> The same is true for people that say that antidepressants are mostly placebo. They are not.

In fairness, anti-depressants are a lot of drugs. The article gives a list. 23 of them seemed to be better than placebo, 19 of them were much less clear.

> When people say that antidepressants saved their life, they aren’t joking or exaggerating in the least.

Placebos can also save people's lives.

I was incapable of the compassion you're talking about until I had a bad shroom trip and felt some horrible, hard-to-describe anxiety the next morning. It was some of the worst hours of my life until my serotonin system rebalanced itself.

I'm not saying it's the same thing as depression or regular anxiety, but it gave me tremendous perspective on how bad these conditions can be and you just don't have the ability to "shake it off" when things are unbalanced.

Maybe that's how my wife feels when she's off the meds. Shit. Now imagine having a douchebag by your side second-guessing your pain. Never again.

> Maybe that’s how my wife feels

The good thing is it isn’t necessary to know how someone else feels to have compassion.:)

It’s enough to accept you don’t understand the other person‘s thought process and stop trying to tell them what they are thinking. You don’t need to fix things, you just need to listen and not make them justify or explain themselves to you.

Doing nothing is better than doing the wrong thing.

This comes from my own personal experience. I can’t relate to people on an emotional level. Every relationship is processed with deliberate, logical action. If I love a friend, I need to figure out what would change their internal state so they can experience that love.

From the outside, this looks like I can relate on an emotional level.

Precisely. That's what I took from the experience as well. If that's so hard and I had no idea about it until now, maybe there are other things that I don't know, and some that I will never learn, and I should tread lightly.

Lexapro saved my life

Lexapro made me feel like I was randomly being dropped down an elevator shaft for 6 months after I stopped taking it. I’m glad it worked for you, and am not minimizing that, but these medications have a side effects profile a mile long and should be a therapy of last resort in my opinion.

The problem with antidepressants are that while we know, more or less, what they do, we don't know why they work for some and not for others. Escitalopram (Lexapro) was a vast improvement for me over Citalopram. Then it plateaued and a year later, left me anhedonic. Tried an SNRI that would give me brain zaps every day a few hours before my next dose and it was horrendous to quit using. It also messed with my ability to meditate for a long while. Basically, I could put myself in a mental state that would trigger the same kind of painful brain zaps that withdrawal from the SNRI caused.

They have a half life and you cannot stop taking them cold turkey without these symptoms, your psychiatrist should help you ween off of it slowly.

At the time I was unemployed and didn’t have a car, not much the psychiatrist could do about my “dirt pooritis” symptoms.

I can't go so far as to say it saved my life, but I'm part of that cohort of 10% of men who develop postpartum depression. Taking a small dosage of Lexapro had zero side effects for me and helped me deal with not just the anxiety and depression I was experiencing but also a lot of pre-existing anxious behavior that I didn't even realize was abnormal.

Huge quality of life improvement. 10/10 would medicate again.

A: The same is true for people that say that antidepressants are mostly placebo. They are not.

B: When people say that antidepressants saved their life, they aren’t joking or exaggerating in the least.

Are placebos unable to save lives?

Not claiming antidepressants are or are not mostly placebo, and don't mean to minimize the pain of depression in anyway. I just don't think whether or not they saved a person's life is an indication either way. The placebo effect is real, right? As in the subject actually gets better after taking it.

> Keep your pet theories to yourself if you are not a subject matter expert or someone who has experienced it first hand.

This is the internet, friend. I wish you the best, but maybe don't put too much hope into that one. I think you'll have better luck cultivating the ability to be comfortable having your own beliefs while others have different (possibly wrong!) ones.

When you do this, you're just accusing people of having no real evaluative power about their own experience. It's pointless, and it's not really an opinion.

Placebo-controlled RCTs show that some people react well to antidepressants with major variation from person to person.

Maybe I wasn't being clear, since I didn't mean to accuse anyone of anything.

I'm not disputing that someone had the genuine experience of antidepressants saving their life. I'm asking if that precludes antidepressants acting as a placebo.

In other words both things can be true: antidepressants saved someone's life and antidepressants can act as placebo (even in the case where they saved someone's life). And notice I'm saying "can be true". I'm not saying they are true, cause I have no idea.

This is a logic question, not some kind of moral attack.

There are indeed some form of serious depression that are non-responsive to psychotherapy alone. Those are however not the norm. Dr. David D Burns, practising psychiatrist and author of the book Feeling Good: The New Mood Therapy has written a whole chapter in it on the appropriate use case and effectiveness of anti-depressants today. (If you are considering using anti-depressants, I urge everyone to get the latest revision of his book and read that chapter). He believes anti-depressant has its use during treatment but also shares studies that suggest modern psychotherapy, like Cognitive Therapy which he advocates, has now begun to surpass the effectiveness of anti-depressants in "curing" depression in the long-term.

A particular point he makes about depression in it is insightful: Although depression is conventionally viewed as a medical illness, research studies indicate that genetic influences appear to account for only about 16% of depression. For many individuals, life influences appear to be the most important causes.

As a counterpoint, I experienced such severe negative symptoms after taking SSRIs that I had to be hospitalized for months. Medical treatment is not without its risks. I would always advise trying NPIs before drugs.

I don't in any way mean to discount adverse affects, or negative experiences. Those are just as valuable points. People should be aware of the risks when they take any pharmaceutical, and there are doctors who will happily prescribe these drugs without educating the patient or themselves about downsides and alternatives.

My point is that a lot of the commenters here are saying some variation of "have you tried being happier?" and "these drugs do nothing". Both of which are absurd to the point of offensiveness to people who have gone through it, in the same way that it would be absurd (and offensive) to claim that these drugs have no possible downsides and a negative reaction is placebo.

If only I knew what an NPI was.

Non pharmaceutical intevention

The placebo effect is a statistical reporting effect. Not a physical effect.

Somaticizers absolutely will change their behavior in response to a placebo.