So does this mean SSRIs don’t work?
“No convincing evidence” that depression is caused by low serotonin levels
481–490 of 625 posts
Re: “No convincing evidence” that depression is caused by low serotonin levels
#482Yeah, 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…
I think a lot of this is about English (and probably most languages) being vary lacking in ways to describe both short-time and long-time mood effects. Talking about a dopamine rush from completing a difficult task or an endorphin rush from sport isn't very accurate, but despite everyone knowing the feeling we never made better words for them.
Similarly "I've low dopamine" is just a modern version of "I have the blues" or "I'm depressed". That's all good, as long as everyone involved knows that it's a short hand, or maybe a double-meaning of the word, not an actual medical description. Just like somebody who is "a little OCD" has none of the symptoms of actual OCD.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#483There’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.
Please don't post offtopic flamewar comments, regardless of how wrong other people are or you feel they are. It just makes everything worse. Also, please don't go on about downvotes. That's in the site guidelines too: https://news.ycombinator.com/newsguidelines.html Edit: I assume you're talking about https://news.ycombinator.com/item?id=32161183 , which was correctly downvoted for being a flamewar comment. Please do…
> Please don't post comments like that or https://news.ycombinator.com/item?id=32161488
This is the one I was referring to. I’ll admit that the first one you linked was not productive, but I’m reasonably sure you’re taking a less charitable interpretation of this one in light of that. As far as what makes “everything” worse, the prevalence of attitudes like those I was challenging are the reason I almost died without treatment. But if they’re politely stated, no harm no foul?
Re: “No convincing evidence” that depression is caused by low serotonin levels
#484Yeah, 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…
> I have a friend that's convinced that her ADHD 'causes depression' because her brain does not produce 'enough dopamine'
Interesting, and she is somewhat right, but is wrong about the 'enough dopamine' part, if I understand correctly. I have heard that dopamine plays a role in ADHD (seems likely our neurotransmitters don't absorb enough, but even that is an overly simplistic explanation of the unknown and true reality).
But yea, I also have ADHD and yes, it can cause depression. Not due to dopamine, but because of the negative feedback-loop ADHD can create.
For example, let's pretend I have some big assignment I need to complete, and I am without access treatment (professional or self-medication). If can't muster the "powers" to work on/finish said assignment, I start to get extremely anxious and/or I get depressed that I failed to finish said assignment. Said anxiety/depression only makes my ADHD symptoms worse which makes the anxiety/depression worse. Thus I will struggle more to complete future work, which only fuels said anxiety/depression even more, and the loop keeps on iterating.
Though, sometimes the anxiety can be extremely helpful. I can muster some insane kind of hyperfocus due to the pressure of a looming deadline. I spent decades of my life relying on anxiety to complete tasks, that even with treatment, it's extremely hard to start and finish tasks without the anxiety.
It's an annoying and rough way to live, but oh well, I am just grateful I do not have something worse.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#485I 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 wonder how many people think they have depression, but are actually simply suffering from despair.
Medication won't help you if you're living paycheck-to-paycheck, dealing with landlords constantly increasing rents while wages are stagnant, worried that getting sick and missing a couple days of work will result in losing your place to live.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#486Earlier 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 heard people say that the serotonin deficiency hypothesis was invented by drug companies rather than academics. Is that true?
Re: “No convincing evidence” that depression is caused by low serotonin levels
#487Earlier quoted context omitted.
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
For me it was around the same time Mo3 mentioned they took, maybe a bit more than one year and a half. It's been long, so I don't remember precisely. However I was in a quite sorry state before... I was having several panic attacks a week. My therapy alone was also not working well, I was doing twice a week. After starting it, everything started falling into place. I never had a panic attack again. I never had any do…
I would like to see more discussion of the role of SSRIs in treating anxiety, rather than depression (which always seems to be the default focus). I also suffered from panic that went away completely with SSRIs. I have never had issues with depression, but these medications gave me my life back.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#488Yeah, 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…
The low-dopamine hypothesis for ADHD is a legitimate idea still being actively studied.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#489Earlier quoted context omitted.
I don't think that's an accurate summary of the state of the art on ECT: https://www.nice.org.uk/guidance/ng222/chapter/Recommendatio... It sometimes works, it's contraindicated for certain people, comes near the end of the list of things to try (wait to see if you get better and get some excercise/sleep/sunlight being low risk interventions for mild depression) and even when it is used and does work, starting/contin…
I'm not sure what part of what I said you disagree with. Nothing in the NICE guidelines explains how ECT works - because like the rest of the world NICE does not know. Once odd aspect with ECT is that it seems to transiently improve parkinson's, again no one knows why.
I was disagreeing specifically with this bit:
> electroconvulsive therapy which has proven time and again to be the most effective treatment for depression
Switch "the most" for "an" and we agree I think.
Re: “No convincing evidence” that depression is caused by low serotonin levels
#490I 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 would generalize that even further to an abundance of possibility. In terms of anxiety, possibility, however remote, contributes to decision paralysis and over analysis.
In terms of depression, an abundance of possibility leads to disappointment, deferred action, and deferred acceptance.
I can only speak for myself, but a preoccupation with trying to optimize my life in the face of infinite possibility has led to a tremendous amount of anxiety and at times depression. For lack of a better term, it is an Omnivore's Dilemma of the Soul.