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Most people on antidepressants don’t need them

economist.com

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Re: Most people on antidepressants don’t need them

#41

Post by sirsinsalot »

tecleandor wrote: post #33
cameronh90 wrote: post #21

Statements like this need to be worded very carefully. In many people's minds, saying something like "most people don't need antidepressants" quickly becomes "antidepressants are useless". Many people who may benefit from them get scared away. Speaking as someone who has been on/off antidepressants for GAD+OCD for the better part of a decade, I've had countless people tell me that antidepressants are useless and just…

For what we've been reading this last years, it's not like antidepressants are worthless, it's like antidepressants aren't doing what we think are doing. The "depression is lack of serotonin" theories seem to have less and less base every day, but SSRIs don't only act on serotonin (just review their side effects). I've done, mostly, vortioxetine and sertraline. For some of us, some SSRIs or SNRIs work. Some don't. Pr…

Depression, OCD, GAD, ADHD and most other neurological issues stem from complex feedback loops and deficiency in neurotransmitter systems.

They're labels applied to symptoms, not causes.

Like any complex system with feedback loops, sometimes intervention in the loop causes it to rebalance.

Sometimes the loop break is an intervention in serotonin, sometimes dopamine, sometimes GABA.

There is never a silver bullet. But there are bullets that make life manageable enough to break cyclic issues.

Re: Most people on antidepressants don’t need them

#43

Post by sirsinsalot »

Like it or not, you are your neurology. You are your synaptic structure, you are your neurotransmitters.

This trick of conscious self awareness doesn't trump neurology.

You can't meditate out of physical systems malfunctioning any more than you can meditate away a broken leg.

These drugs are like casts for broken bones. Just because you can't see the broken system doesn't make it less physical.

Get a cast. Heal the anatomy. Try and walk again.

Re: Most people on antidepressants don’t need them

#44

Post by KvanteKat »

marginalia_nu wrote: post #12

It can on one hand be argued antidepressants aren't necessary for anyone. You can argue that and be correct. This is because antidepressants don't actually cure depression, but lessen the symptoms and enable severe depression to be cured through behavioral changes. It's a line of reasoning that is technically true but really sort of missing the point. The problem with treating depressed people is to get them to actua…

> The problem with treating depressed people is to get them to actually do the things that will help them. That can be incredibly difficult without medication.

The problem with talking about doing "things that will help them" is that we don't really have a lot of effective clinical interventions. Even the most common interventions (SSRIs, Congnitive Behavioral Therapy, physical exercise, etc.) are not really that effective at treating depression and have little to no effect in large parts of the affected population. That being said, these treatments _do_ work for some people so they should definitely not be dismissed out of hand (although it may in some cases be regression to the mean more than anything else, i.e. if you get better after a while on your own but have undergone treatments of one form or another you may erroneously believe your most recent treatment was effective).

Re: Most people on antidepressants don’t need them

#45

Post by cameronh90 »

tecleandor wrote: post #33
cameronh90 wrote: post #21

Statements like this need to be worded very carefully. In many people's minds, saying something like "most people don't need antidepressants" quickly becomes "antidepressants are useless". Many people who may benefit from them get scared away. Speaking as someone who has been on/off antidepressants for GAD+OCD for the better part of a decade, I've had countless people tell me that antidepressants are useless and just…

For what we've been reading this last years, it's not like antidepressants are worthless, it's like antidepressants aren't doing what we think are doing. The "depression is lack of serotonin" theories seem to have less and less base every day, but SSRIs don't only act on serotonin (just review their side effects). I've done, mostly, vortioxetine and sertraline. For some of us, some SSRIs or SNRIs work. Some don't. Pr…

I completely agree. I believe we have no idea how these drugs work at the moment.

For one, serotonin receptors are _everywhere_, notably the gut, which also has a strong relationship with emotional state. And as you point out, they don't just affect serotonin. Given we have a whole bunch of drugs that attempt to be serotonin selective, but where each one affects different people in different ways, it seems likely to me that the non-serotonin effects are likely significant.

Plus, what's the reason so many of us are anxious, depressed, neurotic, autistic, ADHD, etc. without obvious cause? Why would a huge chunk of the population have a imbalance of brain chemicals?

Ultimately I suspect my GAD/OCD is probably environmental, but environmental in a way that I can't easily identify or fix. Maybe it's the unnatural desk job oriented lifestyle I have, or maybe it's plastics in my blood, processed foods, lack of religion, social media or something else. Or maybe the neurotransmitters just sometimes need a kick up the arse to get them back into proper functioning.

All I really know is sertraline helps me live a normal life, and for that I'm thankful.

Re: Most people on antidepressants don’t need them

#46

Post by Fradow »

cameronh90 wrote: post #21

Statements like this need to be worded very carefully. In many people's minds, saying something like "most people don't need antidepressants" quickly becomes "antidepressants are useless". Many people who may benefit from them get scared away. Speaking as someone who has been on/off antidepressants for GAD+OCD for the better part of a decade, I've had countless people tell me that antidepressants are useless and just…

Another +1 for Sertraline. It worked wonder for me after 2 years of depression (classified as mild to severe using some clinical test).

I've been taking it for 4 months, and since my life has gotten back to normal my doctor has advised tapering off of it, starting today. We'll see how it goes.

I thought it was standard procedure to advise trying tapering off if your life got back to normal, and see how it goes (at least that's how my doctor presented it). I guess that's not a worldwide standard though.

Re: Most people on antidepressants don’t need them

#47

Post by ykonstant »

aa-jv wrote: post #32
cameronh90 wrote: post #21

Statements like this need to be worded very carefully. In many people's minds, saying something like "most people don't need antidepressants" quickly becomes "antidepressants are useless". Many people who may benefit from them get scared away. Speaking as someone who has been on/off antidepressants for GAD+OCD for the better part of a decade, I've had countless people tell me that antidepressants are useless and just…

Quoted post unavailable.

Your comment is execrable.

Re: Most people on antidepressants don’t need them

#48

Post by jansan »

broken_glass wrote: post #29
jansan wrote: post #20

I was about to write that there clearly are huge differences betwween the US and the rest of the world, but it seems some European countries have caught up with the US, especially Iceland, with more than 140 daily doses per 1000 adults [1]. Interestingly Iceland frequently has one of the top positions in the world happiness report [2]. [1] https://en.wikipedia.org/wiki/List_of_countries_by_antidepre... [2] https://en…

Aren't areas near North Pole dealing with more seasonal depression due to lack of light in winter months?

It seems so. I wonder how much can be compensated with Vitamin D supplements or light therapy.

Re: Most people on antidepressants don’t need them

#49

Post by mrweasel »

broken_glass wrote: post #29
jansan wrote: post #20

I was about to write that there clearly are huge differences betwween the US and the rest of the world, but it seems some European countries have caught up with the US, especially Iceland, with more than 140 daily doses per 1000 adults [1]. Interestingly Iceland frequently has one of the top positions in the world happiness report [2]. [1] https://en.wikipedia.org/wiki/List_of_countries_by_antidepre... [2] https://en…

Aren't areas near North Pole dealing with more seasonal depression due to lack of light in winter months?

Given that the lack of light can cause depression, it would be more prevalent the further North (or South) you go as the conditions aren't present at the equator. What would be interesting to know is if people who live in the more Northern regions are more resistant to seasonal depressions, compared to some one from Southern Europe or the Middle East.

Re: Most people on antidepressants don’t need them

#50

Post by gilded-lilly »

I’m someone who has dealt with mental health issues over the course of my life.

The main causes are the following:

1) Illicit drug use. 2) Stress/anxiety/fear/grief

The answer is to accept the hard truths and understand what is the root cause of your depression. Is it lack of friends and family? Lack of hope for the future? Lack of enjoyment in things that previously made you happy? Belief that somehow success/truth comes at the expense of enjoyment of life (“ignorance is bliss”). Is it past trauma? A job/relationship you hate? Body/health issues? Aging? Feeling like you’ve achieved all your dreams but you’re more unhappy than ever? Bullying? Feeling unsatisfied? Unfulfilled? Shame about past behaviors?

All of these problems have solutions. Figure out what is at the core of your problem, and then treat it. Every problem is different.

For me, I realized I was harboring an incredible amount of pent up rage and resentment. The rage was so deep that it was all I could think about. Then I realized, I had to forgive the people who’d wronged me. And forgive them I did. I genuinely forgave them, in my own mind. And just like that, all my happiness came back to me. Suddenly I was free.

Also, I believe that almost all of our problems can be traced back to fear. So stop worrying. It’s a waste of energy.

There are some mental health issues that do require hospitalization and a short stint of medication to get people back on their feet and able to function. But I don’t believe in long term medication. Drugs are not the answer.

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