BlameAnesthesia posted... SSRIs do work for people with anxiety and with depression that's more in-line with how psychiatry diagnoses depression (the anhedonia, disruptions in sleep and appetite, the sluggishness).
This goes beyond medicine and more to my personal opinion that there is a subset of people who either feel miserable, or have existential crisis, or otherwise have certain expectations about "happiness" that are unrealistic that are more akin to negative thought patterns that are probably better treated with CBT than medication because they've primed their cognition to have a "negative" bias on their stimuli and environments. You see this a lot with how they comment about what their expectations of treating their depression is supposed to look like. "I still don't feel happy, just flat." Happy is a really tricky thing. I think in our modern times, a lot of people conceptualize happiness like that feeling when you're a kid and you open up a present you are really excited about. Or the first time you ride on a rollercoaster. Those are not sustainable sensations to have that kind of mood 24/7 and the pursuit of such a life is not unlike a drug addict that is quite literally just chasing the biochemical equivalent of that kind of life. And much like drug addicts who experience a higher "ceiling" of "happiness", the behavioral patterns that inevitably lead to creating such "happiness" automatically means the routine of every day life will simply feel "flat" or even worse, it's something to be avoided. Hence, they continually chase that high at any cost.
Happiness is really a philosophical concept that as cliche as it sounds is found within and can be more sustained with reflective thought and an acceptance of your station in life or what you are doing with your life and finding contentment. And so it's no wonder medication alone doesn't fix their problems, it's more cognitively based that is better addressed with CBT.
Sometimes you need both because the lack of motivation and anhedonia would preclude one from being able to even tackle the challenge of resetting those negative thought patterns. But for those people with those automatic thought patterns that just gives that "negative bias" on reality, taking medication alone might not result in the desired effect because like COVxy mentioned these problems are more rooted in established behavioral routines and habits. But for people with really bad anxiety or for people who truly suffer from a lot of the "SIG E CAPS" symptoms of depression do see relief with medication. The only unfortunate part being that it takes several weeks to see an effect and a lot of the times people need to try different medications and doses trialed over a long period of time before finding the sweet spot. At least that's what I gathered from my psychiatry rotations back in med school.
First may I say thank you for the well thought out nature of your reply (and that of others in the topic who arent basically just fuck you TC and took the time to think about what I was actually saying).
Putting the epistemology of happiness aside for a moment, I know that even though my life is both objectively and subjectively better than it was when I was younger and un-medicated (and between depressive seasons), my feelings of happiness didnt get this smoothed out as when Im taking my medication.
Its like, when I know its safe to do so Ill taper off and try to go without my medication. Ive discussed this with my specialist and they are ok with it.
From an experiential point of view, I can tell the difference between the range and intensity of emotions while on and while off. Those around me can tell the difference in my reactions to things when Im on and off.
It feels like I have to choose between staying at a stable baseline with the highs and lows cut off or a situation where I can feel the whole range of emotion, but I just cant sleep and I run the risk of going into an anxious/depressive shitstorm.