12 ms·

I can’t believe we’ve normalized anti depressants as a society. I’m about to get downvoted into oblivion for this take though. I’m not trying to discount ment

by googaar 1mo ago

I can’t believe we’ve normalized anti depressants as a society. I’m about to get downvoted into oblivion for this take though. I’m not trying to discount mental health, I just think there are better solutions than drugs to fix your state of mind. Also think that some people are dealt a tougher hand than most, and that for a small subset of humans, anti depressants are the most fitting cure.

D-Machine 1mo ago
Agreed. They have to be significantly helping at least some, but we can't say who these people are for certain yet, or how many there really are. And yes, in some cases, no other options are possible, so even if the evidence is pretty dismal for their effectiveness, they are still broadly safe enough to definitely be worth a try. They probably just shouldn't be the first-line approach.
SV_BubbleTime 1mo ago
[flagged]
- wredcoll 1mo ago
  There's hundreds of years of "depression isn't real and even if it was real the only treatment is to take a walk in the woods!!" and like a decade of "man, ssris are great, they really helped me". Public responses have probably not finished overcorrecting.
  - SV_BubbleTime 1mo ago
    Fair. But imo the issue with that might be that “just man up and go take a walk” may still be better advice than “hey kid with your underdeveloped brain… take this maybe psychoactive drug that absolutely changes your brain chemistry in ways we absolutely do not understand causing almost certain addiction with effectively zero supervision unless you self-report murderous and psychotic tendencies! Don’t mind that I’m making kickbacks on every subscription!!” In terms of possible damage to self and others. And to long term society.
wat10000 1mo ago
I don’t get why people are so negative about drugs. They’re just a medical treatment, with pluses and minuses. If they help and they’re not too costly then what’s the big deal? Half the population is addicted to caffeine and nobody cares. A huge number of people need medical intervention for other things and we don’t get this quasi moralistic opposition to them.
- D-Machine 1mo ago
  Agreed. The problem is largely that the pluses of antidepressants have been quite significantly overstated, and the minuses have been understated, meaning the cost-benefit equation is unfortunately quite different than what the general public assumes. We don't want to get rid of them, we just need to recalibrate prescribing, and also to properly assess cessation at intervals more frequently than we have been.
  - wat10000 1mo ago
    Yeah, I’m open to the idea that their effectiveness may have been overestimated and they’re overprescribed as a result. But this “I can’t believe we’ve normalized antidepressants” “there are better solutions than drugs” stuff is just moralizing.
    - D-Machine 1mo ago
      I suppose it can be moralizing, and probably is in the parent comment. For me I still feel the surprise because I've followed the evidence carefully for well over a decade, and the methodological problems and lack of evidence for meaningful effectiveness have always been clear. I.e. it is clear standardized effect sizes are meaningless, and you need to determine important differences, as this is just basic science, but only a tiny handful of papers ever bothered. So it feels very much like "how can we have normalized something so incredibly scientifically shaky", i.e. for me the moralizing is not "drugs are bad, how are we normalizing drugs" it is "how can an entire medical field and society so recklessly adopt something so obviously weakly supported". I.e. my dismay is more about the weak epistemic standards of society than it is about drugs.
BeetleB 1mo ago
> I’m not trying to discount mental health, I just think there are better solutions than drugs to fix your state of mind. Find one that's as effective on the general population. I mean, sure, perhaps lifestyle changes are better. Can you get a higher percentage to change them and improve people's lives than we currently can with drugs? As a top performer in school, I definitely think (and still point out), that you can get fantastically high results in SAT/GRE without paying any test prep service. I and many of my peers did it. There are better solutions than paying those services. But how many who don't pay do as well as those who do? I can tell them how to study as much as I can, but the reality is that statistically, people who attend will do better than if they don't. From a medical standpoint, telling people to change how they live and think has a fairly low success rate. The best options usually don't work on the masses.
cameronh90 1mo ago
Clothes too. If you're cold, why not just move to a tropical country where you can be naked, as nature intended?
deleted 1mo ago
[deleted]
kbelder 1mo ago
I tend to feel the same way. The medication is obviously useful in some cases and for some conditions, but there's also a pushback against the notion that it isn't the best solution for other cases and conditions. There are cases where other solutions might be healthier, especially in the long term, but the availability of a potential pharmaceutical fix interferes. And look at the new batch of weight-loss drugs. It's a similar circumstance. It's a wonder drug in many ways, helps so many people that wouldn't have been helped otherwise. Yet, also being used in some cases as a shortcut to avoid a behavioral change that would be advantageous for a person to do. It is important to remember that there are people for whom these drugs are literal lifesavers. And at the same time, there are those for whom the drugs enable avoidance of fixing a root cause.
FatherOfCurses 1mo ago
I can't believe we've normalized taking insulin as a society. There are better ways than drugs to fix your Type 2 diabetes.

by googaar 1mo ago

D-Machine 1mo ago

Agreed. They have to be significantly helping at least some, but we can't say who these people are for certain yet, or how many there really are. And yes, in some cases, no other options are possible, so even if the evidence is pretty dismal for their effectiveness, they are still broadly safe enough to definitely be worth a try. They probably just shouldn't be the first-line approach.

SV_BubbleTime 1mo ago

[flagged]

wredcoll 1mo ago
There's hundreds of years of "depression isn't real and even if it was real the only treatment is to take a walk in the woods!!" and like a decade of "man, ssris are great, they really helped me". Public responses have probably not finished overcorrecting.
- SV_BubbleTime 1mo ago
  Fair. But imo the issue with that might be that “just man up and go take a walk” may still be better advice than “hey kid with your underdeveloped brain… take this maybe psychoactive drug that absolutely changes your brain chemistry in ways we absolutely do not understand causing almost certain addiction with effectively zero supervision unless you self-report murderous and psychotic tendencies! Don’t mind that I’m making kickbacks on every subscription!!” In terms of possible damage to self and others. And to long term society.

wat10000 1mo ago

I don’t get why people are so negative about drugs. They’re just a medical treatment, with pluses and minuses. If they help and they’re not too costly then what’s the big deal? Half the population is addicted to caffeine and nobody cares. A huge number of people need medical intervention for other things and we don’t get this quasi moralistic opposition to them.

D-Machine 1mo ago
Agreed. The problem is largely that the pluses of antidepressants have been quite significantly overstated, and the minuses have been understated, meaning the cost-benefit equation is unfortunately quite different than what the general public assumes. We don't want to get rid of them, we just need to recalibrate prescribing, and also to properly assess cessation at intervals more frequently than we have been.
- wat10000 1mo ago
  Yeah, I’m open to the idea that their effectiveness may have been overestimated and they’re overprescribed as a result. But this “I can’t believe we’ve normalized antidepressants” “there are better solutions than drugs” stuff is just moralizing.
  - D-Machine 1mo ago
    I suppose it can be moralizing, and probably is in the parent comment. For me I still feel the surprise because I've followed the evidence carefully for well over a decade, and the methodological problems and lack of evidence for meaningful effectiveness have always been clear. I.e. it is clear standardized effect sizes are meaningless, and you need to determine important differences, as this is just basic science, but only a tiny handful of papers ever bothered. So it feels very much like "how can we have normalized something so incredibly scientifically shaky", i.e. for me the moralizing is not "drugs are bad, how are we normalizing drugs" it is "how can an entire medical field and society so recklessly adopt something so obviously weakly supported". I.e. my dismay is more about the weak epistemic standards of society than it is about drugs.

BeetleB 1mo ago

> I’m not trying to discount mental health, I just think there are better solutions than drugs to fix your state of mind. Find one that's as effective on the general population. I mean, sure, perhaps lifestyle changes are better. Can you get a higher percentage to change them and improve people's lives than we currently can with drugs? As a top performer in school, I definitely think (and still point out), that you can get fantastically high results in SAT/GRE without paying any test prep service. I and many of my peers did it. There are better solutions than paying those services. But how many who don't pay do as well as those who do? I can tell them how to study as much as I can, but the reality is that statistically, people who attend will do better than if they don't. From a medical standpoint, telling people to change how they live and think has a fairly low success rate. The best options usually don't work on the masses.

cameronh90 1mo ago

Clothes too. If you're cold, why not just move to a tropical country where you can be naked, as nature intended?

deleted 1mo ago

[deleted]

kbelder 1mo ago

I tend to feel the same way. The medication is obviously useful in some cases and for some conditions, but there's also a pushback against the notion that it isn't the best solution for other cases and conditions. There are cases where other solutions might be healthier, especially in the long term, but the availability of a potential pharmaceutical fix interferes. And look at the new batch of weight-loss drugs. It's a similar circumstance. It's a wonder drug in many ways, helps so many people that wouldn't have been helped otherwise. Yet, also being used in some cases as a shortcut to avoid a behavioral change that would be advantageous for a person to do. It is important to remember that there are people for whom these drugs are literal lifesavers. And at the same time, there are those for whom the drugs enable avoidance of fixing a root cause.

FatherOfCurses 1mo ago

I can't believe we've normalized taking insulin as a society. There are better ways than drugs to fix your Type 2 diabetes.