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I think that the United States is getting better about dealing with mental health, but we still have a long way to go. This is a little soap-boxy and anecdotal,

I think that the United States is getting better about dealing with mental health, but we still have a long way to go. This is a little soap-boxy and anecdotal, and I apologize if it's inappropriate here. If I hadn't gotten a prescription for Prozac I probably would have killed myself by now. And I definitely would have destroyed my marriage and most of my important friendships. That's not an over-dramatization, it's the honest truth just based on the direction my life was heading without them. If you can't make your own neurotransmitters, store bought are fine. I'm not writing this to say "RARGH YOU MUST USE THESE DRUGS", but I absolutely am writing it to say "hey, this worked for me and got me out of a really dark and bad place". If you are reading this from a dark and bad place, please know that you're not alone. You have a lot of options, and I promise that if you take that first step, things can get better.

publicfig 9y ago
As someone in the very same boat, I appreciate and can relate to the line you have to walk. My life was positively changed by going on Prozac in a way that I didn't think was possible. After years and years of trying any way of dealing with depression that didn't involve medication, I was absolutely at a dangerous place. Most of my reasoning was that I didn't really believe in the efficiency of medication, and even if so, I didn't think I was actually someone with depression, just that I had been, since i was a kid, putting myself into constant situations that caused severe anxiety and depression. It didn't all work at once, and I had a lot of weird steps between starting and being in a state that I would now consider "my normal self that I never knew I actually was", but it's been an overall life changing experience. That being said, I understand that medication, or even the same medications, can't work for some people in the way they did with me. It's difficult to explain the position of "I know medication doesn't always work and isn't always an answer, but sometimes it is an answer that I would hate to be missed out on".
evincarofautumn 9y ago
Likewise, if storebought doesn’t do the trick, some people (myself and my partner included) have better luck with the recreational variety—mushrooms were the thing that kicked me in the psychological ass and started me on the path to recovery from alcoholism (which was partly self-medicating for anxiety). To be clear, this is absolutely not something I’d recommend lightly. Taking (who knows how strong) mushrooms or LSD isn’t exactly the most precise or reliable way to go about it, and there are attendant risks. I just hope in the future there’s more access to psychedelics (and analogues) in a safe, professional setting, because they’ve been shown to be another potentially useful tool in the antidepressant/anxiolytic/self-care kit.
- deleted 9y ago
  [deleted]
- tyu100 9y ago
  This study, along with long-accepted clinical practice and the generic cheapness of most anti-depressants now, and the effectiveness of CBT/therapy if it's available to you, means you should really avoid self-medicating for major depression. Why take risks with your health when there are lots of safe, cheap and efficacious treatments that can be monitored by your doctor?
  - aianus 9y ago
    Psychiatrists have a three month waiting list here in Canada and therapy is $100/h.
    - markroseman 9y ago
      Three months in some places. Here in Victoria, unless you're in crisis, it's actually almost impossible for most people to get in to see a psychiatrist, and if you can, the waiting list is well over a year.
  - evincarofautumn 9y ago
    I generally agree—I guess I just mean I wish there were a safer/tested way to take advantage of other serotonergics, after the first line of defense fails, for those who are less cavalier than I am about their neurochemistry. Also in my case it wasn’t depression, so I can’t really speak to that, but SSRIs are also prescribed for anxiety disorders. I chose not to go on them when they were offered because I didn’t feel that the side effects were worth it, and they weren’t the correct treatment anyway because at the time I was mainly anxious due to alcohol withdrawal. (I’m lucky I didn’t have a seizure!)
  - soundwave106 9y ago
    The poster asked for "access to psychedelics (and analogues) in a safe, professional setting", which ideally (if the treatment is one that indeed works and isn't placebo) would be one that is monitored by your doctor. I agree that self-medication is not idea. The issue here I think is that most current anti-depressants are currently of the SSRI / SNRI / tri-cyclic class. These treatments work great for some people, but do not work for everyone. In one case (ketamine), this particular hallucinogenic drug has emerged as a candidate for anti-depression therapy (at least in mechanism) that works quite a bit different than the above (acts on glutamate). Non-hallucinogenic glutamatergic anti-depression drugs are being developed as a result, but as one is well aware, this takes time. Until one of these drugs emerges (rapastinel seems furthest along at this time), off-label ketamine clinics do exist where you can take the drug with some degree of clinical supervision. I have not seen too much on the serotonin agonist hallucinogens in the past relieving depression, but Googling, there does seem to be a newish article on psilocybin (https://www.nature.com/articles/s41598-017-13282-7 https://www.nature.com/articles/s41598-017-13282-7) that suggests it does offer a possible interesting anti-depression mechanism too. Possibly more exploration is needed here to confirm whether it works well (or not) and, if so, how. I don't think we've even come close to exploring all routes to resolving depression, so I think exploring as many routes as possible is a good path. (And I do think scientists are doing this -- the parent article was for instance the first time I've heard of a melatonin receptor agonist as an anti-depressant candidate! https://en.wikipedia.org/wiki/Agomelatine https://en.wikipedia.org/wiki/Agomelatine )
anticnstrctv 9y ago
Attitudes towards mental health in the US and the west in general are quite frustrating, and I hope they are improving. On the right there seems to be a tendency to deny nuanced views of mental illness from economic, religious, or simply conservative cultural motivations, or to push sedative (using this term metaphorically) medication as a panacea. On the left there are many influenced by the (understandable but deeply destructive) anti-psychiatry movements who both affirm mental illness and deny proper care. It is quite frustrating to see someone talk about their own "undiagnosed mental illness" while citing Foucault to disparage people you care about for seeking psychiatric methods that, as you described, saved their lives.
- markroseman 9y ago
  The anti-psychiatry folks are extreme enough that they deny mental illness altogether, though many other "psychiatric survivor" communities do not deny, and often celebrate "lived experience", but are critical of psychiatric treatments.
analogmemory 9y ago
> If you are reading this from a dark and bad place, please know that you're not alone. You have a lot of options, and I promise that if you take that first step, things can get better. I really think they need to have some sort required of "Life Skills" class in high school. In which they teach you how to get help, how to ask for help, how to share your feelings with friends in a safe way. And your options if you do get into a deep dark way. Based on personal evidence, almost every adult gets depressed in some way and many don't know how to get help or deal with it in a healthy way. I didn't learn any of that till my 30s. I nearly committed suicide multiple times. Our current society and the toxic religious one i grew up in taught me that a man needs to be strong and doesn't need to rely on others. Pray to God and just pull yourself up by your bootstraps mentality. It's amazing how helpful it is to know that you are loved and cared for. And people want to help you. You just have to ask for it.
jdietrich 9y ago
>If I hadn't gotten a prescription for Prozac I probably would have killed myself by now. The majority of people with depression just get better of their own accord, for no obvious reason. The NNT for most antidepressants is ~7, meaning you need to give them to about seven patients for one patient to see a clinically-significant improvement. The evidence suggests that there's no significant relationship between SSRI use and suicide risk except for young people, for whom SSRIs may actually increase the risk of suicidal behaviours and self-harm. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353604/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353604/ >If you can't make your own neurotransmitters, store bought are fine. There is no evidence whatsoever that people with depression are "deficient" in neurotransmitters. We don't really understand the mechanism of action of any antidepressant. Plenty of drugs that have no effect whatsoever on serotonin are equally effective as SSRIs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471964/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471964/ Antidepressants can be useful for some patients, but they aren't miracle drugs - they aren't even particularly good drugs. If you're depressed then you should certainly consider pharmacological treatment, but you should regard it as only one tool among many. Talking therapy is equally effective and the combination of drugs and talk therapy is more effective than either alone. You might need to try several different drugs before you find one that works for you and has tolerable side-effects, especially if you have been depressed for some time or have comorbid conditions. If your depressive symptoms are relatively mild, you should probably look at lifestyle interventions like diet, exercise, sleep hygiene and self-help before considering drug treatment. https://www.nice.org.uk/guidance/cg90 https://www.nice.org.uk/guidance/cg90
- deleted 9y ago
  [deleted]
- tyrex2017 9y ago
  NNT might be 7 for one drug and one try, but the therapist will try several drugs and doses. I could imagine that NNT might significantly improve if you consider “use antidepressants” instead of “use 1 antidepressant 1 time”
  - jdietrich 9y ago
alex_hitchins 9y ago
I know exactly where you are coming from. Me too. Thank you be being honest and sharing your experience.
hestipod 9y ago
I'd like to expand a bit and reiterate that not everyone who suffers from depression has primary depression with no discernable cause. Most seriously depressed people in my experience have various situational causes (physical health, financial, social etc) and the depression is a side effect of those and not the main issue. Without tackling the root cause, drugs usually just cover, drag out, and add issues, yet the mental health system mostly uses these drugs as a blunt instrument and fail to address the cause. In the right circumstance, and right conditions, they CAN enable someone to get out of a rut and take actions they wouldn't have without so they do have a place after someone with unexplainable depression who has tried less invasive and risky options like lifestyle changes. I am not encouraging people not to try medication if they feel it is a good option, simply asking people to realize A. It's not a cure without a plan to fix the cause and B. Not to follow the common victim blaming that often occurs when these simple "fixes" don't work for people (OP isn't doing that and I don't intend to sound as if I am saying so...in fact they made it clear it's not a magical fix suited for all) Drugs are a tool, not a cure, and need to be wielded responsibly and properly. Sadly I don't believe that happens a lot of the time.
- branx 9y ago
  Jordan Peterson talks about this in one of his lectures. I can't look it up now but if you google "Jordan Peterson antidepressant" you should find something
imperio59 9y ago
Just because it worked for you doesn't mean it works for everyone, actually by far you're the anomaly... See https://nypost.com/2016/04/05/are-antidepressants-making-women-sicker/ https://nypost.com/2016/04/05/are-antidepressants-making-wom... Also would you say the drug cured you? Are you able to function without taking it now?

publicfig 9y ago

As someone in the very same boat, I appreciate and can relate to the line you have to walk. My life was positively changed by going on Prozac in a way that I didn't think was possible. After years and years of trying any way of dealing with depression that didn't involve medication, I was absolutely at a dangerous place. Most of my reasoning was that I didn't really believe in the efficiency of medication, and even if so, I didn't think I was actually someone with depression, just that I had been, since i was a kid, putting myself into constant situations that caused severe anxiety and depression. It didn't all work at once, and I had a lot of weird steps between starting and being in a state that I would now consider "my normal self that I never knew I actually was", but it's been an overall life changing experience. That being said, I understand that medication, or even the same medications, can't work for some people in the way they did with me. It's difficult to explain the position of "I know medication doesn't always work and isn't always an answer, but sometimes it is an answer that I would hate to be missed out on".

evincarofautumn 9y ago

Likewise, if storebought doesn’t do the trick, some people (myself and my partner included) have better luck with the recreational variety—mushrooms were the thing that kicked me in the psychological ass and started me on the path to recovery from alcoholism (which was partly self-medicating for anxiety). To be clear, this is absolutely not something I’d recommend lightly. Taking (who knows how strong) mushrooms or LSD isn’t exactly the most precise or reliable way to go about it, and there are attendant risks. I just hope in the future there’s more access to psychedelics (and analogues) in a safe, professional setting, because they’ve been shown to be another potentially useful tool in the antidepressant/anxiolytic/self-care kit.

deleted 9y ago
[deleted]
tyu100 9y ago
This study, along with long-accepted clinical practice and the generic cheapness of most anti-depressants now, and the effectiveness of CBT/therapy if it's available to you, means you should really avoid self-medicating for major depression. Why take risks with your health when there are lots of safe, cheap and efficacious treatments that can be monitored by your doctor?
- aianus 9y ago
  Psychiatrists have a three month waiting list here in Canada and therapy is $100/h.
  - markroseman 9y ago
    Three months in some places. Here in Victoria, unless you're in crisis, it's actually almost impossible for most people to get in to see a psychiatrist, and if you can, the waiting list is well over a year.
- evincarofautumn 9y ago
  I generally agree—I guess I just mean I wish there were a safer/tested way to take advantage of other serotonergics, after the first line of defense fails, for those who are less cavalier than I am about their neurochemistry. Also in my case it wasn’t depression, so I can’t really speak to that, but SSRIs are also prescribed for anxiety disorders. I chose not to go on them when they were offered because I didn’t feel that the side effects were worth it, and they weren’t the correct treatment anyway because at the time I was mainly anxious due to alcohol withdrawal. (I’m lucky I didn’t have a seizure!)
- soundwave106 9y ago
  The poster asked for "access to psychedelics (and analogues) in a safe, professional setting", which ideally (if the treatment is one that indeed works and isn't placebo) would be one that is monitored by your doctor. I agree that self-medication is not idea. The issue here I think is that most current anti-depressants are currently of the SSRI / SNRI / tri-cyclic class. These treatments work great for some people, but do not work for everyone. In one case (ketamine), this particular hallucinogenic drug has emerged as a candidate for anti-depression therapy (at least in mechanism) that works quite a bit different than the above (acts on glutamate). Non-hallucinogenic glutamatergic anti-depression drugs are being developed as a result, but as one is well aware, this takes time. Until one of these drugs emerges (rapastinel seems furthest along at this time), off-label ketamine clinics do exist where you can take the drug with some degree of clinical supervision. I have not seen too much on the serotonin agonist hallucinogens in the past relieving depression, but Googling, there does seem to be a newish article on psilocybin (https://www.nature.com/articles/s41598-017-13282-7 https://www.nature.com/articles/s41598-017-13282-7) that suggests it does offer a possible interesting anti-depression mechanism too. Possibly more exploration is needed here to confirm whether it works well (or not) and, if so, how. I don't think we've even come close to exploring all routes to resolving depression, so I think exploring as many routes as possible is a good path. (And I do think scientists are doing this -- the parent article was for instance the first time I've heard of a melatonin receptor agonist as an anti-depressant candidate! https://en.wikipedia.org/wiki/Agomelatine https://en.wikipedia.org/wiki/Agomelatine )

anticnstrctv 9y ago

Attitudes towards mental health in the US and the west in general are quite frustrating, and I hope they are improving. On the right there seems to be a tendency to deny nuanced views of mental illness from economic, religious, or simply conservative cultural motivations, or to push sedative (using this term metaphorically) medication as a panacea. On the left there are many influenced by the (understandable but deeply destructive) anti-psychiatry movements who both affirm mental illness and deny proper care. It is quite frustrating to see someone talk about their own "undiagnosed mental illness" while citing Foucault to disparage people you care about for seeking psychiatric methods that, as you described, saved their lives.

markroseman 9y ago
The anti-psychiatry folks are extreme enough that they deny mental illness altogether, though many other "psychiatric survivor" communities do not deny, and often celebrate "lived experience", but are critical of psychiatric treatments.

analogmemory 9y ago

> If you are reading this from a dark and bad place, please know that you're not alone. You have a lot of options, and I promise that if you take that first step, things can get better. I really think they need to have some sort required of "Life Skills" class in high school. In which they teach you how to get help, how to ask for help, how to share your feelings with friends in a safe way. And your options if you do get into a deep dark way. Based on personal evidence, almost every adult gets depressed in some way and many don't know how to get help or deal with it in a healthy way. I didn't learn any of that till my 30s. I nearly committed suicide multiple times. Our current society and the toxic religious one i grew up in taught me that a man needs to be strong and doesn't need to rely on others. Pray to God and just pull yourself up by your bootstraps mentality. It's amazing how helpful it is to know that you are loved and cared for. And people want to help you. You just have to ask for it.

jdietrich 9y ago

>If I hadn't gotten a prescription for Prozac I probably would have killed myself by now. The majority of people with depression just get better of their own accord, for no obvious reason. The NNT for most antidepressants is ~7, meaning you need to give them to about seven patients for one patient to see a clinically-significant improvement. The evidence suggests that there's no significant relationship between SSRI use and suicide risk except for young people, for whom SSRIs may actually increase the risk of suicidal behaviours and self-harm. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353604/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353604/ >If you can't make your own neurotransmitters, store bought are fine. There is no evidence whatsoever that people with depression are "deficient" in neurotransmitters. We don't really understand the mechanism of action of any antidepressant. Plenty of drugs that have no effect whatsoever on serotonin are equally effective as SSRIs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471964/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471964/ Antidepressants can be useful for some patients, but they aren't miracle drugs - they aren't even particularly good drugs. If you're depressed then you should certainly consider pharmacological treatment, but you should regard it as only one tool among many. Talking therapy is equally effective and the combination of drugs and talk therapy is more effective than either alone. You might need to try several different drugs before you find one that works for you and has tolerable side-effects, especially if you have been depressed for some time or have comorbid conditions. If your depressive symptoms are relatively mild, you should probably look at lifestyle interventions like diet, exercise, sleep hygiene and self-help before considering drug treatment. https://www.nice.org.uk/guidance/cg90 https://www.nice.org.uk/guidance/cg90

deleted 9y ago
[deleted]
tyrex2017 9y ago
NNT might be 7 for one drug and one try, but the therapist will try several drugs and doses. I could imagine that NNT might significantly improve if you consider “use antidepressants” instead of “use 1 antidepressant 1 time”
- jdietrich 9y ago

alex_hitchins 9y ago

I know exactly where you are coming from. Me too. Thank you be being honest and sharing your experience.

hestipod 9y ago

I'd like to expand a bit and reiterate that not everyone who suffers from depression has primary depression with no discernable cause. Most seriously depressed people in my experience have various situational causes (physical health, financial, social etc) and the depression is a side effect of those and not the main issue. Without tackling the root cause, drugs usually just cover, drag out, and add issues, yet the mental health system mostly uses these drugs as a blunt instrument and fail to address the cause. In the right circumstance, and right conditions, they CAN enable someone to get out of a rut and take actions they wouldn't have without so they do have a place after someone with unexplainable depression who has tried less invasive and risky options like lifestyle changes. I am not encouraging people not to try medication if they feel it is a good option, simply asking people to realize A. It's not a cure without a plan to fix the cause and B. Not to follow the common victim blaming that often occurs when these simple "fixes" don't work for people (OP isn't doing that and I don't intend to sound as if I am saying so...in fact they made it clear it's not a magical fix suited for all) Drugs are a tool, not a cure, and need to be wielded responsibly and properly. Sadly I don't believe that happens a lot of the time.

branx 9y ago
Jordan Peterson talks about this in one of his lectures. I can't look it up now but if you google "Jordan Peterson antidepressant" you should find something

imperio59 9y ago

Just because it worked for you doesn't mean it works for everyone, actually by far you're the anomaly... See https://nypost.com/2016/04/05/are-antidepressants-making-women-sicker/ https://nypost.com/2016/04/05/are-antidepressants-making-wom... Also would you say the drug cured you? Are you able to function without taking it now?