Recovering Emotions After 24 Years on Antidepressants

https://www.madinamerica.com/2018/10/recovering-emotions-24-years-antidepressants/

280 152 8 years ago

pasabagi5• 8 years ago

YMMV, but for me, anti-depressants allow me to have emootions. When I'm off them, emotions are way too intense, so I clamp them all down until they're barely there. After two years of anti-depressants, I'm finally able to listen to music I really like, read books I find emotionally affective.

asah• 8 years ago

interesting! what are you on and what dose did you settle on?

pasabagi5• 8 years ago

I'm on setraline - a pretty light dose, these days (can't remember it off the top of my head). I've been prescribed a bunch of stuff over the years, and have developed the impression that the prescription process is more art than science. Doctors tend to overprescribe, so you get sledge-hammer style effects. A good psychiatrist will usually prescribe two or more anti-depressants in light doses, so you don't really get side-effects or weird stuff.

Obviously, starting and stopping drugs is always rough, but I have tried living without them, and I see no benefits. You do generally get side-effects to some degree (I have very dry skin at the moment) - but if you have even the most trivial depression, you'll probably find you prefer them to even a light episode. Also, they aren't a silver bullet. I still have depressive days, from time to time - but the difference is, it's not my life anymore. I can hold down jobs, have relationships, etc.

Fnoord4• 8 years ago

For me, Prozac (SSRI) cuts off those sharp edges. But when I started using it I could barely walk with it (e.g. taking stairs gave me intense muscle fatigue, nausea, and I was very tired in general), so strong it was (eventually this initial effect faded away). I have an ASD diagnosis.

pasabagi5• 8 years ago

When I started on venlafaxin, I used to fall out of chairs. I think part of what gives anti-depressants such a bad rap is they have a god-awful beginning and end.

I still go around evangelising them, because I just can't bear to imagine all the people who get put off by the (horrible) start and horror stories, and live in purgatory for years with no light at the end of the tunnel. Because, as far as I can see, side-effects usually just mean the dosage is wrong, or the drug-combo is wrong.

agumonkey• 8 years ago

I have a parallel, I used to be overly shy (crippled to a point); thus drinking two beers would de-inhibit (npi) me just enough to be able to sit in a party without feeling affraid etc. Some say that it's a bit alcoholism, but to me it just recalibrated a twisted system to be able to be stable and ~normal.

Best wishes for the future.

tw1010• 8 years ago

How do you recover emotions without ever having been on antidepressants?

psergeant4• 8 years ago

https://www.thecut.com/2016/04/what-it-s-like-to-wake-up-fro...

PavlikPaja2• 8 years ago

Autistic people were never thought to lack emotions, in fact many complain about feeling too intense emotions. The article is garbage.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518049/

https://www.frontiersin.org/articles/10.3389/fnhum.2010.0022...

Spivak• 8 years ago

Assuming you're not being snarky I would strongly recommend talking to a therapist if you feel this way. There are many reasons people have suppressed/muted emotions and a good one will help you find yours.

One example of a cause that's not just 'you might have depression' is 'you might be transgender'. One of the most common experiences of trans women is severely suppressed emotions prior to recognizing their dysphoria and before HRT. Some of my favorite things to read on the internet are stories from trans women about the first time they cried (and then usually cried again because they were so happy about it), the first time they laughed uncontrollably, or the first time they felt passion/anger. Super hartwarming stuff.

psergeant4• 8 years ago

The only thing that seems to be universally true about mental health is that we’re all different, and someone else’s experiences rarely apply perfectly to your own.

I put off getting on the meds for at least 15 years longer than I should have done because of stories like this. They have been life changing lot positive for me with almost no downsides.

In addition, I’ve read more than one story like this where the person eventually decides it’s time to get back on the SSRIs after a year or two off.

Experiment, find what works for you, but these articles that are angry at big pharma and describe pills as primarily bad need to be seen very much as just localised experiences.

presscast2• 8 years ago

In all fairness, though, these aren't isolated incidents. There seems to be some subgroup of the general population that suffers from SSRIs. That's what's interesting here -- what binds these people together as a group.

In other words, brushing this aside as "just a bunch of individuals" isn't useful, nor is it satisfying anyone's intellectual curiosity.

psergeant4• 8 years ago

brushing this aside as "just a bunch of individuals" isn't useful

If it gets one person like me who was under the impression that SSRIs make you a zombie, to try them, then it’s useful.

Broken_Hippo• 8 years ago

Yes, it does. Some individuals react differently. Some individuals cannot take aspirin daily for heart benefits, some cannot take ibuprofen for pain relief. Both these drugs can have reactions with other medications. It isn't an insignificant portion of the population, but we shouldn't allow those individuals create a dialogue that scares others away from trying the drug.

If anything, we just need to spend a bit more time talking to folks about the possible side effects of the medications.

escape_goat2• 8 years ago

They aren't isolated incidents, just as the testimonials from people who were really helped by the exact same drug aren't isolated incidents, and the testimonials from people who have experienced side-effects that were not discovered by the original qualification study are not isolated incidents.

Psychiatric medications, in many cases, do genuinely affect different people differently. This has been well known for a long time. It also contributes to the contrast between anecdotal clinical experience and what are often dismal statistical performances.

The difficulty is with people who feel that they have a grievance with the pharmaceutical companies and the medications themselves, when they actually have a grievance with the doctors who directed their care.

mysticmode2• 8 years ago

This! is what I believe not only in mental illness perspective but in every way. I'm bipolar type 2 and I have been on and off on medications for a long time and suffered a lot. For the past 4 years I've been continuously taking meds and my life, my work and my relationship with other people has improved and I'm quite stable.

Like you said, people are different, the thing that works for one person doesn't necessarily need to be working for others. Antidepressants and other meds saved my life!

tren• 8 years ago

Hey! I'm wondering how long it took you to get diagnosed as bipolar 2, and who diagnosed it - GP, psych? This last year I've been suffering depressive episodes that have really affected my capacity to function properly. They're always interspersed with really good days, maybe too good -- heaps of planning and ideas, unbridled optimism etc. It's hard to know what's considered to be the baseline for normal mood fluctuations.

rjkennedy98• 8 years ago

Keep in mind that for many people taking drugs is:

a) not a choice they personally made (coercion by the school system or authorities or parents).

b) they were lied to about the effects and side effects.

c) they were prescribed 'off-label' which means essentially with no proven efficacy.

When you say "Experiment, find what works for you" keep in mind how offensive that is to people who feel they were lied/coerced into a taking drugs that in some cases ruined their lives.

psergeant4• 8 years ago

When you say "Experiment, find what works for you" keep in mind how offensive that is to people who feel they were lied/coerced into a taking drugs that in some cases ruined their lives.

Right, like suggesting people find employment is offensive to people who have experienced slavery.

escape_goat2• 8 years ago

I have strong feelings about your response.

There are people who were either medicated at a young age or forced to take medication through legal proceedings. Of those, most will have experienced the same hit-or-miss phenomenon with psychiatric medication. In some cases, however, this means that they were forced to take medications that had debilitating side-effects or didn't particularly work, and experienced serious stress trauma due to their ongoing helplessness in the situation.

I do not expect them to be any less capable than anyone else, as a result, of understanding that other people are not them. I do not expect them to be offended when other people describe experiences that are not theirs.

You're responding to the advice of someone who has taken medications voluntarily and had control over the process; this person is writing in response to an article by a man who, for all his bad experiences, was ALSO taking medications voluntarily.

The statement that you single out as objectionable is actually nearly universal advice, and reflects my own experience with medications and mental health problems.

If your comments about "how offensive that is" are based in your own experience as someone who was coercively medicated, I would be interested in hearing an explanation of why you find them objectionable. If they are not, however, I seriously question the value of your interjection into the conversation.

I am attempting to be gentle and moderate in my response and I apologize if it seems harsh to you.

astura• 8 years ago

"Off-label" does not mean "no proven efficacy."

Some off label uses have little to no research behind them, but some are well studied.

sigotirandolas• 8 years ago

It's just human nature, I guess. There's people from whom antidepressants don't work, and there's people from whom therapy doesn't work (unfortunately, those are not mutually exclusive). However, it seems to me that the individuals with the combination (antidepressants dont't work, therapy works) have a much easier time making an impacting narrative given our current intrinsic and social biases.

My advice to those suffering from depression/anxiety would be to do their research and decide which treatment method they prefer, and to reevaluate once in a while how it is working, keeping in mind that it's very easy to get into a 'bubble' and discard or discredit potential treatment options. No one, no matter how smart, is able to overcome biased thinking.

In my opinion, there are only a few options that have substantial evidence going for them (by the so-called mainstream science): various SSRIs, combinations and uncommon antidepressants, cognitive-behavior therapy and mindfulness-based therapy. One should balance exploitation (taking whatever one thinks works better at a given moment) and exploration (taking one option that one hasn't tried yet) to maximize the chances of successful treatment.

nicoburns• 8 years ago

Out of interest, how long have you been taking them for? I've heard lots of stories of fantastic short-term benefits, but not very many (in fact, not any that I can think of) where they continued to work long term. I'm not saying they can't work long term, in fact I guess that's why I'm asking, to see whether you are or know of examples where they have worked out long term.

snegu• 8 years ago

I took them for about 15 years (with a couple of little breaks), and they helped significantly the whole time. I went off them when I got pregnant (did CBT), and am still off 3 years later. I would love to go back on because the anxiety has come back (though not the panic) and I know I don't have to feel like this. However, the stigma keeps me off. Kinda sad.

ssorina• 8 years ago

I am also a bit skeptical when strong anti-Pharma opinions are expressed, based on personal experience only. Meta-analyses have shown that for severe depression, antidepressants are a first line of attack, only seconded or aided by CBT, but not interchangeable in terms of efficacy. It's kind of stupid to counterargue with yet another personal story, but for me not being able to take SSRIs has proven to be a real problem. I developed a somewhat rare side-effect with both SSRIs and SNRIs, I basically covered up in unexplanable bruises and given the increased risk of internal bleeding, am cut off from this medicine class completely. The only time in my life where I was not crippled by anxiety was on these meds. I continually try relaxation, CBT, DBT and whatnot, but unfortunately I am one of those who does not respond as well to therapy as I do to medication. To be really honest, I am on the other side of the fence: I hope big pharma comes up with something else than benzos and SSRIs for anxiety, so that I can be relieved from the task of living my life spiting anxiety 70% of the day.

throwaway8952373• 8 years ago

I hope big pharma comes up with something else than benzos and SSRIs for anxiety, so that I can be relieved from the task of living my life spiting anxiety 70% of the day.

Have you tried psilocybin mushrooms or DMT? I'd been on meds for years treating depression and anxiety. A few mushroom and DMT experiences have basically cured my depression and anxiety and opened up a whole new way of looking at things.

op00to4• 8 years ago

I'm a legal medical cannabis patient in my state, and it has been HUGE in helping me use CBT in controlling my anxiety. Far better than Benzos.

curun1r4• 8 years ago

Have you considered meditation? It's been somewhat of a godsend for me after more than a decade of horrible side effects from anti-depressants. I'd highly recommend the eastern variety since I got no benefit from the watered-down "mindfulness" variety peddled by my psychologist and didn't have that "aha" moment until my first 10-day retreat.

epmaybe2• 8 years ago

I don't know if I'd call them localised experiences per say, as I feel it minimizes what patients experience. I've probably done that to commenters here in the past regarding depression and pharmaceuticals.

However, I largely agree with what you are saying, everyone is going to have different reactions to these medicines. They're all "dirty" (note that SSRIs are far more specific in effects than previous generations of antidepressants) in terms of the vast number of effects neurotransmitters have in our brain, so it's understandable that they wouldn't work the same for everyone.

drb912• 8 years ago

Hey if we’re offering sample sizes of one, SSRIs make me sleepy and unmotivated—nearly the opposite of a helpful effect. I’ve also heard quite a few complaints from women friends about weight gain. Sexual side effects are common. For me, at least, SSRI medication was and remains to be a distraction from mental health treatment.

I also have plenty of rage at big pharma, but that’s more around enabling bad therapists to prescribe medicine without providing the appropriate support. They obviously have every incentive to make sure that anyone who sees a psychiatrist has some medicine that could apply.

op00to4• 8 years ago

Huh. SSRIs made my life way better, but I also get sexual side effects. For me, at least, SSRI medication was and remains to be a critical link in mental health treatment.

rhizome3• 8 years ago

Hey if we’re offering sample sizes of one, SSRIs make me sleepy and unmotivated—nearly the opposite of a helpful effect. [...]Bad therapists...prescribe medicine without providing the appropriate support

Consider the possibility that you have had bad doctors diagnosing and prescribing for you. Also, there are a lot of therapists that don't (can't) prescribe, maybe it's a good idea to seek help in that direction?

interfixus• 8 years ago

The causes of my depression were environmental. I grew up in a very dysfunctional family in Minnesota. My parents were both alcoholics and depressed, and their dysfunction became my growth environment

This may be the case, and there may be corroborative evidence for such a conclusion that we are not told about.

But as presented, it's just a set of circumstances, presumably correlated. If both parents suffered depression, author might reasonably be supposed to have a strong genetic predisposition.

Random_Person• 8 years ago

I've been tapering off of my antidepressant for 3 weeks now after 4 years.

The sudden flood of emotions has been weird, but familiar. I can't imagine going decades without.

mnm1• 8 years ago

It took me about a year to get to the point the author describes where I felt nothing and didn't care whether I lived or died. I wasn't suicidal--at last I don't think I was--but I was rapidly approaching that point. I was so desperate, I let the doctor put me on benzodiazepines for anxiety even though I knew from previous experience that I would not only become dependent but addicted. After seven years of that, I had enough and stopped seeing all doctors. I weaned myself off the benzos as no doctor I saw even knew how to do it nor did they want to. It wasn't as hard as I thought. After I was off that, the hard part started. Over the course of years I learned how to deal with life again. Eventually I took up running, my own meditation equivalent and soccer. Slowly things improved. It's not always great and many of the original problems are still there but they are mostly manageable.

I'm lucky to be alive really. I try to remember all this suffering at the hands of doctors and the pharma industry that could have been avoided. I will have trust a so called mental health professional again, especially if they are drug pushers. The conflict of interest was readily apparent throughout the whole ordeal both when taking antidepressants and benzodiazepines. It's funny how we demonize some drug dealers while having insurance coverage for others. And all this without a single shred of proof that these medicines work, that there is even such a thing as a chemical imbalance. Because there isn't. If this is what mental health doctors call facts, the entire establishment has failed and derailed into nothing more than making humongous profits from getting people addicted to the drugs they push. It's fucking disgusting.

simen2• 8 years ago

I sympathize with you, I really do. I've had some similar experiences. But you're overstating the case. Numerous meta-analyses have found that antidepressants do work for people with severe depression, much better than placebo. Unfortunately there's many people for whom they don't work, and even when they work you may have to try many different kinds to find the right one(s). The state of depression treatment is sadly not very good right now, everyone knows this. But it's just not true that there's not "a single shred of proof that these medicines work".

Depression treatment doesn't depend on "chemical imbalance" as an explanation either. Research on whether antidepressants work proceeds alongside research on why they work, if they do--usually studies on the efficacy of drugs are completely independent of mechanism. They study clinical outcomes, not neurochemical or larger structural brain issues.

So even if we had no idea why antidepressants (potentially) work, we could still know that they do work based on clinical outcomes. And it's not exactly true that we have no clue at all. The past 20 or so years the monoamine hypothesis hasn't been the main avenue of research into the neurobiology of depression. These days, it's at best considered one possible factor, not the defining and only factor. There's a lot of research into the structural changes that follow depression and recovery. For instance it's now known that serotonin helps regulate the expression of BDNF, which in turn regulates the growth and repair of brain cells and synapses. So it may well be that serotonin triggers large-scale "repairs" in the brain in areas related to emotional processing, such as the amygdala. Here you can see that the focus isn't so much on individual levels of "chemicals" in the brain as on the structure of the brain and how different natural and exogenous factors affect that.

gcb0• 8 years ago

just because it works better than placebo doesn't make it the best treatment.

all over the world, terapies works better than antidepressants, with infinitely less undesirable side effects for patient and society. yet in the US it is very common to treat depression (and many other conditions) with drugs alone.

arguments against drugs is not favor of "don't do anything". that argument would be extremely dumb.

just to give some perspective on how badly interpreted the data is in your argument: brain-splitting surgery, which is still used for epilepsy, also shows a cure for several other conditions, yet nowadays you would be a criminal for even suggesting it for things it was widely used 20 years ago.

dhubris• 8 years ago

From past experience, about four months after I've tapered off anti-depressants I'll want to die. It'll take about a year to recover once I'm back on them.

But that's me. What works for me may not work for you. Unfortunately, a lot of it is trail and error, along with a lot of hard work, to figure out what is the best treatment for each individual. It sucks that this is the case.

At I wrote once upon a time[1]: "There is no silver bullet. Pragmatism trumps opinion. If, and I stress, if what you are doing is working for you, then I wish you good fortune, and would never tell you you're doing it the wrong way."

[1] https://dhubris.livejournal.com/14447.html

choot• 8 years ago

I am using Withania Somnifera to cure my depression. I've not experienced the loss of emotions using it.

FourthProtocol• 8 years ago

American use of antidepressants comes up at dinner conversation every so often. Stats are readily available, but what's less apparent is why it's so widespread in the US. Does anyone have any ideas why this is?

projektfu• 8 years ago

I'm taking a wild guess based on your domain name that you're in the UK.

It appears to be about 11% in the US, 7% in the UK. So, 63% more in the US, but still a reasonably small fraction of the population. Or, if 11% is sizable, so is 7%.

https://www.businessinsider.com/countries-largest-antidepres...

The question is how many suffer depression without medication, and how many remain on antidepressants after recovering, as an insurance policy. Is there less suffering in Korea? Or more stigma against using antidepressant drugs?

tk75x• 8 years ago

11% of ~325 million vs 7% of ~65 million = ~31 million more people using antidepressants in the US than the UK. Also I'd hardly say >10% is reasonably small, but that's a judgement call.

DenisM• 8 years ago

I’m guessing that population density has a negative effect on social interactions, plus having to drive everywhere reduces physical exertion, plus larger distances are more likely to cut one off from their extended family, plus industrially-made produce is less nutritious, plus non-universal healthcare is non-universal.

JustThrowMeAway2• 8 years ago

    After almost 25 years of taking antidepressants,
    I had no emotion left whatsoever. I felt dead and
    wanted to be dead.

I wonder how to understand this.

If you have no emotions, can you still want something? Why would you want to die?

I tend to understand this sentence in a way that means she was suffering. But isn't suffering the same as experiencing negative emotions?

Or is this supposed to mean that she had no good emotions left, only painful ones?

eugman• 8 years ago

Think of a sine wave, with the y-axis representing the positivity/negitivity. A representation of life's ups and downs.

I think what she was saying when she said "no emotion left" is that the amplitude of that wave was nearly zero. The wave didn't go up or down much. When she said, "I want to be dead", she's saying that the the average value is down in the negatives.

egypturnash• 8 years ago

nothing matters

there is just endless work, endless things that need to be done to keep yourself alive

and why do you bother when the reward is just more endless days like today? nothing to live for, nothing to care about, no energy to do anything but just sit around watching your body slowly fall apart

fighting against entropy is constant work and actually giving a shit about anything helps give you a reason to put in that work

and by "work" i don't just mean "your day job", I also mean things like "getting out of bed" or "feeding yourself" or "doing anything at all interesting"

brian_herman• 8 years ago

:( depression is not fun

op00to4• 8 years ago

This article is absolute bullshit and quite frankly dangerous. It seems to me this woman was emotionally vulnerable and taken in by a snake oil huckster masquerading as a doctor.

Shortly after I started seeing him, my new doctor had me read the book Anatomy of an Epidemic by Robert Whitaker.

Robert Whitaker's theses in that book have repeatedly been scientifically disproven. It's anti-science drivel.

The pharmaceutical industry also says that mental illness represents a physical problem with the brain that needs to be fixed. There are no studies that prove that this is true.

This statement is untrue. Literally three seconds of googling showed me this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471964/

Which basically says that when we deplete the body of certain neurotransmitters, people get depressed. That sounds like a pretty clear statement that there are biological processes at play in mental illness.

JustThrowMeAway2• 8 years ago

    a pretty clear statement that there are
    biological processes at play in mental illness

It's a statement that biological processes can cause mental illness. That does not mean that mental illness has to be caused by biological processes.

mgamache• 8 years ago

There are issues with the simple Serotonin model:

With SSRIs it takes weeks to see an effect, but Serotonin levels are elevated within days why the delay? (There are theories, but all point to Serotonin as a secondary effect)

Also, antidepressants work in a minority of people (20%-25%), but Serotonin levels are effected in almost all users. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0087089/

op00to4• 8 years ago

That's correct - Serotonin is not the only factor. That still refutes the author's hypothesis that mental illness is some sort of personality defect.

subcosmos5• 8 years ago

Elevated serotonin levels drive synaptic plasticity, stimulating neurons in key brain regions to wire up. It's this increase in grey matter over weeks that is associated with better outcomes, particularly in PTSD.

This has been shown in several studies that use MRI before and after treatment, and explains the lag time.

dwaltrip• 8 years ago

Unless you believe she is lying about doing much better after quitting her meds and trying other treatments such as meditation and group therapy, the article is not complete bullshit.

That being said, I would not be surprised if there is truth to what you said about that book.

kryogen1c2• 8 years ago

Unless you believe she is lying about doing much better after quitting her meds

This is an unscientific and inaccurate. The placebo and nocebo affects are real with actual health effects. Sometimes drugs don't make it to market because they have positive effects less effective than placebo.

Alex39176• 8 years ago

Robert Whitaker's theses in that book have repeatedly been scientifically disproven.

The book doesn't even have a thesis. Good job not even reading enough of the Wikipedia article to plausibly pretend to have read it.

Also, did you even read the link you posted? It says exactly the opposite of what you're claiming it says. The conclusion is literally, "Simple biochemical theories that link low levels of serotonin with depressed mood are no longer tenable."

rhizome3• 8 years ago

Hasn't it been decades since a pure serotonin theory was tenable?

baumgarn• 8 years ago

I think you're stepping into a fallacy here. Of course every thought process is bound to biological processes in the brain. So we can see this as some sort of biochemical mapping of our understanding and perception of the world, and our social status in it. Why should the solution to a negative outlook be to mess with the chemistry alone, through drugs?

You can just as well ask the other way around, what kind of world and experience is leading to such a detrimental biochemical mapping. The woman in the article describes this herself, she was called fat and ugly by her father throughout childhood. This has to do with social status, not brain chemistry. I find it quite frankly disturbing that the solution to such a learned insecurity should be just drugs.

HBlix2• 8 years ago

If you had a childhood full of physical abuse, and your right leg was frequently broken until it became malformed, then the solution might involve crutches. All of which is to say, just because the damage done is in the past, doesn’t mean that it can’t have lasting effects you can’t just wish away. The developing human brain, it has been shown time and again, undergoes permanent changes associated with abusive environments. Those are real, physical changes that may require interventions beyond talking or therapy. It’s not just learned insecurity, it’s the biochemical changes wrought by years of stress during a formative period.

thomasfedb2• 8 years ago

Why should the solution to a negative outlook be to mess with the chemistry alone, through drugs?

Well perhaps because it works?

We identified 28 552 citations and of these included 522 trials comprising 116 477 participants. In terms of efficacy, all antidepressants were more effective than placebo, with ORs ranging between 2·13 (95% credible interval [CrI] 1·89–2·41) for amitriptyline and 1·37 (1·16–1·63) for reboxetine.

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Of course there's issues with publication bias, but this is the best evidence we have to work with. Psychotherapy ("talking") also works, and so the teaching I've received tells me to prescribe both in tandem, although the drugs "alone" do help. I'm a student doctor.

I find it quite frankly disturbing that the solution to such a learned insecurity should be just drugs.

I think your implicit suggestion here is that the correct treatment is unlearning. I suggest that this is not always possible. The plausible mechanism is that damage during development might result in "built in" changes that can't be talked away.

Retra• 8 years ago

Perhaps drugs are just easier? You spend 30 years learning how to be depressed, do you really want to spend another 30 learning how to unlive the last 30?

rhizome3• 8 years ago

I find it quite frankly disturbing that the solution to such a learned insecurity should be just drugs.

Who besides you is saying "just drugs?" From what I've read, the greatest success comes from drugs and therapy.

curun1r4• 8 years ago

Which basically says that when we deplete the body of certain neurotransmitters, people get depressed

Your statement represents a logical fallacy. I can also prove that depleting a car of gasoline causes it not to run, but fixing the fuel situation won't make all non-running cars functional. Just look at the more recent research that shows a connection between our microbiome and mood disorders to see that depression is often far more complex than the simple neurotransmitter model favored by big pharma.

The causes of depression are varied and what works for some won't work for others. As someone else that lost a decade of my life to the numbness of anti-depressants, I've seen first-hand the psychiatric industry's strong preference for directing patients towards medication-based approaches. Taking medication was the worst mistake I've ever made in my life and I believe that more people need to hear messages like the one in this article. In particular, I very much wish that I, like the woman in the article, had started meditation much earlier as it has become, by far, the most effective thing I've done to deal with my depression.

iliketosleep• 8 years ago

It does seems as though SSRIs shouldn't be used as first-line therapy. They are powerful drugs that alter brain chemistry in ways that aren't properly understood. There are a number of low-hanging fruit which can be tried first, such as increased exposure to sunlight, exercise, change in diet, meditation, CBT and so on. But if all of these fail, an SSRI is definitely worth trying - they do work for some people.

shoulderfake• 8 years ago

The entire medical profession is medication-first... my brother was diagnosed with MS and none of the many doctors he talked to mentioned ANYTHING regarding diet. Meanwhile as soon as you do your own research you find out that diet is your primary means of battling it. I was also diagnosed with depression few years ago, these fucking monkeys instantly gave me some ssris...I wasn't depressed. I had a sleep problem that wouldn't go away and had anxiety but they gave me those pills first and foremost. I didnt take that shit, but you get my point.

ma2rten• 8 years ago

I am quoting from your link:

"The serotonin hypothesis of depression has not been clearly substantiated. Indeed, dogged by unreliable clinical biochemical findings and the difficulty of relating changes in serotonin activity to mood state, the serotonin hypothesis eventually achieved “conspiracy theory” status, whose avowed purpose was to enable industry to market selective serotonin reuptake inhibitors (SSRIs) to a gullible public."

adrice727• 8 years ago

Johann Hari covers a lot of the history of antidepressants in "Lost Connections." Per the studies he covers in the book, most of the benefits are placebo effect. The remainder is somewhat of a mystery. Whether you give someone a medication that increases the level of serotonin in their system (i.e. an SSRI), or that decreases the level of serotonin, the effect will the be same. Replace the drugs targeting serotonin with drugs that target dopamine and you can expect the same effect.

https://www.theguardian.com/books/2018/jan/17/lost-connectio...

loceng6• 8 years ago

I am not agreeing or disagreeing with anything the author said, nor any references she makes to books or otherwise, however that's such a shallow/basic view of the brain you're putting forward as a counter-point.

The brain and physical-mental-emotional-spiritual body are far more complex than a single physical lever being pulled and a single affect happening; neurotransmitters are the transaction layer, the currency, the current/flow itself.

Likewise, there isn't only a single mechanism or cause of dis-function or dis-ease - the only possibility isn't simply because of a lack of or too many neurotransmitters needing a counterbalance; this isn't to say people some people won't experience benefit from something as simple/basic, however to dismiss other possibilities is naive, and likewise if they can so simply be helped - I'd be curious to see what simple situational-environmental impact has lead them to feeling depressed or lethargic, and whether something like a yoga practice (up to practicing all 7 branches of yoga) would have a greater impact short-term and long-term -- vs. keeping someone in a holding pattern or making them worse; the problem here then is on a societal-economic level, whereby in the short-term it's cheaper to give someone $10 worth of pills every month vs. getting them into a routine with yoga or other; it's also lazy and an extension of how we still as a society treat people - and don't take care of everyone, and that you're lucky/fortunate if you are born into a healthy (physically-mentally-emotionally-spiritually) family with adequate supports and finances, reducing your chances of being negatively impacted by the stagnant, the status quo.

SSRIs/SSNRI's themselves force a change in function by being re-uptake inhibitors, meaning they cause more neurotransmitter to linger in an area - and this doesn't seem to be evenly distributed and/or there is more going on with coping mechanisms, otherwise you could 100% predict the behaviour changes via an increase or decrease. As the author points out, there is relatively short period of testing required for these medications - and they are heavily controlled for vs. when they hit the wild for distribution [and the list of problems there is far too long for me to get into here].

There can be coping mechanisms, blocks, setup by other functions of the brain - purposefully - as a way to protect oneself from something (the ego mind, for survival purposes), e.g. insufferable conditions/experience and overwhelm that the brain/mind can't handle, and so it goes on lock-down. These drugs/medications, from my own experience, and observations of/with others - if it is such a condition with something underlying/suppression/repression going on, protecting oneself from a variety of potential things (injury from physical pain, or other).

Did you know there's a higher rate of suicide (and suicide ideation) if you take certain medications vs. placebo? This can tie into the theory that these medications force changes against self-protective mechanisms. Likewise, it shouldn't be difficult or a stretch to understand someone could be protecting themselves (from consequences), by protecting others, by blocking overwhelming anger and impulses that they learned to suppress/repress to hurt others - resulting in them hurting others, and perhaps in super violent/extreme ways due to not having coping mechanisms blocking them from doing so.

Contrast drugs like SSRIs (et al) with what I will call medicines - like Ayahuasca, psilocybin (magic mushrooms), or MDMA (reference to recent MAPS.org recent study) - that instead of forcing change in mechanism by inhibiting, it floods the brain with higher levels of serotonin that the brain normally doesn't release or have on its own (or mimics closely the serotonin transmitter). Likewise with Ayahuasca ceremonies or MDMA-assisted psychotherapy (or recreational-therapeutic MDMA-assisted dance party with friends you trust in a good environment), there is a contextual setting that will make these safer or more impactful - allowing positive and social pathways to open up (or language pathways relating to talking) - vs. a doctor spending a very short period with them out of context of the life of the person, prescribing an SSRI or other to them and putting them back into their daily life.

I was severely fucked up in different ways because of doctors prescribing different SSRIs (and the like) starting at the age of 17, and the peak/tipping point at 21-22 after more unexpected (or unknown at the time) side-effects - is when I realized I can't trust those doctors, nor those medications, because the industry doesn't actually have a proper fucking clue about them, and it's all an experiment on each individual. The medications had a cascade and accumulative affect on symptoms/problems, making me permanently worse until I could start solving the underlying problems - which ended up being in part food related, in part hearing related, in part from underlying physical injuries I had that I didn't realize I had - and I'm simplifying, it's more complex than that - and hard to believe on the surface, which is why I am writing a book to explain as much detail as possible.

I'm 35 now and only recently had significant healing of physical injury that was an underlying problem since I was a child, through stem cell injections, and will return to the US soon for another treatment to heal more of the remaining physical pain.

I hope you can appreciate your literal "three seconds of Googling" allowing you to come to a conclusion is less trustworthy (on the surface anyhow) than someone who experienced how anti-depressant medications impacted them for 24 years - and then who considers that they had to recover from that experience. I don't disagree that it is complex - and therefore difficult to understand - especially because you have the interplay of what depression, anxiety, and other, can cause behaviourally in someone without the various impact and side-effects of medications.

It looks part of her recovery was finding people she could start building trust to, who then helped her learn about emotions, meditation, and other self-awareness and social-relationship building practices. She also connected to her "inner guide"(or God, whatever she feels most comfortable or comforted calling it) which could perhaps be labeled as intuition, or as an autonomous nervous system working together well on its own without logical mind being engaged; enough learning happened via mind and analysis, to start trusting herself autonomously (trust is or is a part of autonomy), allowing the body to relax, allowing the mind to relax - as there's a feedback loop between the two: the more physical stress - the more mental stress, the more mental stress - the more physical stress.

Linking back to MDMA-assisted psychotherapy gaining benefit by tapping into language and memory pathways of post-traumatic experiences, there are other talk therapies like Innerchild Regression therapy which, in part, explores similarly early childhood relationships and learning to connect or reconnect to those - and understand them better, to process emotion that you may not have been able to before, due to an unsafe environment at the time - allowing those experiences/unhealed emotional wounds, to now start to come up and be healed-processed/learned from.

Anyway, I'm writing a book to share my full story, my experiences with healthcare, the problems I encountered and explain the solutions I propose. It will take me awhile. It will fill in a lot of details here to what I mentioned, perhaps making it easier to understand - or believe. I'm also beginning to put together applications for different stages of research, to be able to reference hard evidence relating to a protocol I've developed based on my understandings and experiences healing, recovering.

bigmit373• 8 years ago

Would you be able to share how you were able to solve your problem and what the actually underlying cause was? Just a brief overview.

I’m currently on SSRIs and they actually do help me sleep, but it’s not really helping with the underlying problems.

As for SSRIs they are transformative for some people, and science doesn’t really understand the mechanism. They seem to think that there are secondary effects that are the reasons for the effectiveness of SSRIs on some people.

However, doctors seems to be too quick to prescribe SSRIs. I’ve read horror stories about people with some sort of iron-ferretin deficiency as their underlying problem and they were prescribed SSRIs instead of getting a simple iron test which would have pinpointed the cause of the symptoms.

These days you really need to do your own research and bring up all these points to your doctor.

pasabagi5• 8 years ago

I don't think an idea of depression that's based on anecdote and opinion is deeper than the mainstream account - which is limited ('shallow') because of the complexities of brain function you've mentioned. The fact is, for the vast majority of depressed people (including myself), anti-depressants work. For some people, they don't. Granted, the healthcare system is as fucked as any other system in our society, but the basic science is, if not absolutely sound, at least playing the odds.

subcosmos5• 8 years ago

It's not so much that neurotransmitter levels are just lower than they should be - reuptake inhibitors fix that problem very quickly....

A more nuanced modern understanding that we have now is that the increased levels of neurotransmitters in the brain signal the neurons to form more synapses, and this increase in grey matter in key brain regions, over months, is what has been repeatedly shown to improve the condition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790407/

https://www.ncbi.nlm.nih.gov/pubmed/23988273

Specifically, serotonin-induced synaptic plasticity changes in the anterior cingulate and orbital prefrontal cortex allow the old brain (limbic emotional areas) and new brain (neocortex) to communicate better.

philwelch• 8 years ago

This sounds a lot like an indirect form of the same mechanism as TMS.

Arbitrary46572• 8 years ago

Your kneejerk defensiveness is an indication that maybe it isn't "absolute bullshit" or "quite frankly dangerous." Not everybody has had the exact same wonderful experience with SSRI medication, and personally I can relate to the problems described in the article. Please don't immediately assume someone who disagrees with you is "anti-science". This isn't anti-vaccination nonsense we're talking about here.

Vaslo• 8 years ago

I take a very small amount of Nortriptyline for horrible IBS. It has changed my life. In addition, while the small dose does make me a little more tired, my anxiety has improved and the debilitating effects of IBS have all but vanished. These pills are like any treatment, they can open the gate to Heaven, or if poorly managed, can open the gate to Hell.

ocdtrekkie• 8 years ago

I was forced into antidepressants by my parents when I was younger, and after coming off of them, I realized I hadn't enjoyed things like music for years while I was on them. Definitely something that had a negative impact on my teen years and it took me years to recover.

But I recognize that for others it can be crucially necessary.

justin_ht_dang• 8 years ago

These type of personal anecdote fuelled by a general distrust of 'big pharma' can be very misleading and discourage patients from seeking professional help.

I also want to point out that the author of that book she speaks highly of also happened to be the Presiden of the publication[1]. I think not mentioning this fact make the article even less credible.

[1] https://www.madinamerica.com/staff-page/

patrickg_zill• 8 years ago

How did people deal with mental illness before these drugs were around?

I recall that melancholia was a real diagnosis a long time ago.

My personal view is that in some cases physical exercise can be helpful. I have family that are on Wellbutrin etc., and others that studiously avoid any drugs.

Nasrudith2• 8 years ago

The same way they dealt with infections before antibiotics - unhealthy self-medication and at times dying.

flaniganswake• 8 years ago

Thank you for sharing this.

odiroot• 8 years ago

I'm a bit worried how many people on social media and Internet in general (also here) are fighting some personal war against antidepressants. This is not helping and may cause a lot of suffering to some people.

We're in some wacky second generation New Age where everything illogical is the the obvious solution, just for the sake of breaking with the old.

There's really many people for whom literally no amount of talking, meditation or working out (Internet's favourites) will help. Yes, for them, before they can even start thinking about successful therapy (etc.), the chemical imbalance is so strong they need to bring their bodies to the baseline (or close to it).

Again, militantly opposing SSRIs creates very dangerous situation where people in need can end up getting hurt or dead.

AnIdiotOnTheNet• 8 years ago

As someone who spent a good amount of time on an SSRI, I get where they're coming from. The people who prescribed them to me seemed to think I was fine, and saw no reason I should try to get off them despite personality changes and what I would term "an inability to experience". It was as though I was only able to observe my own life from the outside.

The problem with SSRIs isn't that they can't be useful, it's that the medical industry is full of people who don't seem to know how to use them. They just wanted to throw a pill at the problem and get me out of their office as fast as they could to extract maximum profit out of my visits.

hndamien• 8 years ago

Unfortunately, unless the Dr prescribing them has taken them, it is very hard to appreciate exactly what they are doing to you. There are very subtle effects that are very important to being a happy human that these drugs remove. The data supporting their effectiveness over the absence of them is dubious as well. That isn't to say they don't work, just that over large enough cohorts, the wins and the losses seem to cancel out.

DubiousPusher• 8 years ago

I appreciate this person sharing their story. If you are struggling with mental illness please be cautious before following this person's example. Her circumstances may be very different from your own. If you want to consider a simillar course please talk to your healthcare professionals and the people in your support network first.

For every story of someone successfully discontinuing psychoactive there is one that ends in disaster.

braindongle• 8 years ago

Those of us in the field of psychiatric research encounter innumerable illness narratives of this sort. Everyone has their own story to tell about what went wrong and what helps.

While these anecdotes may be of value to the storyteller, they are at best worthless if you are serious about understanding your options in mental health. Evidence-based psychiatry is messy, but good people are working hard to build credible evidence, and not just for pills. "Everything is biased by pharma money" is often said by people on the sidelines. Psychiatric services researchers know better.

Interested in meditation vs medication for depression? Start with a systematic review in a reputable journal, like this: https://goo.gl/yN1asm

jccalhoun• 8 years ago

Who is this person? I searched her name and didn't find anything that indicated that she is someone to listen to about mental health.

zahllos• 8 years ago

I have had an anxiety problem for a long while now and like the author have recently stopped taking medication for it. I've developed enough techniques from a combination of therapies like mindfulness and CBT and have enough support in place to check this is working that my doctor agrees with this approach. Additionally, I felt the problems caused by the side effects of my medication outweighed the benefits gained by taking it. Finally, I realized that for me exercise simply isn't optional. I have at times in my life been extremely fit and these times have always corresponded to the periods I've handled my anxiety best.

I find the article somewhat troubling in that the author seems to imply that antidepressants are a big pharma conspiracy and are difficult to stop. I personally have had side effects - insomnia, sexual dysfunction, the "fog" the author mentions, although I wouldn't describe it as zombie-like. There are other possible side effects as well, like inducing the liver to release enzymes into the blood stream that imitate fatty liver/liver failure in blood tests, significant weight gain etc. However, I have not had all of these on all tablets - on some, yes, on others, nothing at all. Regarding stopping, the worst case was venlafaxine. I've heard people describe the experience as "brain zaps". It feels a little bit like an electric shock in the brain and is fairly unpleasant (this is with tapering down properly under medical supervision). However, on no antidepressant have I ever felt the need to take the tablet, or to take more of it than the prescribed dose and I have never felt taking a lower dose while stopping to be problematic - it does not resemble fighting addiction at all (I've known people who were addicts and for some of them their addiction killed them, so I have some basis to make this comparison).

Ultimately however, taking antidepressants is a trade off between how bad the side effects are (and I stress that in some cases there were none) and the benefit from the tablet (in some cases, none as well) versus the impact the problem (depression/anxiety/...) is having on your day to day life. In my case and I suspect in the author's case as well, at the time I started taking the tablets the benefits outweighed the side effects and allowed me to be a somewhat functioning member of society. By taking antidepressants I was able access other treatments such as CBT and benefit a little from them, as well as hold down a job. Also, it has to be said that when I first started having problems with my disorder I didn't have anywhere near the same emotional maturity or understanding of myself as I do today. I feel that this understanding has a significant effect on my ability to use things like mindfulness and CBT alone, without any other help - I am benefiting far more from it now. I also wonder if the author would have been so successful with meditation if they had used this and only this technique 24 years ago.

I suspect in many cases finding what works takes time and is a process that can't really be avoided. I'm uncomfortable because the author is implying it can be and moreover that antidepressants should always be avoided. I disagree. I'm glad the author found something that helps and I'd also recommend mindfulness, but I feel that sometimes people need help and antidepressants are one option and that people shouldn't discount them based on articles like this - instead they should have a thorough conversation with a medical professional (if necessary, more than one) about their options.

dennisgorelik• 8 years ago

I was taking 500 mg of Nefazadone in the evening

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https://en.wikipedia.org/wiki/Nefazodone

Nefazodone is available as 50 mg, 100 mg, 150 mg, 200 mg, and 250 mg tablets for oral ingestion.

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Why would she take such a big dosage of antidepressants? Could she try to reduce the dosage?

Nasrudith2• 8 years ago

From my experience SSRIs are like the prince searching for Cinderella with the glass slippers in reverse - trying tons of them to find the one that finally works. I have had all sorts of fun side effects until I got a combination that was stable - the first one worked fine except for causing unsolicited panic attacks, some had lesser side effects but worse depression, another left me irritable and shifting strongly on political spectrum ironically. The combination I'm on now wound up having the reverse with sexual side effects - it improved things over not taking any medication.

I find it is completely the opposite for emotions with anti-depressants. They don't suppress them but allow me to feel a wider range than just null, fear, anger, and despair. There also are some therapeutic components as well and they aren't a panacea. For one I have become more outspoken as I find repressing my emotions is a depression trigger.

Recovering Emotions After 24 Years on Antidepressants

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