(yes, I've tried psychedelics; they're fascinating and super promising, but at least for me, not transformative in the way that SSRIs were)
No individual depression treatment works for everyone. SSRIs are not a magic bullet. Neither are psychedelics. But if you're depressed and haven't tried SSRIs, you owe it to yourself and everyone in your life to at least test the hypothesis that they might help.
Scott Alexander's page on SSRIs is a great, relatively objective resource, from a psychiatrist who regularly prescribes them: https://lorienpsych.com/2020/10/25/ssris/
I think in my part my negative reaction is, like many people, having observed the effects of SSRIs on young people. It's well known that risks like suicidal ideation are actually higher among those under 25, and in general it is awful to see the mental health crisis among young people dealt with primarily via instantly reaching toward semi-permanent medication, rather than considering other treatments.
Prozac actually saved my life. Psychedelics since have certainly enhanced it, but they could not accomplish what prozac did. I can go into more detail if interested.
What was your experience like? And do you still take it?
You might be interested in the book "Empire of Pain: The Secret History of the Sackler Dynasty"[1] by Patrick Radden Keefe. Although it focuses on Oxycodone and other painkillers it touch on Prozac and other SSRI's. Quite the eye opener...
I don't mean to bring other classes of drugs in, only to note that it is _very common_ for someone to go in for one thing, find it doesn't work, and then to start tweaking / adding / combining in an attempt to find a solution, and that's where the real problems often live.
Psychiatrists can have similar issues but you don’t meet with them nearly as often. Once I got on meds that worked for me, we’d have a 30 minute meeting every two months just to check in and see if any adjustments were needed. That was fine by me because I was going to a therapist weekly, the two were aware of each other and would communicate if needed, and it saved both of us time.
Btw, have you noticed exposure to sunlight to make you even more laid back? I've recently been casually tracking a correlation in that for myself.
The bad sides of of SSRI's are as overblown as the good sides of psychedelics are. It's easy to form an opinion from reading personal experiences online but that doesn't reflect the real world imho.
I have schizoaffective disorder, bipolar type So I am prone to being more sensitive to SSRI. This is mostly to do with my genetically odd 5HT2A receptors.
Depression is no longer really a part of my life anymore after I found I was zinc deficient. But now I do tend towards the manic and have issues with psychosis still so I need to be careful with my serotonin.
Zinc can inhibit the observe shows copper, so that’s why the copper tested.
> That is, there are a bunch of tests that ask you a bunch of questions about your feelings and symptoms, and you can add them up and call that a “depression score”, and if you do that, antidepressants have an effect size of 0.3. Or you can ask patients “how depressed do you feel on a scale of 1-10”, and if you do that, antidepressants have an effect size of 0.5. I think the latter is better, because it’s what we actually care about (how patients are doing), and the tests are kind of dumb and ask about a lot of symptoms most people realistically aren’t experiencing.
(In other words, if you ask a patient with depression how they are feeling, and they say 'great', and then you ask them questions like "are you managing to shower every day", or "did you think about suicide a lot this week" and they give the same answers as a depressed person, they are cured!)
Does weird napkin math which clearly can't be justified:
> For those people, they will have a large real effect size of 1.0, plus a large placebo effect size of 0.9, for a very large total effect size of 1.9.
(How do you get to add the placebo effect back on to the postulated 'large real effect size'??)
Says that extremely common side effects are 'very unusual':
> It can be any or all of decreased libido, difficulty orgasming, difficulty getting an erection, difficulty enjoying sex, or decreased sensation in the genitals. These usually go away a few weeks to months after stopping the medication, but in rare cases they might linger for months or years, and there are a few people who say their sexual side effects never went away. These cases are very unusual and still not well understood.
(Note that in the same article he points out that, in general, the medication only improves mood or anxiety while you keep taking it, when you stop taking it you still have the depression or other conditions. So the fact that sexual disfunction usually gets resolved after stopping taking the medication isn't much relief. For most people SSRIs will never lead to a steady state where you are stable with regards to your mental health issue and also are able to enjoy sex.)
Makes armchair psych connection between well-studied things which are not the same:
> When everything goes right, SSRIs blunt negative but not positive emotions. But many people even at reasonable doses will notice that their most extreme positive emotions become a little less extreme (this may be part of the problem with sex).
(Difficulty getting aroused or orgasming or feeling in the mood for sex is not the same as "most extreme positive emotions becoming a little less extreme")
What I am on now (Lexapro) was life changing in a good way, with only minor sexual side effects that more or less went away.
As such, studies that day "SSRIs have this effect on people" or "have these side effects" are fundamentally flawed. Despite belonging to a common class, there isn't a universal experience.
This news will probably come as a huge surprise to the psychiatric epidemiologists who carried out the peer-reviewed research that Alexander mangles! They probably thought all SSRIs were exactly the same!
I was with you up to this. What even is a “psychiatric epidemiologist” I had to look it up,
“It is a subfield of the more general epidemiology. It has roots in sociological studies of the early 20th century. However, while sociological exposures are still widely studied in psychiatric epidemiology, the field has since expanded to the study of a wide area of environmental risk factors, such as major life events,“
Yeah, I don’t know, I’d sort of go with an experienced clinician when it comes to advice about pills. Sociology/epidemiology is cool, but there’s a lot to say for the importance of “practice” in medicine.
It's a bit like doing a meta analysis of hydrocarbons in two and four stroke engines. Some will work better than others in some situations, but the meta analysis itself isn't illuminating when you are putting liquid propane into a gunked up carburetor.
For what it's worth, synthetic opioids and spinal fusion saved my life. If I'd listened to the Internet, I'd have likely never pursued treatment or maybe just taken Kratom and gotten massages or something, fearing I'd end up a drug addict with a worse spine than I started with.
My advice is to take a breath and focus on the present. Chip away at what’s causing your anxiety. Don’t shy away from working on yourself. Use your medication as a tool, not as a solution.
I’m painfully aware that these are all much easier said than done. It was a three year journey for me. And who knows - I may start having panic attacks again. If I do, I’m going to try buspar.
Also. Don’t be afraid to switch medications. Don’t just live with severe side effects. Sexual dysfunction, lethargy, significant weight gain - this is no way to live your life. I found the Prozac - Wellbutrin combo to be pretty tame in that department.
I can't say the drug use caused it, but I and the rest of her friends are of the opinion that it contributed (we all have experience with psychedelics, mostly in our younger days). We know that the microdosing also turned into macrodosing on a lot of occasions. She's in a group of friends who follow Phish around, and it's basically part of their identity.
She's doing better now, but still thinks she's in some kind of a stimulation, and has described feeling like she's on a never-ending acid trip. She's always been one of my most solid friends, and this came completely out of left field.
We can't get her to go see any psychiatrists who would want to put her on anti-psychotics (which is basically all of them). So we just tell her we love her, and try to convince her that if this is all a big simulation, we're not in on it either.
The only signs we can come up with were a few times going back 20 years, either at a party (drugs) or a canoe trip (drugs) where she thought people were talking about her/plotting against her. I wasn't on the canoe trip, but I always believed her that some people in another group of friends we know were mercilessly cruel to her. Now I tend to think it was a manifestation of whatever this is.
Other than that she's been one of my most solid friends and always had her shit together, very successful career, someone I would call when I needed life advice, etc.
It's pretty easy to slip into this. I don't have a good answer for solving this but criminalization is definitely a bad answer, so we will have to find a way to discourage such tendencies. It may be that it is mostly or entirely a cultural thing in which case public understanding of the drug is a prerequisite, so I'm glad more are starting to learn about it as a result of decriminalization and legalization.
I hope she can find some way to be comfortable again.
But I think there are some serious risks to heavy, prolonged use that probably aren't well-studied or understood. Also for all I know her problems stem from the acid and not the shrooms.
I’m all for people trying them but the effects shouldn’t be underestimated. I’ve had powerful feelings of anxiety, love, euphoria, mania or sadness on different times. Very different from pot which has a pretty uniform and predictable effect on me.
Cannabis is quite a powerful drug for many. A lot more powerful than most "hard drugs" like stimulants, empatogens, opioids or sedatives, which don't "mind fuck" at all unless you do them days on end or ridiculous dosages.
No one is getting ego-death and dimensional transcendence from ripping dabs of THC concentrate all night. Just lots of paranoia and distress.
Its distressing to spill your coffee. It's also distressing to have your house burn down. The difference is large.
The THC induced paranoia and distress are usually due to effects like time-dilation, memory impairment, depersonalization, thought loops etc, which I'd put into more or less same category as you get from psychedelics or dissociatives.
Plenty of bad trips with quite low doses of THC too: https://erowid.org/experiences/exp.php?ID=70884
I think the "hardness" of different drugs, especially in how strong the effect is, is mostly a cultural and legal artifact that doesn't really correlate that much with the actual experience.
Acid also stimulates dopamine receptors, so this could be similar to amphetamine psychosis.
And what have you done for us?
I mean a cup of coffee might push the wrong person over the edge if they’re already in the midst or about to enter a serious mental health crisis?
Of course you’d have to assume a psychoactive substance might contribute but maybe not?
I’ve had serious depressive stints of existential crisis where the world felt like it was telling me I don’t need to exist anymore and I’ve had them before and I’ve had them before and after smoking pot, did it contribute maybe ? Maybe not. I’ve smoked pot since and never had the same symptoms.
I feel like that whole "world feeling it was telling you you didn't need to exist anymore" may have been it trying to point to you towards a no-self experience, which can actually be a very beautiful experience, where the 'you' experiencing reality fades away and there is just reality.
I hope this comment was okay with you, and I apologize if it disturbed you. Still, if you've got nothing better to do with your time, no-self may be something to look into.
At some point I kind of just agreed with this new idea and have been running with it since.
Buddhism often tells you to let your pain and suffering be your guide, and it works,at least in my experience.
Thanks for your thoughtful response.
She later apologized and said she thought I was joking. We don't talk anymore.
As for recovery, Jesus saved me. He can save your friend too, if she lets Him.
It is interesting to observe, retrospectively, how the brain can adopt a new set of axioms and coerce every one of the "senses" into supporting those axioms - no matter how detached from "our typical understanding of reality" (whatever that means) they are.
Brainwashing is real. Just make people really emotionally unstable and then hit them with an onslaught of social pressure with a vision.
https://opentheory.net/2019/11/neural-annealing-toward-a-neu...
In short, I had lost all faith in the "official narrative" of creation/existence/whatever as taught in schools/society/etc. that I had grown up believing (growing up I'd have called myself atheist, then agnostic). You might call this an anti-science view, but I'd counter it is more scientific to reject a theory when it does not match observations than to keep it just because it's "the standard". Anyways, this put me on a path of not knowing anything to believe, which is to say any seemingly small flashback/thought/whatever could shatter whatever worldview I had been temporarily existing in and send me into a seizure.
This continued for some time until I began to be touched by what christians would call the Holy Spirit, which guided me towards preachers of the Gospels (aka "The Word", aka "Jesus Christ" (see John 1)). I began to see the innate truth presented by The Word, as I saw how my lived experiences were consistently in agreement with it. For one, I embraced prayer and observed the Father respond to it.
Basically, I built up a new worldview around The Word (Jesus Christ) and it has been unshakable, in stark contrast to all the attempts I had made to do the same without Jesus (Matthew 7:24-27 summarizes this well).
(For those following along, this is a cute and fun example of Scripture being used to rebuke attempts to shake the foundation. The forces that be typically aren't so overt.)
Ephesians 5:18 instructs us to "not get drunk on wine, which leads to debauchery. Instead, be filled with the Spirit". And it is indeed accurate that the feeling is a higher high than wine or weed will take you. I suppose molly or heroin might be superior but I have no experience with those. And there's something psychologically nice about feeling good because you are doing the God-ordained right-thing, versus simply hijacking chemical receptors. And the Holy Spirit has no "come-down", which is nice.
Do you have Scriptural support for that? It seems like the Holy Spirit often communicated with words (e.g., "the Spirit said to Philip, “Go over and join this chariot.”"), unless you think that is simply the way it is recorded
You're saying you see dead people.
I'm trying to imagine how it relates from your short summary[1] but I'm confused how Aphantasia plays into that. [1] https://news.ycombinator.com/item?id=37995645
Phenomenologically, I'm not sure people typically "see" Jesus (Holy Spirit, et al) as much as perceive their presence or influence.
(I'd say the seeing dead people thing was a simple, bad-faith comment, but I believe it was Thomas Aquinas who made the "if you can't see it, it's because God didn't want you to see it" class of arguments regarding insensible phenomenon, so maybe it's actually a profound theological treatise they're working up.)
Yes.
> Phenomenologically, I'm not sure people typically "see" Jesus (Holy Spirit, et al) as much as perceive their presence or influence.
Not quite. Jesus is unique in the Trinity as being the fleshly form of God that can indeed be associated with a clear image, that people (at least at some point in history) were expected to see and hear. Accordingly, I have heard some (but certainly not all) Christians speak of "seeing" Jesus in a phantastic sense (sometimes quite regularly - even constantly), and conversing with Him at length in this same sense. That is beyond my ability to reason about, so I do not.
> if you can't see it, it's because God didn't want you to see it
Indeed. Learning of my own aphantasia left me feeling profoundly broken, and it was in a sense the subject of that original "bad trip". It was unsettling to learn that "everyone else" has some seemingly magical power that I do not, and I had developed a fascination with finding a way to "fix myself".
I've since come to consider my nature to be God's intentional creation, so if there is some way I am different from others there is certainly a good reason for it – even though I might not know what that reason is.
I’m starting to come around to the view that ridicule of religiosity is quite often more vacuous than spirituality.
So who has any right to ridicule anyone else for having a different perspective?
Just choose whatever narrative that floats your boat and live and let live.
It’s one thing to be ignorant of the creator (and deny creations miraculous nature), but to be ignorant of world history; please read about Rome.
> So who has any right to ridicule anyone else for having a different perspective?>
> Just choose whatever narrative that floats your boat and live and let live.
Sometimes the right answer is that there isn't enough information to choose, therefore making it 'objectively' correct.
I don't need to have an answer for life, the universe and everything to reject that kind of answer. It smells way too much of humans. The Bible even has a bit where it says a pot should not criticize his potter for making it crooked -- while the potter blaming and condemning the pot he made is perfectly fine and sane. If you have a problem and try to fix it with such things, you now have two problems. "Jesus can save you, if you let him" -- nope, he can just do it if he exists and gives a fuck about anything other than playing abusive games.
The Quran is no better, with God bragging how he could have made everyone rightly guided but didn't because he promised to fill hell with people and djinn and always keeps his promises.
It all boils down to "might is right". That stuff isn't insane, by definition, at least to those who actually lap it up, because God threatens the people who reject it.
If a God exists, and made clouds and sparrows and sunshine and love, I would basically be spitting in his face for even considering any that sordid stuff. You might say I know my shepherd's voice, and differentiate it from humans in a trench coat pretending to be a giant, which sounds like nails on a chalkboard to me. I can dig Meister Eckhart, anything below that is just brown shirt antics in my sight, and my reaction to it was and is "come at me, bro". Don't tell me my knee will bend, bend it. Shit or get off the pot.
And people who are fine with being saved from eternal torture through essentially random chance ("being pulled"), while others who are every bit as bad as them get tortured forever, who are crying tears of gratitude while looking the other way, are not the ones I would want to spend eternity with.
> That God kinda-became human to "sacrifice" himself (with no loss, got up 3 days later to live forever, nothing was sacrificed) in order to forgive the sins of people, but only if they believe it
Christianity and its doctines are much deeper and richer on these topics than this characature would imply.
2. 'profound and incomprehensible suffering' - what is Jesus supposed to have suffered which is different from many other humans who have been betrayed, tortured and killed? Whatever you think it is, it appears to be extra-biblical. The Gethsemane quote is just "my soul is exceedingly sorrowful, even unto death". Allowing for loss in translation this is an expression of suffering well within human experience.
3. 'the vast majority do beleive that there are effects for everyone, regardless of belief in this life or the next' Sorry, no. The vast majority of modern Christians belong to churches for which 'sola fide' is not just an essential part of their theology, but the foundation of their existence.
And everyone is affected: even if they may not be saved, they are all still resurrected in the end days. This is uncontroversial, and documented throughout the bible. Here is a summary: https://www.desiringgod.org/articles/will-all-people-be-resu...
And not sure why you say "conservative Evangelical" as if it means less. They are the most biblically-based sect around.
But in my opinion, it's because they're better than the religion. That is their humanity, such humanity is not found in the source materials. I can only speak for myself: in my early 20s, I was confused and deeply in pain about the state of the world, and through a series of coincidences (or signs from God :P) I ended up kinda, vaguely, believing in it. I wanted to believe in it. But I could not get over my empathy for everyone: if everybody isn't saved, nobody is saved. Not to mention that "saving" someone from the wrath you inflict on someone for not believing you saved them is equal parts crazy and abusive. Jesus can mock the wise and laud the wide-eyed children all he wants, but even in the deepest depths of my desperation I could not accept it. I read the stuff, I think about it, and I'm out.
My beef isn't with God, if it exists. But I do have beef with religion, yes. Disappointed with the Bible, I turned to the Quran, found the exact same content with even more bragging. And something about "Jesus can save you (if you let him)" did kinda trigger me, since the Bible says, nobody can come to God lest they get pulled. So don't blame people for not getting pulled, that's victim blaming.
Under these interpretations, there is no "wrath" inflicted upon the lost, they simply do not gain the reward of having faith and instead enter into the "default" death state.
> "Jesus can save you (if you let him)" did kinda trigger me, since the Bible says, nobody can come to God lest they get pulled. So don't blame people for not getting pulled, that's victim blaming.
Your view is sounds consistent with a lack of belief in Free Will, is that what you believe? The Calvinist branch of Christianity supports this view, but it is not the only interpretation. If you don't believe in Free Will might as well just stop reading here because nothing is in your control anyways :)
If on the other hand you do believe in Free Will, it must be the case that you have a choice in coming to Christ. It is true that nobody can come unless they are pulled, but they can also resist that pull. The Bible speaks many times of God saying mortals resisted His call. Most famously perhaps Sodom and Gamora.
And the pull can come in many forms, most commonly in being preached the Gospel. It is very hard at this point to exist in the world without someone at some point having attempted to preach the Gospel to you, and the Bible makes it clear that Jesus Christ gave up his life so that all may be saved. Indeed, the most famous sentence in perhaps all of time supports this: "For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life" (emphasis mine).
So under a non-Calvinist interpretation everybody has the opportunity to come to salvation, assuming they have heard of Christ (the pull), and it is up to them to choose to do so, by choosing to believe in Him.
It's a shame you can only experience your comment from your perspective.
Now, you are the author of the entire creation. At any point you can intervene in any way you want, for instance to relocate an entity that was very far from the light to be much closer to it. And you do indeed do this quite regularly. In fact a large amount of what you do as the author is go out to find the entities that are very far from the light and shepherd them back to be close to it. Sometimes, this relocation sticks: the entity sees the light, recognizes it, and continues to pursue it. Sometimes, it doesn't: the entity either wanders around aimlessly with no regard for the direction of the light, or indeed it actively pursues darkness.
At the end of the generation you have a spectrum of entities: those who never left the light, those who strayed occasionally but always took to your shepherding back, ..., all the way to those who actively ran away from the light at every opportunity. So yes, you are the author. You have complete control over how all these entitles move into the next generation, and you can save all of them if you'd like. But why would you?
And if the goal is just to allow as many entities as possible to enjoy the light, why not relocate them all to be close to it? Why not save all of them into the next generation?
> And if the goal is just to allow as many entities as possible to enjoy the light, why not relocate them all to be close to it? Why not save all of them into the next generation?
I'm not sure that is the goal, but regardless your machine only has finite resources, but is changed with presenting an infinite environment. Sacrifices must be made.
And if you have an argument to make, make it. Don't just say "other people made arguments, and trust me: they were really good".
Sure, he was wrong... but not worthy of ridicule. It's just so easy and satisfying to assume that disagreement indicates stupidity.
Ditto for any flamewar, but the religious kind is particularly bad and also easy to avoid.
> As for recovery, Jesus saved me. He can save your friend too, if she lets Him.
It's best not to proselytize on HN. It's ok to talk about your own experience of course, but when it starts to move into standard religious tropes, that's already a kind of flamebait and discussion quality plummets, and boy did that happen in this thread.
I think the best you can do is be a calm friend and imagine you're dealing with a two year old without being condescending.
You could also try contacting https://challengingpsychedelicexperiences.com/
There are also therapists who work with people before and after psychedelic experiences, called psychedelic integration therapists. They usually have legit mainstream psychotherapy qualifications.
There are also integration circles where people support each other. For example, https://acerintegration.com/ This was set up by a researcher in psychedelics. Not sure if it would be appropriate for someone experiencing psychosis though. You could also try contacting the researcher directly for recommendations: https://www.drrosalindwatts.com/
There are also forums where you could ask for advice, e.g. https://old.reddit.com/r/RationalPsychonaut/
They might be able to point you to other resources like this in your area.
Another contributing factor in all this is she lost her job, which gave her a lot of satisfaction. She has savings, so she's not hurting for money. But sitting around all day in her head and getting depressed isn't good.
Do you know how frequent the macrodosing became? I have never seen or heard (anecdotal) of microdosing leading to a psychotic break. But frequent use (more than once every three weeks) of large quantities will almost certainly harm you in the long run.
I assume stuff like that happens a lot in her Phish group. Other times we've hung out at a party she's broken acid/e/shrooms out and I'm thinking, "We're not 25 anymore, we don't have to do this."
At the time I kind of admired her for still being willing to go to those deeply introspective trippy places, whereas I'd rather just get a nice buzz and not plumb the depths of my soul. But now I'm thinking it's probably a good thing to hang that stuff up after a while, or at least not keep doing it regularly.
From my experience, the psychedelics will "tell you" to slow down, but it's up to the individual to make that choice.
Here's a recent Guardian article:
https://www.theguardian.com/society/2023/apr/17/i-stopped-sl...
From the article:
> Horowitz experienced a prolonged antidepressant withdrawal in 2015 that caused intense panic attacks and, he says, even left him contemplating suicide. This personal experience has led the training psychiatrist to become an advocate for reforming antidepressant deprescribing.
> In June 2022 the UK health regulator, Nice, amended its guidance on how to support people coming off antidepressants, acknowledging the severity and length of withdrawal symptoms can vary. Nice encourages slow, staggered tapering over many months, if needed.
> In Australia, the RANZCP guidelines continue to recommend tapering by halving and quartering the lowest dose over about two to six weeks, and acknowledged that while slower tapering might sometimes be needed, it mostly isn’t possible in Australia “as current preparations of antidepressants do not allow for the dose to be reduced by such small decrements”.
There are well documented side effects of stopping SSRI usage that are not related to the original symptoms that the drug is prescribed to treat.
But yes, we all have different experiences, and there are many types of SSRIs. :-)
> psychiatrist and former RANZCP president, Prof Malcolm Hopwood, says most people who taper off a standard antidepressant dose will be able to do so without major withdrawal symptoms ... "There’s a _small_ group who really experience significant withdrawal symptoms that they really find very difficult to manage"
Discontinuation symptoms are a real risk, but people who could really benefit from these drugs absolutely shouldn't be put off by a categorization of these symptoms as being typical.
A small group that has severe side effects and finds them very difficult to manage is kind of a big deal in a class of drugs that actually have small effect size in the medical literature.
0: https://www.health.harvard.edu/blog/discontinuation-syndrome...
Comments like this -- and there are an awful lot of them online -- dissuaded me for a very long time from taking SSRIs. And that was a terrible mistake: SSRIs have been a life-changing good for me. I am on a high dose of Lexapro, and in no way do I live in a gray fog, and my relationships are markedly better. My GAD is gone, completely.
A few years ago, a doctor tried to convince me that they were causing sleep apnea, so I came off them, slowly, over many months. I didn't have cessation symptoms. My anxiety slowly returned, in proportion to the dosage, my sleep apnea didn't improve, and I was glad to start them again.
They're terrible for some people, but they work well for others. I don't think they should automatically be disregarded.
> In the worst case, they cause suicidal ideation
Is this actually true? My understanding is that people in severe depression can have suicidal ideation but not actually be able to put in the effort/energy needed to go through with it. SSRIs initially give you a little more boost in energy before the mood-lifting effects kick in. During that middle phase, we observer higher suicide rates because you've now enabled them to have effort to follow through with their suicidal ideas.
It seems like you forgot the word "ideation" is in the original claim you're disputing, based on your description. Yes it is true that SSRIs can cause suicidal _ideation_. And the first step to suicide is suicidal ideation.
You can only know how bad it was in retrospect.
I no longer experience anxiety to the same degree I did back then, no use of other SSRIs or any other drugs.
This isn't meant to scare people into not trying SSRIs, just sharing my experience. I think had I been more informed of the potential risks and changed my attitude of toughing it out, it could've probably been more beneficial.
Stopping cold turkey was bad news for me, too. I got the "zaps" any time I turned my head. So, I decided to taper down, which worked fine.
GlaxoSmithKline paid the Department of Justice $3 billion for covering up evidence of this while promoting their SSRI to under-18s. They paid the fine in 2012, 11 years ago. The medical trial was done in 1994-1998.
In 2003, the (UK medicines regulator) MHRA obtained full clinical data from Glaxo, and based on that data forming robust evidence of significant increase in suicidality, both the MHRA and the FDA immediately said that paroxetine couldn't be prescribed to under-18s.
The UK govt rules on how to report medical trials were changed in relation to what happened with the publication of the Glaxo Paxil trials.
GSK paid around $1 billion in the 2000-2010s to settle several hundred lawsuits, including many many suicides and several family annihilations.
The main investigative news TV show in the UK, Panorama, reported on this in 4 shows between 2002 and 2007.
The Boston Globe did significant investigative work on this around 2005, including a book published by their reporter.
In view of that, your question comes across as at best, uninformed and naive.
Sometimes I feel foolish for being skeptical about safety claims for food additives/cosmetics/pharmaceuticals/etc, then other times it feels completely rational.
But you do you, I won't judge foreign exotic cultures.
2/ there is increasing evidence that psychedelic therapies for mental illness were all based on hype and don’t actually perform any better or at all
Psychedelic therapies are most definitely not based on hype -- there's real research being conducted by real doctors, and it's only becoming more prevalent.
[1] https://www.hopkinsmedicine.org/psychiatry/research/psychede... [2] https://www.nejm.org/doi/full/10.1056/NEJMoa2206443
Let's hope language doesn't have something to do with how humans perceive reality! (Or, maybe I have that backwards.)
This year it's been discovered that 5HT2A (ie the sub-type psychedelics target) receptors are implicated in my disorder which would explain why messing around with serotonin-modifying chemicals had adverse effects. I wonder how many people are walking around with sub-clinical neurological issues that get suddenly exacerbated by antidepressants?
Psilocybin on the other hand acts kind of like the serotonin molecule itself. It attaches to most of the serotonin receptors, including the two receptor. The reason why it works for so long is you get such a huge and strong attachment to the serotonin receptors that the body ends up, reducing the serotonin receptors in response. It’s this lack of serotonin receptors that make us more sensitive to what little serotonin we make.
There’s nothing non-pharmacological about the effects of mushrooms.
What we believe we know is that low serotonin in the brain does not directly cause depression, and artificially lowering serotonin in individuals does not induce depression (at least not in the way researchers have done so, within the time limits they measured).
None of this necessarily means that SSRI activity downregulating the reuptake of serotonin is not the primary mechanism of action (pharmacologically speaking, it definitely is the main thing this class of drug is doing in the body).
It's worth noting that we also have a ton of serotonin receptors in our GI tract, and SSRIs do have notable activity there as well, to the point that they can relieve chronic constipation in some individuals. Although levels of serotonin outside the brain (which represent 95% of serotonin produced by the body and our microbes) generally get ignored in analysis of depression, since serotonin cannot cross the blood brain barrier, it may well be very relevant to human health, both physical and mental, for as yet unknown reasons.
Depression is a multi causal disorder.
SSRI side effect prevalence is a hard thing to measure for a large variety of reasons. But in [1] only 1/4 patients report the side effects as ”very bothersome.” Given that 100% of patients are so anxious/depressed that they want to try psych meds, it seems like SSRIs are a great treatment option for many.
A quarter of patients reporting very troubling side effects is not great for a class of drugs with an effect size around 0.3, or about 10% more reduction in depression symptom scores compared to placebo. If you have run out of options and are desperate for relief, it may be an appealing risk/reward equation for some people. But the notion that 100% of patients believe they need these meds, rather than had the drug recommended by a doctor/psychiatrist (who maybe didn't go into great detail about the potential risks vs tempering expectations about how likely they are to help), is absurd. It totally ignores how our medical system operates in most cases. Many times, the doctors prescribing will be informed by drug company PR literature moreso than careful reading of scientific research.
Isn't this the primary effect, more than a side effect? Atleast in my case, it's been super helpful, going from jumping between a 1 to 7 in mood, to just lie around 4-5-6.
As others have stated in this thread, this overt generalization is harmful. SSRIs and psychedelics have both been studied, and both have outcomes that we don't really understand. To say one is better or worse than the other in most cases is pure ignorance.
We all have roughly the same physical properties to our brains but how they develop is truly unique to every individual, which leads some methods of treatment for mental health disorders more or less effective than others. I am 100% onboard with pursuing psychs for treatment if you want, but its not for everyone and neither are SSRIs.
I'd downvote this if the responses weren't so full of instructive counterpoints.
It took me MONTHS to even consider SSRIs because of rhetoric like this that is online and pervasive in our culture.