5 ms·

The chemicalization, medicalization and commercialization of depression is a dead end. While the chemical imbalances might be real, the symptoms are due to actu

by cung 5y ago

The chemicalization, medicalization and commercialization of depression is a dead end. While the chemical imbalances might be real, the symptoms are due to actual situations in your life. Treating the symptoms with drugs is a pretend solution that only works because it is often the first step people take to actually better their life.

Broken_Hippo 5y ago
" it is often the first step people take to actually better their life." What makes you think this - and what makes you think that so many folks have so much agency in their life? A lot of folks don't, and if you have depression, you generally have even less of it because you wind up with an inability to see options you do have... if any. It isn't like everyone can escape poverty or a bad spouse (it takes money to divorce someone or even leave if you need to get your own place). It isn't like anyone can magically make a disease diagnosis go away nor does changing jobs always fix things, especially if the reason you stay is because you desperately need the health insurance or because no where else pays as much in your area (and moving costs money). We don't make sure folks have tools to improve their life. Additionally, this really just blames the victim and I really hope you don't say this to folks actually suffering.
- pjerem 5y ago
  I 100% agree with your post but i’d like to add something about this : > It isn't like everyone can escape poverty or a bad spouse You are right and medicalization is useful to overcome this. But there is a real risk, as a society, that we find it normal to treat the depression induced by those issues, rather than the issues themselves. We should treat poverty and work towards making divorce less painful rather than thinking medication allows a status-quo. But that’s another topic on its own and absolutely not a counter argument of your answer.
  - bayesian_horse 5y ago
    Poverty and spousal abuse aren't actually statistically significant causes for depression. You seem to labor under the fallacy to think that anti-depressants are some kind of lifestyle drugs that generally improve mood or tolerance of adversity. They don't.
    - deleted 5y ago
      [deleted]
    - pjerem 5y ago
      > You seem to labor under the fallacy to think that anti-depressants are some kind of lifestyle drugs that generally improve mood or tolerance of adversity. They don't. I absolutely don’t see where I wrote that. I exactly know what anti-depressant are and are not. I’m currently taking them (though that’s for chronic anxiety). So I absolutely know that they don’t improve mood or tolerance of adversity. They « just » flatten the emotional curve, I don’t see how having flat emotions (even the good ones) are some sort of enjoyable « lifestyle ». But it does allow me to work on my anxiety issues without being submerged by ridiculously amplified anxiety.
    - hellbannedguy 5y ago
      You are probally right on chemicals that treat depression. I couldn't find the original Psychologist who decided to use The Freedom of Information Act to procure All the studies concerning the efficy of Antidepressant drugs. He collated the all the clinical studies, and not just the cherry picked ones. What he found puckered a few Psychiatrists arses, but they still prescribe like it's the end of the world, and rake in a very comfortable income. I can't remember the guy's name, but this study might suffice. https://www.scientificamerican.com/article/antidepressants-do-they-work-or-dont-they/ https://www.scientificamerican.com/article/antidepressants-d...
      - mellavora 5y ago
        I think you might mean this? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/ Antidepressants and the Placebo Effect Abstract Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain. Indeed, their supposed effectiveness is the primary evidence for the chemical imbalance theory. But analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect. Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin. Nevertheless, they all show the same therapeutic benefit. Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind. The serotonin theory is as close as any theory in the history of science to having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.
  - fighterpilot 5y ago
    Is medication actually effective at treating depression, though? At least 4/5ths of the effect is known to be placebo, and there's a compelling argument that perhaps it's all placebo: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/
bayesian_horse 5y ago
That is a wrong and damaging statement. You are ignoring the reality of depression as a disease. It has been shown that depression, in the medical definition, is often not caused by situations in the patient's life. Thus it is equally foolish to believe, the patients could "better their life" and thereby alleviate depression. Somehow assuming the symptoms of depression actually allow any of that. Hard to improve your life if you can barely get out of bed. Your comment is the exact kind of stigmatizing, patient-blaming and "just stop being depressed" bullshit that hasn't worked for centuries and contributes to the problem.
- OJFord 5y ago
  I don't necessarily agree with GP, but I think your comment is the worst-possible reading of it, as in taking it in the worst light. > stigmatizing, patient-blaming and "just stop being depressed" is coming from > the symptoms are due to actual situations in your life ? Isn't that the opposite, GP is saying yes it is real, but arguing that the drugs are like spraying air freshener in a room that still contains the source of the stink? Again, not saying I agree, I just didn't read it as stigmatising or 'just stop' at all.
Honga 5y ago
Would you have any sources to back this up? Seems like a big claim to go against standard practice. I suffer from chronic episodic depression. But my life is objectively great and fulfilling. Are you saying that I should not be at peace with my lifestyle? Or that my depression is a nurture rather than nature type issue? I'm both triggered and curious to hear your thoughts.
pjerem 5y ago
I don’t agree with you about the « dead end » of medicalization. Medicalization really help you to break the circle. It temporarily treats the symptoms and allows you a timeframe where you can work towards the origin of your issues. And if for some reason, you can’t, it at least helps you live a more supportable life. Here we are in a mental disease but you can easily make an analogy with any disease. If you need re-education after an accident that broke something, the first step is generally to treat the symptoms that could block you to achieve re-education. As an example, my dad completely lost its equilibrium after a brain stroke. Re-education was long and hard, eventually succeeded, but would have been totally impossible without medication against nausea, which you constantly get when your equilibrium system is failing. And I would add that, AFAIK, some forms of depressions are purely chemical issues. And it isn’t surprising. There exists tons of diseases that are chemical issues.
himinlomax 5y ago
This is complete nonsense as well as damaging for people who suffer from depression and who would believe your nonsense instead of seeking science-based help.
frereubu 5y ago
You can split definitions of depression in a number of ways, but one that's been around for a long time is exogenous (external causes) and endogenous (internal causes). The idea that symptoms are only due to life situations is simplistic and wrong. This feels a bit like the straw man arguments about economics only treating people as rational actors, whereas economists have been aware of the issues with that for decades.
- gatestone 5y ago
  The conflict between the external world and your inner self (psychology, neurology,nurture) is a situational problem, not so much medical. You don’t have to seek blame, not from outside or inside in your self. But you can look for a solution in changing either or both.
  - gatestone 5y ago
    You may be an exceptional character: very dumb or smart; maybe too sensitive of too unemphatic; on some strange neurodiversity spectrum; maybe you was raised by a bit too personal parents; maybe you adopted radical or odd ideologies etc., ad infinitum Or you may live in an exceptional external situation. It can be good (you are a rock star) or bad (many). Either way, either case or a bad mix of internal and external may wear you out in the long run, and you stop functioning, you burn out, you become depressed.
haxiomic 5y ago
Depression is a symptom that can be the result of a multitude of physiological causes and not always psychological. One could induce the effects of serious depression in a person through gene therapy, specific nutritional deficiency, certain drugs, for example. It can be hard to understand the cause for each person, and I do believe strongly we currently under-treat and under-investigate depression and it’s sources in people The arguments put forward in the article and video are good and do a better job than I could at explaining what we know about depression
OJFord 5y ago
Is it not contradictory to say it's a 'dead end', and also (only) 'works because it is often the first step people take to actually better their life'? (emphasis mine) I don't have strong feelings either way (and basically will just do what a doctor tells me to do as long as I somewhat understand it seems to make sense) but I've vouched (not voted) for the parent comment because I think there's already the beginning of interesting discussion here; people can (have) disagree(d), but there's not really a reason to flag it IMO.
belorn 5y ago
The environment impact the chemical balance of the human body. The chemical balance impact how the environment impacts the chemical balance. Depression is the inability to recover from loss. With some of the more extreme depressions the mind can even invent losses which does not exist in the form of delusions. There are also seasonal depression where individuals lose temporarily the ability to handle loss. The actual situations in your life is not major factors in those, through the environment could provide protective benefits.
kayodelycaon 5y ago
Eh… that really depends on what the source of the depression is. I’m bipolar and I’ll never be free of depression, hypomania, anxiety, and the various parts of my brain that are broken. While medication and therapy can reduce symptoms, there is no cure. When I get depressed, I just have to ride it out. All I can do is accept that. There are forms of depression that are biological in nature, just like bipolar is, and there is no cure, only mitigation.
dec0dedab0de 5y ago
I don't think everyone should be piling on, you're mostly correct. Except that your first and last points are contradictory. A dead end and a first step are different things. Though I thought it was common knowledge that these drugs are supposed to be a first step, that too many people use as a crutch, while thinking they are a cure.

by cung 5y ago

Broken_Hippo 5y ago

" it is often the first step people take to actually better their life." What makes you think this - and what makes you think that so many folks have so much agency in their life? A lot of folks don't, and if you have depression, you generally have even less of it because you wind up with an inability to see options you do have... if any. It isn't like everyone can escape poverty or a bad spouse (it takes money to divorce someone or even leave if you need to get your own place). It isn't like anyone can magically make a disease diagnosis go away nor does changing jobs always fix things, especially if the reason you stay is because you desperately need the health insurance or because no where else pays as much in your area (and moving costs money). We don't make sure folks have tools to improve their life. Additionally, this really just blames the victim and I really hope you don't say this to folks actually suffering.

pjerem 5y ago
I 100% agree with your post but i’d like to add something about this : > It isn't like everyone can escape poverty or a bad spouse You are right and medicalization is useful to overcome this. But there is a real risk, as a society, that we find it normal to treat the depression induced by those issues, rather than the issues themselves. We should treat poverty and work towards making divorce less painful rather than thinking medication allows a status-quo. But that’s another topic on its own and absolutely not a counter argument of your answer.
- bayesian_horse 5y ago
  Poverty and spousal abuse aren't actually statistically significant causes for depression. You seem to labor under the fallacy to think that anti-depressants are some kind of lifestyle drugs that generally improve mood or tolerance of adversity. They don't.
  - deleted 5y ago
    [deleted]
  - pjerem 5y ago
    > You seem to labor under the fallacy to think that anti-depressants are some kind of lifestyle drugs that generally improve mood or tolerance of adversity. They don't. I absolutely don’t see where I wrote that. I exactly know what anti-depressant are and are not. I’m currently taking them (though that’s for chronic anxiety). So I absolutely know that they don’t improve mood or tolerance of adversity. They « just » flatten the emotional curve, I don’t see how having flat emotions (even the good ones) are some sort of enjoyable « lifestyle ». But it does allow me to work on my anxiety issues without being submerged by ridiculously amplified anxiety.
  - hellbannedguy 5y ago
    You are probally right on chemicals that treat depression. I couldn't find the original Psychologist who decided to use The Freedom of Information Act to procure All the studies concerning the efficy of Antidepressant drugs. He collated the all the clinical studies, and not just the cherry picked ones. What he found puckered a few Psychiatrists arses, but they still prescribe like it's the end of the world, and rake in a very comfortable income. I can't remember the guy's name, but this study might suffice. https://www.scientificamerican.com/article/antidepressants-do-they-work-or-dont-they/ https://www.scientificamerican.com/article/antidepressants-d...
    - mellavora 5y ago
      I think you might mean this? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/ Antidepressants and the Placebo Effect Abstract Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain. Indeed, their supposed effectiveness is the primary evidence for the chemical imbalance theory. But analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect. Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin. Nevertheless, they all show the same therapeutic benefit. Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind. The serotonin theory is as close as any theory in the history of science to having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.
- fighterpilot 5y ago
  Is medication actually effective at treating depression, though? At least 4/5ths of the effect is known to be placebo, and there's a compelling argument that perhaps it's all placebo: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

bayesian_horse 5y ago

That is a wrong and damaging statement. You are ignoring the reality of depression as a disease. It has been shown that depression, in the medical definition, is often not caused by situations in the patient's life. Thus it is equally foolish to believe, the patients could "better their life" and thereby alleviate depression. Somehow assuming the symptoms of depression actually allow any of that. Hard to improve your life if you can barely get out of bed. Your comment is the exact kind of stigmatizing, patient-blaming and "just stop being depressed" bullshit that hasn't worked for centuries and contributes to the problem.

OJFord 5y ago
I don't necessarily agree with GP, but I think your comment is the worst-possible reading of it, as in taking it in the worst light. > stigmatizing, patient-blaming and "just stop being depressed" is coming from > the symptoms are due to actual situations in your life ? Isn't that the opposite, GP is saying yes it is real, but arguing that the drugs are like spraying air freshener in a room that still contains the source of the stink? Again, not saying I agree, I just didn't read it as stigmatising or 'just stop' at all.

Honga 5y ago

Would you have any sources to back this up? Seems like a big claim to go against standard practice. I suffer from chronic episodic depression. But my life is objectively great and fulfilling. Are you saying that I should not be at peace with my lifestyle? Or that my depression is a nurture rather than nature type issue? I'm both triggered and curious to hear your thoughts.

pjerem 5y ago

I don’t agree with you about the « dead end » of medicalization. Medicalization really help you to break the circle. It temporarily treats the symptoms and allows you a timeframe where you can work towards the origin of your issues. And if for some reason, you can’t, it at least helps you live a more supportable life. Here we are in a mental disease but you can easily make an analogy with any disease. If you need re-education after an accident that broke something, the first step is generally to treat the symptoms that could block you to achieve re-education. As an example, my dad completely lost its equilibrium after a brain stroke. Re-education was long and hard, eventually succeeded, but would have been totally impossible without medication against nausea, which you constantly get when your equilibrium system is failing. And I would add that, AFAIK, some forms of depressions are purely chemical issues. And it isn’t surprising. There exists tons of diseases that are chemical issues.

himinlomax 5y ago

This is complete nonsense as well as damaging for people who suffer from depression and who would believe your nonsense instead of seeking science-based help.

frereubu 5y ago

You can split definitions of depression in a number of ways, but one that's been around for a long time is exogenous (external causes) and endogenous (internal causes). The idea that symptoms are only due to life situations is simplistic and wrong. This feels a bit like the straw man arguments about economics only treating people as rational actors, whereas economists have been aware of the issues with that for decades.

gatestone 5y ago
The conflict between the external world and your inner self (psychology, neurology,nurture) is a situational problem, not so much medical. You don’t have to seek blame, not from outside or inside in your self. But you can look for a solution in changing either or both.
- gatestone 5y ago
  You may be an exceptional character: very dumb or smart; maybe too sensitive of too unemphatic; on some strange neurodiversity spectrum; maybe you was raised by a bit too personal parents; maybe you adopted radical or odd ideologies etc., ad infinitum Or you may live in an exceptional external situation. It can be good (you are a rock star) or bad (many). Either way, either case or a bad mix of internal and external may wear you out in the long run, and you stop functioning, you burn out, you become depressed.

haxiomic 5y ago

Depression is a symptom that can be the result of a multitude of physiological causes and not always psychological. One could induce the effects of serious depression in a person through gene therapy, specific nutritional deficiency, certain drugs, for example. It can be hard to understand the cause for each person, and I do believe strongly we currently under-treat and under-investigate depression and it’s sources in people The arguments put forward in the article and video are good and do a better job than I could at explaining what we know about depression

OJFord 5y ago

Is it not contradictory to say it's a 'dead end', and also (only) 'works because it is often the first step people take to actually better their life'? (emphasis mine) I don't have strong feelings either way (and basically will just do what a doctor tells me to do as long as I somewhat understand it seems to make sense) but I've vouched (not voted) for the parent comment because I think there's already the beginning of interesting discussion here; people can (have) disagree(d), but there's not really a reason to flag it IMO.

belorn 5y ago

The environment impact the chemical balance of the human body. The chemical balance impact how the environment impacts the chemical balance. Depression is the inability to recover from loss. With some of the more extreme depressions the mind can even invent losses which does not exist in the form of delusions. There are also seasonal depression where individuals lose temporarily the ability to handle loss. The actual situations in your life is not major factors in those, through the environment could provide protective benefits.

kayodelycaon 5y ago

Eh… that really depends on what the source of the depression is. I’m bipolar and I’ll never be free of depression, hypomania, anxiety, and the various parts of my brain that are broken. While medication and therapy can reduce symptoms, there is no cure. When I get depressed, I just have to ride it out. All I can do is accept that. There are forms of depression that are biological in nature, just like bipolar is, and there is no cure, only mitigation.

dec0dedab0de 5y ago

I don't think everyone should be piling on, you're mostly correct. Except that your first and last points are contradictory. A dead end and a first step are different things. Though I thought it was common knowledge that these drugs are supposed to be a first step, that too many people use as a crutch, while thinking they are a cure.