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Their over-prescription is no doubt a problem. That being said, I have family members that are verteran's from the Vietnam era. Anti-depressants made their exis

Their over-prescription is no doubt a problem. That being said, I have family members that are verteran's from the Vietnam era. Anti-depressants made their existence possible. They all had so much trouble adjusting and maintaining relationships. The change was night and day different. Anecdotal evidence isn't really evidence, I know that. And the pharma companies are really just the worst. I have seen these things really work though. EDIT: It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to?

Alex3917 10y ago
> I have seen these things really work though. The argument (based on some large scale trials and other data) is that after 2+ years, those on SSRIs are worse off than they would have been without them. The issue is that by taking SSRIs, you may be getting a few weeks of negligible benefits in exchange for a lifetime of being disabled, when otherwise you'd have been better after a few months using other interventions.
- falcolas 10y ago
  > are worse off than they would have been without them With, or without continuing monitored dosage to account for the body's corrections towards what it perceives as equilibrium? If without a continued dosage, is this before or after a "withdrawl" phase?
  - Alex3917 10y ago
    > With, or without continuing monitored dosage to account for the body's corrections towards what it perceives as equilibrium? The efficacy of SSRIs isn't dose dependent. And the the monoamine hypothesis is a long disproven myth.
    - pjc50 10y ago
      > The efficacy of SSRIs isn't dose dependent This is rather surprising, given that most pharmaceuticals are, and contradicted by the experience of people I've known who've been prescribed them and advised to taper withdrawal - which is then experienced as reducing effectiveness.
- Leon 10y ago
  Can you cite this?
  - Alex3917 10y ago
    The book the article is about...
- Broken_Hippo 10y ago
  That means there is more to figure out, not that people shouldn't be taking them. It could be that a combination of therapy and SSRI's are the answer, or they only work with certain blood chemistry and we develop a test for such a thing so we'll know. Someone with a major mental illness might just do worse after a couple of years, despite medication. Some folks with bi-polar disorder truly can't work, despite the medications, for example. They'd definitely be doing "worse" after starting their medications, some of which might easily include SSRIs, but it isn't really because they started medications. None of this means we shouldn't use them, just use them responsibly with a bit more medical oversight. After all, for some people these really do help.
GuiA 10y ago
> It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to? http://www.vanityfair.com/news/2015/05/ptsd-war-home-sebastian-junger http://www.vanityfair.com/news/2015/05/ptsd-war-home-sebasti...
- themgt 10y ago
  Agreed for sure. As someone who's lived or spent time in a number of other cultures I do think there's something excessively (if not uniquely) toxic about American life, which if I had to summarize (and agree with Sebastian Junger), would be: lack of community.
  - pcmaffey 10y ago
    It's more than just the absence of community. The real sorrow comes from a culture that actively encourages us to abandon community in favor of striving for personal gain. Community is there and possible. We just don't know how to reach it.
    - amelius 10y ago
      Another problem lies in the extreme pursuit of youthfulness, and the lack of respect for the elderly, the latter of which is opposite to what you find in "happy" cultures. It creates a rather sad outlook on life.
    - jelly 10y ago
      I can't help thinking organised religion was /the/ way to create a local community. Unless the state steps in and "forces" locals to gather regularly (in the way fear of god "forces" worshippers together) there's little reason for family X on road A and family Y on road B to meet, let alone shared experience for them to bond over.
      - vertex-four 10y ago
rubicon33 10y ago
As much as I want to believe things are over prescribed, and that medications don't actually help, my anecdotal experience is very similar to yours. I've heard nothing but extremely positive things. Comments like "I have my life back". And "I finally feel okay in my own skin". I've been long skeptical of the pharma industry, and those drugs... But the more I hear personal accounts like that, it's hard to remain skeptical.
- funnyfacts365 10y ago
  Who would say getting high on drugs could fix lifes instead of destroying them...
  - Sanddancer 10y ago
    A lot of medications have different effects based on dosage. For example, DXM, the active ingredient in most cough medicines is a deleriant at very high doses, and people take it recreationally (robotripping). Does this mean we should ban Robitussin? Another example is that cocaine in small doses is used as a numbing agent. Medications can and do have different effects given the dosage.
    - funnyfacts365 10y ago
      The sarcasm flew right over your head...
- masterDepressor 10y ago
  Well, in my case, the result of me taking antidepressants was gaining 120lb, stopping leaving the house, and spending hours a day posting on 4chan and jacking off to porn since I no longer cared about the negative emotions such actions would have previously inspired in me. I also felt like I was going crazy when I stopped taking the medecine. The result now is that I'm very high performing in all areas of my life, and I have lost over 120lb and achieved a nornal weight, but I believe that my stint with antidepressants have permanently taken several years off my life span. They also contributed to significant delays in my economic, intellectual, and social development, as they seemed to bring me from relatively poorly functioning (but functioning) human being to out of control explosion of self-destruction and shit. But maybe it's different for older people who take them.
komali2 10y ago
I've been attacked before, even by employers, for claiming I need Adderall to work. I'm told ADHD isn't real, I just need to suck it up and focus, that I'm an addict, etc. I've never really found an apt metaphor to describe what ADHD is and why I need to medicate it. To many people, disease is on or off - you either have the virus or pathogen or missing chromosome, or you don't. The sliding scale of mental illnesses is hard to describe. So if I say I can't focus , they say "lots of people can't focus ." I try to use obesity as a metaphor, like, lots of people are fat, most people can become not fat by eating right and working out, but a rare selection of people genuinely have a disease that make it difficult to the point of needing medication to aid their weight loss. They could still lose weight by doing the stuff other people do to lose weight, but it will be way harder and they'll never be able to achieve what other people can without medication. That's me and Adderall. Yea, I can work without it. I can meditate and suck it up and drink coffee or whatever. But I'm hamstringing myself, and I'm exerting way more energy than the average person does to do the "simple" thing of staying focused. Better if I just pop 5mg (I stay at the lowest possible dosage) of Adderall and actually be a functional member of society.
- mjburgess 10y ago
  ADHD is a horribly misnamed condition. It's caused by a delay in the development of the frontal cortex which puts people about 30% behind their peers in many higher order cognitive functions. If depression is like the flu, ADHD is like missing a leg. You can't regrow or cure a missing leg, all you can do is use a prosthesis -- for ADHD stimulants are the prosthesis for the missing development of the higher order brain functions. ADHD is a serious impairment to normal cognitive functioning. However everything a person with ADHD experience is a part of everyone's ordinary rational expectations: things forgotten, things missing, a lack of motivation, difficulty focusing, emotional dis-regulation, lack of social awareness. And that makes popular perception very difficult to correct -- because it isn't that these things happen, its that they happen to an extreme because of a significant neurological impairment.
  - DiabloD3 10y ago
    As a side note, it seems a lot of ADD/ADHD sufferers should be diagnosed with (instead of or also including) ODD or an executive functioning disorder. Our brains, largely, are badly designed. And it sucks, especially with the HN crowd, we'd all be ten times more productive if we didn't all suffer from the same shit.
maxxxxx 10y ago
"It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to?" American Life is very harsh and unforgiving without doubt. There are upsides to everything being competitive and everybody supposed to make his own luck. But when you have a problem you are in a very unfriendly environment.
deleted 10y ago
[deleted]
gdulli 10y ago
Prescription drugs save lives (or one's quality of life) all the time, and it sounds obvious but people forget or don't recognize that. It doesn't always work because it's not an exact thing, two bodies can have different reactions to the same prescription. The same body can different reactions to the same prescription at different times. And some doctors make mistakes and some exercise poor judgment. But too many people latch onto the negative anecdotes and the narrative of us vs. the evil drug companies. It's like with police. You can see them as fundamentally your enemy, or else fundamentally on your side but since they're just people like all of us, many are below average at their job and some outliers are incompetent or truly evil. The way you choose to see it says more about you than about law enforcement.
joe_the_user 10y ago
Well, What you are ultimately saying that drug X made the person's existence possible under the current circumstances and given the current options. My anecdotal evidence is a friend who went for years working a night shift and playing RPGs during the day, wracking a massive sleep deficit and engaging in other irresponsible behavior. Antidepressants made his existence possible. Until they finally stopped working and he reached full psychological disability. It is extremely difficult to say this means. My reflex is to give the "folk psychology" explanation that he'd pushed away the "real problem" for so long that when it "caught up to him", he couldn't deal with it. But it could just as well be the chemicals gave him a few more years. Now if I suspect, chemicals or not, if he'd had job/leisure activity combo that satisfied him more and didn't produce sleep deficits, he would have at least lasted longer.
TeMPOraL 10y ago
> EDIT: It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to? Anecdote: my mother told me that when she was young and they could - living in Poland - finally get to watch some American movies, they were perplexed by one thing: it seemed that every other American goes to a shrink. They used to laugh at the western lifestyle because of that. Fast-forward ~30 years, and every other person in Poland also visits a psychiatrist...
tn13 10y ago
> It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to? Clearly these people have not been to India, China or some place like that. At least in India mental issues are not even diagnosed and people suffer from mental issues rest of their lives unable to cope and sometimes disowned by family. Modern american life might have its issues but I think it is probably the best kind of life humans are living compared to past or elsewhere on earth.
- vinay427 10y ago
  I agree with the first part that India does not handle mental issues well, but I disagree with the latter part. The US as some have pointed out here is quite exceptionalist in that it's unforgiving to those who are not the highest achievers. This is certainly not the case to the same extent in India, where in my (limited) experience an average honest middle-class lifestyle is more admirable in and of itself. This leads the US to have an entrepreneurial spirit at the cost of some other aspects of life.
vacri 10y ago
> It's funny, but people never seem to question if modern American life actually, you know, is good for mental health Speaking as an outsider, it seems to me that the US lionises some mental illnesses. For example, someone gets up on stage and gets passionately frothy about 1776, and they get accolades. In other countries that person would be treated as a nutter.
Florin_Andrei 10y ago
> It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to? To me this is self-evident. Our lives have become more and more comfortable physically, less challenging, less stressful. But from a mental perspective, we are doing FAR more deliberate, conscious effort than any of our ancestors. Emphasis on conscious. Being a hunter-gatherer surely required a lot of processing power, but over time we've adapted so that a lot of that effort is not conscious. And we don't seem to have a problem processing a heck of a lot of data unconsciously. It's this newfangled, forced-conscious processing that we are not adapted for, and is very stressful.
kps 10y ago
One part of ‘American life’ is the intense Puritan/Calvinist streak that holds that suffering is necessary for redemption: using mere science to make people feel better is evil. Among those that would claim to reject Puritanism the appeal to nature is a search-and-replace copy. Then you have Chernyshevsky's “the worse the better”: the proles need to be kept miserable so they'll revolt.
- gozur88 10y ago
  >One part of ‘American life’ is the intense Puritan/Calvinist streak that holds that suffering is necessary for redemption: using mere science to make people feel better is evil. I've been living in the US for five decades, and I've never, ever run into someone who articulated that belief.
  - dwaltrip 10y ago
    The Bible tells that after the Fall, when Adam and Eve ate the apple in the garden of Eden, man is now destined to forever work for survival (such as tilling the earth for food) as part of our punishment. This has large implications for social policy, universal basic income, etc. It isn't usually directly stated, but I have heard it a few times. To be fair, I'm not cetain how influential this idea is in overall Christian thought.
DanBC 10y ago
Good doctors are fully aware of the bio-psycho-social factors to "illness", and they recognise the strength of multidisciplinary teams that work across all these things. But mental health tends to be underfunded, and employment support or drug and alcohol rehab or whatnot even more so.
randomgyatwork 10y ago
You are right about the modern life being the problem for most of us.

Alex3917 10y ago

> I have seen these things really work though. The argument (based on some large scale trials and other data) is that after 2+ years, those on SSRIs are worse off than they would have been without them. The issue is that by taking SSRIs, you may be getting a few weeks of negligible benefits in exchange for a lifetime of being disabled, when otherwise you'd have been better after a few months using other interventions.

falcolas 10y ago
> are worse off than they would have been without them With, or without continuing monitored dosage to account for the body's corrections towards what it perceives as equilibrium? If without a continued dosage, is this before or after a "withdrawl" phase?
- Alex3917 10y ago
  > With, or without continuing monitored dosage to account for the body's corrections towards what it perceives as equilibrium? The efficacy of SSRIs isn't dose dependent. And the the monoamine hypothesis is a long disproven myth.
  - pjc50 10y ago
    > The efficacy of SSRIs isn't dose dependent This is rather surprising, given that most pharmaceuticals are, and contradicted by the experience of people I've known who've been prescribed them and advised to taper withdrawal - which is then experienced as reducing effectiveness.
Leon 10y ago
Can you cite this?
- Alex3917 10y ago
  The book the article is about...
Broken_Hippo 10y ago
That means there is more to figure out, not that people shouldn't be taking them. It could be that a combination of therapy and SSRI's are the answer, or they only work with certain blood chemistry and we develop a test for such a thing so we'll know. Someone with a major mental illness might just do worse after a couple of years, despite medication. Some folks with bi-polar disorder truly can't work, despite the medications, for example. They'd definitely be doing "worse" after starting their medications, some of which might easily include SSRIs, but it isn't really because they started medications. None of this means we shouldn't use them, just use them responsibly with a bit more medical oversight. After all, for some people these really do help.

GuiA 10y ago

> It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to? http://www.vanityfair.com/news/2015/05/ptsd-war-home-sebastian-junger http://www.vanityfair.com/news/2015/05/ptsd-war-home-sebasti...

themgt 10y ago
Agreed for sure. As someone who's lived or spent time in a number of other cultures I do think there's something excessively (if not uniquely) toxic about American life, which if I had to summarize (and agree with Sebastian Junger), would be: lack of community.
- pcmaffey 10y ago
  It's more than just the absence of community. The real sorrow comes from a culture that actively encourages us to abandon community in favor of striving for personal gain. Community is there and possible. We just don't know how to reach it.
  - amelius 10y ago
    Another problem lies in the extreme pursuit of youthfulness, and the lack of respect for the elderly, the latter of which is opposite to what you find in "happy" cultures. It creates a rather sad outlook on life.
  - jelly 10y ago
    I can't help thinking organised religion was /the/ way to create a local community. Unless the state steps in and "forces" locals to gather regularly (in the way fear of god "forces" worshippers together) there's little reason for family X on road A and family Y on road B to meet, let alone shared experience for them to bond over.
    - vertex-four 10y ago

rubicon33 10y ago

As much as I want to believe things are over prescribed, and that medications don't actually help, my anecdotal experience is very similar to yours. I've heard nothing but extremely positive things. Comments like "I have my life back". And "I finally feel okay in my own skin". I've been long skeptical of the pharma industry, and those drugs... But the more I hear personal accounts like that, it's hard to remain skeptical.

funnyfacts365 10y ago
Who would say getting high on drugs could fix lifes instead of destroying them...
- Sanddancer 10y ago
  A lot of medications have different effects based on dosage. For example, DXM, the active ingredient in most cough medicines is a deleriant at very high doses, and people take it recreationally (robotripping). Does this mean we should ban Robitussin? Another example is that cocaine in small doses is used as a numbing agent. Medications can and do have different effects given the dosage.
  - funnyfacts365 10y ago
    The sarcasm flew right over your head...
masterDepressor 10y ago
Well, in my case, the result of me taking antidepressants was gaining 120lb, stopping leaving the house, and spending hours a day posting on 4chan and jacking off to porn since I no longer cared about the negative emotions such actions would have previously inspired in me. I also felt like I was going crazy when I stopped taking the medecine. The result now is that I'm very high performing in all areas of my life, and I have lost over 120lb and achieved a nornal weight, but I believe that my stint with antidepressants have permanently taken several years off my life span. They also contributed to significant delays in my economic, intellectual, and social development, as they seemed to bring me from relatively poorly functioning (but functioning) human being to out of control explosion of self-destruction and shit. But maybe it's different for older people who take them.

komali2 10y ago

I've been attacked before, even by employers, for claiming I need Adderall to work. I'm told ADHD isn't real, I just need to suck it up and focus, that I'm an addict, etc. I've never really found an apt metaphor to describe what ADHD is and why I need to medicate it. To many people, disease is on or off - you either have the virus or pathogen or missing chromosome, or you don't. The sliding scale of mental illnesses is hard to describe. So if I say I can't focus , they say "lots of people can't focus ." I try to use obesity as a metaphor, like, lots of people are fat, most people can become not fat by eating right and working out, but a rare selection of people genuinely have a disease that make it difficult to the point of needing medication to aid their weight loss. They could still lose weight by doing the stuff other people do to lose weight, but it will be way harder and they'll never be able to achieve what other people can without medication. That's me and Adderall. Yea, I can work without it. I can meditate and suck it up and drink coffee or whatever. But I'm hamstringing myself, and I'm exerting way more energy than the average person does to do the "simple" thing of staying focused. Better if I just pop 5mg (I stay at the lowest possible dosage) of Adderall and actually be a functional member of society.

mjburgess 10y ago
ADHD is a horribly misnamed condition. It's caused by a delay in the development of the frontal cortex which puts people about 30% behind their peers in many higher order cognitive functions. If depression is like the flu, ADHD is like missing a leg. You can't regrow or cure a missing leg, all you can do is use a prosthesis -- for ADHD stimulants are the prosthesis for the missing development of the higher order brain functions. ADHD is a serious impairment to normal cognitive functioning. However everything a person with ADHD experience is a part of everyone's ordinary rational expectations: things forgotten, things missing, a lack of motivation, difficulty focusing, emotional dis-regulation, lack of social awareness. And that makes popular perception very difficult to correct -- because it isn't that these things happen, its that they happen to an extreme because of a significant neurological impairment.
- DiabloD3 10y ago
  As a side note, it seems a lot of ADD/ADHD sufferers should be diagnosed with (instead of or also including) ODD or an executive functioning disorder. Our brains, largely, are badly designed. And it sucks, especially with the HN crowd, we'd all be ten times more productive if we didn't all suffer from the same shit.

maxxxxx 10y ago

"It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to?" American Life is very harsh and unforgiving without doubt. There are upsides to everything being competitive and everybody supposed to make his own luck. But when you have a problem you are in a very unfriendly environment.

deleted 10y ago

[deleted]

gdulli 10y ago

Prescription drugs save lives (or one's quality of life) all the time, and it sounds obvious but people forget or don't recognize that. It doesn't always work because it's not an exact thing, two bodies can have different reactions to the same prescription. The same body can different reactions to the same prescription at different times. And some doctors make mistakes and some exercise poor judgment. But too many people latch onto the negative anecdotes and the narrative of us vs. the evil drug companies. It's like with police. You can see them as fundamentally your enemy, or else fundamentally on your side but since they're just people like all of us, many are below average at their job and some outliers are incompetent or truly evil. The way you choose to see it says more about you than about law enforcement.

joe_the_user 10y ago

Well, What you are ultimately saying that drug X made the person's existence possible under the current circumstances and given the current options. My anecdotal evidence is a friend who went for years working a night shift and playing RPGs during the day, wracking a massive sleep deficit and engaging in other irresponsible behavior. Antidepressants made his existence possible. Until they finally stopped working and he reached full psychological disability. It is extremely difficult to say this means. My reflex is to give the "folk psychology" explanation that he'd pushed away the "real problem" for so long that when it "caught up to him", he couldn't deal with it. But it could just as well be the chemicals gave him a few more years. Now if I suspect, chemicals or not, if he'd had job/leisure activity combo that satisfied him more and didn't produce sleep deficits, he would have at least lasted longer.

TeMPOraL 10y ago

> EDIT: It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to? Anecdote: my mother told me that when she was young and they could - living in Poland - finally get to watch some American movies, they were perplexed by one thing: it seemed that every other American goes to a shrink. They used to laugh at the western lifestyle because of that. Fast-forward ~30 years, and every other person in Poland also visits a psychiatrist...

tn13 10y ago

> It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to? Clearly these people have not been to India, China or some place like that. At least in India mental issues are not even diagnosed and people suffer from mental issues rest of their lives unable to cope and sometimes disowned by family. Modern american life might have its issues but I think it is probably the best kind of life humans are living compared to past or elsewhere on earth.

vinay427 10y ago
I agree with the first part that India does not handle mental issues well, but I disagree with the latter part. The US as some have pointed out here is quite exceptionalist in that it's unforgiving to those who are not the highest achievers. This is certainly not the case to the same extent in India, where in my (limited) experience an average honest middle-class lifestyle is more admirable in and of itself. This leads the US to have an entrepreneurial spirit at the cost of some other aspects of life.

vacri 10y ago

> It's funny, but people never seem to question if modern American life actually, you know, is good for mental health Speaking as an outsider, it seems to me that the US lionises some mental illnesses. For example, someone gets up on stage and gets passionately frothy about 1776, and they get accolades. In other countries that person would be treated as a nutter.

Florin_Andrei 10y ago

> It's funny, but people never seem to question if modern American life actually, you know, is good for mental health. Maybe people are mentally ill because the world is super effing weird and hard to adjust to? To me this is self-evident. Our lives have become more and more comfortable physically, less challenging, less stressful. But from a mental perspective, we are doing FAR more deliberate, conscious effort than any of our ancestors. Emphasis on conscious. Being a hunter-gatherer surely required a lot of processing power, but over time we've adapted so that a lot of that effort is not conscious. And we don't seem to have a problem processing a heck of a lot of data unconsciously. It's this newfangled, forced-conscious processing that we are not adapted for, and is very stressful.

kps 10y ago

One part of ‘American life’ is the intense Puritan/Calvinist streak that holds that suffering is necessary for redemption: using mere science to make people feel better is evil. Among those that would claim to reject Puritanism the appeal to nature is a search-and-replace copy. Then you have Chernyshevsky's “the worse the better”: the proles need to be kept miserable so they'll revolt.

gozur88 10y ago
>One part of ‘American life’ is the intense Puritan/Calvinist streak that holds that suffering is necessary for redemption: using mere science to make people feel better is evil. I've been living in the US for five decades, and I've never, ever run into someone who articulated that belief.
- dwaltrip 10y ago
  The Bible tells that after the Fall, when Adam and Eve ate the apple in the garden of Eden, man is now destined to forever work for survival (such as tilling the earth for food) as part of our punishment. This has large implications for social policy, universal basic income, etc. It isn't usually directly stated, but I have heard it a few times. To be fair, I'm not cetain how influential this idea is in overall Christian thought.

DanBC 10y ago

Good doctors are fully aware of the bio-psycho-social factors to "illness", and they recognise the strength of multidisciplinary teams that work across all these things. But mental health tends to be underfunded, and employment support or drug and alcohol rehab or whatnot even more so.

randomgyatwork 10y ago

You are right about the modern life being the problem for most of us.