10 ms·

Depression is likely not caused by a chemical imbalance in the brain, study says

44 points by typeofhuman 4y ago

jurschreuder 4y ago
I think social status is really important. I was never depressed and never really suicidal but I had suicidal thoughts and a lot of frustration. When my social status rose they went away. As a software developer I had a very low social status compared to say a lawyer. I am now a CTO and have a high social status. But I think software developer is generally a profession that comes with relatively low status for the education level, as compared to say doctor or lawyer. I think it's also this relatively low status that got me frustrated, finishing my Uni best in class and then being at the mercy of pretty dumb project managers. This is why I find it important to give my developers a high social status, expensive office, expensive clothes, an assistant, etc. Though society these days tries to teach you status is not important, I believe you cannot escape the nature of the beast. We need social status to be happy.
unknownsky 4y ago
I cannot overstate how much harm this myth caused me. I first got sent to a doctor for depression when I was 12. They asked nothing about my life or my home, just gave me a test with a checklist of symptoms and then told me I had this chemical imbalance. If they had asked anything about my home, they would have discovered that my father was abusive. Then they could have told me that my father's behaviour was abuse and my depression was a natural reaction to abuse. By ignoring my life, the doctors implicitly communicated to me that the way my father treated me was normal and to be expected, and in fact his behaviour was so obviously normal that experts don't even bother asking about it. I spent the next 20 years taking drug after drug after drug trying to find one that really and truly worked, while I was in a string of abusive relationships. Every one of the frequent trips to the doctor further cemented the idea that my relationships were normal and had nothing to do with my depression, and that this was so obvious it wasn't even worth looking into. I finally figured it out 5 years ago. I turned instead to a domestic abuse counsellor who trained me in how to identify the difference between abusive and healthy relationships. I applied those principles and was finally depression-free. If I had never been told this myth, then I would have reflected on what in my life might be causing the way I feel and I would have "cured" it decades earlier. The myth actively stopped me from ever doing that.
- joemazerino 4y ago
  Thanks for sharing your experience. Glad you're living better now
- leobg 4y ago
  Now who could have possibly benefited from you buying into this myth? I’d say selling mass produced drugs on a subscription basis is a lot easier money than to talk through one patients’ problems, one at a time. (It’s also the fault of us consumers. We do often prefer the magic pill over doing the work. This is one more story that perhaps will make us wiser.)
- mountainriver 4y ago
  So much of this, the chemical imbalance narrative has been incredibly harmful. SSRIs can be helpful for people but should never be given in a vacuum. People are usually are depressed because of something
  - nomel 4y ago
    > the chemical imbalance narrative has been incredibly harmful. Yet beneficial for others. I know several people who only sought help, and came to terms with their depression, after understanding that it was not their home life, not their fault, and that it was, in their case, just a physiological imbalance (seemingly inherited for most), and where helped tremendously by ingesting chemicals. I also have examples of people who were told that antidepressants should be avoided, and it's better to "just change" and "be happy", who are no longer with us. I think the most harm comes from oversimplifying complex topics that we barely understand, which appears to be what happened in your case, and what you appear to be approaching now. As someone else posted, some expert opinions that are worth reading: https://www.sciencemediacentre.org/expert-reaction-to-a-review-paper-on-the-serotonin-theory-of-depression/ https://www.sciencemediacentre.org/expert-reaction-to-a-revi...
    - mountainriver 4y ago
      Totally agree, for some people chemicals are life saving, for others they are actually life ending. I think we just need to do a deeper analysis of the individual and ongoing therapy. Challenge is the economics of that
ActorNightly 4y ago
https://slatestarcodex.com/2015/04/05/chemical-imbalance/ https://slatestarcodex.com/2015/04/05/chemical-imbalance/
- teslabox 4y ago
  A sentence or two summarizing the link would be helpful: “This is the slatestarcodex psychiatrist’s 2015 take on ‘chemical imbalances’”
bojangleslover 4y ago
Ask yourself deep down how often do you feel depressed? I bet 90% of people feel depressed sometimes. Feeling depressed sometimes is just the human condition. I bet the discussion around depression would look a lot different if it weren't so profitable to make antidepressants.
- attemptone 4y ago
  > Feeling depressed sometimes is just the human condition. Sure, but when we're talking about Depression it's about consistent behaviours and feelings over at least two weeks. I mean, sure, I can deal with a day of suicidal-thoughts but having them over a month is not healthy and it certainly is not just "feeling depressed sometimes". The antidepressants made me numb. I can agree with that. But that numbness was way more preferable than the mental anguish I had to go through.
- plandis 4y ago
  Clinical depression has a defined definition and symptoms exhibited need to be present for 2+ weeks at a time. As someone that has been medicated for depression in the past I can tell you that having suicidal thoughts for weeks on end is not normal. The thing that honesty saved me was therapy. I say all this because I think you’re potentially doing a great harm in downplaying depression. If someone reading this does feel persistently bad for an extended amount of time seeking therapy is a good idea.
  - bojangleslover 4y ago
    Why two weeks? Who decides that's the cutoff? I think two weeks is a pretty minor "funk"
    - ncmncm 4y ago
      If you imagine clinical depression is some kind of "funk"... just keep it to yourself. People with clinical depression do not need your abuse added to their troubles.
    - 4y ago
fupimeng 4y ago
It could be caused by genetics https://med.stanford.edu/depressiongenetics/mddandgenes.html https://med.stanford.edu/depressiongenetics/mddandgenes.html
- sweezyjeezy 4y ago
  Yeah but through what means are those genes acting?
  - ncmncm 4y ago
    How do any?
afpx 4y ago
On the other hand, it's pretty clear that chronic depression (and other psychiatric illnesses) are partially heritable. So, maybe not an "imbalance" but chemicals are involved somewhere.
- deleted 4y ago
  [deleted]
ncmncm 4y ago
So, it is back to square one. Why do depression meds work? Hypothesis A failed, move on to B. But any discussion of depression that fails to deal with it as at least a half-dozen independent illnesses, each with its own biochemical basis, is intrinsically garbage, and any conclusions bankrupt. This is why we keep seeing spurious reports that "antidepressants don't work". In every case, they take "depression" as a biochemically meaningful diagnosis of one illness, and run a RCT of medication X on a sample with illnesses A, B, C, D, E, and F. If X helps F but makes E worse, and has no effect on A-D, what will the "result" of the trial be? Garbage. "Gold-standard" garbage, if you like. GIGO. People promoting garbage results should be ashamed. Fired, too. Incompetents in medical research make things worse for us all.
- yarg 4y ago
  Why would they be fired? PFizer's making billions.
piinbinary 4y ago
For an entire book with this thesis, see Lost Connections
spzb 4y ago
Here's some expert responses to this paper https://www.sciencemediacentre.org/expert-reaction-to-a-review-paper-on-the-serotonin-theory-of-depression/ https://www.sciencemediacentre.org/expert-reaction-to-a-revi...
exolymph 4y ago
The idea that depression writ large is a monolithic, monocausal phenomenon is ludicrous.
imwillofficial 4y ago
When first prescribed depression meds, I once how the doctor came to the chemical imbalance diagnosis, could we measure these chemicals for a better diagnosis? He told me it was guess work, we don’t know why the meds work, but often they do. I was surprised.
imwillofficial 4y ago
Ya gently related, I was able to get off anti anxiety/depression meds and ADHD medication with Kratom. Worth researching if one is in a similar situation.
8bitsrule 4y ago
I understand that some people have somehow gotten stuck in a bad situation and can't see any way out of it. Expert help might be available for that. But then there are aspects of life that we can change. Including how we think of ourselves For that, there's wisdom out there to help. Here's one kind. [https://wisdomquotes.com/zen-quotes/ https://wisdomquotes.com/zen-quotes/]
oigursh 4y ago
My gut says some of my crippling depression is down to multiple rounds of antibiotics throughout my life. If fecal transplants, or some cheaper-to-prescribe version were made available, feels like that would go a long way to helping a certain portion of people who are depressed, anxious, and have weight or immune disorders etc.

44 points by typeofhuman 4y ago

I think social status is really important. I was never depressed and never really suicidal but I had suicidal thoughts and a lot of frustration. When my social status rose they went away. As a software developer I had a very low social status compared to say a lawyer. I am now a CTO and have a high social status. But I think software developer is generally a profession that comes with relatively low status for the education level, as compared to say doctor or lawyer. I think it's also this relatively low status that got me frustrated, finishing my Uni best in class and then being at the mercy of pretty dumb project managers. This is why I find it important to give my developers a high social status, expensive office, expensive clothes, an assistant, etc. Though society these days tries to teach you status is not important, I believe you cannot escape the nature of the beast. We need social status to be happy.

unknownsky 4y ago

I cannot overstate how much harm this myth caused me. I first got sent to a doctor for depression when I was 12. They asked nothing about my life or my home, just gave me a test with a checklist of symptoms and then told me I had this chemical imbalance. If they had asked anything about my home, they would have discovered that my father was abusive. Then they could have told me that my father's behaviour was abuse and my depression was a natural reaction to abuse. By ignoring my life, the doctors implicitly communicated to me that the way my father treated me was normal and to be expected, and in fact his behaviour was so obviously normal that experts don't even bother asking about it. I spent the next 20 years taking drug after drug after drug trying to find one that really and truly worked, while I was in a string of abusive relationships. Every one of the frequent trips to the doctor further cemented the idea that my relationships were normal and had nothing to do with my depression, and that this was so obvious it wasn't even worth looking into. I finally figured it out 5 years ago. I turned instead to a domestic abuse counsellor who trained me in how to identify the difference between abusive and healthy relationships. I applied those principles and was finally depression-free. If I had never been told this myth, then I would have reflected on what in my life might be causing the way I feel and I would have "cured" it decades earlier. The myth actively stopped me from ever doing that.

joemazerino 4y ago
Thanks for sharing your experience. Glad you're living better now
leobg 4y ago
Now who could have possibly benefited from you buying into this myth? I’d say selling mass produced drugs on a subscription basis is a lot easier money than to talk through one patients’ problems, one at a time. (It’s also the fault of us consumers. We do often prefer the magic pill over doing the work. This is one more story that perhaps will make us wiser.)
mountainriver 4y ago
So much of this, the chemical imbalance narrative has been incredibly harmful. SSRIs can be helpful for people but should never be given in a vacuum. People are usually are depressed because of something
- nomel 4y ago
  > the chemical imbalance narrative has been incredibly harmful. Yet beneficial for others. I know several people who only sought help, and came to terms with their depression, after understanding that it was not their home life, not their fault, and that it was, in their case, just a physiological imbalance (seemingly inherited for most), and where helped tremendously by ingesting chemicals. I also have examples of people who were told that antidepressants should be avoided, and it's better to "just change" and "be happy", who are no longer with us. I think the most harm comes from oversimplifying complex topics that we barely understand, which appears to be what happened in your case, and what you appear to be approaching now. As someone else posted, some expert opinions that are worth reading: https://www.sciencemediacentre.org/expert-reaction-to-a-review-paper-on-the-serotonin-theory-of-depression/ https://www.sciencemediacentre.org/expert-reaction-to-a-revi...
  - mountainriver 4y ago
    Totally agree, for some people chemicals are life saving, for others they are actually life ending. I think we just need to do a deeper analysis of the individual and ongoing therapy. Challenge is the economics of that

ActorNightly 4y ago

https://slatestarcodex.com/2015/04/05/chemical-imbalance/ https://slatestarcodex.com/2015/04/05/chemical-imbalance/

teslabox 4y ago
A sentence or two summarizing the link would be helpful: “This is the slatestarcodex psychiatrist’s 2015 take on ‘chemical imbalances’”

bojangleslover 4y ago

Ask yourself deep down how often do you feel depressed? I bet 90% of people feel depressed sometimes. Feeling depressed sometimes is just the human condition. I bet the discussion around depression would look a lot different if it weren't so profitable to make antidepressants.

attemptone 4y ago
> Feeling depressed sometimes is just the human condition. Sure, but when we're talking about Depression it's about consistent behaviours and feelings over at least two weeks. I mean, sure, I can deal with a day of suicidal-thoughts but having them over a month is not healthy and it certainly is not just "feeling depressed sometimes". The antidepressants made me numb. I can agree with that. But that numbness was way more preferable than the mental anguish I had to go through.
plandis 4y ago
Clinical depression has a defined definition and symptoms exhibited need to be present for 2+ weeks at a time. As someone that has been medicated for depression in the past I can tell you that having suicidal thoughts for weeks on end is not normal. The thing that honesty saved me was therapy. I say all this because I think you’re potentially doing a great harm in downplaying depression. If someone reading this does feel persistently bad for an extended amount of time seeking therapy is a good idea.
- bojangleslover 4y ago
  Why two weeks? Who decides that's the cutoff? I think two weeks is a pretty minor "funk"
  - ncmncm 4y ago
    If you imagine clinical depression is some kind of "funk"... just keep it to yourself. People with clinical depression do not need your abuse added to their troubles.
  - 4y ago

fupimeng 4y ago

It could be caused by genetics https://med.stanford.edu/depressiongenetics/mddandgenes.html https://med.stanford.edu/depressiongenetics/mddandgenes.html

sweezyjeezy 4y ago
Yeah but through what means are those genes acting?
- ncmncm 4y ago
  How do any?

afpx 4y ago

On the other hand, it's pretty clear that chronic depression (and other psychiatric illnesses) are partially heritable. So, maybe not an "imbalance" but chemicals are involved somewhere.

deleted 4y ago
[deleted]

ncmncm 4y ago

So, it is back to square one. Why do depression meds work? Hypothesis A failed, move on to B. But any discussion of depression that fails to deal with it as at least a half-dozen independent illnesses, each with its own biochemical basis, is intrinsically garbage, and any conclusions bankrupt. This is why we keep seeing spurious reports that "antidepressants don't work". In every case, they take "depression" as a biochemically meaningful diagnosis of one illness, and run a RCT of medication X on a sample with illnesses A, B, C, D, E, and F. If X helps F but makes E worse, and has no effect on A-D, what will the "result" of the trial be? Garbage. "Gold-standard" garbage, if you like. GIGO. People promoting garbage results should be ashamed. Fired, too. Incompetents in medical research make things worse for us all.

yarg 4y ago
Why would they be fired? PFizer's making billions.

piinbinary 4y ago

For an entire book with this thesis, see Lost Connections

spzb 4y ago

Here's some expert responses to this paper https://www.sciencemediacentre.org/expert-reaction-to-a-review-paper-on-the-serotonin-theory-of-depression/ https://www.sciencemediacentre.org/expert-reaction-to-a-revi...

exolymph 4y ago

The idea that depression writ large is a monolithic, monocausal phenomenon is ludicrous.

imwillofficial 4y ago

When first prescribed depression meds, I once how the doctor came to the chemical imbalance diagnosis, could we measure these chemicals for a better diagnosis? He told me it was guess work, we don’t know why the meds work, but often they do. I was surprised.

imwillofficial 4y ago

Ya gently related, I was able to get off anti anxiety/depression meds and ADHD medication with Kratom. Worth researching if one is in a similar situation.

8bitsrule 4y ago

I understand that some people have somehow gotten stuck in a bad situation and can't see any way out of it. Expert help might be available for that. But then there are aspects of life that we can change. Including how we think of ourselves For that, there's wisdom out there to help. Here's one kind. [https://wisdomquotes.com/zen-quotes/ https://wisdomquotes.com/zen-quotes/]

oigursh 4y ago

My gut says some of my crippling depression is down to multiple rounds of antibiotics throughout my life. If fecal transplants, or some cheaper-to-prescribe version were made available, feels like that would go a long way to helping a certain portion of people who are depressed, anxious, and have weight or immune disorders etc.