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> The number of US adults with MDD increased by 12.9%, from 15.5 to 17.5 million, between 2010 and 2018, whereas the proportion of adults with MDD aged 18–34 ye

> The number of US adults with MDD increased by 12.9%, from 15.5 to 17.5 million, between 2010 and 2018, whereas the proportion of adults with MDD aged 18–34 years increased from 34.6 to 47.5 If about half of young adults suffer from a disorder, it makes me question if it’s a disorder at all. And the noted impact of economic factors and things like Covid highlight the “nurture” aspect of the disorder instead of “nurture” (e.g. the “chemical imbalance” internet myth). I’ve been diagnosed with MDD, GAD, ADHD, and bipolar type 1 but after I suffered a manic episode while on psych meds , I really dug into the research of psychiatrists and now have the controversial opinion it’s very weak science riding on the coattails of the rest of Western medicine and is obviously influenced by the for profit pharmaceutical companies. The DSM 5 wasn’t even created in the open. Both as societies and as individuals, we need to introspect on how we can be so relatively wealthy yet so often so fundamentally unhappy. And the idea that half of the population has a brain disorder rather than is in a bad environment and conditioned by circumstances to feel that way seems hard to believe. I’m very interested in the anti psychiatry movement which includes a small minority of medical professionals, and I’m more open to sane ideas that I used to consider “new age.” But more than anything, I think many aspects of mental health are like losing weight - very simple but difficult especially in the wrong environment. Close family relationships, diet, exercise, time outdoors, a sense of community, less time on social media - we mostly know that this is the key to feeling better but we desperately want an easier answer in pill from someone in a white coat and our profit driven medical system is more than happy to oblige.

ipnon 5y ago
I hope that before dismissing you, any critics would lend weight to the fact that you have been diagnosed with several disorders and been through the psychiatric system. You have some skin in the game here. So even though your advice is certainly not universal and many perceive great benefit from psychiatric treatment, there is some truth to be had in your argument.
- caddemon 5y ago
  The comment tone is way beyond advice and makes some bizarre claims about profit motives. Psychiatry is a hard subject and there has been some bad research, but it's pretty clear he has also done some reading on fringe sites. I understand being upset by shitty doctors and going down that rabbit hole, but it would be irresponsible to not respond to the comment when others on the fence about medication might be swayed. The key point he is missing is that psychiatric disease can make those lifestyle changes orders of magnitude harder for someone to make than it would be for a healthy adult. As lifestyle gets worse you get a terrible loop going. Medication helps many break that loop - certainly not all, but it is something to seriously consider with your doctor. If he was able to make those changes without medication that is great for him, but I think his message is kind of analogous to a rich entrepreneur that grew up poor telling everyone else they should just work harder and they'll move up in life. Is it probably good advice for those people to work harder? Yes, but many of them do not have the talent or luck to actually move up much, so it cheapens the message a lot.
CrazyStat 5y ago
> If about half of young adults suffer from a disorder This is a misreading of the (admittedly confusing) statistic > the proportion of adults with MDD aged 18–34 years increased from 34.6 to 47.5 This is not saying that 47.5% of 18-34 year-olds have MDD, but rather that of adults with MDD, 47.5% are in the 18-34 age range.
Nav_Panel 5y ago
Are you at all interested in reading recommendations?
Guthur 5y ago
After a certain point wealth has very little correlation with happiness. Once you get above basic needs the return on wealth to happiness really quickly diminishes.
- Red_Leaves_Flyy 5y ago
  That studies recently been challenged by the contrary results of a new one. https://www.forbes.com/sites/alexledsom/2021/02/07/new-study-shows-that-more-money-buys-more-happiness/ https://www.forbes.com/sites/alexledsom/2021/02/07/new-study... I for one, would be much happier with a less overtly abusive workplace, and oppressive living situation. Money is not everything, but as I cannot afford a better existence, it might as well be the only thing that matters.
nyanpasu64 5y ago
What alternative exist for close family relationships, for people who were abused by their families?
- Red_Leaves_Flyy 5y ago
  I'm not sure if you're asking for specific advice personally, or thinking of others but my response is generally the same. It's very hard for even a well adjusted person to create a replacement familial environment. In decades past the advice would be to go to church. Today? I've got no clue, I'm trying to figure this out. Establishing, and garnering respect for, clear boundaries with ones abusers is an exceptionally tough task for teams of social workers working in the context of child protective services who have leverage, and the legally authorized threat of force, over the abusers. The best alternatives are to "build relationships" with good people and find a "good psychologist" to assist you along the path as you assuredly take detours off your path and lose your way. It's hard, you'll find disappointments, may be revictimized, possibly suffer your own regressions and have to rely on yourself more than anyone should have too. I'm sorry I don't have good answers, but the task at hand is surmountable and everyone deserves a safe, loving, supportive familial-like community to uplift them and be uplifted by them.
alasdair_ 5y ago
For context, I've had almost exactly the same set of diagnoses as you, except my manic episodes were shorter so they called it type II. I largely agree with you - diet, exercise, close friends, time in the sun and so on are fantastically useful and underrated. They solve a lot of things. That being said, even when I had lots of close friends and was in fantastic shape, I wanted to kill myself. SSRIs stopped me from thinking about suicide every single day of my life - they literally changed my life. Lithium largely fixed the mania. If there are real, objectively bad things happening and taking a drug can stop them, I'm all for it. I definitely think that psychiatrists don't know WHY a lot of things work and I think they way they diagnose and treat patients is basically just "try these and see if they work" but I don't think it's worth throwing everything away just because the solution needs a lot of improvement.
caddemon 5y ago
There are certainly issues with psychiatric disease diagnosis, but I also don't think it's surprising MDD diagnoses are high (the real number in that age bracket seems to be somewhere in the range of 10-20%). AFAIK the DSM criteria for MDD only require a single depressive episode. Having a depressive episode at some point over the course of a lifetime should be seen as normal IMO. Someone can have a depressive episode and benefit from help at the time just as someone can develop a bacterial infection and require treatment. It does not need to be thought of as a chronic state, even though in a minority of cases that will occur (and is obviously much more debilitating). Sometimes medication is extremely beneficial, other times it is not, but very few people are just being pumped with/kept on meds. You can see here that only ~6% of people with a diagnosed depressive episode in 2017 were treated with meds alone: https://www.nimh.nih.gov/health/statistics/major-depression https://www.nimh.nih.gov/health/statistics/major-depression Of course most therapy is going to include work on lifestyle habits like what you've mentioned. While many of the people regularly receiving therapy were also on a medication, it is standard of care to do meds + CBT as they have well-documented and independent impacts on depression recovery. It is normal to taper off use of antidepressant after a first depressive episode, and I think it's safe to say most people doing combination treatment will have proper oversight of their medication use. Maintenance medication is mainly suggested for those with a history of recurring episodes. I'll also note I don't think this has anything to do with money grabbing. Prozac remains the most prescribed antidepressant, yet it is not under patent. Therapy on the other hand can cost an arm and a leg. Of course therapy cannot be mass-produced, but from an individual prescriber perspective therapy is more likely to be financially incentivized. No doubt psychiatry is still operating largely in the dark ages, but that's simply because it is a hard problem (and perhaps some institutional incompetence mixed in). Drug development for psychiatric disease has actually mostly hit a wall, and numerous pharma companies have cut neuroscience research departments, because these clinical trials had a low enough success rate that the R&D costs could no longer be justified. Further, I agree that lifestyle decisions can have a bigger impact than people think, but this sort of anti-medication attitude and thinly-veiled accusations of laziness only push patients away from good lifestyle changes. Depression can make it harder to do those things you mentioned, and it becomes a very nasty cycle. Medication can help break that cycle if used properly. It is indeed important to make clear that the meds are a tool and not a magic cure all, and I hate the common sarcastic remarks that get posted in depression groups like "thanks exercise cured me". But I get where some of that defensiveness is coming from. Let's all try to acknowledge that a treatment plan is going to involve multiple pieces, different pieces for different people, and is not going to be easy or perfectly effective. There's a fine line between helping and enabling, but a lot of people seem to err so far on one side that they either applaud terrible behavior or talk down to people about symptoms that they don't fully understand. Meds can be a lifesaver for some and are not desirable for others, that is something that needs to be determined by the patient and their care team(s).
Red_Leaves_Flyy 5y ago
Diagnoses are billing codes. They are not labels, identities, or personality traits. This reductionism is rampant, even amongst highly credentialed professionals. It is therefore my opinion that one is better served to investigate why they're using maladaptive coping strategies, learn new strategies, and demand that they be supported by the very community who allowed them to decay so far. (We can argue causation until the cows bones have fully composted, but that's a dead end.) Mind you support is like a crutch for someone with a broken leg. If you give someone with a broken leg a wheelchair and don't let them walk for two years their uninjured leg will atrophy causing another problem. Likewise, if left untreated a person's broken leg will not set correctly causing a cascade of problems until the damage is appropriately treated. Mental illnesses, barring: brain damage, disease, etc, are often times the result of a cohort of untreated wounds in a persons past that are difficult and increasingly expensive to heal with time, but it is our obligation to engage in whatever ways necessary so that when it us on the bench we can be supported. Any more specific examples I can give are likely to be far more controversial than what I've already said and I would prefer to stay on topic regarding the treatment of serious mental illnesses like MDD.

ipnon 5y ago

I hope that before dismissing you, any critics would lend weight to the fact that you have been diagnosed with several disorders and been through the psychiatric system. You have some skin in the game here. So even though your advice is certainly not universal and many perceive great benefit from psychiatric treatment, there is some truth to be had in your argument.

caddemon 5y ago
The comment tone is way beyond advice and makes some bizarre claims about profit motives. Psychiatry is a hard subject and there has been some bad research, but it's pretty clear he has also done some reading on fringe sites. I understand being upset by shitty doctors and going down that rabbit hole, but it would be irresponsible to not respond to the comment when others on the fence about medication might be swayed. The key point he is missing is that psychiatric disease can make those lifestyle changes orders of magnitude harder for someone to make than it would be for a healthy adult. As lifestyle gets worse you get a terrible loop going. Medication helps many break that loop - certainly not all, but it is something to seriously consider with your doctor. If he was able to make those changes without medication that is great for him, but I think his message is kind of analogous to a rich entrepreneur that grew up poor telling everyone else they should just work harder and they'll move up in life. Is it probably good advice for those people to work harder? Yes, but many of them do not have the talent or luck to actually move up much, so it cheapens the message a lot.

CrazyStat 5y ago

> If about half of young adults suffer from a disorder This is a misreading of the (admittedly confusing) statistic > the proportion of adults with MDD aged 18–34 years increased from 34.6 to 47.5 This is not saying that 47.5% of 18-34 year-olds have MDD, but rather that of adults with MDD, 47.5% are in the 18-34 age range.

Nav_Panel 5y ago

Are you at all interested in reading recommendations?

Guthur 5y ago

After a certain point wealth has very little correlation with happiness. Once you get above basic needs the return on wealth to happiness really quickly diminishes.

Red_Leaves_Flyy 5y ago
That studies recently been challenged by the contrary results of a new one. https://www.forbes.com/sites/alexledsom/2021/02/07/new-study-shows-that-more-money-buys-more-happiness/ https://www.forbes.com/sites/alexledsom/2021/02/07/new-study... I for one, would be much happier with a less overtly abusive workplace, and oppressive living situation. Money is not everything, but as I cannot afford a better existence, it might as well be the only thing that matters.

nyanpasu64 5y ago

What alternative exist for close family relationships, for people who were abused by their families?

Red_Leaves_Flyy 5y ago
I'm not sure if you're asking for specific advice personally, or thinking of others but my response is generally the same. It's very hard for even a well adjusted person to create a replacement familial environment. In decades past the advice would be to go to church. Today? I've got no clue, I'm trying to figure this out. Establishing, and garnering respect for, clear boundaries with ones abusers is an exceptionally tough task for teams of social workers working in the context of child protective services who have leverage, and the legally authorized threat of force, over the abusers. The best alternatives are to "build relationships" with good people and find a "good psychologist" to assist you along the path as you assuredly take detours off your path and lose your way. It's hard, you'll find disappointments, may be revictimized, possibly suffer your own regressions and have to rely on yourself more than anyone should have too. I'm sorry I don't have good answers, but the task at hand is surmountable and everyone deserves a safe, loving, supportive familial-like community to uplift them and be uplifted by them.

alasdair_ 5y ago

For context, I've had almost exactly the same set of diagnoses as you, except my manic episodes were shorter so they called it type II. I largely agree with you - diet, exercise, close friends, time in the sun and so on are fantastically useful and underrated. They solve a lot of things. That being said, even when I had lots of close friends and was in fantastic shape, I wanted to kill myself. SSRIs stopped me from thinking about suicide every single day of my life - they literally changed my life. Lithium largely fixed the mania. If there are real, objectively bad things happening and taking a drug can stop them, I'm all for it. I definitely think that psychiatrists don't know WHY a lot of things work and I think they way they diagnose and treat patients is basically just "try these and see if they work" but I don't think it's worth throwing everything away just because the solution needs a lot of improvement.

caddemon 5y ago

There are certainly issues with psychiatric disease diagnosis, but I also don't think it's surprising MDD diagnoses are high (the real number in that age bracket seems to be somewhere in the range of 10-20%). AFAIK the DSM criteria for MDD only require a single depressive episode. Having a depressive episode at some point over the course of a lifetime should be seen as normal IMO. Someone can have a depressive episode and benefit from help at the time just as someone can develop a bacterial infection and require treatment. It does not need to be thought of as a chronic state, even though in a minority of cases that will occur (and is obviously much more debilitating). Sometimes medication is extremely beneficial, other times it is not, but very few people are just being pumped with/kept on meds. You can see here that only ~6% of people with a diagnosed depressive episode in 2017 were treated with meds alone: https://www.nimh.nih.gov/health/statistics/major-depression https://www.nimh.nih.gov/health/statistics/major-depression Of course most therapy is going to include work on lifestyle habits like what you've mentioned. While many of the people regularly receiving therapy were also on a medication, it is standard of care to do meds + CBT as they have well-documented and independent impacts on depression recovery. It is normal to taper off use of antidepressant after a first depressive episode, and I think it's safe to say most people doing combination treatment will have proper oversight of their medication use. Maintenance medication is mainly suggested for those with a history of recurring episodes. I'll also note I don't think this has anything to do with money grabbing. Prozac remains the most prescribed antidepressant, yet it is not under patent. Therapy on the other hand can cost an arm and a leg. Of course therapy cannot be mass-produced, but from an individual prescriber perspective therapy is more likely to be financially incentivized. No doubt psychiatry is still operating largely in the dark ages, but that's simply because it is a hard problem (and perhaps some institutional incompetence mixed in). Drug development for psychiatric disease has actually mostly hit a wall, and numerous pharma companies have cut neuroscience research departments, because these clinical trials had a low enough success rate that the R&D costs could no longer be justified. Further, I agree that lifestyle decisions can have a bigger impact than people think, but this sort of anti-medication attitude and thinly-veiled accusations of laziness only push patients away from good lifestyle changes. Depression can make it harder to do those things you mentioned, and it becomes a very nasty cycle. Medication can help break that cycle if used properly. It is indeed important to make clear that the meds are a tool and not a magic cure all, and I hate the common sarcastic remarks that get posted in depression groups like "thanks exercise cured me". But I get where some of that defensiveness is coming from. Let's all try to acknowledge that a treatment plan is going to involve multiple pieces, different pieces for different people, and is not going to be easy or perfectly effective. There's a fine line between helping and enabling, but a lot of people seem to err so far on one side that they either applaud terrible behavior or talk down to people about symptoms that they don't fully understand. Meds can be a lifesaver for some and are not desirable for others, that is something that needs to be determined by the patient and their care team(s).

Red_Leaves_Flyy 5y ago

Diagnoses are billing codes. They are not labels, identities, or personality traits. This reductionism is rampant, even amongst highly credentialed professionals. It is therefore my opinion that one is better served to investigate why they're using maladaptive coping strategies, learn new strategies, and demand that they be supported by the very community who allowed them to decay so far. (We can argue causation until the cows bones have fully composted, but that's a dead end.) Mind you support is like a crutch for someone with a broken leg. If you give someone with a broken leg a wheelchair and don't let them walk for two years their uninjured leg will atrophy causing another problem. Likewise, if left untreated a person's broken leg will not set correctly causing a cascade of problems until the damage is appropriately treated. Mental illnesses, barring: brain damage, disease, etc, are often times the result of a cohort of untreated wounds in a persons past that are difficult and increasingly expensive to heal with time, but it is our obligation to engage in whatever ways necessary so that when it us on the bench we can be supported. Any more specific examples I can give are likely to be far more controversial than what I've already said and I would prefer to stay on topic regarding the treatment of serious mental illnesses like MDD.