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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

#281

Post by Etheryte »

eyelidlessness wrote: post #268

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.

Have you considered that your comment may have been downvoted because you come across unnecessarily hostile, not because of some absurd attack on your person? Similarly, any space is a good space to discuss and spread awareness on mental health — even if only one person finds an idea to help them, whatever their situation may be, it's already a massive positive.

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

#282

Post by emodendroket »

nl wrote: post #277
emodendroket wrote: post #220

Earlier quoted context omitted.

If we change the word "unhappy" to "despairing" does it make sense?

I don't know - it's your argument. If it helps, unhappiness/despair seem like different degrees of the same feeling. Depression is a different feeling. The closest analogy I can think of is that "amused" and "satisfied" are both positive feelings, but they are different and you can't treat the cause the same even if some of the symptoms are similar.

“Exogenous depression” is supposed to be experienced by about a fifth of people at one point or another. What if many persistent cases of depression were actually exogenous? That might be more interesting than parsing the difference between despair, hopelessness, anhedonia, and depression.

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

#283

Post by imtringued »

bawolff wrote: post #198
smolder wrote: post #122

I'm going to go out on a limb and guess the prominence of depression is largely caused by a broken interface with the world at large. The traps created by modern society wherein you struggle for other people's benefit are better designed than ever before. What our social machine procedurally treats as progress is advances in subjugation. Depression may often be an artifact of "efficiency" with respect to extracting v…

> In different terms, maybe we have too many rich people (exploiters) in a situation where it's clearly very foolish to keep growing in number (and productivity) to support them. Maybe we just need to rebalance our economy to make it work better for those currently exploited and endemically depressed people. Don't all those rich people also get depression? I think that rules out a marxist reading here. If you're goin…

People lament their functional redundancy in society. Markus Persson Notch got depression after he became a billionaire. The workers lament their redundancy because they can be replaced and abandoned all the time.

People want to be needed, instead we have become isolated individuals that need no one in particular.

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

#284

Post by imtringued »

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.

Actually there is something worse than a deadend job. Having a job you are financially dependent on but where you aren't assigned any work so you must constantly come up with ways to look busy and productive.

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

#285

Post by heavyset_go »

valec wrote: post #271
heavyset_go wrote: post #249

Earlier quoted context omitted.

To add to this, SSRI onset efficacy corresponds with the downregulation of serotonin receptors in the brain. "Low serotonin" isn't what's being treated or changed, but the number of receptors and their activation rates. SSRIs can reduce emotional lability, which makes sense when you figure that downregulation and increased activation of serotonin receptors is a relatively stable system compared to an unmedicated brai…

i think it corresponds most exactly with the desensitization of dendritic autoreceptors

Yeah, downregulation is one of the last steps in desensitization.

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

#286

Post by paulmilligrams »

tptacek wrote: post #162
carabiner wrote: post #43

Earlier quoted context omitted.

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…

It's a strange mode of persuasion, making arguments about how we should frame psychological dysfunction that quote a man who pooped into a hole in the corner of a shack while in hiding after trying to down a passenger jet.

Quoting the Unabomber was a strange choice considering the main idea isn't unique to him and stands on its own merit:

"Instead of removing the conditions that make people depressed modern society gives them antidepressant drugs."

Examining the social factors that contribute to pathology isn't controversial nor does it downplay the role of drugs in reducing harm.

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

#287

Post by coffee_beqn »

ratww wrote: post #256
Mo3 wrote: post #229

Earlier quoted context omitted.

Funnily enough the one I used to take (Escitalopram) apparently has been found to begin permanently altering brain function after only a few hours of first ingestion. I was pretty happy with it. No pun intended

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

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

#288

Post by imtringued »

tsimionescu wrote: post #221
carabiner wrote: post #43

Earlier quoted context omitted.

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…

It's very funny to describe SSRIs or SNRIs essentially as "happy pills". They are very unpleasant drugs to take, especially in the first month or so when starting to use them, and no one would be using them if they didn't feel there is a serious problem in their lives. Not to mention, depression takes several forms, and not all of them are related to unhappiness. A common form is related to anxiety, with people exper…

>no one would be using them if they didn't feel there is a serious purulente in their lives.

You are playing into the argument, people often don't have a choice to avoid a depression inducing environment, they only have the choice of using drugs or not.

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

#289

Post by _moof »

mathgladiator wrote: post #77
PragmaticPulp wrote: post #58

Earlier quoted context omitted.

Ketamine treatment is interesting, but it's not really a replacement for SSRIs. The anti-depressant effects of Ketamine are unfortunately relatively short-lived. Tolerance also seems to develop to the effects over time. There are some adventurous providers experimenting with frequent ketamine dosing over long periods of time, but the results haven't really been great from what I've seen. Also, a psychedelic experienc…

I'm finding the biggest impact from the psychedelic experience as a spiritual awakening, and the biggest thing I feel is that I'm no longer in the nihilism trap.

I hope it sticks for you. For me it wore off completely after only three weeks.

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

#290

Post by raptorraver »

smolder wrote: post #122

I'm going to go out on a limb and guess the prominence of depression is largely caused by a broken interface with the world at large. The traps created by modern society wherein you struggle for other people's benefit are better designed than ever before. What our social machine procedurally treats as progress is advances in subjugation. Depression may often be an artifact of "efficiency" with respect to extracting v…

I tend to think that our disconnection from the nature causes depression to humans. We have come so far from our natural living conditions that we fall ill to depression and other diseases. Another aspect is the lack of physical work that is very unnatural for us. We sit in cubicles (or at home office nowadays), use our brains and fingers to do work and at best hit the gym few times a week. After which we eat our stomach full and entertain us with things that were invented during last generation. Life certainly is safer and better for us, but it's making us unhappy. We live like medieval royals and like them we suffer mental illnesses (https://en.wikipedia.org/wiki/List_of_mentally_ill_monarchs).
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