“No convincing evidence” that depression is caused by low serotonin levels • Hacker News Board

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

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Post by _yoqn » Wed, Jul 20, 2022, 10:08 PM UTC

s-lambert wrote: post #158

_yoqn wrote: post #65

Earlier quoted context omitted.

Yeah they are probably into some extremely toxic, unnatural things that cause them to secretly hate themselves. I wonder how much shady sexual shenanigans happens in the households of the top 1%? Plenty of drugs, gossip, gluttony, lust, etc. Happiness comes from the overcoming of not unknowable obstacles toward a known goal. It's the journey, not the destination. And the trick is to set another goal once you attained…

>Happiness comes from the overcoming of not unknowable obstacles toward a known goal. It's the journey, not the destination. And the trick is to set another goal once you attained the one you're on. I find this kind of bizarre because you can look around and see how it's obviously not true. Dogs are happy as clams to just socialize with their owners / other dogs and just live. People hustling to always get to the nex…

A. People aren't dogs. We are of a much higher level intelligence and self awareness. That's why psychological studies of rats, or even apes, as human analogs is ludicrous.

B. The happiest people on the planet are extremely ethical, have a good moral compass and have a will to help others. They have goals and attain them. And they especially don't blame their environment for their shortcomings. They find ways to adjust their environment to themselves and not the other way around.

Someone who is content with a simple life is still following that maxim. Their goal is to live each day in relative comfort according to their own standards.

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

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Post by hirvi74 » Wed, Jul 20, 2022, 11:06 PM UTC

sinecure wrote: post #535

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…

Belief dictates reality. This is the fundamental driver behind the common effectiveness of placebo. Which leads to the question, does depression exist as a flaw in the brain? A malfunction? Or is it like a mind virus, that it becomes an inescapable suffering because we are told we are broken and powerless to fight these feelings? If a person is feeling sad, often, and without reason, and you tell them "Sorry, your br…

How would you describe a condition like Bipolar Disorder where the brain swings in both directions? Depression is half of Bipolar, but is the brain broken in this case? What about the manifestation of psychotic features?

Based on my understanding of the condition, typical anti-depressants tend to be a contraindication for Bipolar Disorder (can induce mania), so in some regards it seems like the medications not only work for Bipolar, but they work a little too well.

If depression is not a disease, is Bipolar a disease -- half a disease? I am curious what you think. I do not suffer from BP, but I was misdiagnosed with it at one time (I never had psychotic episodes or anything), and doctors wanted to load me up with medications. Luckily, I refused, and I later found out that wasn't the issue, which caused me to lose a lot of faith in psychology/psychiatry. However, the whole process made me more empathic to those with the disorder.

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

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Post by andrekandre » Wed, Jul 20, 2022, 11:22 PM UTC

actually_a_dog wrote: post #116

missedthecue wrote: post #100

Earlier quoted context omitted.

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.

Now look at what it gets spent on. Specifically, take a closer look at housing, healthcare and higher education. All three of those have risen far, far faster than inflation for many years.

whats really interesting is, while some things like electronics and automobiles etc have been getting cheaper, intangibles like healthcare and education have been increasing in cost... whats the cause?

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

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Post by kemiller » Wed, Jul 20, 2022, 11:40 PM UTC

root_axis wrote: post #518

kemiller wrote: post #478

Earlier quoted context omitted.

I think ADHD causes depression because you get constant negative feedback from (many) teachers & bosses.

IMO, this hypothesis doesn't pass the smell test. One of the defining qualities of clinical depression is that personal success in life does not obviate the symptoms; there are many widely know examples of beloved and successful people being unable to overcome the burden of crushing depression.

Well, first of all, I didn't say it was the only cause for depression; it's a condition that comes in lots of different flavors and this is only one.

Second, to elaborate a bit more, having to constantly manage your brain in order to get it to do what you need can be exhausting. Any success you achieve feels like it's extremely tenuous, and I'd say most AD(H)D people have had an experience of doing well for a while and then everything falling apart. So nothing ever feels safe. The negative feedback you get will tend to reverberate much more loudly in that environment than the positives.

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

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Post by dogcomplex » Thu, Jul 21, 2022, 12:57 AM UTC

smolder wrote: post #248

dogcomplex wrote: post #231

Earlier quoted context omitted.

Gonna attempt to short circuit the "you think WE have it bad? Whatabout 1700s?" argument by adding that the "broken interface" theory may be much more about the patient's perception and confidence of the trap we're in than the actual truth of relative conditions. There also might now be a greater philosophical understanding of the global picture than the average person back in the day. Back then we didn't have an int…

Yes, honestly I regret making the jab at "rich people". It's oversimplifying things. I appreciate your take on this.

Thanks! Yeah you shouldn't feel bad - rich people are a good example, and I would expect them to have a lot more resources to escape depression in general

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

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Post by kerryoco » Thu, Jul 21, 2022, 1:03 AM UTC

harborseal wrote: post #493

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…

Yes, but people are still being told by their psychiatrists that depression is caused by low serotonin levels as if it were an objective fact. Seeing this happen made me lose a lot of trust in the medical profession. Is it like this for all illnesses or just mental ones?

many illnesses are reproducible. you can give people viruses and they do indeed get sick. so i don't think you need to discount the entirety of medicine.

afaik, there is no reproducible causality for depression; we can't induce it. we only measure it's correlations and have % confidence in hypotheses.

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

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Post by hammyhavoc » Thu, Jul 21, 2022, 1:04 AM UTC

wizofaus wrote: post #544

hammyhavoc wrote: post #515

Earlier quoted context omitted.

I dunno about that. I know several doom-and-gloom mongers who seem to get off on sharing the woes of the world in group conversations. As a result, I've barely used Facebook or any kind of social media since the pandemic began. Quite literally, haven't used it this year except to post an interview.

Discuss: HN qualifies as "social media". Why or why not?

Hardly. Profiles are extremely minimal, and it's not much more fleshed out than the average WordPress comment system is. I can't follow people on HN (AFAIK) either.

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

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Post by eggy1 » Thu, Jul 21, 2022, 1:42 AM UTC

carabiner wrote: post #43

walrus01 wrote: post #19

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.

IOW: Are you ready for me to diagnose your totally normal reaction to our shitty society as mental illness so I can get you addicted to mind altering drugs for the rest of your life? https://imgur.com/Jb1mJyx Or as the Unabomber said, "Imagine a society that subjects people to conditions that make them terribly unhappy then gives them the drugs to take away their unhappiness. Science fiction? It is already happening…

This reminds me a lot of Mark Fisher and Capitalist Realism. Obviously if the article is true then who is to say about low serotonin levels, but in any case "It goes without saying that all mental illnesses are neurologically instantiated, but this is nothing about their causation if it is true, for instance, the depression is constituted by low serotonin levels, was still needs to be explained is why particular individuals have low levels of serotonin. This requires a social and political explanation; ... This pathologization these problems - treating them as if they were caused only by chemical imbalances in the individuals neurology and/or by their family background - any question of social systemic causation is ruled out." In essence a liberal worldview is not equipped to deal with mental illness.

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

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Post by sizzle » Thu, Jul 21, 2022, 2:16 AM UTC

hirvi74 wrote: post #533

TurkishPoptart wrote: post #523

Earlier quoted context omitted.

The Andrew Huberman podcast has a great episode on the dynamics of ADHD. The brain does not properly distribute dopamine to where it wants to send it, which challenges your planning/reward matrices.

As much as I love the Huberman podcast, I do feel he spoke outside of his domain a bit too much on that episode in certain sections. Sure, he is far more credentialed than I am, but it's not like he conducted any of the research himself. He is merely spouting off what one could find on PubMed, APA, etc.. While I think mindfulness can be beneficial, the research he cited about just 17 minutes (or whatever arbitrary nu…

There are studies about magnesium supplementation helping with adhd

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

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Post by librarianscott » Thu, Jul 21, 2022, 2:16 AM UTC

ggm wrote: post #76

asveikau wrote: post #67

Earlier quoted context omitted.

> It doesn't make sense to make blanket statements about "the drugs" when psychiatric drugs differ widely in this regard. > I'd be cautious of taking advice from anyone who makes blanket statements about "the drugs". This is bordering on uninformed anti-psychiatry. Yeah, as someone who has been close to people who need antipsychotics, I sometimes feel the anti-antidepressant crowd extrapolates to all psychiatric drug…

I am not anti-antidepressant, or drugs in general. Bipolar people get huge benefit from their medications. And their families! The ones I know also say there are times they miss the emotional highs. It's probably why they (and schizophrenics) go non-compliant.

There are many, many, many pharmacy drugs that can stop suicidal thoughts fast and don't have the track record of the "modern antidepressants". Long, long, long track records. Small dose lithium and lamotrigine come to mind right away. But how they work--nope, not clear. Okay, we'll agree it's not serotonin, how does that help us? Would it help if American doctors could prescribe 3 weeks for a spa holiday like European doctors? Maybe, for low-level depression, but not for suicidal thoughts, that just won't cut it. There is bipolar I and bipolar II and so big differences. Schizophrenia, big difference. But again, knowing that it isn't serotonin, that's nice, now what?