Anti-Depressants actually work* - a detailed essay

[Darren Dirt]

Fascinating and citation-filled ... if interested in the subject you will find reading the whole thing is worth turning off your TLDR trigger.

http://slatestarcodex.com/2014/07/07/ssris-much-more-than-you-wanted-to-know/


*as one of the comments the comments says, SSRIs work especially with a sufferer's "cope level" more than "happy level" ... at least initially.
For example: My personal experience matches this. The primary effect of antidepressant medication on me has been to take me from "I hate doing this stupid @%&# - @%&# the consequences, I'm just not going to do it" to "I hate doing this stupid @%&# - okay, Mom, I'll get to work on it."
But also: I saw the two addressing different domains ... Lexapro made the emotional load such that I could at least function while therapy helped me gain the ability to move forward."

[Darren Dirt]

In fairness*, in addition to or as an alternative to the above, there's this perspective:

"...people have to want to do the work to be well. They?ve got to find the time to move their bodies and eat real, nutritious food. (And manage their stress and have social connections, etc.)

I think our real hope as a society is to encourage kids to take care of their bodies and their minds and their spirits and hope that eventually, we will see a cultural shift away from medication and mental distress toward healthy lifestyles and mental health.
"
- comment @ http://www.madinamerica.com/2014/08/the-cocktail-party/




* cuz I'm tired of my posts about Deep Subjects tending to come across as more "lawyer" and less "judge" -- see http://slatestarcodex.com/2014/08/03/unspoken-ground-assumptions-of-discussion
(also the reason, I suspect, that many of those posts stir up zero discussion. Disappointingly. )

[Tom]

I've heard a theory that anti depressants act on the brain much like cocaine and other stimulants, rather than actually improving your depression, it just papers over it. And to be honest thats what it feels like to me a lot of the time. And it would totally explain why one of the "side effects" listed for pretty much all anti depressants is "suicide" (and depression... because it doesn't actually get rid of the depression, it just masks it).

[Mr. Analog]

That's why drugs aren't the solution they are the stepping stone to wellness. That's how my doctor is treating it and that's how all doctors should treat it

[Tom]

Indeed. They help, but should not be relied on for a "cure".

[Thorin]

The writer of that article put a lot of effort and time into research.  I applaud them for working that hard on something that they won't get paid for.

SSRI and SNRI drugs clearly do have an effect on those that are depressed, although the why isn't understood because the true cause of depression isn't understood.  In that sense, they're kinda like old folk remedies that people stumbled upon (eg certain types of mud from certain rivers would kill off bacteria, it was found out in the modern age this was because there were minuscule organisms living in said mud that would eat the bacteria).

Darren, you're right to point out that people have to want to change before they can change.  I add in that people will change once they truly want to (not when they say they want to, but when they really, deep down in their soul, have the overriding desire to change).

Tom, if the drug you're taking for depression just makes it feel like you're papering over it, like it's turning into an uncaring automaton, then try any of the other drugs.  Also, not sure what kind of depression you have, but I know that Major Depressive Disorder gets treated differently than Manic Depression (aka Bipolar Disorder).

Darren, I typically don't reply to your Deep Subjects posts because the older ones have come across as trolling, and the newer ones you're typically posting it because of some comment you found insightful but then forget to share that comment with us (which with this one, you helpfully did post, and see, I'm posting now).

For me, I found this comment to be super-insightful: http://slatestarcodex.com/2014/07/07/ssris-much-more-than-you-wanted-to-know/#comment-119269.  It's a long comment, but read it all the way through.  The commenter says they don't have ADD (well, ADHD nowadays) because they don't remember having it as a child, but it sure measures up quite well with how ADHD is diagnosed (http://en.wikipedia.org/wiki/Adult_attention_deficit_hyperactivity_disorder#Diagnosis).  I see what the comment describes in at least a couple of people that surround me in my daily life.

[Tom]

Tom, if the drug you're taking for depression just makes it feel like you're papering over it, like it's turning into an uncaring automaton, then try any of the other drugs.  Also, not sure what kind of depression you have, but I know that Major Depressive Disorder gets treated differently than Manic Depression (aka Bipolar Disorder).

The uncaring automaton was what I was trying to get away from. The anti-depressants basically just make me edgy and hypomanic.

It turns out that I may not be BiPolar. Instead, the new thing my sister and I got Dxed for gets misdiagnosed as BiPolar a lot. And it's not even a mental disorder, rather its a physical one that can (and does) effect the brain. And the way that anti-depressants act on me and my sister is basically how a lot of people with this particular disorder are effected by them (we go manic or hypomanic).

But I was talking in general. A lot of people find that anti-depressants don't actually get rid of the depression, rather it gives them more energy, and makes it easier to "cope" with the depression. Which cocaine would do too but cocaine has other issues....

Oh and hah, I'm probably ADHD after all as well. looool. Was diagnosed with it when I was a kid (ADD actually), but then the BiPolar made so much sense, and BiPolar is often misdiagnosed as ADD/ADHD in children... It's all just a confusing mess, because EVERYTHING in the brain, and in fact the body are directly connected. We (and doctors) really don't know a damn thing about how the brain (and a lot of things in the body) really work, so its a lot of guess work, and trial & error.

[Mags]

Was just listening to a pod cast the other night, apparently in some case studies placebo pills out performed many antidepressants by a lot (believe it was 60%). Suppose it shouldn't be total surprise that the brain is the best thing for treating the brain. Would be nice to be able to trick your self, so could avoid the nasty side effects, as I can personally attest.

[Darren Dirt]

Placebo Effect: even more mysterious than SSRIs!

I read 2 lengthy articles about placebos, after reading the above. Can't believe how little "experts" understand even after 50+ years of including them in scientific research.

I'll skim my history to find the articles maybe. World-flipped-upside-down kind of info.


PS: Thorin, on my phone the direct link http://slatestarcodex.com/2014/07/07/ssris-much-more-than-you-wanted-to-know/#comment-119269 does not seem to open the specific comment -- what was Date:Time:Username?

[Darren Dirt]

http://www.wired.co.uk/magazine/archive/2009/10/features/the-placebo-problem-big-pharmas-desperate-to-solve
http://www.wired.co.uk/magazine/archive/2009/10/features/the-placebo-problem-big-pharmas-desperate-to-solve/page/2
http://www.wired.co.uk/magazine/archive/2009/10/features/the-placebo-problem-big-pharmas-desperate-to-solve/page/3

I coulda sworn there was also a 2nd non-Wired article I read about Placebo Effect, but idk. Maybe it was just Wikipedia. But *wow* PE different based on geography? And even color of pill? Derp...

[Thorin]

PS: Thorin, on my phone the direct link http://slatestarcodex.com/2014/07/07/ssris-much-more-than-you-wanted-to-know/#comment-119269 does not seem to open the specific comment -- what was Date:Time:Username?

Look for Kaj Sotala, July 10 2014, 2:36am.

Sucks that the phone doesn't handle in-page references (aka anchors).

[Darren Dirt]

PS: Thorin, on my phone the direct link http://slatestarcodex.com/2014/07/07/ssris-much-more-than-you-wanted-to-know/#comment-119269 does not seem to open the specific comment -- what was Date:Time:Username?

Look for Kaj Sotala, July 10 2014, 2:36am.

Sucks that the phone doesn't handle in-page references (aka anchors).

Actually, the problem was that on my phone I selected to the clipboard somehow "http://domain.ext/path/file#123456." in the link -- removing the "." at the end made the link work. And yeah I nodded my head a TON when I first read that comment, still did when I re-read it.

[Tom]

He can be as certain as he wants that he didn't have ADHD as a kid, but that wont make it true


Also, I don't know if I believe that ADHD can't develop, or at the very least worsen in adulthood.

[Darren Dirt]

He can be as certain as he wants that he didn't have ADHD as a kid, but that wont make it true


Also, I don't know if I believe that ADHD can't develop, or at the very least worsen in adulthood.

I'm pretty sure I was un-diagnosed or at least borderline... considering my adult life for the last 20 years.

Anyone else see the PBS fundraising a year or two ago with Patrick McKenna ("Marty" from "Traders", that annoying guy from "Red Green" and also a guy from Codco -- it was enlightening (re. ADHD)

[Thorin]

My wife may have been undiagnosed, but inattentive rather than hyperactive. The post I highlighted seems to describe almost to a tee how she traveled through life until a regular doctor suggested it might be ADHD.