6 ms·

There seems to be an increasing number of non-academic articles, essays and books that are expressing the idea that the Serotonin hypothesis of depression is fl

There seems to be an increasing number of non-academic articles, essays and books that are expressing the idea that the Serotonin hypothesis of depression is flawed. It seems like the drug industry just picked up this idea in the 70s and has been running with it (to the bank) ever since Anecdotally, I have come to believe that SSRIs have a temporary mood-altering effect, possibly combined with a placebo effect that wears off over time - as your body adapts to the induced serotonin imbalance. The only answer from the medical profession? Increase the dose. I saw this with my own mother. She went from being a mildly depressed retired housewife to suicidal within the space of 12 months. She started on low-dose SSRIs which seemed to work for a while before she regressed. Each time she started to feel depressed again she would be prescribed with an increased dosage. This pattern repeated until she was taking the maximum 'allowed' dosage, by this point she was delusional, paranoid and suffered terrifying, persecution-style hallucinations - perhaps not surprising seeing how much her brain chemistry must have been out of whack. Sadly, I'm making these observations with hindsight, she took her own life in 2015. I wish I could share this article with my dad, if I knew it wouldn't break his heart. Both she and my father couldn't share with their children how gravely ill she was until it was too late. They both trusted their doctors implicitly. What they weren't prepared for was the fact that the theory that formed the basis of her treatment was, it seems, no more than guesswork supported only by publication bias, wishful thinking and greed. Ironically, one of my first web development jobs, way back in 2000, was at a 'medical communications company' where I created an intranet site for GSK (IIRC) for use by their salespeople to shore up the claims of the effectiveness of Seroxat/Paxil and counter negative studies. So, I guess that makes me complicit in all this too.

dsego 9y ago
Almost all antidepressants list the increase of suicide risk as a side effect, which is frightening. Zoloft for example [1]: > An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs. [1]https://www.drugs.com/sfx/zoloft-side-effects.html https://www.drugs.com/sfx/zoloft-side-effects.html On a personal note, I am very sorry for your loss.
- EdwardDiego 9y ago
  From my experience, it's because as they kick in, you suddenly have energy and motivation you didn't have before, but you still have the suicidal thoughts until they become properly efficacious.
  - ufo 9y ago
    IIRC this is also the most widely accepted theory for it.
  - justasitsounds 9y ago
    I've heard that too. Along with the apparent external signs of an 'uptick in mood' (for want of a better phrase) when someone resolves to end it: IE. a lifting of a burden. I'd also like to say, to anyone reading this who is entertaining thoughts of self-harm or suicide: Please, please reach out for help. In my mother's case her suffering was almost certainly compounded by an irrational shame and self-imposed stigma. I'm just an armchair critic, if you are taking medication and you feel like it is helping - it is. If it isn't helping, please talk to your healthcare professionals about alternative treatment - there are always other options that don't involve hurting those who love you
- dsego 9y ago
  I am also very disillusioned with the psychiatric profession. The way they prescribe drugs seems no better than guesswork. Two years ago my dad having what I recognized as parkisonisms and akathisia but the psychiatrist said it wasn't possible because they had stopped giving him haldol. But then when she saw him, she said why we didn't come sooner (it's always the patient's fault) and quickly prescribed akineton. This has helped a little, but he has never recovered fully. He had also been on various antidepressants since 1994, Cymbalta, Velafax, Quentiax, Seroxat, Mirzaten, Ladiomil, probably more. I mean, what's the use? What is the actual use of taking those pills for decades?
  - colordrops 9y ago
    Making money for big pharma, unfortunately. It's really ugly out there.
taurath 9y ago
I have at different points in my life had major depressive episodes where an ssri does nothing whatsoever, and others when the same ssri same dose completely knocked it out. I’ve never seen a single study that shows altnernative efficacies in the same person, but it happened to me. Just one data point though.
mmirate 9y ago
> So, I guess that makes me complicit in all this too. No, that makes the salespeople, and your bosses at that communications company, complicit. We're just as neutral and tool-like as the computers we program.
- thomasfortes 9y ago
  This argument is dangerous. You can extend that to any point of the chain, salespeople can be considered as just neutral and tool like as programmers and the blame shifted up ad infinitum. While I don't think that he was complicit in this case (maybe the thought that what he was doing could have bad repercussions never went through his head, I don't know...), if you know that you're writing a program that will be used to calculate a way to kill the biggest number of people in a terrorist attack, would you still claim that you're not complicit because your boss that is paying you are the one complicit? If you don't know what are the uses of the program, I think that you can claim that, but if you know, definitely you're being complicit, even if you're being paid or working under orders (and not under duress).
  - mmirate 9y ago
    If the program's user-to-be is a customer instead of someone in the same company? Sure. I would also gladly write a program used to calculate a way to kill the biggest number of terrorists in a missile strike, and that has much less potential to be illegal (thus monumentally costly, and thus wholly counterproductive ... but again that's the businesspeople's concern). And your argument is dangerous, by ignoring the ultimate authority+responsibility of any company's leadership and investors.
  - jjeaff 9y ago
    I would point out the difference in someone who simply creates a tool, and a salesperson who, perhaps, knowingly lies, stretches the truth, hides inconvenient truth, and otherwise uses unethical means to promote something they know is wrong. There is also a very steep scale of diminishing complicity. Is the accountant that works at the electric company which provides electricity to the office building where the sketchy sales guys plot to sell their unhealthy products also complicit (assuming he knows what goes on there)?
iovrthoughtthis 9y ago
My partner, mother and sister take ssri's. This is my mental model for them and the depression it treats. 1) I see depression as the relevant neurological area of the brain learning to get too good at paying attention to negativity. (Overfitting to associating things with bad feelings, outcomes etc) 2) serotonin is a key chemical in the process of learning which I model as changing the way we associate emotions with situations, things etc. 3) by taking ssri's you provide the brain with an excess of serotonin which increases the capacity to learn new emotional associations provided you are exposed to those situations and positive feelings / outcomes. In this way, I believe (based only on my own reading and more as a thought aid than anything else) that treating the checmical aspect of depression is only viable if you treat the environmental aspect simultaneously. So just taking ssri's won't work. You need a good, safe, supportive environment to learn to be positive in again.
flowless 9y ago
My mother suffers from depression and is medicated already for quite some time. Every year when autumn comes her condition gets worse and she ends up in hospital for few weeks where they change her medication and let her recover just to experience the same during the next year. What's especially stunning to me is the reaction of my father and my family who instead to provide her with support and peaceful environment just sends her to hospital instead. From my perspective this all seems to be caused by the lifestyle she lives and her immediate surroundings - she's like under constant pressure to behave the way the rest of the ppl expect from her and she cares too much about what other ppl think about her. Another cause which I think is quite relevant is that she doesn't have much friends or hobbies of her on own so she's too dependent on my father who mostly cares for himself. I'm trying to talk to my larger family about this problem but most of the time they just dismiss my claims about her not having a good life, cause they don't want to make more of a drama by talking to my father to change his habits - they see it like everything is ok and the problem is with my mother who is just mentally ill. This is escalating as I'm slowly getting more and more reluctant to even talk to my farther, sister and the rest of the people who don't see this as a problem. I'm even thinking of translating articles like this so they can read this and possibly understand that's not everything is about drugs. Any ideas of what can I do are welcome as this is the source of my depression and anxiety for quite some time.
- tcj_phx 9y ago
  > Every year when autumn comes her condition gets worse and she ends up in hospital for few weeks [...] Light is anti-stress. Sounds like your mother would benefit from supplemental light (UV/red/etc) when the sun goes away for the winter. Enough UV, but not too much...
  - TheSpiceIsLife 9y ago
    I've had wild and rapid success with 8,000 to 10,000 IU of Vitamin D and 600mg of magnesium as magnesium amino acid chelate, per day. YMMV. Edit: fixed a word
    - 9y ago
Jaruzel 9y ago
I take an SNRI (newer variant of SSRI), and have done solidly now for over 2 years. However before that I had some failed attempts of taking other long-term SSRIs. When I started taking my current medication, it was due to a massive breakdown which left me an uncontrollable sobbing mess on the floor. I was totally incapacitated. I started taking the SNRI (along with Diazepam/Valium for immediate effect), and after about 10 days, I became massively suicidal; It was just through sheer willpower, and the knowledge of upsetting people who cared about me that prevented me from doing anything about it. After about 3 weeks or so, those daily feelings dissipated, and I started feeling more 'normal'. Well people said it was 'normal' - for me, I just feel odd. I live with the 'altered' version of me, knowing it's not really who I am. Coming to terms with just that, is the hardest part of being in this state. My dose is really high, and I have no intention of increasing it. I also committed (properly) to therapy, and that helped immensely. I constantly consider getting my dose lowered, with the aim to be totally off the drugs, but in reality, I know that will never happen. My psychiatrist said that "first time depression usually results in a re-occurrence 40% of the time, second time depression is 60%, and if it hits a third time, that's you done - you will always be this.'
mnm1 9y ago
Doctors and scientists who bothered to conduct even the most cursory research on this topic have known that the chemical imbalance hypothesis, aka "serotonin hypothesis" is bullshit. There is no evidence for it and never has been. This mirrors the claims of the sugar industry telling us to eat sugar instead of fat. Completely unscientific advice becoming mainstream to the point where doctors are committing malpractice en masse and actually believe the stupidity they failed to verify. There should be some class action lawsuits based on this. The proponents of this idiotic, unscientific, unproven, unsubstantiated theory have ruined countless lives. Who knows how many people they have driven to hopelessness and suicide just to make money off of them? Just from personal experience, I know it's not zero. These are lives lost that didn't have to be. All in the name of profit. This is the kind of society we live in and we wonder why a huge percentage of the population is depressed?
yekm 9y ago
https://www.youtube.com/watch?v=NOAgplgTxfc https://www.youtube.com/watch?v=NOAgplgTxfc

dsego 9y ago

Almost all antidepressants list the increase of suicide risk as a side effect, which is frightening. Zoloft for example [1]: > An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs. [1]https://www.drugs.com/sfx/zoloft-side-effects.html https://www.drugs.com/sfx/zoloft-side-effects.html On a personal note, I am very sorry for your loss.

EdwardDiego 9y ago
From my experience, it's because as they kick in, you suddenly have energy and motivation you didn't have before, but you still have the suicidal thoughts until they become properly efficacious.
- ufo 9y ago
  IIRC this is also the most widely accepted theory for it.
- justasitsounds 9y ago
  I've heard that too. Along with the apparent external signs of an 'uptick in mood' (for want of a better phrase) when someone resolves to end it: IE. a lifting of a burden. I'd also like to say, to anyone reading this who is entertaining thoughts of self-harm or suicide: Please, please reach out for help. In my mother's case her suffering was almost certainly compounded by an irrational shame and self-imposed stigma. I'm just an armchair critic, if you are taking medication and you feel like it is helping - it is. If it isn't helping, please talk to your healthcare professionals about alternative treatment - there are always other options that don't involve hurting those who love you
dsego 9y ago
I am also very disillusioned with the psychiatric profession. The way they prescribe drugs seems no better than guesswork. Two years ago my dad having what I recognized as parkisonisms and akathisia but the psychiatrist said it wasn't possible because they had stopped giving him haldol. But then when she saw him, she said why we didn't come sooner (it's always the patient's fault) and quickly prescribed akineton. This has helped a little, but he has never recovered fully. He had also been on various antidepressants since 1994, Cymbalta, Velafax, Quentiax, Seroxat, Mirzaten, Ladiomil, probably more. I mean, what's the use? What is the actual use of taking those pills for decades?
- colordrops 9y ago
  Making money for big pharma, unfortunately. It's really ugly out there.

taurath 9y ago

I have at different points in my life had major depressive episodes where an ssri does nothing whatsoever, and others when the same ssri same dose completely knocked it out. I’ve never seen a single study that shows altnernative efficacies in the same person, but it happened to me. Just one data point though.

mmirate 9y ago

> So, I guess that makes me complicit in all this too. No, that makes the salespeople, and your bosses at that communications company, complicit. We're just as neutral and tool-like as the computers we program.

thomasfortes 9y ago
This argument is dangerous. You can extend that to any point of the chain, salespeople can be considered as just neutral and tool like as programmers and the blame shifted up ad infinitum. While I don't think that he was complicit in this case (maybe the thought that what he was doing could have bad repercussions never went through his head, I don't know...), if you know that you're writing a program that will be used to calculate a way to kill the biggest number of people in a terrorist attack, would you still claim that you're not complicit because your boss that is paying you are the one complicit? If you don't know what are the uses of the program, I think that you can claim that, but if you know, definitely you're being complicit, even if you're being paid or working under orders (and not under duress).
- mmirate 9y ago
  If the program's user-to-be is a customer instead of someone in the same company? Sure. I would also gladly write a program used to calculate a way to kill the biggest number of terrorists in a missile strike, and that has much less potential to be illegal (thus monumentally costly, and thus wholly counterproductive ... but again that's the businesspeople's concern). And your argument is dangerous, by ignoring the ultimate authority+responsibility of any company's leadership and investors.
- jjeaff 9y ago
  I would point out the difference in someone who simply creates a tool, and a salesperson who, perhaps, knowingly lies, stretches the truth, hides inconvenient truth, and otherwise uses unethical means to promote something they know is wrong. There is also a very steep scale of diminishing complicity. Is the accountant that works at the electric company which provides electricity to the office building where the sketchy sales guys plot to sell their unhealthy products also complicit (assuming he knows what goes on there)?

iovrthoughtthis 9y ago

My partner, mother and sister take ssri's. This is my mental model for them and the depression it treats. 1) I see depression as the relevant neurological area of the brain learning to get too good at paying attention to negativity. (Overfitting to associating things with bad feelings, outcomes etc) 2) serotonin is a key chemical in the process of learning which I model as changing the way we associate emotions with situations, things etc. 3) by taking ssri's you provide the brain with an excess of serotonin which increases the capacity to learn new emotional associations provided you are exposed to those situations and positive feelings / outcomes. In this way, I believe (based only on my own reading and more as a thought aid than anything else) that treating the checmical aspect of depression is only viable if you treat the environmental aspect simultaneously. So just taking ssri's won't work. You need a good, safe, supportive environment to learn to be positive in again.

flowless 9y ago

My mother suffers from depression and is medicated already for quite some time. Every year when autumn comes her condition gets worse and she ends up in hospital for few weeks where they change her medication and let her recover just to experience the same during the next year. What's especially stunning to me is the reaction of my father and my family who instead to provide her with support and peaceful environment just sends her to hospital instead. From my perspective this all seems to be caused by the lifestyle she lives and her immediate surroundings - she's like under constant pressure to behave the way the rest of the ppl expect from her and she cares too much about what other ppl think about her. Another cause which I think is quite relevant is that she doesn't have much friends or hobbies of her on own so she's too dependent on my father who mostly cares for himself. I'm trying to talk to my larger family about this problem but most of the time they just dismiss my claims about her not having a good life, cause they don't want to make more of a drama by talking to my father to change his habits - they see it like everything is ok and the problem is with my mother who is just mentally ill. This is escalating as I'm slowly getting more and more reluctant to even talk to my farther, sister and the rest of the people who don't see this as a problem. I'm even thinking of translating articles like this so they can read this and possibly understand that's not everything is about drugs. Any ideas of what can I do are welcome as this is the source of my depression and anxiety for quite some time.

tcj_phx 9y ago
> Every year when autumn comes her condition gets worse and she ends up in hospital for few weeks [...] Light is anti-stress. Sounds like your mother would benefit from supplemental light (UV/red/etc) when the sun goes away for the winter. Enough UV, but not too much...
- TheSpiceIsLife 9y ago
  I've had wild and rapid success with 8,000 to 10,000 IU of Vitamin D and 600mg of magnesium as magnesium amino acid chelate, per day. YMMV. Edit: fixed a word
  - 9y ago

Jaruzel 9y ago

I take an SNRI (newer variant of SSRI), and have done solidly now for over 2 years. However before that I had some failed attempts of taking other long-term SSRIs. When I started taking my current medication, it was due to a massive breakdown which left me an uncontrollable sobbing mess on the floor. I was totally incapacitated. I started taking the SNRI (along with Diazepam/Valium for immediate effect), and after about 10 days, I became massively suicidal; It was just through sheer willpower, and the knowledge of upsetting people who cared about me that prevented me from doing anything about it. After about 3 weeks or so, those daily feelings dissipated, and I started feeling more 'normal'. Well people said it was 'normal' - for me, I just feel odd. I live with the 'altered' version of me, knowing it's not really who I am. Coming to terms with just that, is the hardest part of being in this state. My dose is really high, and I have no intention of increasing it. I also committed (properly) to therapy, and that helped immensely. I constantly consider getting my dose lowered, with the aim to be totally off the drugs, but in reality, I know that will never happen. My psychiatrist said that "first time depression usually results in a re-occurrence 40% of the time, second time depression is 60%, and if it hits a third time, that's you done - you will always be this.'

mnm1 9y ago

Doctors and scientists who bothered to conduct even the most cursory research on this topic have known that the chemical imbalance hypothesis, aka "serotonin hypothesis" is bullshit. There is no evidence for it and never has been. This mirrors the claims of the sugar industry telling us to eat sugar instead of fat. Completely unscientific advice becoming mainstream to the point where doctors are committing malpractice en masse and actually believe the stupidity they failed to verify. There should be some class action lawsuits based on this. The proponents of this idiotic, unscientific, unproven, unsubstantiated theory have ruined countless lives. Who knows how many people they have driven to hopelessness and suicide just to make money off of them? Just from personal experience, I know it's not zero. These are lives lost that didn't have to be. All in the name of profit. This is the kind of society we live in and we wonder why a huge percentage of the population is depressed?

yekm 9y ago

https://www.youtube.com/watch?v=NOAgplgTxfc https://www.youtube.com/watch?v=NOAgplgTxfc