4 ms·

Sorry, you are very very wrong about this. Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't kn

by dimal 5y ago

Sorry, you are very very wrong about this. Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing. Medical professionals only have one tool in their arsenal for depression: antidepressants. So a medical doctor will likely prescribe them, whether that's appropriate or not. Antidepressants are no joke. Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide. And does the average doctor monitor all their patients regularly to make sure they're not having suicidal thoughts? Nope. And doctors generally won't know anything about the difficulty of getting _off_ the antidepressant if it didn't work. Asking for advice on the internet is a very valid strategy, given the terrible state of mental health care in the US.

frankincense 5y ago
You're a frontend engineer, not a doctor. You're not qualified to give advice on medicine.
- vorpalhex 5y ago
  They aren't writing a prescription for op, they are sharing anecdotal data. That's a reasonable thing to do. Having had a critical infection repeatedly misdiagnosed until I finally went out of my way to pick a better professional, I don't buy the "just have faith in your doctor" argument. Doctors are more like plumbers than we like to admit. There are good ones and bad ones, and it's hard to tell the difference. They do best when you can give them direction (cooperatively) and when you are willing to get a second opinion.
- elwell 5y ago
  Weird, did you research them?
- andrewzah 5y ago
  So what? Everyone has had stories about misdiagnoses or not being taken seriously by doctors, etc. I had a condition that took a long time to get a fix until I changed my doctor and got a proper evaluation done. And that wasn't even for mental health, which the US is not particularly well known for. My doc would come in, listen for maybe 1-2 mins, prescribe some shit and leave. I had to take stuff into my own hands and drive 2 hours to another hospital to finally get something done. Parent comment is not giving explicit medical instructions. All they're saying is "talk to a medical professional" isn't some miracle advice that always works, particularly for mental health. It's fine to give anecdotes as long as one holds them with a grain of salt.
- dimal 5y ago
  So any support group is invalid then? AA? Smart Recovery? Addiction is a medical problem, so just talk to your doctor? If you have PTSD, don't talk to other people with PTSD, just isolate and talk to your doctor? If you have depression, don't talk to other people who have had depression, who might make you feel less alone, just talk to your doctor? Think through what you're saying.
  - frankincense 5y ago
    Those support groups don't give advice about medicine.
    - dimal 5y ago
      Um, they kinda do. In my experience it's generally not "advice" in the same way a doctor gives it, but it's been more along the lines of, "I took X. Y happened." Not, "You should (not) take X because it (worked/didn't work) for me". People keep saying we should _normalize_ talking about mental health, and what you're suggesting goes against that. If we were discussing heart health and someone were to talk about their exercise, diet and medication online, would you say, "Hey, wait a minute! You're not a doctor. You can't say that." Of course not. What you're advocating for is an overly paternalistic approach to mental health issues, as if people are too dumb to listen to different viewpoints and come to their own conclusions.
- lostdog 5y ago
  You are an engineer and not a public health researcher. You are not qualified to give advice on whether consulting a doctor is the right course of action.
kayodelycaon 5y ago
Not OP, but I have. If you go to a family doctor in the US, they really aren’t qualified or trained in treating mental health. My psychiatrist was fairly clear on what was what and which things needed to be treated with therapy and which medication could help with. (Medication helps symptoms, it does not cure.) Finding the right medication would take months or years and will not solve everything. There will be side effects that I needed to monitor and report. And so on. When seeing any doctor, you are your own best advocate. It helps to come prepared, knowing your family history, and things you are struggling with. Researching medications can help, but most people are not qualified to use them without supervision, myself included. Note: This is assuming you need medication. It was fairly clear in my case medication was absolutely required to at least treat psychosis. I prefer to refer friends to a therapist or psychologist, who do not prescribe medication.
SkyPuncher 5y ago
> Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide FWIW, my understanding is this has little to do with the drugs and mostly to do with the recovery process. In a deep depression, you might have suicidal thoughts, but lack the will to take action on those thoughts (because depression takes away your motivation). As you a person comes out of depression, they tend to recover their motivation before their suicidal thoughts dissipate. This creates a situation where a person with suicidal thoughts now has motivation - which means they have the potential motivation to take action on their suicidal thoughts. The important nuance of this is anti-depressants don't necessarily make your suicidal thoughts _more_ suicidal. In fact, it's likely, anti-depressants are making your suicidal thoughts _less_ severe. However, they do increase your motivation before they can fully eliminate suicidal thoughts. I'm not saying you should take an anti-dpressant willy-nilly. It's just BS to be fear mongering like this without considering why this situation happens.
- heavyset_go 5y ago
  In the beginning of SSRI consumption, it causes initial 5HT2C upregulation and activation, which can directly cause feelings of anxiety, dread, hopelessness, and restlessness/akathisia[1]. Over time, however, the body down regulates 5HT2C in response to its activation, and those symptoms tend to dissipate. In a way, yes, there can be feelings induced that can provide the motivation and energy to go through with suicidal thoughts, but those unpleasant emotions aren't exactly triggered by an inherent will to die. Those who experience akathisia sometimes feel like the only way to rid themselves of the feeling is to end their lives. I point this out because it might seem, or feel to those experiencing it themselves, that those suicidal thoughts are organic and what the person really wants, but they tend to be exacerbated directly by medication and can get better with time. I also point it out because there are ways to sidestep 5HT2C activation with different medications or combinations, it doesn't necessarily have to be inevitable. [1] https://en.wikipedia.org/wiki/Akathisia https://en.wikipedia.org/wiki/Akathisia
  - oaktrout 5y ago
    I didnt find any info on 5HT2C in the linked source above, not saying what you've said isn't true, just that I was interested and didn't find much info.
_moof 5y ago
> Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing. And you think a random stranger knows any better? I know firsthand that the medical profession has serious limitations in its understanding of and ability to treat depression, but no way in hell am I taking some rando's advice over that of any of the many doctor's I've seen.
- ajkjk 5y ago
  That makes no sense to me, if you're trying to deal with mental health problems and struggling you're going to be looking for new ideas from any source. Doctors are good at giving garden-variety medical advice that's validated by studies, but there's so many other ideas out there that they're not going to know about. Their background gives them expertise on what medicine says about mental health, not about the human experience itself. Anecdotally I've been to therapists and doctors that were no help and I've read an article online [1] which was a tremendous help. [1]: https://kajsotala.fi/2017/07/how-i-found-fixed-the-root-problem-behind-my-depression-and-anxiety-after-20-years/ https://kajsotala.fi/2017/07/how-i-found-fixed-the-root-prob...
  - bawolff 5y ago
    Strangers on the internet are usually pretty good at helping you self-justify whatever it is you want to do, because no matter what position you take, whether it is a really good idea or not, there is always someone on the internet who agrees with you.
    - ajkjk 5y ago
      Fine, if that gets you taking action when you're depressed, so be it. Anyway in discussions like this I feel like what it lost is that you will actually respond to how compelling the thing someone else is saying is. Like, it's not "oh a bunch of opinions, I'll get influenced by one randomly and it's probably wrong". It's "oh, a bunch of opinions, which explain why they think they're right and how well it worked for them, I'll incorporate that into my own understanding".
heavyset_go 5y ago
> Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide This type of side-effect is thought to be mediated by 5HT2C activation when initially starting SSRIs, however, over the period of about two weeks, 5HT2C receptors downregulate and reach an equilibrium that can cause the effect to diminish or go away entirely. As an aside, there's research that suggests that abnormal amounts of upregulated 5HT2C receptors are present in suicide victims. One of the reasons Prozac is recommended as a first line of treatment, besides the fact that it has a long half-life, is because of its 5HT2C antagonism that can block 5HT2C from extracellular serotonin activation from SSRI effects. There are also plenty of antidepressants that don't typically cause that particular problem, especially if they aren't typical SSRIs or serotonin agonists.
APhoenixRises 5y ago
Granted everyone's case is different, but my doctor went forward with medications only as part of a comprehensive plan to deal with my mental health which included seeing a therapist and committing to an exercise program (it sounded silly to be before, but exercise can be for some people can be nature's antidepressant). I'm on a 6 week to 3-month schedule of follow-up visits with my doctor to keep track of where I'm at mentally. Yes, there are absolutely doctors out there that will toss pills to people and send them on their way, but I don't think it's the majority. I also vet doctors the same way I would a mechanic or anyone else who is going to be doing important work for me. It can be hard, but there are doctors who care about doing the right thing out there.

by dimal 5y ago

frankincense 5y ago

You're a frontend engineer, not a doctor. You're not qualified to give advice on medicine.

vorpalhex 5y ago
They aren't writing a prescription for op, they are sharing anecdotal data. That's a reasonable thing to do. Having had a critical infection repeatedly misdiagnosed until I finally went out of my way to pick a better professional, I don't buy the "just have faith in your doctor" argument. Doctors are more like plumbers than we like to admit. There are good ones and bad ones, and it's hard to tell the difference. They do best when you can give them direction (cooperatively) and when you are willing to get a second opinion.
elwell 5y ago
Weird, did you research them?
andrewzah 5y ago
So what? Everyone has had stories about misdiagnoses or not being taken seriously by doctors, etc. I had a condition that took a long time to get a fix until I changed my doctor and got a proper evaluation done. And that wasn't even for mental health, which the US is not particularly well known for. My doc would come in, listen for maybe 1-2 mins, prescribe some shit and leave. I had to take stuff into my own hands and drive 2 hours to another hospital to finally get something done. Parent comment is not giving explicit medical instructions. All they're saying is "talk to a medical professional" isn't some miracle advice that always works, particularly for mental health. It's fine to give anecdotes as long as one holds them with a grain of salt.
dimal 5y ago
So any support group is invalid then? AA? Smart Recovery? Addiction is a medical problem, so just talk to your doctor? If you have PTSD, don't talk to other people with PTSD, just isolate and talk to your doctor? If you have depression, don't talk to other people who have had depression, who might make you feel less alone, just talk to your doctor? Think through what you're saying.
- frankincense 5y ago
  Those support groups don't give advice about medicine.
  - dimal 5y ago
    Um, they kinda do. In my experience it's generally not "advice" in the same way a doctor gives it, but it's been more along the lines of, "I took X. Y happened." Not, "You should (not) take X because it (worked/didn't work) for me". People keep saying we should _normalize_ talking about mental health, and what you're suggesting goes against that. If we were discussing heart health and someone were to talk about their exercise, diet and medication online, would you say, "Hey, wait a minute! You're not a doctor. You can't say that." Of course not. What you're advocating for is an overly paternalistic approach to mental health issues, as if people are too dumb to listen to different viewpoints and come to their own conclusions.
lostdog 5y ago
You are an engineer and not a public health researcher. You are not qualified to give advice on whether consulting a doctor is the right course of action.

kayodelycaon 5y ago

Not OP, but I have. If you go to a family doctor in the US, they really aren’t qualified or trained in treating mental health. My psychiatrist was fairly clear on what was what and which things needed to be treated with therapy and which medication could help with. (Medication helps symptoms, it does not cure.) Finding the right medication would take months or years and will not solve everything. There will be side effects that I needed to monitor and report. And so on. When seeing any doctor, you are your own best advocate. It helps to come prepared, knowing your family history, and things you are struggling with. Researching medications can help, but most people are not qualified to use them without supervision, myself included. Note: This is assuming you need medication. It was fairly clear in my case medication was absolutely required to at least treat psychosis. I prefer to refer friends to a therapist or psychologist, who do not prescribe medication.

SkyPuncher 5y ago

> Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide FWIW, my understanding is this has little to do with the drugs and mostly to do with the recovery process. In a deep depression, you might have suicidal thoughts, but lack the will to take action on those thoughts (because depression takes away your motivation). As you a person comes out of depression, they tend to recover their motivation before their suicidal thoughts dissipate. This creates a situation where a person with suicidal thoughts now has motivation - which means they have the potential motivation to take action on their suicidal thoughts. The important nuance of this is anti-depressants don't necessarily make your suicidal thoughts _more_ suicidal. In fact, it's likely, anti-depressants are making your suicidal thoughts _less_ severe. However, they do increase your motivation before they can fully eliminate suicidal thoughts. I'm not saying you should take an anti-dpressant willy-nilly. It's just BS to be fear mongering like this without considering why this situation happens.

heavyset_go 5y ago
In the beginning of SSRI consumption, it causes initial 5HT2C upregulation and activation, which can directly cause feelings of anxiety, dread, hopelessness, and restlessness/akathisia[1]. Over time, however, the body down regulates 5HT2C in response to its activation, and those symptoms tend to dissipate. In a way, yes, there can be feelings induced that can provide the motivation and energy to go through with suicidal thoughts, but those unpleasant emotions aren't exactly triggered by an inherent will to die. Those who experience akathisia sometimes feel like the only way to rid themselves of the feeling is to end their lives. I point this out because it might seem, or feel to those experiencing it themselves, that those suicidal thoughts are organic and what the person really wants, but they tend to be exacerbated directly by medication and can get better with time. I also point it out because there are ways to sidestep 5HT2C activation with different medications or combinations, it doesn't necessarily have to be inevitable. [1] https://en.wikipedia.org/wiki/Akathisia https://en.wikipedia.org/wiki/Akathisia
- oaktrout 5y ago
  I didnt find any info on 5HT2C in the linked source above, not saying what you've said isn't true, just that I was interested and didn't find much info.

_moof 5y ago

> Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing. And you think a random stranger knows any better? I know firsthand that the medical profession has serious limitations in its understanding of and ability to treat depression, but no way in hell am I taking some rando's advice over that of any of the many doctor's I've seen.

ajkjk 5y ago
That makes no sense to me, if you're trying to deal with mental health problems and struggling you're going to be looking for new ideas from any source. Doctors are good at giving garden-variety medical advice that's validated by studies, but there's so many other ideas out there that they're not going to know about. Their background gives them expertise on what medicine says about mental health, not about the human experience itself. Anecdotally I've been to therapists and doctors that were no help and I've read an article online [1] which was a tremendous help. [1]: https://kajsotala.fi/2017/07/how-i-found-fixed-the-root-problem-behind-my-depression-and-anxiety-after-20-years/ https://kajsotala.fi/2017/07/how-i-found-fixed-the-root-prob...
- bawolff 5y ago
  Strangers on the internet are usually pretty good at helping you self-justify whatever it is you want to do, because no matter what position you take, whether it is a really good idea or not, there is always someone on the internet who agrees with you.
  - ajkjk 5y ago
    Fine, if that gets you taking action when you're depressed, so be it. Anyway in discussions like this I feel like what it lost is that you will actually respond to how compelling the thing someone else is saying is. Like, it's not "oh a bunch of opinions, I'll get influenced by one randomly and it's probably wrong". It's "oh, a bunch of opinions, which explain why they think they're right and how well it worked for them, I'll incorporate that into my own understanding".

heavyset_go 5y ago

> Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide This type of side-effect is thought to be mediated by 5HT2C activation when initially starting SSRIs, however, over the period of about two weeks, 5HT2C receptors downregulate and reach an equilibrium that can cause the effect to diminish or go away entirely. As an aside, there's research that suggests that abnormal amounts of upregulated 5HT2C receptors are present in suicide victims. One of the reasons Prozac is recommended as a first line of treatment, besides the fact that it has a long half-life, is because of its 5HT2C antagonism that can block 5HT2C from extracellular serotonin activation from SSRI effects. There are also plenty of antidepressants that don't typically cause that particular problem, especially if they aren't typical SSRIs or serotonin agonists.

APhoenixRises 5y ago

Granted everyone's case is different, but my doctor went forward with medications only as part of a comprehensive plan to deal with my mental health which included seeing a therapist and committing to an exercise program (it sounded silly to be before, but exercise can be for some people can be nature's antidepressant). I'm on a 6 week to 3-month schedule of follow-up visits with my doctor to keep track of where I'm at mentally. Yes, there are absolutely doctors out there that will toss pills to people and send them on their way, but I don't think it's the majority. I also vet doctors the same way I would a mechanic or anyone else who is going to be doing important work for me. It can be hard, but there are doctors who care about doing the right thing out there.