I'd wonder why everything felt so hard for me, why I was so stressed out all the time. And how it could be that no one else seemed to be horrified by the existential realities of life. At the same time I wanted to participate in life so I could help change things for the better-- but damn every morning was a new battle. And then I decided to start the same medication again, and boom.
About a year later and I feel normal. It's amazing. I'm like.. is this how people feel all the time? You guys just wake up and don't dread the day? Lol it's almost funny now. They blunt my emotions.. but turns out i was hyper sensitive to everything. In an awful , stressful way. I still have white hair from that period of life.
Sometimes, medication is the answer. I had a perfectly fine life on paper yet couldn't be happy. My theory is this was because of some adverse childhood events I experienced, that seemed to change something in me. Thank God for modern medicine.
And I learned sometimes the best advice is don't listen to others-- only you know what's best for you. People are complicated and therapy doesn't always work.
Have you considered some sort of regression therapy such as hypnotherapy or if more adventurous, plant medicine? I sat next to a pretty senior FBI guy on a domestic US flight once. He was a hypnotherapist who claimed that in almost all cases they were able to use hypnosis to get information about what happened even if the conscious person was completely unable to recall any details.
In most shamanic traditions, a lot of work is devoted to bringing up and purging out past trauma. Examples include plant vapor baths to sweat things out, purgatives to release emotional trauma (often present in the stomach / belly) and plant medicines such as ayahuasca that act as both a purgative and help form new perspectives of past experiences.
There's no guarantee that the information they received was true. I imagine hypnosis is in the same category as lie detectors with respect to its...interpretability.
I appreciate many think it's snake oil, I did too years ago. But have seen first hand great results.
In the 80s we had Satanic Panic because of false memories "retrieved" with hypnotherapy. It turned out that the "memories" were implanted unknowingly by the hypnotherapists themselves.
I find those ideas intriguing in their own ways, but I'm not sure if they'd help in my situation.
You certainly can get memories back this way; the problem is that they'll be fabricated, especially from childhood.
I agree both these kinds of therapy are effective though.
FBI still works with hypnotherapists.
I’m not anti-medication by any means. I will probably need medication to feel OK for the rest of my life, but EMDR has augmented my treatment in a meaningful way. If you haven’t tried it, it’s at least worth looking into.
The only reason I'm still alive is due to SSRIs, they have definitely taken away some of the highs of life but they also took away the incessant thoughts of suicide. They have side effects. They suck and the idea of being physically and mentally addicted to a mood stabilizer is a huge bummer. But I know that the people around me (and you) want us around, even if it's not 100 percent of who we really are. If your meds are working for you, messing around with them because you want to "hack" your brain isn't necessarily the best course of action. Be smart.
Side comment: doing a PhD in a foreign country is no joke. First rule of doing a PhD is: don't do a PhD.
Whatever that treatment might be.
Not just slightly different. It can be extremely variable from person to person.
It’s well-known in medical research and clinical practice that medications likes SSRIs range from helpful to neutral to net negatives depending on the patients and situation. Sadly, too many people fixate on the potential negative side effects and avoid trialing treatments altogether.
For anyone suffering: It’s true that medications might not work out for you, but if they do address your condition and you’re one of the many people whose lives benefit greatly, then it would be tragic to avoid medications based on fear of potential negative outcomes.
Not just SSRIs. I had a very bad experience with Mucinex D (or DM?) about 12 years ago, the first time I tried it. I can only imagine it was what clinical depression is like. For two days (until I stopped taking because I was so scared) I lost all interest in my life. I wasn't interested in my young children, ow my wife, or watching anything on TV I usually like, or playing a game. I was questioning my work life choices as well because nothing at work held the slightest interest. I would go home, do what was required of me, then sit in bed and stare at the wall until I went to bed.
That is, to this day, one of the scariest experiences in my life. I've since heard of one or two other people that had similar experiences with it.
[0]: https://en.m.wikipedia.org/wiki/Dextromethorphan see section on dependence and withdrawal
It’s not interchangeable with SSRIs, obviously.
IMO, the fear is not really about short-term negatives, but about it turning into drug abuse, without actually tackling the root cause.
Such drugs should only be used in extreme cases.
For example, adverse childhood experiences are highly correlated with depression. What's the underlying problem to tackle with a 50 year old adult who is depressed as a result of abuse as a child? Some things just change you and no amount of therapy can undo that
Within the first 10 minutes he speaks of the fact that rational thought as we see it simply does not exist. All our choices are based on the ability to distinguish a preference and that ability is based on emotion.
It would only make sense that medication impairing our emotions would also impair our choice making.
In general, I've found this idea was quite natural to me, but always seems quite foreign to others except those with a background in neurology, meditation, sometimes physics, and Buddhist circles.
People seem especially hostile to this when you start talking about the criminal justice system.
However, if you take the same people and (at some other point in time) change the topic of conversation to some object level issue, they then behave as if they have no knowledge whatsoever. And if you remind them, it isn't just that they get angry (as would be expected), but they seem literally unable to recall the knowledge that they do possess.
I genuinely believe that to some degree, the default human mind can't really multi-task abstract and object level thinking, so if you throw a bit of emotion and cognitive quirks [1] into the mix, add it all together [2] into one big system, you have a half decent model for explaining why the world is the way it is.
I'm leaving a ton of stuff out of course, but this is one of the more fundamental ideas in my hypothesis.
> In general, I've found this idea was quite natural to me, but always seems quite foreign to others except those with a background in neurology, meditation, sometimes physics, and Buddhist circles.
Agree....I truly think its possible that things like Buddhism are an important aspect: if a person can't "get" Buddhism (or can't take it seriously), I suspect they will also not be able to properly understand this topic.
> People seem especially hostile to this when you start talking about the criminal justice system.
Oh, can you expand on this?
The belief that we are rational beings making informed calculated decisions is outdated and proven to be wrong.
Yet, we continue to think of ourselves this way, at our peril.
Hope I am not out of bond but I think this demonstrates why a moral code also has to be an intellectual thing and not just an instinct thing.
Tangentially related - I had the experience - from being in a depression - of empathizing more with people down on their luck, people who are chronically grumpy or unlikable etc, or maybe those that are afraid of unknown people. I'm not sure how to explain it, but it made me see different sides of the human experience and I got out alive.
Is morality "entirely subjective"? When someone says, "Torturing children is immoral", do you really want to reply "That's entirely subjective". The very reply itself seems morally compromised, even immoral.
A good philosophical argument for the objectivity of morality is the "companions in the guilt" argument. Most people accept the objectivity of rationality, even those who deny the objectivity of morality. And yet, when we examine the two in detail, we can find a great many similarities between rationality and morality – morality says "don't do X", where X might be torturing a child, rationality says "don't believe X", where X might be the QAnon conspiracy theory; morality values states of affairs positively or negatively (moral vs immoral), rationality does the same (rational vs irrational) – in light of these similarities, how is it not special pleading to affirm the objectivity of one yet deny it of the other? To justify treating them differently, you'd need to give a good reason for doing so – but rarely is any reason given at all, and I don't think any of them are good. Rationally, we must either affirm the objectivity of morality or deny the objectivity of rationality. I think, to affirm the objectivity of morality is the better horn to take – we might even conclude it is the more rational one, if we believe that rationality itself requires belief in its own rationality. Hence, morality is objective.
This, regardless of how you feel about the subject matter, is a factually false statement. That's not how instincts work, or what they are. Additionally, even without that error, the statement holds false.
How do they work? What are they then?
> Additionally, even without that error, the statement holds false.
How? Why?
That was meant to be "if we believe that rationality itself requires belief in its own objectivity". Thought one word typed another.
I've never heard of that. Why would they be testing an infant for their reaction to an antidepressant drug? Just curious.
I would have hoped clinicians would start at the lowest possible dose, and titrate up. I've certainly heard of the "you need about xx mg, use this dose" first doses, tho.
To me, this is Yet Another reason one should never receive medical advice alone, especially when thinking is impaired. That trusted friend / partner needs to ask the hard questions of the prescribing clinician; but rules make any 3rd party except spouse difficult for adults.
They often accompany one another. I've had panic attacks in the past, and was diagnosed with generalized anxiety disorder. I can't claim that bupropion fixes panic attacks proper, and I'm not a doctor, but it does help me with my depression. (I haven't had a panic attack in a long time.)
It's not a silver bullet; you can still find yourself in mentally stuck states, the difference is the physical side of things seems to be 'gated' at the low end so that your spiraling down isn't as deep as it is before. There's still a lot of work to do to recognize + slow that descent, but it is a tool to help with that.
Wellbutrin and NDRIs typically aren't that great for anxiety, but they can help.
In my opinion, SSRIs should only be used as a tool to help make the patient more receptive to therapy.
It should never ever be used a substitute for therapy. I too have noticed that without someone to help keeping your behaviour in check, some undesirable (but not necessarily dark) personality traits could take over. Not to mention that someone needs to be there to check on you during the first weeks of use when the drug actually causes a deeper depression before it starts mellowing your feelings.
BTW. My second SSRI use also left me with permanently dry eyes and nose: me needing eye drops and to avoid dusty, dry environments for the rest of my life.
What helped me was switching away from a first-line SSRI and onto something a bit more niche: Mirtazapine. It's definitely worth trying a variety of SSRIs because everyone is different and it's really common for the first one or two that you try to not work well.
I agree that ultimately therapy/coping strategies are the right cure, medicine is a way to bootstrap otherwise incapable people into persuing exercise, therapy, social stuff etc. If you can achieve that without the help of meds, more power to you!
If you take it before bedtime, it sedates you in a deep sleep. But 3-4 hours later, if you wake up, it would be like you didn’t take anything.
You may even have trouble going back to sleep if you wake up early.
Of course all this varies greatly for every individual.
I have taken other SSRIs before, but it is puzzling how each one has its own particular behavioral effects even though they all are increasing serotonin.
The reality is, SSRIs and other pharmaceuticals that have been used to treat common psychiatric illnesses (anxiety/depression) have dismal outcomes and fail the vast majority of patients that they have been given to.
Fortunately, there is a growing body of evidence that MDMA and psychedelic assisted therapy could revolutionize the treatment of mental health disorders.
Unfortunately, for the last 50 years, governments, industry and the military industrial complex (together with the MSM) have spread lies and scaremongering to block the therapeutic use of these life-changing therapies.
Here is another video for anyone wanting to know more about the topic:
(Lecture by Prof. David Nutt: The New Psychedelic Revolution)
I'm optimistic that the next few decades will bring about better approaches to these massively underserved (and largely exploited and discarded) people.
References: https://www.nature.com/articles/s41591-021-01336-3
https://www.tandfonline.com/doi/full/10.1080/09540261.2021.1...
For some folks this is actually roughly the ailment that they suffer from:
> Anhedonia is a diverse array of deficits in hedonic function, including reduced motivation or ability to experience pleasure.[1] While earlier definitions emphasized the inability to experience pleasure, anhedonia is currently used by researchers to refer to reduced motivation, reduced anticipatory pleasure (wanting), reduced consummatory pleasure (liking), and deficits in reinforcement learning.[2][3][4]
The symptoms you explain are why it is important to pair therapy with antidepressents.
I'm very surprised your therapist did not alter your scrip.
I'm not saying medication is not effective - it was extremely effective for me in different phases of my life and probably saved me from suicide, however in my adult life I found the emotional blunting and apathy that came with not just SSRIs but DSRIs and other classes of medications to be extremely concerning.
MAPS.org did clinical trials, MDMA-assisted psychotherapy for veterans with treatment resistant PTSD, to great success.
I am enthusiastic about the advancement of research in this area and frustrated that it was delayed for so long due to political reasons, but please keep in mind that people with mood disorders or trauma can be desperate and may not make the best choices for themselves on their own.
Your final sentence also rings true for any remedy including SSRIs which many people have been harmed by, likewise your pointing out to this research not advancing due to political reasons - including system and regulatory capture - can be applied to existing treatments that were approved but perhaps should not have been; the conspiracy hypothesis that's becoming mainstream is that things like MDMA, psychedelics et al, were suppressed by for-profit industrial complexes via "the war on drugs" because pharma's patented daily-use recurring business model products couldn't compete with the very cheap to make, administer "2-3 times per year" chemicals that don't have anything close to the same "side" effect profile.
You can see how this regulatory capture still has a hold in Canada for the alcohol industry, where alcohol's a known carcinogen, and as a society we put warnings on tobacco products but no such warnings on alcohol - and this isn't the only incongruence in Canadian policy/culture.
Acute drug experiences with therapy and behavioral modification are the future.
do some molly and ketamine and have a good talk.
Note that while the evidence for Ketamine's antidepressant effect is actually strong, that does not mean you should get into the habit of snorting a gram of special K a day.
Ketamine abuse is known to cause serious, practical damage to the GI tract, the urinary system, the liver, and the brain.
What does it do and why is that helpful?
Experimentally, it works. There are theories (google will give you a couple vaguely plausible mechanisms), but it's too early to say. And it's likely that the antidepressive effect of ketamine has nothing to do with its NMDA antagonism, given that other NMDA receptor antagonists do not work as antidepressives.
Neuroscience theory lags far behind applied psychiatry, so all know is people whose depression resists normal treatment now have another very promising option, with a very different mechanism from normal antidepression treatment.
Mechanisms of action are difficult to be objective about. It is a lot more complicated than dopamine and serotonin regulation and uptake, receptors and antagonists.
Today was pleasant, despite every reason not to be. It's like the "hope" qualia.
Also TIL “qualia” - what a wonderful word.
It's like zero thought has been put into quality of life by practitioners, so long as their metrics are met
E.g. "x, y, z attributes on the ABC scale went down. Looks like you're in remission!"
"But doctor, my dick doesn't work, I've gained 40lbs, and everything feels flat."
"We can prescribe a stimulant for appetite suppression, a vasodilator for the libido... but the 'flat' is all in your head. I'm going to write you a recommendation to a psychologist so they can talk to you about it."
Absolute ninnies.
I understand what you mean about engaging in out-of-personality behaviors, lack of moral code, and the nausea and panic that accompanies the memories of "who you were" on a certain medication (they do go away, with time. And they lose their emotional impact once you accept that it was due to medication, and rationalize it away). They warn you that there might be personality changes, and you'll feel different, but I don't think they understand the absolute gravity of what that means. Even pharmacists go on their soapbox every time you ask for a different brand (because X brand doesn't feel the same, and the FDA has issued numerous warnings about quality control): "the only thing different about brand name medication is the marketing. They're all bio-equivalent and it's all in your head." Fuck off.
This isn't even addressing that it's likely most of the "anti-depressive" effect is placebo in SSRIs and the like. "Oh I feel very different now from this medication. That means it's strong, and effective, and I should be getting better now"; it's in the same vein as chiropractic, except with more woo-woo and theatre ("modern medicine!!!").
There are better substances that can be used off-label/aren't "copyrighted" that actually solve emotional issues by (properly) regulating neurotransmitters and genomic expression to achieve pro-humanist results, instead of soulless pro-metrics and "quantitative" results. But they're not being marketed, because the current batch of psychoactive chemicals is riding on decades of marketing and "works" (see: generates outsized profits).
In my opinion, almost all of these have been a net-negative on society. Opiates, benzos, "anti-psychotics," "anti-depressives," and the like: they're all shit.
There are better chemical (and lifestyle solutions) to these problems, but right now the medical complex has a hard-fought monopoly on health treatment; so anything that would usurp power from them is a no-no (a la "fuck pro-consumer, I'm getting mine").
Most people's androgen:estrogen balance (and levels) are absolutely off kilter, if they live a modern life (no exercise/only exercise is the gym, lack of sunlight, sitting down all day, living in a city, braindead birth control protocols with only estrogens, etc.).
Tuning that would be the most beneficial. And it would get to the root of the problem viz. fixing a mismatched upregulation/downregulate of neurotransmitter receptors (f.e. increasing sensitivity of GABA receptors, decreasing sensitivity of noradrenaline receptors, and so on) -- instead of just a simple and stupid "hur dur lets flood the synaptic cleft with serotonin/dopamine/catecholamines."
Barring that, there exist others that do not disrupt one's natural HPTA, and are more "targeted" towards neurons, rather than the whole body.
Peptides:
There are an assortment of peptides, but their main uses are specifically in gene expression/and cell signal tuning. They're hit or miss. A lot of woo-woo shit going on, and many people hype them up as a cure-all (because there's money to be made); when that's taken into account (and the lack of extensive research), you'll find an assortment of chemicals to play around with.
Russian synthetic adaptogens:
These are their own category of "adaptogens" popular in the Russian medical community (and seeing Western adoption). E.g. semax, bromantane, selank etc. They act as hormones/signaling molecules by changing the expressions of genes (leading to downstream changes of natural peptide levels, behavior of psychological/catecholamine systems, and so on).
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All of these, in my opinion and experience, are leagues better than the garbage that is peddled by the U.S's medical community -- because this actually changes shit on the genomic level, rather than fucking with the physical processes outright (ex. imagine the difference between cloud seeding to get more rainfall vs. diverting rivers, to fill aquifers. One of these is much more sustainable and has less side-effects).
[1] is a letter to the British Journal of Psychiatry by one Gordon Parker. It does two things: first it briefly mentions a study by Kirsch et al which you can find at https://journals.plos.org/plosmedicine/article?id=10.1371/jo... and then it makes some comments on the significance of that study's results.
It's the results of Kirsch et al that you're referring to here (Parker says that they found that "newer antidepressant drugs are equivalent to or no better than placebos"; the rest of Parker's letter is concerned with the question of what the study's findings mean.
So, two questions. First, since Parker rather than Kirsch is what you cited, does Parker in fact say that "long term outcomes on psychiatric drugs are no better than placebo"? Nope. He says there are three possible explanations for results like Kirsch's: (1) the drugs are ineffective, (2) the analyses are no good, (3) something about randomized controlled trials makes them unsuitable for answering this sort of question. "The third explanation – that there are substantive limitations to current procedures for testing antidepressant treatments – is argued here as the most sustainable."
OK, so the source you're citing doesn't agree with your claim, but maybe the source he cites does? I linked to Kirsch et al above, and have two observations to make. The first is that "no better than placebo" is better than it sounds, because it seems that placebo is actually pretty effective against depression! The second is that what they find is, unequivocally, not "no better than placebo". It's "not very much better than placebo". Their exact words: "Although the difference between these means easily attained statistical significance [], it does not meet the three-point drug–placebo criterion for clinical significance used by NICE."
(Kirsch et al also looked at whether these effects differ depending on how bad the depression is. They do: if you are more severely depressed, the effect of antidepressant drugs isn't very different but the effect of placebo decreases as the severity of the depression increases. Which again looks to me as if the situation is more "placebo is pretty good for depression" than "antidepressants are no good".
So I'd say you're zero for two at this point.
I took a quick look at [2] as well, because why not.
Right in the abstract it says: "There are no placebo treatments." so this is definitely not offering any support for a comparison between antidepressant drugs and placebo. Maybe it's intended instead to support your claim about relapse rates after long-term use followed by discontinuation? Doesn't seem possible, given the study's purpose and structure.
They were trying to answer the question: if you're suffering from depression, and the usual antidepressants don't do a good job of treating it, what else might work well?. So the plan was to take a bunch of patients with major depressive disorder, and give them 8-12 weeks of citalopram. If that works well, they're out of the study. If not, they get some other treatments, involving some combination of other medications and/or cognitive therapy. If that doesn't work, they try some other drugs. If that doesn't work, try some other drugs. And then, if the first antidepressant didn't work well but one of the later things did, keep them on that for the next 12 months and check monthly on how it's going.
You will note that nothing in this description offers any way to look for relapse rates for patients who use an antidepressant drug for a prolonged period and then stop. The only patients who are using an antidepressant drug for a prolonged period in this study aren't stopping.
So what did the study find? Well, the page you linked to says ... "No results posted".
Maybe you just posted the wrong link. It appears that the study was actually done. There is some information about the results here: https://www.nimh.nih.gov/funding/clinical-research/practical.... I don't see anything there that looks like it supports any of your claims.
Zero for three. At this point I don't feel much enthusiasm for checking your other two links.
“Although these biases did not significantly inflate estimates of drug efficacy, reporting biases led to significant increases in the number of positive findings in the literature.”
Which is literally the opposite of what you’re citing on efficacy.
/sigh.
please stop this, you're contributing to the stigma both in terms of mental health, and that lifesaving medication is somehow an addition.
https://www.sciencealert.com/science-proves-diet-can-send-ty...
Click their first citation. It’s a study that shows that people who discontinue their antidepressants are more likely to relapse than people who continue taking them.
It also says that relapse is more likely if the person was depressed for longer before receiving treatment (e.g. excessively delaying treatment made relapse more likely)
It doesn’t support their wild anti-psychiatry rant at all. Don’t be fooled by off the wall comments that try to overload you with a list of citations that they know most people won’t read.
> > Compared with patients whose antidepressants were discontinued, those with continued treatment showed much lower relapse rates (1.85 vs. 6.24%/month), longer time to 50% relapse (48.0 vs. 14.2 months), and lower 12-month relapse risk (19.5 vs. 44.8%) (all p < 0.001).
It literally says that antidepressants work.
> The common belief that these drugs are effective treatments (esp. in the US)…
They diverge from placebo and are effective treatments. It’s not a US thing at all. I don’t know why you think it’s limited to the United States, but then again the rest of your post is full of misinformation.
Please stop parroting this anti-psychiatry nonsense and trying to use studies that say the opposite of the misinformation you’re trying to spread.
>> discontinuation after long-term usage is associated with higher relapse rates [0,1,2]
To paraphrase, those who stop taking experience higher relapse rates than those who continue to take, which is also what you cited:
>> those with continued treatment showed much lower relapse rates
SSRIs aren’t the only promising solution.
> SSRIs aren’t the only promising solution.
I don't think it's very helpful to vaguely bring up "supplements" like that. There are so many, and they range from being harmful, to being placebos, to being actually helpful. Plus there's a huge amount of utter quackery around them.
Do you have any specific "promising" ones in mind?
The entire mental health industry is focused on extracting as much from vulnerable people as possible. Unless you have a spare 1200$ to 1600$ a month laying around you won't be able to afford therapy anyway...
I will be extremely hesitant to take antidepressants and anti-anxiety medications ever again after my last experience with them. For me, the medications helped by tempering all of my feelings - I no longer felt sad or anxious, instead I just felt mellow and apathetic about everything. And feeling apathy is an incredibly scary thing because I also no longer derived any joy from my hobbies, from sex, from exercise, etc. I could no longer feel sad but I could no longer feel happy, either.
Even worse, I found myself engaging in behaviors I would never have engaged in otherwise, like compulsive lying. My moral code was compromised because I no longer felt the guilt and shame that normally inhibits unscrupulous behavior. I look back on that time now and I think about some of my actions and I feel nauseous.
There is value to medications that inhibit or regulate serotonin, and every individual's experience will be slightly different based on their genetics and the circumstances of their life. However, for me, even though I benefited from them at various points in my life (especially as a teenager), as an adult now I'm much more likely to depend on coping strategies I've learned through therapy than medication when it comes to dealing with my mood.