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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 masquer

• JustThrowMeAway 8y 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 8y 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/ https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0087089/
  • op00to 8y 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.
    • tomnipotent 8y ago
      Our society considers it a personality defect because people suffering from mental health issues have behavior that deviates too far from the average. It wasn't that long ago that people thought cancer patients were contagious.
      • subcosmos 8y ago
        Viral infections are thought to contribute to 15-20% of all cancers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2267909/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2267909/
    • anyfoo 8y ago
      Who’s asserting a personality defect? There are plenty of people whose depression stems from real, tangible issues in their present or past life. Solving these problems or, if they don’t actually have any active relevance to present life anymore, just processing them, has also been shown to be very effective. You don’t have to have a “defect” to have a problem. Depression spirals and is self-perpetuating, so it has a nasty tendency to stick, but assuming that all depression only stems from a simple chemical imbalance, with no correlation to anyone’s life situation (again, past or presence) is very simplistic. I’m not arguing for the article, but against the opposite view that all depression is rooted in chemical instead of psychological causes.
  • subcosmos 8y 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 8y 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.
  • kryogen1c 8y 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.
    • darkerside 8y ago
      Let's assume you are right and the positive effects were completely attributed to placebo effect. If placebo effect is an effective treatment that results in a cure, what exactly is your complaint?
      • kryogen1c 8y ago
        > If placebo effect is an effective treatment that results in a cure, what exactly is your complaint? It's not reproducible because it's not medicine.
        • macawfish 8y ago
          Your idea of medicine is missing something important: the complex, messy, slippery, irrational, dynamic process called "healing."
        • darkerside 8y ago
          Did you mean it's not medicine because it's not reproducible? I don't really understand the statement either way tbh. Let's acknowledge that my question also assumed the most favorable scenario for your argument. Most objective observers would agree there is a nonzero chance that the treatment was not totally based on placebo effect, but rather on undiscovered science. You do understand that, right? That not all science has been discovered, there are many things we do not know or understand, and yet are true. If we cling to what has been proven and refute anything else, we freeze all progress. I can think of nothing less scientific.
• Alex3917 8y 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."
  • rhizome 8y ago
    Hasn't it been decades since a pure serotonin theory was tenable?
    • Alex3917 8y ago
      It was never tenable. The research showing that reduced levels of serotonin ameliorate depression didn’t come after the fact, it came from the original paper. The authors just ignored that when writing the conclusion.
• baumgarn 8y 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.
  • HBlix 8y 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.
    • jschwartzi 8y ago
      The thing you're missing is that it is learned insecurity that is associated with the biochemical changes, and that by doing the work to unlearn the insecurity as the author did you can reverse the biochemical changes. You can't make the statement that the biochemical changes are the cause of the insecurity, only that they are associated with it. And that's very important, because an "if-then" statement does not imply the converse. That is, if you reverse the biochemical changes you do not necessarily make the learned insecurity go away. A broken leg is way less complicated than the synapses that form your perception of yourself, and far better understood. You can't really conflate the two without committing a logical fallacy. Treating the broken leg and the brain changes as identical in complexity is akin to treating the construction of a rivet the same as the construction of a Boeing 737. The fact is that you can change, and you can feel better, but you also have to put in the work to change yourself. It's the hardest thing you will ever do if you grew up in a dysfunctional family because it requires you to deny years of your experience in favor of the received wisdom of how the world really works, and not everyone can do this. But if you do the work the reward in the end is that you're not permanently crippled by addiction to psychiatric medication.
• curun1r 8y 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 8y 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.
    • subcosmos 8y ago
      They saved my life after a decade of trying everything else.
      • loceng 8y ago
        Do you mind sharing what "everything else" you tried included?
    • curun1r 8y ago
      This is exactly my view. I see medication as the nuclear option. It's important to have it in reserve, since it can work, but you should try everything else first because of how badly the medication route can go. The "first do no harm" doctrine is violated by taking a medication-first approach.
• ma2rten 8y 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 8y 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-connections-johann-hari-review https://www.theguardian.com/books/2018/jan/17/lost-connectio...
    • Alex3917 8y ago
      > Replace the drugs targeting serotonin with drugs that target dopamine and you can expect the same effect. Anything, drug or non-drug, that has any effect on the senses will have roughly the same effect. E.g. hot therapy, cold therapy, meditation, float therapy, aromatherapy, massage, acupuncture, etc. There's nothing at all special about serotonin, it just happens to sit at the intersection of several different areas of pseudoscience and a lot of marketing dollars. The research that lead to the monoamine hypothesis in the first place was faked.
      • subcosmos 8y ago
        There is something special about serotonin - throughout evolution, it has been an important part of regulating social emotional processing in animals and humans. It strongly regulates the function of the salience network in the brain, alterations of which are associated with anxiety disorders. Like other neurotransmitters, serotonin is specifically synthesized in a specific brain region, the raphe nuclei. (Dopamine is from the substantia nigra) Brain circuits have lots of overlap but they definitely have specialization. Case in point, genes associated with serotonin processing have SNPs for depression-like illnesses. Sapolsky gives one of the better lectures on the specific features associated with abnormal serotonin, dopamine, or neuropinephrine signaling, and their associated symptomology. Ultimately it's the job of the psychiatrist to figure out what's out of balance based on behavior. https://www.youtube.com/watch?v=NOAgplgTxfc https://www.youtube.com/watch?v=NOAgplgTxfc
• loceng 8y 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.
• subcosmos 8y 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/pmc/articles/PMC4790407/ https://www.ncbi.nlm.nih.gov/pubmed/23988273 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 8y ago
    This sounds a lot like an indirect form of the same mechanism as TMS.
• Arbitrary4657 8y 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.