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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

#461

Earlier quoted context omitted.

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.

Are you saying God likes to yeet buggy unmaintainable spaghetti code directly into production?

Hmm. We really ARE created in his image - at least I am.

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

#462

Earlier quoted context omitted.

> 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.

I don't understand this need to make everything white or black, unless we want to pretend we live in a word as simple as a kids' novel. You can't just throw away milleniums of history and people because in the past 60 years we have become too lazy and addicted to modern convenience.

No, preindustrial ages weren't the hell they're made to be nor a golden age by any means. The same can be said of today. Stop playing defensive and think openly instead, there's lot we can improve by learning from the past.

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

#463

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…

I have a friend that's convinced that her ADHD 'causes depression' because her brain does not produce 'enough dopamine'. I'm noticing more and more among my peers a mythology around brain chemicals that's about as accurate as the four humors but with a scientific-sounding veneer. All brain function (and thus all bodily function, because the brain is the whole person /s) can be traced back to the presence or absence of a nominal amount of certain chemicals.

I wonder how the popular understanding of these processes will evolve as more and more is discovered and understood.

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

#465

Earlier quoted context omitted.

> 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 hi…

To be clear: The serotonin deficiency hypothesis has been floated for a long time as one of the possible underlying changes involved in depression etiology. It’s not even a stretch, given that we can find upregulations of the serotonin transporter in response to chronic unpredictable mild stress, the fact that 5-HTP (serotonin precursors) supplementation can boost mood, and the fact that many drugs of abuse operate t…

I've tried lots of natural anti-depressant remedies. Background: I've suffered with major depression my entire life with frequent suicidal ideation and several near-suicides. It's fairly seasonal and wile it happens throughout the year the worst time is in the winter near the solstice. I've also struggled with difficulty falling asleep since very young childhood, though that has gotten somewhat better with age (over 50 now).

** warning ** If you are on any prescription anti-depressants, don't stop taking them or modify your routine without talking to your doctor first.

5-HTP: nasty side effects from unwanted metabolism in the gut and excess serotonin levels in the brain that border on serotonin syndrome sometimes. After the initial 8 hours or so of bad side effects the anti-depressant effects last for about two days followed by a very hard crash on day 3. During the 2 "good" days the quality of the effect is a bit "off" and gives me an unusually "comfortable feeling" that is while much better than depression is not the most productive or normal feeling (see melatonin below for contrast). Be extremely careful with 5-HTP, serious serotonin syndrome can easily develop, especially if you are on other anti-depressants and can be fatal. I don't take 5-HTP anymore because of these side effects and better options (below).

THC: Very effective during use (edibles = 4-6 hours), but tolerance levels build requiring higher doses. mild anti-depressant effects trail off gradually after day or two and quality is generally good. Of course cannabis has some side effects: short term memory impairment, general slight cognitive reduction but I have found these side effects can be virtually eliminated with L-Dopa (see below)

L-Dopa: Taken with vitamin B-6, this is one of the few things I have found that enhances the cannabis experience rather than taking away from it. This increases dopamine levels in the brain which enhances the high and for me also seems to miraculously eliminate the side effects of cannabis (maybe this is due to offsetting dopamine depletion by THC?). I have also found that L-Dopa even seems to increase general cognitive functioning beyond undoing the effects of THC (maybe reversing age related degredation? It makes my brain feel like it did when I was 18). L-Dopa does have serious side effects however: It dramatically and seriously increases anxiety/paranoia for several hours so I only take it with cannabis edibles and even then not every time, no more than once per week. It's very important to know how to manage paranoia since THC also frequently triggers paranoia and the L-Dopa seems to amplify that. My method is to consciously and affirmatively "acknowledge and disregard" any paranoid or anxiety related thoughts. I have found that once I consciously identify and acknowledge certain thoughts are caused by the drugs/supplements and are not real (or as important as they seem), they disappear and everything is ok.

Melatonin: This is by far the best anti-depressant I have ever used. Essentially no side effects other than putting you to sleep 30 mins after use, which when taken before bed is a huge plus (I have had difficulty falling asleep my entire life). Anti-depressant effects last for a few days, gradually trailing off without the hard crash of 5-HTP. The quality of the effect is also excellent (much better than 5-HTP). The best way I can describe it is "feeling healthy, energetic yet relaxed, and normal" most of the time. It's like a miracle drug, at least for me. I take 5mg every 3-4 days as needed.

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

#466

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…

>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.

This for me doesn't seem logical. It could be that a long term imbalance makes you depressed, and reverting that imbalance takes time to affect the thought processes towards the positive. Only because the reaction is delayed, it doesn't mean it's not causal.

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

#467

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…

This is called nostalgia.

History was not neater, nor more uniform. The typical departure point in 1950s conformism, with the assumption that prior history must have been even more conformist.

But that's not how most of history treated gender roles, marriage, work, etc.

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

#468

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…

My theory is that depression is situational and doing things changes our situation, hopefully to one that is less depressing. Thinking about things isn’t very helpful if you don’t actually do anything. Medications can help people think less and do more, and do seem to be one of many correlates of depression.

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

#469

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…

> 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.

This is not a new theory. It's called negative self talk, and fixing that is one of the core approaches in treatment of anxiety and depression.

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

#470

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…

I have a friend that's convinced that her ADHD 'causes depression' because her brain does not produce 'enough dopamine'. I'm noticing more and more among my peers a mythology around brain chemicals that's about as accurate as the four humors but with a scientific-sounding veneer. All brain function (and thus all bodily function, because the brain is the whole person /s) can be traced back to the presence or absence o…

This is like the right/left brain generalization that everyone seems to still believe in.
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