5 ms·

It’s very easy to explain. By going straight to medication you are treating the symptom not the cause. And you don’t even know if it works. SSRIs don’t work fo

by zpeti 3y ago

It’s very easy to explain. By going straight to medication you are treating the symptom not the cause. And you don’t even know if it works. SSRIs don’t work for many people and we only found out 2-3 years ago. Opioids were prescribed to half of America for back pain. That gives scope for healthy scepticisms at least. Just because you might have some anecdotal evidence of some chemicals working, doesn’t mean it works for others or that it leads to a good place. Lastly - there are clearly lifestyle and even moral choices that people make or don’t make that can lead to mental health issues. Just from a common sense perspective it seems much healthier to try and deal with these first, with therapy, than just medicating. And not just therapy. Exercise, diet. We know these affect mental health, yet pills are easy, and they make doctors money. medicating is much easier than searching, finding and healing the cause. Therapy takes years, if not decades. I can understand why people pick the easier route, but easier is not always better. Also, are you just permanently going to be on pills then? I mean it’s a great subscription business, I can see that.

haldujai 3y ago
> By going straight to medication Initial treatment recommendations: For mild to moderate postpartum unipolar major depression, we suggest psychotherapy as initial treatment. This approach is consistent with multiple practice guidelines, and is especially useful for lactating patients who do not want to expose their infants to antidepressants. However, antidepressants (eg, selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors, bupropion, and mirtazapine) are a reasonable alternative if psychotherapy is not available, not successful, or is declined, or if the patient has previously responded to antidepressants. In addition, combination treatment with pharmacotherapy plus psychotherapy is useful for some patients. Source: UpToDate. > And you don’t even know if it works. While evidence for SSRIs is weak in meta-analyses this is not one of them. I will also agree that a single trial (i.e. the original post and what led to approval) is not definitive but does in fact suggest it works and will continue to be assessed in post-market studies.
mtlmtlmtlmtl 3y ago
Look. It's not some earth shattering revelation that "SSRIs don't work for many people". This has been known since SSRIs first appeared on the scene. This is also true of any other treatment you can think of. The reason they became the first choice as far as antidepressants go is they were a lot safer and better tolerated than the older alternatives. Besides, there's a lot more to psychiatry than just SSRIs. But with people like you it's always about SSRIs. Can't shut up about the SSRIs. If you hadn't noticed, this new drug is not an SSRI! Psychiatrists recommend therapy, they recommend changes in diet and they recommend exercise. Clinical psychology, though technically a separate discipline from psychiatry, not being under the umbrella of medicine, is very much developed, researched and practiced in tandem and cooperation withpsychiatry, and vice versa. You're constructing an elaborate strawman here, where the only reason for using drugs is some evil financial motive. It's just not that simple. There bad apples, and perverse incentives, but not only bad apples. Most doctors do in fact care about helping their patients. Therapy can't fix everything. Therapy alone is not always sufficient and can be just as hit and miss as medication. Not everything is some deep personal issue that needs to be analysed and resolved. Mental disorder is often genetic, even neurological in nature. All the therapy in the world won't stop a bipolar person from cycling between mood disturbances, or someone with ADHD from being unable to concentrate. We can't throw the baby out with the bathwater. Medication, therapy, meditation, diet, exercise, sleep hygiene are all part of the psychiatric toolbox.
- zpeti 3y ago
  I agree with you, but what we are arguing about is how much, and when? Looking at how many people are medicating for mental health issues in the west (or world), I find it extremely unlikely this is because all these people have gone through therapy, exercise and diet and they have to take medication. No. It’s the easy route to some sort of medicated happiness, and it’s profitable, so everyone does it. But this many people shouldn’t be doing it. They shouldn’t be taking the easy route, because it’s not dealing with many issues we should be dealing with, as society and as individuals.
  - habinero 3y ago
    It's not the "easy route". It's a route that _works_. Saying it's "medicated happiness" is ridiculous fearmongering. Antidepressants do not make you happy. They do not change how you think or how you act. They can't. If you think they do, you do not know what you're talking about.
flangola7 3y ago
While I agree there are often additional deeper causes, picking up a prescription will begin faster than waiting for capitalism to be done away with.
- Sakos 3y ago
  Shit, I needed SSRIs before I was in any way capable of processing and dealing with my internal issues. I wasted a decade before giving in and trying the SSRI route and I regret not doing it sooner. It would've saved me and my loved ones a lot of suffering.
- DontchaKnowit 3y ago
  Capitalism isnt depressing anyone. Jealousy? Thatll do it
sgift 3y ago
> SSRIs don’t work for many people and we only found out 2-3 years ago. If you only found out 2-3 years ago that SSRIs don't work for many people that's decidedly a you-problem. Psychiatry has known this for ages, which is one of the reasons that depression treatment is still tricky. You have to try what works for each person individually. And usually it's a combination of things.

by zpeti 3y ago

haldujai 3y ago

> By going straight to medication Initial treatment recommendations: For mild to moderate postpartum unipolar major depression, we suggest psychotherapy as initial treatment. This approach is consistent with multiple practice guidelines, and is especially useful for lactating patients who do not want to expose their infants to antidepressants. However, antidepressants (eg, selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors, bupropion, and mirtazapine) are a reasonable alternative if psychotherapy is not available, not successful, or is declined, or if the patient has previously responded to antidepressants. In addition, combination treatment with pharmacotherapy plus psychotherapy is useful for some patients. Source: UpToDate. > And you don’t even know if it works. While evidence for SSRIs is weak in meta-analyses this is not one of them. I will also agree that a single trial (i.e. the original post and what led to approval) is not definitive but does in fact suggest it works and will continue to be assessed in post-market studies.

mtlmtlmtlmtl 3y ago

Look. It's not some earth shattering revelation that "SSRIs don't work for many people". This has been known since SSRIs first appeared on the scene. This is also true of any other treatment you can think of. The reason they became the first choice as far as antidepressants go is they were a lot safer and better tolerated than the older alternatives. Besides, there's a lot more to psychiatry than just SSRIs. But with people like you it's always about SSRIs. Can't shut up about the SSRIs. If you hadn't noticed, this new drug is not an SSRI! Psychiatrists recommend therapy, they recommend changes in diet and they recommend exercise. Clinical psychology, though technically a separate discipline from psychiatry, not being under the umbrella of medicine, is very much developed, researched and practiced in tandem and cooperation withpsychiatry, and vice versa. You're constructing an elaborate strawman here, where the only reason for using drugs is some evil financial motive. It's just not that simple. There bad apples, and perverse incentives, but not only bad apples. Most doctors do in fact care about helping their patients. Therapy can't fix everything. Therapy alone is not always sufficient and can be just as hit and miss as medication. Not everything is some deep personal issue that needs to be analysed and resolved. Mental disorder is often genetic, even neurological in nature. All the therapy in the world won't stop a bipolar person from cycling between mood disturbances, or someone with ADHD from being unable to concentrate. We can't throw the baby out with the bathwater. Medication, therapy, meditation, diet, exercise, sleep hygiene are all part of the psychiatric toolbox.

zpeti 3y ago
I agree with you, but what we are arguing about is how much, and when? Looking at how many people are medicating for mental health issues in the west (or world), I find it extremely unlikely this is because all these people have gone through therapy, exercise and diet and they have to take medication. No. It’s the easy route to some sort of medicated happiness, and it’s profitable, so everyone does it. But this many people shouldn’t be doing it. They shouldn’t be taking the easy route, because it’s not dealing with many issues we should be dealing with, as society and as individuals.
- habinero 3y ago
  It's not the "easy route". It's a route that _works_. Saying it's "medicated happiness" is ridiculous fearmongering. Antidepressants do not make you happy. They do not change how you think or how you act. They can't. If you think they do, you do not know what you're talking about.

flangola7 3y ago

While I agree there are often additional deeper causes, picking up a prescription will begin faster than waiting for capitalism to be done away with.

Sakos 3y ago
Shit, I needed SSRIs before I was in any way capable of processing and dealing with my internal issues. I wasted a decade before giving in and trying the SSRI route and I regret not doing it sooner. It would've saved me and my loved ones a lot of suffering.
DontchaKnowit 3y ago
Capitalism isnt depressing anyone. Jealousy? Thatll do it

sgift 3y ago

> SSRIs don’t work for many people and we only found out 2-3 years ago. If you only found out 2-3 years ago that SSRIs don't work for many people that's decidedly a you-problem. Psychiatry has known this for ages, which is one of the reasons that depression treatment is still tricky. You have to try what works for each person individually. And usually it's a combination of things.