Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

bmj.com

Post reply on HN
Print view View original

531–540 of 625 posts

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

#531

Post by olyjohn »

multiplegeorges wrote: post #431
tsol wrote: post #425

Earlier quoted context omitted.

Not everyone wants to trip in order to feel alright, and not everyone can handle it. Children and the elderly come to mind

When used for treatment, you don't "trip" in the recreational sense. The medication is taken in a very controlled environment with a highly trained mental health professional. There are also pre- and post-sessions to help people prepare for the experience and come out from it with positive outcomes. Agreed that children probably shouldn't be given such strong drugs. I don't think you'd find a professional advocating…

It's just too bad that most people can't get access to this treatment. It's extremely difficult to get into, and impossible for most people.

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

#532

Post by sinecure »

throwawayacc2 wrote: post #413

I 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…

This is essentially what Ted Kaczynski (the Unabomber) theorized and wrote about in his manifesto, that industrialization and its abundance of comforts and options have destroyed human happiness and that we would all be better off if we lived simple hunter gatherer lives and knew nothing of modernity or technology. That the hunter who catches a deer and feeds his tribe is immensely more happy and fulfilled than the stock broker who navigates high finance and city life, but can't seem to get that promotion or afford that vacation house his boss has.

Essentially the awareness of everyone else's lifestyle and prosperity, amplified by the advent of print newspaper and now social media, is the key destroyer of joy.

The peasant works his farm and feeds his family and raises his kids. He knows he will not become king. He barely knows what the king's lifestyle is. In modern America we are blasted with thousands of kingly lifestyles 24/7 and are constantly asked, why aren't we living like that? Why do I have to work? Why can't I date the supermodel? Why do I have to struggle with rent?

Our minds have not evolved to deal with this super-stimulus nor the self comparison of endless idealized lifestyles we cannot all realistically achieve.

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

#533

Post by hirvi74 »

TurkishPoptart wrote: post #523
hirvi74 wrote: post #484

Earlier quoted context omitted.

> 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 reali…

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 number) can have permeant changes in the brains of individuals both with and without ADHD to be ridiculous.

I also find any research relating to ADHD and fish oil supplementation to be extremely dubious. It appears research is starting to back-track on that one too.

That being said, I do really enjoy his podcast, but just because he repeats something does not mean it's true/untrue. I would have preferred him to have an interview with an expert in the field of neuropsychiatry or of equal qualification.

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

#534

Post by 999900000999 »

throwawayacc2 wrote: post #413

I 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…

Lost Connections is a great book on this.

Most people used to be apart of some form of community. You made friends, made dinner together, found love , etc. In this community.

Now their's none of that. Everyone is a disposable interchangeable part. Instead of getting a stable job, and having a foundation, now we're all gig workers. Or short-term contractors. Back in the day, you'd work the same job most of your life, and that's one of the ways you made friends.

Back when I lived in LA, I was lucky enough to be a part of a fantastic apartment community. We cooked, and watched sports together. While I had to leave for other reasons, I definitely miss these guys.

The internet's a poor substitute, even at a bar my behavior is restricted by social norms. In real life I've never had anyone call me a slur, or personally attack me.

Online it's absolutely relentless, I don't use social media or online dating for this reason.

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

#535

Post by sinecure »

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 brain is broken, you have depression, we will give you these pills to fix your brain chemistry." You have taken that person's autonomy away. They are now the victim of a disease.

I think the reality is that our society and civilization leads to a certain despair and sadness in many people, one that can be fixed by changing one's lifestyle, mindset, or overcoming challenges. This is not a disease, not a mental illness, not some health problem you cure with a pill. It's a spiritual dilemma that must be faced individually and overcome with effort and belief that one can change.

Essentially, I believe that by diagnosing people with "clinical depression" we are creating a self fulfilling prophecy and condemning them to a victim status that perpetuates their suffering.

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

#536

Post by wins32767 »

niemal_dev wrote: post #474
wins32767 wrote: post #453

Earlier quoted context omitted.

I suddenly became allergic to SSRIs and had to go off of them cold turkey. I didn't have any withdrawal problems at all so it's not a universal issue.

Wow, just wow. Quitting them cold turkey 0 problems, incredible.

I'm not trying to minimize the problems other people have had with withdrawal at all, just saying that it's possible to have a variety of different outcomes being on and off of them.

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

#537

Post by s1artibartfast »

bergenty wrote: post #530
s1artibartfast wrote: post #501

Earlier quoted context omitted.

I think the point is anything can be a chemical process because we are chemical beings. Drowning or having your leg cut off leads to a chemical imbalance, but chemistry isn't always the most productive lens to analyze the problem

Drowning or having your leg cut off are not chronic conditions. I think it makes a lot of sense to analyze chronic problems in the brain through the chemical lens.

>I think it makes a lot of sense to analyze chronic problems in the brain through the chemical lens.

Thats the basically the point I am taking issue with. Myopic focus on chemistry can be terribly misleading. There will always be a chemical component because we are beings made up of chemical components.

a chemical imbalance is by definition always going to be part of the problem. That does not mean it is always the best point of intervention, and certainly not the exclusive focus when trying to understand the problem.

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

#538

Post by ok_dad »

neonate wrote: post #235
ok_dad wrote: post #216

Earlier quoted context omitted.

What do Buddhists have to do with Tom Cruise? Is he a leading member of a Buddhist organization?

I assume bowsamic's point is that people can be wrong about some things and right about others.

[flagged]

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

#539

Post by marcosdumay »

dimal wrote: post #526
swamp40 wrote: post #452

Earlier quoted context omitted.

They work fantastically, from what I have seen firsthand many many times. There is a very good reason for it's use in up to 20% of the population in some groups in the US. Just because we haven't pinpointed why doesn't matter a bit.

“They work fantastically” is a statement that requires many qualifiers. They work fantastically for some subset of people. For other people, they do nothing. For other people, they have negative side effects that make them not worth whatever benefits they provide. For some people, they cause extreme negative effects when the medication is removed. For some other people, they increase the chance that they will commit…

If the effect is systematic, real, and measurable, it's just a matter of giving the medication to the people that benefit from it, and not giving it to the people that don't.

The real question is by what level is the effect is systematic, real, and measurable?

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

#540

Post by olyjohn »

carabiner wrote: post #233
tsimionescu wrote: post #221

Earlier quoted context omitted.

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…

Would you rather be safe in prison for 100 years, or free in a world for 1 day where you could die?

Life isn't like that though. This question is kind of counter-productive.
Post reply on HN