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There are two things that both get called "depression". Like so many other confusing things, this all is the result of fuzzy language. There is depression: th

by blhack 9y ago

There are two things that both get called "depression". Like so many other confusing things, this all is the result of fuzzy language. There is depression: the feeling of being sad. This can be triggered by all sorts of environmental factors, and is ultimately a psychological disorder that can be solved by changing environment variables. There is also depression: the neurochemcial/neurophysiological disorder that has depression (sadness) as one of its symptoms. It can be treated with various (miracle) drugs. -- People who want to fight against the idea that these modern miracles (drugs that treat depression) are effective treatments for this debilitating, but curable disease, belong in the same category as flat earth era, anti-vaxxers and now, apparently, "raw water" fans/advocates. Required viewing: a lecture on this topic by somebody who knows more about it that anybody else who is currently alive: https://youtu.be/NOAgplgTxfc https://youtu.be/NOAgplgTxfc

deleted 9y ago
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tcj_phx 9y ago
> People who want to fight against the idea that these modern miracles (drugs that treat depression) are effective treatments for this debilitating, but curable disease, The modern miracle drugs that effectively treat and cure debilitating depression are not SSRI's. Whatever benefits SSRIs have are probably a result of their influence on neurosteroids: >> Certain antidepressant drugs such as fluoxetine and fluvoxamine, which are generally thought to affect depression by acting as selective serotonin reuptake inhibitors (SSRIs), have also been found to normalize the levels of certain neurosteroids (which are frequently deficient in depressed patients) at doses that are inactive in affecting the reuptake of serotonin. This suggests that other actions involving neurosteroids may also be at play in the effectiveness of these drugs against depression [0] [0] https://en.wikipedia.org/wiki/Neurosteroid#Role_in_antidepressant_action https://en.wikipedia.org/wiki/Neurosteroid#Role_in_antidepre... Other miracle drugs are also helpful for addressing the cause. Big Pharma doesn't care about cause/effect, they just want patients on maintenance treatments. Depressed people usually have some sort of metabolic problem, caused by thyroid problems, inadequate diet, etc. Emotional stress is usually a major factor too. > belong in the same category as flat earth era, anti-vaxxers and now, apparently, "raw water" fans/advocates. Where do you belong? Are you a tireless advocate for the status quo?
- newfoundglory 9y ago
  > Depressed people usually have some sort of metabolic problem, caused by thyroid problems, inadequate diet, etc. In my experience, thyroid etc are the fist things tested for before suggesting depression. Do you have any kind of evidence for that argument ?
jdietrich 9y ago
SSRIs are not miracle drugs. They work, but they don't appear to work especially well. The NNT for SSRIs is about seven, meaning that you need to give SSRIs to about seven patients to resolve one case of depression. That's not terrible, but it's a million miles from a miracle. That number is likely to be somewhat inflated by publication bias. There is no evidence to suggest that Robert Sapolsky "knows more about it than anybody else who is currently alive". He has published four papers on depression, which are all highly speculative and do not involve novel primary research. The most recent of these papers was published 14 years ago. He is clearly an eminent neuroscientist, but he is by no means an expert in depression. A cursory review of the linked lecture suggests that Sapolsky is making bold, weakly substantiated claims about the neurobiological basis of depression that would not be supported by the majority of people working in neuropsychology and psychopharmacology. Your decision to link to this lecture is somewhat peculiar, given that it actually refutes your core claim. In Sapolsky's own words: "all of this knowledge winds up being effective for treating maybe 30, 40 percent of people... the vast majority of people, the antidepressant drugs don't do a whole lot" (timestamp 38:30). https://doi.org/10.1002/14651858.CD007954 https://doi.org/10.1002/14651858.CD007954 https://profiles.stanford.edu/robert-sapolsky?tab=publications https://profiles.stanford.edu/robert-sapolsky?tab=publicatio...
cpncrunch 9y ago
IMO it seems more likely that there is one "thing" called depression, that it is caused by a number of factors such as stress, emotional upset and illness, and that the chemical imbalance is the brain's way of generating feelings of depression.

by blhack 9y ago

deleted 9y ago

[deleted]

tcj_phx 9y ago

> People who want to fight against the idea that these modern miracles (drugs that treat depression) are effective treatments for this debilitating, but curable disease, The modern miracle drugs that effectively treat and cure debilitating depression are not SSRI's. Whatever benefits SSRIs have are probably a result of their influence on neurosteroids: >> Certain antidepressant drugs such as fluoxetine and fluvoxamine, which are generally thought to affect depression by acting as selective serotonin reuptake inhibitors (SSRIs), have also been found to normalize the levels of certain neurosteroids (which are frequently deficient in depressed patients) at doses that are inactive in affecting the reuptake of serotonin. This suggests that other actions involving neurosteroids may also be at play in the effectiveness of these drugs against depression [0] [0] https://en.wikipedia.org/wiki/Neurosteroid#Role_in_antidepressant_action https://en.wikipedia.org/wiki/Neurosteroid#Role_in_antidepre... Other miracle drugs are also helpful for addressing the cause. Big Pharma doesn't care about cause/effect, they just want patients on maintenance treatments. Depressed people usually have some sort of metabolic problem, caused by thyroid problems, inadequate diet, etc. Emotional stress is usually a major factor too. > belong in the same category as flat earth era, anti-vaxxers and now, apparently, "raw water" fans/advocates. Where do you belong? Are you a tireless advocate for the status quo?

newfoundglory 9y ago
> Depressed people usually have some sort of metabolic problem, caused by thyroid problems, inadequate diet, etc. In my experience, thyroid etc are the fist things tested for before suggesting depression. Do you have any kind of evidence for that argument ?

jdietrich 9y ago

SSRIs are not miracle drugs. They work, but they don't appear to work especially well. The NNT for SSRIs is about seven, meaning that you need to give SSRIs to about seven patients to resolve one case of depression. That's not terrible, but it's a million miles from a miracle. That number is likely to be somewhat inflated by publication bias. There is no evidence to suggest that Robert Sapolsky "knows more about it than anybody else who is currently alive". He has published four papers on depression, which are all highly speculative and do not involve novel primary research. The most recent of these papers was published 14 years ago. He is clearly an eminent neuroscientist, but he is by no means an expert in depression. A cursory review of the linked lecture suggests that Sapolsky is making bold, weakly substantiated claims about the neurobiological basis of depression that would not be supported by the majority of people working in neuropsychology and psychopharmacology. Your decision to link to this lecture is somewhat peculiar, given that it actually refutes your core claim. In Sapolsky's own words: "all of this knowledge winds up being effective for treating maybe 30, 40 percent of people... the vast majority of people, the antidepressant drugs don't do a whole lot" (timestamp 38:30). https://doi.org/10.1002/14651858.CD007954 https://doi.org/10.1002/14651858.CD007954 https://profiles.stanford.edu/robert-sapolsky?tab=publications https://profiles.stanford.edu/robert-sapolsky?tab=publicatio...

cpncrunch 9y ago

IMO it seems more likely that there is one "thing" called depression, that it is caused by a number of factors such as stress, emotional upset and illness, and that the chemical imbalance is the brain's way of generating feelings of depression.