug anything? Good luck.

Erm, are you aware of any other machine, that is able for self repairing and self replicating in a complex and changing environment?

I really would not call my body bad engineering, just because I do not understand how it works in detail.

Rather the opposite, the more I learn, the more amazed I am, how awesome it all is. The complex interactions of chemical, electrical and physical components. (And who knows, maybe even quantum field elements.)

I could not design anything remotely complex at all.

Also, I debug and fix my body all the time, or rather, my body does this mostly in auto mode.

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

#425

Post by tsol »

pineaux wrote: post #355
fragcula wrote: post #336

> Other clinicians say, however, that the notion of depression being because of a simple chemical imbalance is outmoded anyway, and that antidepressants remain a useful option for patients alongside other approaches including talking therapies. This is the key line in the summary. The concept of attacking an idea no one really believes is really a straw man. More importantly the modern practice of medicine is "eviden…

Most effective treatment for depression = psychedelics. They have been used by shamans for eons for this reason. A lot of modern research into this (including 1000s of research studies from the 50s and 60s) confirms it. It was only because Nixon didn't like the fact that kids were not going to war, that the war on drugs was started.

Not everyone wants to trip in order to feel alright, and not everyone can handle it. Children and the elderly come to mind

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

#426

Post by ThrowawayR2 »

pastacacioepepe wrote: post #364
ThrowawayR2 wrote: post #142

Earlier quoted context omitted.

But when, for the vast majority of history, the population faced a much poorer, more monotonous, and less free existence than what the modern worker faces then you jolly well can.

> the population faced a much poorer, more monotonous, and less free existence That's an over simplification. People could still have more free time than we do now[1], while their life could be more monotonous on some aspect, I believe an average office worker life today can be even more monotonous than what a serf life could be. You also have to consider labor alienation, which is a something that didn't exist so mu…

If there are people today who want to put their money where their mouth is and give up the conveniences of modernity to go back to communal subsistence farming under serf-like conditions (and there are places in the world that still live like that), more power to them. I haven't seen any takers.

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

#427

Post by MrYellowP »

Depression isn't caused by chemical imbalances or whatever other causes outside of ones responsibility. It's caused by ones life. The people one shares his life with, the environment, ones approach towards life itself. When you suffer from depression, you suffer from your existence. Either because it is shit, or because you make it shit and don't know better.

It's amazing how far we've come with ignoring that there are a lot of things well within our control when it comes to mental health, as long as we stop pretending they're not.

I'm not saying that everyone has the chance to change his life. I'm saying that there's too much of a lack of self responsibility in favour of dependence on "luck" and "external factors" which "require" medication, because "there's nothing you can do."

I'm not blaming anyone but myself for my state and I certainly don't try to pretend that it's outside of my control. It isn't. I know that, because I can manage it all by myself, without depending on anything. It doesn't change my life and I'm still working on that, but if i blamed some random ass excuse of a chemical imbalance for something that's actually my own fucking fault, then I'll just stay like this forever.

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

#428

Post by multiplegeorges »

throwawayacc2 wrote: post #413

I have a theory which I can’t substantiate, just anecdotes and conversations I had throughout the years. But, I’m convinced a lot of depression/anxiety stems from thinking too much and that in turn is caused by an ever complex word with looser and looser guidelines or norms. I’m not making judgements weather this is necessarily good or bad but rather observing. In the past, even as recent as the 50s but certainly bef…

> And less thinking meant less depression and anxiety.

That's a pretty big claim. I know you're just putting out your own personal theory and you're not trying to declare you have the "answer", but I don't see how that follows.

A first step is establishing that depression is more prevalent now than in the 50s. You'd have to account for the lack of diagnosis then and find some other indicator of the true rate of depression.

Not an easy task, for sure, but my first thought is that depression just went untreated then and people became resigned to their lot in life and suffered.

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

#429

Post by ComputerCat »

I can't access the full text but this is really interesting. I think with how fast paced all the advancements in the scientific community are it's crucial that things we thought we understood are continuously re-assessed and analyzed.

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

#430

Post by fragcula »

webmobdev wrote: post #375
fragcula wrote: post #336

> Other clinicians say, however, that the notion of depression being because of a simple chemical imbalance is outmoded anyway, and that antidepressants remain a useful option for patients alongside other approaches including talking therapies. This is the key line in the summary. The concept of attacking an idea no one really believes is really a straw man. More importantly the modern practice of medicine is "eviden…

> why not take a look at electroconvulsive therapy ... Yet we have no idea how it works ... Or you can stick with something that has been already been scientifically studied and proven to be as effective as anti-depressants in curing depression - Cognitive Therapy. In fact, it even prevents relapses more than anti-depressants: > Depression is one of the most prevalent and debilitating of the psychiatric disorders. St…

We also don't know who CBT works for what it's worth.

It's also fairly limited in suitability (good luck with someone with catatonic depression trying to get them do a hot cross bun), availability (thankfully online therapies are more common now, but it takes 2 mins a day to take a pill and about an hour per week for CBT), affordability (a year of sertraline will cost less than the initial session of session of CBT can).

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