11 ms·

What's missing from this article is that people are reaching for this because the standard medical treatment for these disorders, SSRIs, are pretty terrible. In

What's missing from this article is that people are reaching for this because the standard medical treatment for these disorders, SSRIs, are pretty terrible. In the mild case, the common side effects are blunting of your emotions and sexual dysfunction. So you don't have panic attacks, but you live in a gray fog and your relationships suffer. In the worst case, they cause suicidal ideation. Psychedelics also have psychiatric risks that can be severe and unpredictable, but they don't require prolonged, daily dosages to be effective.

firecall 3y ago
And what they never tell you, in my experience, is the horrible experience of trying to come off them!
- petesergeant 3y ago
  I'm sorry your experience of coming off them was horrible, but that is not "the experience", and many people come off them without issue.
  - FranzFerdiNaN 3y ago
    My wife had multiple talks with a psychiatrist about them to threat depression, and the experience of the psychiatrist was that it's the rare few that can stop taking them without issue. Hell, it's the rare few who find the right kind of antidepressant in one go, most of the time you need to try a few different kinds for a few months, with all the side effects that come with it.
  - firecall 3y ago
    Totally, I'm sure many people have no issues :-) Here's a recent Guardian article: https://www.theguardian.com/society/2023/apr/17/i-stopped-sleeping-the-sometimes-difficult-path-off-antidepressants https://www.theguardian.com/society/2023/apr/17/i-stopped-sl... From the article: > Horowitz experienced a prolonged antidepressant withdrawal in 2015 that caused intense panic attacks and, he says, even left him contemplating suicide. This personal experience has led the training psychiatrist to become an advocate for reforming antidepressant deprescribing. > In June 2022 the UK health regulator, Nice, amended its guidance on how to support people coming off antidepressants, acknowledging the severity and length of withdrawal symptoms can vary. Nice encourages slow, staggered tapering over many months, if needed. > In Australia, the RANZCP guidelines continue to recommend tapering by halving and quartering the lowest dose over about two to six weeks, and acknowledged that while slower tapering might sometimes be needed, it mostly isn’t possible in Australia “as current preparations of antidepressants do not allow for the dose to be reduced by such small decrements”. There are well documented side effects of stopping SSRI usage that are not related to the original symptoms that the drug is prescribed to treat. But yes, we all have different experiences, and there are many types of SSRIs. :-)
    - petesergeant 3y ago
      Also from your article: > psychiatrist and former RANZCP president, Prof Malcolm Hopwood, says most people who taper off a standard antidepressant dose will be able to do so without major withdrawal symptoms ... "There’s a _small_ group who really experience significant withdrawal symptoms that they really find very difficult to manage" Discontinuation symptoms are a real risk, but people who could really benefit from these drugs absolutely shouldn't be put off by a categorization of these symptoms as being typical.
      - kawhah 3y ago
        That guy's job is pushing psychiatric medicine and techniques on society though, right?
        InSteady 3y ago
        The phrasing here definitely makes you wonder how big is the group that experiences moderate side effects that are moderately unpleasant and moderately difficult to manage, and what do these qualifying terms actually mean in terms of severity and overall negative impact on a patient? A small group that has severe side effects and finds them very difficult to manage is kind of a big deal in a class of drugs that actually have small effect size in the medical literature.
  - DiggyJohnson 3y ago
    Isn’t the difficult if coming off SSRIs well documented, both from a procedural and symptomatic angle?
    - petesergeant 3y ago
      Lots of contradictory studies, but this write-up[0] suggests 1 in 5 people have them _if_ they suddenly stop them rather than tapering them off. 0: https://www.health.harvard.edu/blog/discontinuation-syndrome-and-antidepressants-2019040416361 https://www.health.harvard.edu/blog/discontinuation-syndrome...
suzzer99 3y ago
As far as the risks, I have a friend who's been "microdosing" acid and shrooms for a while, and recently had a legitimate psychotic break, thinking all of her life-long friends were in some kind of Truman Show-esque grand conspiracy against her. She ditched town and cut us all off for over a month. I can't say the drug use caused it, but I and the rest of her friends are of the opinion that it contributed (we all have experience with psychedelics, mostly in our younger days). We know that the microdosing also turned into macrodosing on a lot of occasions. She's in a group of friends who follow Phish around, and it's basically part of their identity. She's doing better now, but still thinks she's in some kind of a stimulation, and has described feeling like she's on a never-ending acid trip. She's always been one of my most solid friends, and this came completely out of left field. We can't get her to see any psychiatrists who would want to put her on anti-psychotics (which is basically all of them). So we just tell her we love her, and try to convince her that if this is all a big simulation, we're not in on it either.
- valec 3y ago
  is she bipolar by any chance? if not, does she have a family history of bipolar or schizophrenia? or, does she have any cluster-b personality disorders?
  - suzzer99 3y ago
    She's not bipolar. I don't know family history other than her brother is an addict and her mom posts 20 political memes a day on FB that venture into conspiratorial stuff (but that describes a lot of people I know). The only signs we can come up with were a few times going back 20 years, either at a party (drugs) or a canoe trip (drugs) where she thought people were talking about her/plotting against her. I wasn't on the canoe trip, but I always believed her that some people in another group of friends we know were mercilessly cruel to her. Now I tend to think it was a manifestation of whatever this is. Other than that she's been one of my most solid friends and always had her shit together, very successful career, someone I would call when I needed life advice, etc.
    - 3y ago
davmre 3y ago
Counterpoint: SSRIs were transformative for my depression. Side effects were minor and manageable (eg, Wellbutrin worked well to prevent any sexual dysfunction). I was on them for several years and had no problem tapering off. My understanding is that this is a pretty typical experience. Rhetoric like this was actively harmful in dissuading me for years from trying what ended up being by far the most effective treatment for me. (yes, I've tried psychedelics; they're fascinating and super promising, but at least for me, not transformative in the way that fluoxetine was) No individual depression treatment works for everyone. SSRIs are not a magic bullet. Neither are psychedelics. But if you're depressed and haven't tried SSRIs, you owe it to yourself and everyone in your life to at least test the hypothesis that they might help. Scott Alexander's page on SSRIs is a great, relatively objective resource, from a psychiatrist who regularly prescribes them: https://lorienpsych.com/2020/10/25/ssris/ https://lorienpsych.com/2020/10/25/ssris/
- swalling 3y ago
  Thanks for sharing your experience. I think in my part my negative reaction is, like many people, having observed the effects of SSRIs on young people. It's well known that risks like suicidal ideation are actually higher among those under 25, and in general it is awful to see the mental health crisis among young people dealt with primarily via instantly reaching toward semi-permanent medication, rather than considering other treatments.
  - Karrot_Kream 3y ago
    I don't know if reacting to current events to offer medical advice is the best way to go. SSRIs were of great help to me when I was in the throes of my anxiety disorder, but psychadelics had given me harrowingly bad trips before I started a meditation practice (the mental fortitude has really helped.) One particular trip made me feel like I just came back from hell and I didn't feel "back" for days afterward. Mental health is tough and nobody seems to have the answers. As with everything, following the beaten path will lead you to surfaces well-trodden, and answers at this point in time are more personal than known science.
  - deleted 3y ago
petesergeant 3y ago
> SSRIs, are pretty terrible ... you don't have panic attacks, but you live in a gray fog and your relationships suffer Comments like this -- and there are an awful lot of them online -- dissuaded me for a very long time from taking SSRIs. And that was a terrible mistake: SSRIs have been a life-changing good for me. I am on a high dose of Lexapro, and in no way do I live in a gray fog, and my relationships are markedly better. My GAD is gone, completely. A few years ago, a doctor tried to convince me that they were causing sleep apnea, so I came off them, slowly, over many months. I didn't have cessation symptoms. My anxiety slowly returned, in proportion to the dosage, my sleep apnea didn't improve, and I was glad to start them again.
acchow 3y ago
> SSRIs, are pretty terrible They're terrible for some people, but they work well for others. I don't think they should automatically be disregarded. > In the worst case, they cause suicidal ideation Is this actually true? My understanding is that people in severe depression can have suicidal ideation but not actually be able to put in the effort/energy needed to go through with it. SSRIs initially give you a little more boost in energy before the mood-lifting effects kick in. During that middle phase, we observer higher suicide rates because you've now enabled them to have effort to follow through with their suicidal ideas.
- alex_lav 3y ago
  > Is this actually true? My understanding is that people in severe depression can have suicidal ideation but not actually be able to put in the effort/energy needed to go through with it. It seems like you forgot the word "ideation" is in the original claim you're disputing, based on your description. Yes it is true that SSRIs can cause suicidal _ideation_. And the first step to suicide is suicidal ideation.
  - oogetyboogety 3y ago
    I have noticed ssri withdrawal causes suicidal ideation but not enough to go through with it. It's like it causes the thoughts but not the action from thoughts.
    - alex_lav 3y ago
      That’s excellent to hear that for you personally, the ideation did not become reality. However, suicide starts with ideation, so any suicidal ideation must be taken as a potential precursor to suicidal, even if in the end it might not actually progress. You can only know how bad it was in retrospect.
- amirs 3y ago
  I took Sertraline (one kind of SSRI) to treat anxiety, never had depression. No panic attacks anymore, sexual drive was still good, after 3 months I felt superhuman and like my life changed, 3 months after that the suicidal ideation started. I thought it was something I could power through, so I gave it another three months before it became unbearable, and I couldn't book an appointment with my treating doctor for another two months so I quit cold turkey. The withdrawals were so terrible, I was basically a zombie for two weeks. Took me a few months until I felt like myself again. I no longer experience anxiety to the same degree I did back then, no use of other SSRIs or any other drugs. This isn't meant to scare people into not trying SSRIs, just sharing my experience. I think had I been more informed of the potential risks and changed my attitude of toughing it out, it could've probably been more beneficial.
deleted 3y ago
[deleted]
entropyneur 3y ago
I don't think poor performance of SSRIs is really a common reason. People just love magic bullets and shortcuts. It's basically a variant of drinking bleach for COVID, except safer and more fun. (Not a prohibitionist, just against self-medication)
Blackthorn 3y ago
While my emotions have definitely been blunted to some extent, it's resulted in a massive improvement in my relationships.
otabdeveloper4 3y ago
Treating "depression" with chemicals is simply nuts. (And a uniquely American idea.) But you do you, I won't judge foreign exotic cultures.
hcks 3y ago
1/ please stop deterring people from undertaking the medical treatment recommended by professionals 2/ there is increasing evidence that psychedelic therapies for mental illness were all based on hype and don’t actually perform any better or at all
- zeroxfe 3y ago
  You are correct about (1), but "citation needed" for (2). Psychedelic therapies are most definitely not based on hype -- there's real research being conducted by real doctors, and it's only becoming more prevalent. [1] https://www.hopkinsmedicine.org/psychiatry/research/psychedelics-research https://www.hopkinsmedicine.org/psychiatry/research/psychede... [2] https://www.nejm.org/doi/full/10.1056/NEJMoa2206443 https://www.nejm.org/doi/full/10.1056/NEJMoa2206443
  - mistermann 3y ago
    Not to be a pedant, but if you examine the particular word choice in each of your competing propositions, you'll see that you both managed to find a way to be technically incorrect. Let's hope language doesn't have something to do with how humans perceive reality! (Or, maybe I have that backwards.)
perth 3y ago
To add to this, I think the toxic part about this is that SSRIs are the first line treatment, and are handed out like candy when they are not magic cure-alls for whichever ailment. In fact there’s a risk of SSRIs activating self-destructive mania, even in people who do not typically fall under the “bipolar” umbrella. (which, the interactions of SSRIs with undiagnosed disorders is also unsafe given their track record of being handed out like candy).
dtx1 3y ago
As someone with Depression that has tried both SSRIs and Shrooms, my experience was badically: SSRIs keep you alive with a host of side effects or you take a shroom trip once a year and feel better without side effects.
deleted 3y ago
[deleted]
Podgajski 3y ago
Psilocybin works in sort of the same way as SSRI. SSRIs will keep around the serotonin we make, but the problem is, if we’re not making enough serotonin in the first place they won’t be effective. Psilocybin on the other hand acts kind of like the serotonin molecule itself. It attaches to most of the serotonin receptors, including the two receptor. The reason why it works for so long is you get such a huge and strong attachment to the serotonin receptors that the body ends up, reducing the serotonin receptors in response. It’s this lack of serotonin receptors that make us more sensitive to what little serotonin we make. There’s nothing non-pharmacological about the effects of mushrooms.
- amanaplanacanal 3y ago
  I believe that we are pretty sure that serotonin has nothing to do with how SSRIs alleviate depression, despite the name.
  - InSteady 3y ago
    I believe the only thing we are pretty sure about is that we don't know why SSRIs work. What we believe we know is that low serotonin in the brain does not directly cause depression, and artificially lowering serotonin in individuals does not induce depression (at least not in the way researchers have done so, within the time limits they measured). None of this necessarily means that SSRI activity downregulating the reuptake of serotonin is not the primary mechanism of action (pharmacologically speaking, it definitely is the main thing this class of drug is doing in the body). It's worth noting that we also have a ton of serotonin receptors in our GI tract, and SSRIs do have notable activity there as well, to the point that they can relieve chronic constipation in some individuals. Although levels of serotonin outside the brain (which represent 95% of serotonin produced by the body and our microbes) generally get ignored in analysis of depression, since serotonin cannot cross the blood brain barrier, it may well be very relevant to human health, both physical and mental, for as yet unknown reasons.
    - Podgajski 3y ago
      You know why SSRIs work for some people and don’t work for others, because the people who it doesn’t work for don’t have depression caused by serotonin deficiency. Their depression is most likely caused by too much GABA. Depression is a multi causal disorder.
dlkf 3y ago
If you don’t quantify these things and perform cost-benefit analysis, it’s like saying we shouldn’t drive cars , because in the worst case you burn alive. SSRI side effect prevalence is a hard thing to measure for a large variety of reasons. But in [1] only 1/4 patients report the side effects as ”very bothersome.” Given that 100% of patients are so anxious/depressed that they want to try psych meds, it seems like SSRIs are a great treatment option for many. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719451/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719451/
- InSteady 3y ago
  Gotta love the language there. "Very bothersome" sounds so much less problematic than other potential phrasings. Like, "oh dear, I get brain zaps, feel like a zombie, and am having persistent intrusive thoughts that interfere with my ability to think and perform during the day. Gee golly, what a nuisance." A quarter of patients reporting very troubling side effects is not great for a class of drugs with an effect size around 0.3, or about 10% more reduction in depression symptom scores compared to placebo. If you have run out of options and are desperate for relief, it may be an appealing risk/reward equation for some people. But the notion that 100% of patients believe they need these meds, rather than had the drug recommended by a doctor/psychiatrist (who maybe didn't go into great detail about the potential risks vs tempering expectations about how likely they are to help), is absurd. It totally ignores how our medical system operates in most cases. Many times, the doctors prescribing will be informed by drug company PR literature moreso than careful reading of scientific research.
nigma1337 3y ago
> In the mild case, the common side effects are blunting of your emotions Isn't this the primary effect, more than a side effect? Atleast in my case, it's been super helpful, going from jumping between a 1 to 7 in mood, to just lie around 4-5-6.
efields 3y ago
> the standard medical treatment for these disorders, SSRIs, are pretty terrible. In the mild case, the common side effects are blunting of your emotions and sexual dysfunction. So you don't have panic attacks, but you live in a gray fog and your relationships suffer. In the worst case, they cause suicidal ideation. As others have stated in this thread, this overt generalization is harmful. SSRIs and psychedelics have both been studied, and both have outcomes that we don't really understand. To say one is better or worse than the other in most cases is pure ignorance. We all have roughly the same physical properties to our brains but how they develop is truly unique to every individual, which leads some methods of treatment for mental health disorders more or less effective than others. I am 100% onboard with pursuing psychs for treatment if you want, but its not for everyone and neither are SSRIs. I'd downvote this if the responses weren't so full of instructive counterpoints.
justsocrateasin 3y ago
This comment is dangerous and incorrect. Many people have exceptional responses on SSRIs - myself included. I went from having regular panic attacks to living a very normal life with absolutely zero side effects, just from taking the lowest dose of Zoloft (25mg generic sertraline). I don't live in a gray fog, my relationships do not suffer, and I have not had any suicidal ideation. You're cherry picking very rare/extreme instances and noting them to be commonplace. It took me MONTHS to even consider SSRIs because of rhetoric like this that is online and pervasive in our culture.

firecall 3y ago

And what they never tell you, in my experience, is the horrible experience of trying to come off them!

petesergeant 3y ago
I'm sorry your experience of coming off them was horrible, but that is not "the experience", and many people come off them without issue.
- FranzFerdiNaN 3y ago
  My wife had multiple talks with a psychiatrist about them to threat depression, and the experience of the psychiatrist was that it's the rare few that can stop taking them without issue. Hell, it's the rare few who find the right kind of antidepressant in one go, most of the time you need to try a few different kinds for a few months, with all the side effects that come with it.
- firecall 3y ago
  Totally, I'm sure many people have no issues :-) Here's a recent Guardian article: https://www.theguardian.com/society/2023/apr/17/i-stopped-sleeping-the-sometimes-difficult-path-off-antidepressants https://www.theguardian.com/society/2023/apr/17/i-stopped-sl... From the article: > Horowitz experienced a prolonged antidepressant withdrawal in 2015 that caused intense panic attacks and, he says, even left him contemplating suicide. This personal experience has led the training psychiatrist to become an advocate for reforming antidepressant deprescribing. > In June 2022 the UK health regulator, Nice, amended its guidance on how to support people coming off antidepressants, acknowledging the severity and length of withdrawal symptoms can vary. Nice encourages slow, staggered tapering over many months, if needed. > In Australia, the RANZCP guidelines continue to recommend tapering by halving and quartering the lowest dose over about two to six weeks, and acknowledged that while slower tapering might sometimes be needed, it mostly isn’t possible in Australia “as current preparations of antidepressants do not allow for the dose to be reduced by such small decrements”. There are well documented side effects of stopping SSRI usage that are not related to the original symptoms that the drug is prescribed to treat. But yes, we all have different experiences, and there are many types of SSRIs. :-)
  - petesergeant 3y ago
    Also from your article: > psychiatrist and former RANZCP president, Prof Malcolm Hopwood, says most people who taper off a standard antidepressant dose will be able to do so without major withdrawal symptoms ... "There’s a _small_ group who really experience significant withdrawal symptoms that they really find very difficult to manage" Discontinuation symptoms are a real risk, but people who could really benefit from these drugs absolutely shouldn't be put off by a categorization of these symptoms as being typical.
    - kawhah 3y ago
      That guy's job is pushing psychiatric medicine and techniques on society though, right?
      - InSteady 3y ago
        The phrasing here definitely makes you wonder how big is the group that experiences moderate side effects that are moderately unpleasant and moderately difficult to manage, and what do these qualifying terms actually mean in terms of severity and overall negative impact on a patient? A small group that has severe side effects and finds them very difficult to manage is kind of a big deal in a class of drugs that actually have small effect size in the medical literature.
- DiggyJohnson 3y ago
  Isn’t the difficult if coming off SSRIs well documented, both from a procedural and symptomatic angle?
  - petesergeant 3y ago
    Lots of contradictory studies, but this write-up[0] suggests 1 in 5 people have them _if_ they suddenly stop them rather than tapering them off. 0: https://www.health.harvard.edu/blog/discontinuation-syndrome-and-antidepressants-2019040416361 https://www.health.harvard.edu/blog/discontinuation-syndrome...

suzzer99 3y ago

As far as the risks, I have a friend who's been "microdosing" acid and shrooms for a while, and recently had a legitimate psychotic break, thinking all of her life-long friends were in some kind of Truman Show-esque grand conspiracy against her. She ditched town and cut us all off for over a month. I can't say the drug use caused it, but I and the rest of her friends are of the opinion that it contributed (we all have experience with psychedelics, mostly in our younger days). We know that the microdosing also turned into macrodosing on a lot of occasions. She's in a group of friends who follow Phish around, and it's basically part of their identity. She's doing better now, but still thinks she's in some kind of a stimulation, and has described feeling like she's on a never-ending acid trip. She's always been one of my most solid friends, and this came completely out of left field. We can't get her to see any psychiatrists who would want to put her on anti-psychotics (which is basically all of them). So we just tell her we love her, and try to convince her that if this is all a big simulation, we're not in on it either.

valec 3y ago
is she bipolar by any chance? if not, does she have a family history of bipolar or schizophrenia? or, does she have any cluster-b personality disorders?
- suzzer99 3y ago
  She's not bipolar. I don't know family history other than her brother is an addict and her mom posts 20 political memes a day on FB that venture into conspiratorial stuff (but that describes a lot of people I know). The only signs we can come up with were a few times going back 20 years, either at a party (drugs) or a canoe trip (drugs) where she thought people were talking about her/plotting against her. I wasn't on the canoe trip, but I always believed her that some people in another group of friends we know were mercilessly cruel to her. Now I tend to think it was a manifestation of whatever this is. Other than that she's been one of my most solid friends and always had her shit together, very successful career, someone I would call when I needed life advice, etc.
  - 3y ago

davmre 3y ago

Counterpoint: SSRIs were transformative for my depression. Side effects were minor and manageable (eg, Wellbutrin worked well to prevent any sexual dysfunction). I was on them for several years and had no problem tapering off. My understanding is that this is a pretty typical experience. Rhetoric like this was actively harmful in dissuading me for years from trying what ended up being by far the most effective treatment for me. (yes, I've tried psychedelics; they're fascinating and super promising, but at least for me, not transformative in the way that fluoxetine was) No individual depression treatment works for everyone. SSRIs are not a magic bullet. Neither are psychedelics. But if you're depressed and haven't tried SSRIs, you owe it to yourself and everyone in your life to at least test the hypothesis that they might help. Scott Alexander's page on SSRIs is a great, relatively objective resource, from a psychiatrist who regularly prescribes them: https://lorienpsych.com/2020/10/25/ssris/ https://lorienpsych.com/2020/10/25/ssris/

swalling 3y ago
Thanks for sharing your experience. I think in my part my negative reaction is, like many people, having observed the effects of SSRIs on young people. It's well known that risks like suicidal ideation are actually higher among those under 25, and in general it is awful to see the mental health crisis among young people dealt with primarily via instantly reaching toward semi-permanent medication, rather than considering other treatments.
- Karrot_Kream 3y ago
  I don't know if reacting to current events to offer medical advice is the best way to go. SSRIs were of great help to me when I was in the throes of my anxiety disorder, but psychadelics had given me harrowingly bad trips before I started a meditation practice (the mental fortitude has really helped.) One particular trip made me feel like I just came back from hell and I didn't feel "back" for days afterward. Mental health is tough and nobody seems to have the answers. As with everything, following the beaten path will lead you to surfaces well-trodden, and answers at this point in time are more personal than known science.
- deleted 3y ago

petesergeant 3y ago

> SSRIs, are pretty terrible ... you don't have panic attacks, but you live in a gray fog and your relationships suffer Comments like this -- and there are an awful lot of them online -- dissuaded me for a very long time from taking SSRIs. And that was a terrible mistake: SSRIs have been a life-changing good for me. I am on a high dose of Lexapro, and in no way do I live in a gray fog, and my relationships are markedly better. My GAD is gone, completely. A few years ago, a doctor tried to convince me that they were causing sleep apnea, so I came off them, slowly, over many months. I didn't have cessation symptoms. My anxiety slowly returned, in proportion to the dosage, my sleep apnea didn't improve, and I was glad to start them again.

acchow 3y ago

> SSRIs, are pretty terrible They're terrible for some people, but they work well for others. I don't think they should automatically be disregarded. > In the worst case, they cause suicidal ideation Is this actually true? My understanding is that people in severe depression can have suicidal ideation but not actually be able to put in the effort/energy needed to go through with it. SSRIs initially give you a little more boost in energy before the mood-lifting effects kick in. During that middle phase, we observer higher suicide rates because you've now enabled them to have effort to follow through with their suicidal ideas.

alex_lav 3y ago
> Is this actually true? My understanding is that people in severe depression can have suicidal ideation but not actually be able to put in the effort/energy needed to go through with it. It seems like you forgot the word "ideation" is in the original claim you're disputing, based on your description. Yes it is true that SSRIs can cause suicidal _ideation_. And the first step to suicide is suicidal ideation.
- oogetyboogety 3y ago
  I have noticed ssri withdrawal causes suicidal ideation but not enough to go through with it. It's like it causes the thoughts but not the action from thoughts.
  - alex_lav 3y ago
    That’s excellent to hear that for you personally, the ideation did not become reality. However, suicide starts with ideation, so any suicidal ideation must be taken as a potential precursor to suicidal, even if in the end it might not actually progress. You can only know how bad it was in retrospect.
amirs 3y ago
I took Sertraline (one kind of SSRI) to treat anxiety, never had depression. No panic attacks anymore, sexual drive was still good, after 3 months I felt superhuman and like my life changed, 3 months after that the suicidal ideation started. I thought it was something I could power through, so I gave it another three months before it became unbearable, and I couldn't book an appointment with my treating doctor for another two months so I quit cold turkey. The withdrawals were so terrible, I was basically a zombie for two weeks. Took me a few months until I felt like myself again. I no longer experience anxiety to the same degree I did back then, no use of other SSRIs or any other drugs. This isn't meant to scare people into not trying SSRIs, just sharing my experience. I think had I been more informed of the potential risks and changed my attitude of toughing it out, it could've probably been more beneficial.

deleted 3y ago

[deleted]

entropyneur 3y ago

I don't think poor performance of SSRIs is really a common reason. People just love magic bullets and shortcuts. It's basically a variant of drinking bleach for COVID, except safer and more fun. (Not a prohibitionist, just against self-medication)

Blackthorn 3y ago

While my emotions have definitely been blunted to some extent, it's resulted in a massive improvement in my relationships.

otabdeveloper4 3y ago

Treating "depression" with chemicals is simply nuts. (And a uniquely American idea.) But you do you, I won't judge foreign exotic cultures.

hcks 3y ago

1/ please stop deterring people from undertaking the medical treatment recommended by professionals 2/ there is increasing evidence that psychedelic therapies for mental illness were all based on hype and don’t actually perform any better or at all

zeroxfe 3y ago
You are correct about (1), but "citation needed" for (2). Psychedelic therapies are most definitely not based on hype -- there's real research being conducted by real doctors, and it's only becoming more prevalent. [1] https://www.hopkinsmedicine.org/psychiatry/research/psychedelics-research https://www.hopkinsmedicine.org/psychiatry/research/psychede... [2] https://www.nejm.org/doi/full/10.1056/NEJMoa2206443 https://www.nejm.org/doi/full/10.1056/NEJMoa2206443
- mistermann 3y ago
  Not to be a pedant, but if you examine the particular word choice in each of your competing propositions, you'll see that you both managed to find a way to be technically incorrect. Let's hope language doesn't have something to do with how humans perceive reality! (Or, maybe I have that backwards.)

perth 3y ago

To add to this, I think the toxic part about this is that SSRIs are the first line treatment, and are handed out like candy when they are not magic cure-alls for whichever ailment. In fact there’s a risk of SSRIs activating self-destructive mania, even in people who do not typically fall under the “bipolar” umbrella. (which, the interactions of SSRIs with undiagnosed disorders is also unsafe given their track record of being handed out like candy).

dtx1 3y ago

As someone with Depression that has tried both SSRIs and Shrooms, my experience was badically: SSRIs keep you alive with a host of side effects or you take a shroom trip once a year and feel better without side effects.

deleted 3y ago

[deleted]

Podgajski 3y ago

Psilocybin works in sort of the same way as SSRI. SSRIs will keep around the serotonin we make, but the problem is, if we’re not making enough serotonin in the first place they won’t be effective. Psilocybin on the other hand acts kind of like the serotonin molecule itself. It attaches to most of the serotonin receptors, including the two receptor. The reason why it works for so long is you get such a huge and strong attachment to the serotonin receptors that the body ends up, reducing the serotonin receptors in response. It’s this lack of serotonin receptors that make us more sensitive to what little serotonin we make. There’s nothing non-pharmacological about the effects of mushrooms.

amanaplanacanal 3y ago
I believe that we are pretty sure that serotonin has nothing to do with how SSRIs alleviate depression, despite the name.
- InSteady 3y ago
  I believe the only thing we are pretty sure about is that we don't know why SSRIs work. What we believe we know is that low serotonin in the brain does not directly cause depression, and artificially lowering serotonin in individuals does not induce depression (at least not in the way researchers have done so, within the time limits they measured). None of this necessarily means that SSRI activity downregulating the reuptake of serotonin is not the primary mechanism of action (pharmacologically speaking, it definitely is the main thing this class of drug is doing in the body). It's worth noting that we also have a ton of serotonin receptors in our GI tract, and SSRIs do have notable activity there as well, to the point that they can relieve chronic constipation in some individuals. Although levels of serotonin outside the brain (which represent 95% of serotonin produced by the body and our microbes) generally get ignored in analysis of depression, since serotonin cannot cross the blood brain barrier, it may well be very relevant to human health, both physical and mental, for as yet unknown reasons.
  - Podgajski 3y ago
    You know why SSRIs work for some people and don’t work for others, because the people who it doesn’t work for don’t have depression caused by serotonin deficiency. Their depression is most likely caused by too much GABA. Depression is a multi causal disorder.

dlkf 3y ago

If you don’t quantify these things and perform cost-benefit analysis, it’s like saying we shouldn’t drive cars , because in the worst case you burn alive. SSRI side effect prevalence is a hard thing to measure for a large variety of reasons. But in [1] only 1/4 patients report the side effects as ”very bothersome.” Given that 100% of patients are so anxious/depressed that they want to try psych meds, it seems like SSRIs are a great treatment option for many. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719451/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719451/

InSteady 3y ago
Gotta love the language there. "Very bothersome" sounds so much less problematic than other potential phrasings. Like, "oh dear, I get brain zaps, feel like a zombie, and am having persistent intrusive thoughts that interfere with my ability to think and perform during the day. Gee golly, what a nuisance." A quarter of patients reporting very troubling side effects is not great for a class of drugs with an effect size around 0.3, or about 10% more reduction in depression symptom scores compared to placebo. If you have run out of options and are desperate for relief, it may be an appealing risk/reward equation for some people. But the notion that 100% of patients believe they need these meds, rather than had the drug recommended by a doctor/psychiatrist (who maybe didn't go into great detail about the potential risks vs tempering expectations about how likely they are to help), is absurd. It totally ignores how our medical system operates in most cases. Many times, the doctors prescribing will be informed by drug company PR literature moreso than careful reading of scientific research.

nigma1337 3y ago

> In the mild case, the common side effects are blunting of your emotions Isn't this the primary effect, more than a side effect? Atleast in my case, it's been super helpful, going from jumping between a 1 to 7 in mood, to just lie around 4-5-6.

efields 3y ago

> the standard medical treatment for these disorders, SSRIs, are pretty terrible. In the mild case, the common side effects are blunting of your emotions and sexual dysfunction. So you don't have panic attacks, but you live in a gray fog and your relationships suffer. In the worst case, they cause suicidal ideation. As others have stated in this thread, this overt generalization is harmful. SSRIs and psychedelics have both been studied, and both have outcomes that we don't really understand. To say one is better or worse than the other in most cases is pure ignorance. We all have roughly the same physical properties to our brains but how they develop is truly unique to every individual, which leads some methods of treatment for mental health disorders more or less effective than others. I am 100% onboard with pursuing psychs for treatment if you want, but its not for everyone and neither are SSRIs. I'd downvote this if the responses weren't so full of instructive counterpoints.

justsocrateasin 3y ago

This comment is dangerous and incorrect. Many people have exceptional responses on SSRIs - myself included. I went from having regular panic attacks to living a very normal life with absolutely zero side effects, just from taking the lowest dose of Zoloft (25mg generic sertraline). I don't live in a gray fog, my relationships do not suffer, and I have not had any suicidal ideation. You're cherry picking very rare/extreme instances and noting them to be commonplace. It took me MONTHS to even consider SSRIs because of rhetoric like this that is online and pervasive in our culture.