> I’ve done a lot of research and I think psychiatry is pseudoscience and antidepressants are largely placebo.

Please don't spread anti-psychiatry misinformation online. I'm sorry that it didn't work for you, but please don't dissuade others from seeking proper treatment.

Playing devil's advocate: Even if SSRIs are just placebo (they're definitely not, and we have decades of science to explain why that's a false statement), what would be wrong with that? Placebo is remarkably effective, and even placebo is even getting stronger with time: https://www.psychologytoday.com/us/blog/straight-talk/201803...

This is where people are mistaken when they conclude SSRIs are placebo. SSRIs still diverge from placebo, but placebo is so incredibly powerful in short depression studies that it's hard for SSRIs' superiority to reach a numerically large statistical significance.

> I’m really on the mindfulness bandwagon

Mindfulness is a common therapy technique within professional treatment. I think you'd find that a lot of the mainstream self-care practices are mirrored in professionally-guided therapy. However, some people just can't/won't trust professional institutions, so at least we have mainstream pushes for mindfulness and self-care to slip these techniques in the back door.

Many people are upset I called antidepressant placebo. It’s obviously a huge discussion out of the scope of this thread. But keep in mind that companies make a ton of money selling SSRIs and _still_ have trouble differentiating results from placebo, despite arguable massive publication bias influenced by big pharm.

Furthermore the metrics for these things are the most subjective thing in the world, surveys of humans. Most statisticians consider that data very low value but it’s the foundation of modern psychiatry.

Placebo is great if it works, sure, but psych meds have a long list of side effects. It’s be better to get placebo healed by your local witch doctor than a medical doctor, if you’re just relying on placebo.

Again it’s a big discussion and of course I’m open minded to learning more but on the flip side a lot of people take modern psychiatry as infallible medicine despite a lot of flaws.

I agree. The book Lost Connections goes in depth into how all antidepressants are either same as placebo or better by a statistically negligible amount. (Oversimplified but the book does a good job).

https://www.amazon.com/Lost-Connections-Uncovering-Depressio...

It's also misinformation to assume SSRI's work the same way for everyone. For my mother, antidepressants made her suicidal.

> It's also misinformation to assume SSRI's work the same way for everyone.

the person you replied to didn't say that. the point is to defer to professionals and not your own hunches.

Professionals prescribe these long-term to people, even though something like 5/7 cases never get good results.

so did my psoriasis pills .. great now i have fucked skin and wanna kill myself. at least without the pills i just had one of those. neither helps my depression tho.

> I’ve done a lot of research and I think psychiatry is pseudoscience and antidepressants are largely placebo.

For you. There are many causes of depression, and many reactions to the depression and to the various treatments.

For me, the very day I started taking an SSRI I felt physically different. My brain felt slightly too large for my skull, and it felt "fizzy." That, and the loose stools, went away after a time. (We have serotonin receptors in our digestive system, to guard against swallowing poisonous seeds.)

And I immediately felt like cleaning the apartment.

While I still have depression, it's manageable, and the SSRI knocks it back enough that I can see and deal with bouts.

In other words, for me, I seem to have a chemical condition that SSRI is exactly designed to deal with.

For me.

>We have serotonin receptors in our digestive system, to guard against swallowing poisonous seeds.

Nobody knows the purpose of serotonin in the gut [0]. The fact that you've accepted this theory as fact suggests to me that you've also drank the kool-aid with respect to the role of Serotonin in depression, which is very controversial.

Also the fact that you experienced results with SSRIs in such a short timespan (placebo-controlled trials have found depressive symptoms don't get better for months) suggests to me you are experiencing a placebo effect and not some adjustment of a 'chemical condition'.

And this is fine, and I'm happy for you, but I don't think it's unreasonable to demand a better treatment than placebo. The placebo effect has also been shown to be very strong with cancer patient, but placebo wouldn't be an acceptable treatment for them.

[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272651/

Thank you for sharing your experience. I have had a similar experience where the endless stress and burnout culture in the tech field led to total mental collapse about 5 years ago and I can't say I have fully recovered. How have you dealt with employment post meltdown? I have found better jobs since then, however, they all seem to introduce some level of anxiety to my life and I am contemplating leaving tech after 20 years but find that I am not "qualified" to do much else. Just curious if this is a just me issue or if you or others have found a way out of this mess.

If you are really burnt out and want to leave tech, I urge you to do it sooner than later. If you lack qualifications in whatever you want to do, you can still get them. Don't wait, follow your dream. Even if you fail, you'll have less regrets trying than going back to doing work you can't stand anymore.

I've burnt out multiple times and gone back in to tech only to get burnt out again and again, and have dragged my feet in switching careers, and have missed valuable years and decades that I could have been moving towards work I would have found more fulfilling, and now I'm finally trying that career change, but I wish I hadn't wasted all that time working in tech jobs I've lost absolutely all interest in and started to hate decades and decades ago.

From my experience most industries use and abuse people even worse. Sure my tech job is stressful but I've seen most other peoples jobs treat them worse AND compensate them for that less.

This is dangerous. Sure criticize for-profit pharma but it will cause harm to tell others who are struggling to ignore the huge of amount of research on different pharmacological treatments that are over and over again proven to be more effective than placebo.

The meds I'm on have no profit built in. It's like $8 for 90 day supply. The research shows it's so effective that it even lifts mood/energy/sociability for non-diagnosed mood disorder patients (without giving away too much personal detail it was originally an effective treatment for something unrelated to mental health).

If anything these 'change your attitude' or 'tips' kind of articles get under my skin a bit. For many changing habits can be helpful, especially CBT with professional guidance, but for many actual major depressive disorder patients no amount of habit or behavior changes will have meaningful effect without actual medicine.

> I’ve done a lot of research and I think psychiatry is pseudoscience and antidepressants are largely placebo.

Even if they didn't work for you, making claims like this on a public forum is very irresponsible for you, and can be very dangerous for those who really need the help.

Please refrain from making such statements unless you're a medical professional.

I think people should be allowed to share their opinions, even if they're controversial. Just because you disagree doesn't mean he's wrong (nor am I saying he's right).

I have no dog in this fight, but you don't have to Google much to find studies that cast doubt on the efficacy of anti-depressants.

https://www.medicalnewstoday.com/articles/325767

Ehhhhhhh...

And google swings... and it misses...

There are two somewhat competing studies involved in what you linked.

The original meta-analysis is stating that "[a]ll antidepressants were more efficacious than placebo in adults with major depressive disorder." And if you dig into that study, the level of effectiveness varies, but is consistently above a placebo.

The other, states that the original meta-analysis missed some points within their study; specifically that under the standardized criterion, there is an unknown level of bias in the results (73% showing unknown bias, and 26% showing high risk of bias - essentially confirming that most studies couldn't be done in a full blind or double-blind manner); and that while the sample size was high, the effect size was less known due to drop-out rates of the studies.

This isn't necessarily contrary to the initial meta-analysis, but brings to light that they may need to be taken with a level of caution; it doesn't make the claim that anti-depressants are no better than placebos, but that when doing the meta-analysis Cipriani et. al. needed to make more apparent exigencies with their results.

All this being said, the puff piece draws a more black and white tone with the meta-analysis and the meta-meta-analysis results; which tends to be the problem with these types of pieces. Sure, do your own research, but you'll need to dig into what's actually behind the journalistic fluff to get at the real meat and potatoes of the subject, if you don't you may come away with the idea that anti-depressants have 0 efficacy instead of "some efficacy, with the caveat that studies are somewhat mixed on individual results due to the nature of how the studies are conducted."

I agree with everything you said, and was merely pointing out the evidence is far from overwhelming (or even conclusive, in my opinion).

If we're going to talk about making dangerous statements, mentioning that antidepressants are effective while ignoring the fact they increase suicide for some people seems a lot more reckless to me. Of course, you don't know if they will do that until after you are already taking them.

https://www.bmj.com/content/358/bmj.j3697/rr-4

Since at this point it seems unlikely I really "have no dog in this fight," for what it's worth I think antidepressants likely help more people than they harm, but I do think their positive effects are exaggerated by health professionals.

I really like the article you linked; I also found it interesting at the end of it:

  "It is absurd to use drugs for depression that increase the risk of suicide and homicide when we know that cognitive behavioural therapy can halve the risk of suicide in patients who have been admitted after a suicide attempt and when psychotherapy does not increase the risk of murder."

And I think it really speaks to the need to have professionals that aren't just throwing folks on drugs and sending them off. A whole form approach to mental health is needed, where a combination of various forms of therapy may be the best way to help an individual; since pretty much every study can agree that the efficacy essentially comes down to the individual level.

For my ADHD, anxiety, and depression I don't take anything (currently), but I do regularly see a therapist with whom I work through issues I'm having and how to combat them, as well as how to reinforce my successes. This isn't to say that at specific times I haven't tried different pharmacology to combat one or all of these issues; but at this time, the most effective thing __for_me__ has been basic therapy.

This isn't to say that what has worked for me will work for others, but at its most basic, finding a professional that is willing to really dig into what's going on is extremely important, as they will be able to work with the individual to figure out not only what's going on, but even what the goals are and whether they are even achievable goals (elimination of symptoms, management, setting new normal habits, etc. etc. etc).

And that's why I get frustrated with fluff journalism around much deeper studies, they can convince people that an entire system and industry is a bunch of quacks that shouldn't be taken seriously; is the person that's doing self-study going to dig into what it means for a study to show bias or the effect size or the sample size; or whether it's a direct study or a meta-analysis; or what the type of statistical analysis was used (were they using teeming or densification methods for gaps in data, was it a regression analysis, if so was it linear, bilinear, quadratic, etc); I could keep going on... or are they going to just read a couple of journalism pieces and call it a day.

This isn't to say I don't love medium-science (not hard, not soft) journalism; I love Quanta and the pieces they put out about science and math concepts, but if I want to dig deeper I will look up the pub or pre-pub information from the details they're covering; I would hope that someone that's doing self-study would do the same with medium-science medical journalism, but I can't ever guarantee that.

Code blocks for quotes do not display well on mobile. I had to scroll horizontally a dozen times to read that quote.

When I was in university I took psychology modules out of interest and crashed lectures out of curiosity. Im inclined to agree with you. Coming from a pure mathematics background, I felt that their methodology of studying sonething as complex as the human mind and the underlying assumptions rather unqualified, lacks attention to details and a sense of rigour. This opinion and (the OP's remarks) aren't going to be popular here, but this was my observation as I was sitting down in lecture theatres listening to psychologists and their models and how they arrived at them and how they applied them.

Fields like neuroscience and behavioural economics are far better in their approach to understanding how we think. I'm glad you found some measure of comfort in meditation and that you recovered. It takes immense strength to fight an enemy within.

> I’ve done a lot of research and I think psychiatry is pseudoscience and antidepressants are largely placebo.

Then your research methodology leaves a lot to be desired.

Psychiatry is a lot of flailing around and trying different things, probably because we don't have a very good understanding of the exact nature of everyone's condition. Everything seems to help 10-20%. That group does not overlap, and effect sizes vary substantially between individuals.

I have had the experience of deep depression and starting a new medication that pulled me out of it, making me active and functional again. It may have been coincidence, but I doubt it. I then was able to get off that medication and enjoy my life again.

I think that self-care has become shorthand for treating yourself, when sometimes it means being responsible as well.

>I’ve done a lot of research and I think psychiatry is pseudoscience and antidepressants are largely placebo.

Care to link any of them? I have a hard time believing they are placebo, as they fundamentally alter neurochemistry.

Parent probably doesn't mean that they don't do anything, only that they do not actually treat depression.

Wrong either way.

If one doesn't work, try another. Depression is a lot of different illnesses with one name. What helps one might make another worse. The only way to know which you have is which med helps. If any. Some of them (nobody knows how many) don't have a working treattment yet. Others absolutely do, and if it's the one you have, lucky you.

The book Lost Connections goes in-depth into this.

https://www.amazon.com/Lost-Connections-Uncovering-Depressio...

Are you familiar with dialectical behavior therapy [1]? A lot of what you describe as important in your journey (dealing with feelings, mindfulness) are a focal point in DBT.

[1] https://en.wikipedia.org/wiki/Dialectical_behavior_therapy

Regarding just "bad feelings is ok" part. I have a similar belief currently with one difference - bad feeling resulting from something bad happened is normal in my opinion - just like physical pain it helps the body to identify problem and adjust. Chronic bad feelings are not normal - just like chronic pain or inflammation.

I think in many ways antidepressants can actually make things worse because of the emotional blunting side effect that can make it hard to connect with others.

Please don't generalize about things you know little about.

There are many depression treatments that have no "blunting side effect" at all.

My mother committed suicide because of anti-depressants so you can kindly go fuck off with your arrogance and ignorance to boot. The Brain is far more complex than pseudo-intellectuals like yourself like to think. Serotonin does a whole heck of a lot more than control mood so any imbalance caused by the medications can be equally as fatal.

Not buying.

More to the point, there are many, many different drugs with many unrelated modes of action and very different side effects, all labeled "anti-depressants". You can complain about side effects of one of them, or even a related family of them, but pretending all are alike identifies a crank.