“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

#591

Post by zasdffaa » Thu, Jul 21, 2022, 1:16 PM UTC

jack_pp wrote: post #589

zasdffaa wrote: post #585

Earlier quoted context omitted.

So your bad experience is data, my ok experience is anecdote and is worth less than yours. Gotcha. 'I had no problem' means that bad problems aren't inevitable, which opposed the totally unqualified 'SEVERE' claim - they aren't always 'SEVERE'. That doesn't discount anyone's experiences when things do go bad as I acknowledged here https://news.ycombinator.com/item?id=32169654 - I'm not dissing anyone's experiences.

You keep missing the point, there's a reason every doctor who prescribes these drugs will also make sure to taper you off because if you suddenly come off them there will be consequences. Now I'm not gonna troll the literature to figure out what the exact numbers are. It's not about you dissing anyone's experience, it is about you ignoring the reality of this issue just because you were lucky.

Yes, they taper you off. This is to prevent the reactions being potentially SEVERE. In some cases they will still be SEVERE (yours), in other cases they won't (mine). I don't dispute that and I never did.

So what are we disagreeing on?

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

#592

Post by Valakas_ » Thu, Jul 21, 2022, 2:03 PM UTC

hirvi74 wrote: post #495

kemiller wrote: post #478

Earlier quoted context omitted.

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

It's true, and I alluded to this more in depth in a comment in this chain. Growing up in the semi-rural South East, USA, where kids didn't get diagnosed with ADHD. (Fun fact -- I had 5 boys who were my childhood friends that grew up with. We all lived within 3 miles of each other, and all of us have ADHD -- something in the water maybe?) I didn't know I had ADHD until I was in a dark dark place in my early 20s after…

Did the ADHD cause CPTSD or the CPTSD that you might already have from childhood neglect/trauma that you're not aware of/dismiss/paint as "not too bad" manifests itself as ADHD?

Distraction from pain is one of the most common ways we deal with pain when it's not possible to escape it (which is the case for children that suffer emotional abuse/neglect).

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

#593

Post by Valakas_ » Thu, Jul 21, 2022, 2:05 PM UTC

hirvi74 wrote: post #541

oasisbob wrote: post #488

Earlier quoted context omitted.

The low-dopamine hypothesis for ADHD is a legitimate idea still being actively studied.

> legitimate idea still being actively studied. Yes, but it is not conclusive. I for one believe there are multiple types of ADHD. Be it lifestyle induced, lead-exposure induced, TBI induced, genetic, etc.. Us humans like to slap labels on things, but life is rarely so cut and dry.

And you forgot maybe the most important, common and often overlooked one: ADHD that is emotional trauma-induced.

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

#594

Post by blep_ » Thu, Jul 21, 2022, 2:12 PM UTC

rustybelt wrote: post #434

Workaccount2 wrote: post #397

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?

That thing where you can't accelerate to the speed of light is obviously a hack around some glitch that happens when you do so.

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

#595

Post by lighttower » Thu, Jul 21, 2022, 2:39 PM UTC

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…

Can you point us to a source for the accepted real physiological effects of ADs that you shared above?

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

#596

Post by Valakas_ » Thu, Jul 21, 2022, 2:41 PM UTC

lettergram wrote: post #30

One of the most interesting things I heard recently that really hit me like a bolt of lightning… Depression is a disease of despair, and all these treatments are really just treating the symptoms. In other words, people experience despair because of some underlying situation - examples: death of child, lonely, broken home. “Normal” things, and we try to treat it with pharmaceuticals. It would be like treating depress…

There's one cause that is really hard to detect (unless you're informed about it) and that I suspect is behind a lot of people with depression. In fact it took me decades, and only by chance did I realise what it was:

Emotional abuse / neglect, especially the one that occurs in childhood.

* You feel something in life is lacking but dont know what, or blame yourself for it, or look for it in in thrill seeking activities, or through buying stuff to fulffill this emptiness, or you escape from this ever present painful feeling with addiction (hint of what that thing is: being really loved, not romantically loved, but actual unconditional love, the one that only healthy parents can give and which you feel in some way when you have a community behind you. Partial love given by a lot of people ends up almost feeling like parental unconditional love.)

* Can't seem to make friends, or make friends but don't seem to connect at a deep level and end up feeling lonely anyway.

* Also the cause of social anxiety.

* Burnouts due to lack of boundaries (which also come from abuse). Feeling like you put others first all the time, and end up feeling somewhat fake.

* (...)

All of these can lead to depression. And they all have the same root-cause. And barely anybody talks about this (unless you go really looking for these communities, but unfortunately they're not really mainstream).

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

#597

Post by gentleman11 » Thu, Jul 21, 2022, 2:56 PM UTC

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…

It seems to work, by definition, but I don’t think this approach qualifies as science. For a theory to be science, there has to be at least some mechanism. This is just statistics.

Again, it works

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

#598

Post by alsetmusic » Thu, Jul 21, 2022, 2:58 PM UTC

kmmlng wrote: post #579

harborseal wrote: post #493

Earlier quoted context omitted.

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?

I don't think it is an isolated incident. Once something has become "known" among the public and the medical profession, it seems quite difficult to update it. Another example is the dietary cholesterol issue. The human body is incredibly complex and we have quite limited tools to study it, so we are bound to arrive at wrong conclusions. That by itself is to be expected, but what does really worry me is this missing…

> It can take decades for quite a substantial update on what we thought we knew to trickle down from academia to practicing medical professionals.

A recent ep of the Trickle Down podcast (premium offshoot of a show that studies conspiratorial thinking, Q Anon Anonymous), discussed how we learned to treat ulcers with antibiotics and then lost that information for something like fifty years. Changing the scientific understanding of their cause had a Greek doctor going to his country’s health ministry over and over and getting rejected despite results. I think you nailed it.

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

#599

Post by hirvi74 » Thu, Jul 21, 2022, 4:26 PM UTC

Valakas_ wrote: post #593

hirvi74 wrote: post #541

Earlier quoted context omitted.

> legitimate idea still being actively studied. Yes, but it is not conclusive. I for one believe there are multiple types of ADHD. Be it lifestyle induced, lead-exposure induced, TBI induced, genetic, etc.. Us humans like to slap labels on things, but life is rarely so cut and dry.

And you forgot maybe the most important, common and often overlooked one: ADHD that is emotional trauma-induced.

Hmmm, I know (C)PTSD can have issues that seem similar to ADHD, but then again, all these disorders are just a collection of symptoms slapped together. Is cyan a hue of blue or a hue of green -- does it even matter?

The only issue I have with emotional trauma-induced ADHD, is that it's very easy to be a chicken vs. egg issue. I have ADHD, and I experienced what I would consider emotional trauma to some degree (often because of ADHD), but which came first? It seems very cyclical to me.

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

#600

Post by hirvi74 » Thu, Jul 21, 2022, 4:28 PM UTC

sizzle wrote: post #569

hirvi74 wrote: post #533

Earlier quoted context omitted.

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

Star Slate Codex (Scott Alexander) wrote that the evidence for such is basically non-existent. Thus such claims remain dubious at best. Though this was many moons ago, and things change. Do you happen to know of any research that supports this?