Current Events > You're going to see headlines that imply SSRIs don't work, this is false.

(+) Yeah! (+)

Here's a brief explainer:
https://twitter.com/lfoulkesy/status/1550059014867877894?t=qf55aby7G59ROkmL20i3NQ&s=19

Here's one of the misleading articles:
https://www.theguardian.com/society/2022/jul/20/scientists-question-widespread-use-of-antidepressants-after-survey-on-serotonin

Taking SSRIs was a horrible experience for me and actually made everything worse.

SSRIs didn't do anything useful for me.

Thread reader link for those who don't have twitter:
https://threadreaderapp.com/thread/1550059014867877894.html

CRON posted...

Taking SSRIs was a horrible experience for me and actually made everything worse.

Pepys_Monster posted...

SSRIs didn't do anything useful for me.

Cool.

Personal anecdote: I can definitely feel the difference when I'm on SSRIs versus being off of them.

Diagnosed with Generalized Anxiety Disorder. If I'm off them for a few days, I feel more impulsive and I get irritable more easily. If I take any higher dose than what I'm taking now, I feel very unmotivated and somewhat lethargic.

Of course, I cannot speak for other people'a experiences.

Tried 4 or 5 different SSRIs, didnt work for me. Getting a better job (more money = healthier food, much less stress), more exercise, and better sleep helped me the most. I also had to work on my posture and breathing a lot. If antidepressants work for you, theres no shame in using them.

I think it comes do to people are different and its not an exact science. I think its more dangerous to generalize that they work for everyone. But that could be a bit too rational for most to comprehend.

Musourenka posted...

Personal anecdote: I can definitely feel the difference when I'm on SSRIs versus being off of them.

Diagnosed with Generalized Anxiety Disorder. If I'm off them for a few days, I feel more impulsive and I get irritable more easily. If I take any higher dose than what I'm taking now, I feel very unmotivated and somewhat lethargic.

Of course, I cannot speak for other people'a experiences.

About the same here, Im maybe 4 or 5 months into medication now, and I can say I was bad off every day for a long time before I finally talked to someone

i got lucky and the first one they tried had great effects, you couldnt pay me to go back to not taking them

I've been seeing those headlines for years. They always do studies on it.

Here's an article from a few years ago where they talk about it.
https://www.psychologytoday.com/us/blog/psych-unseen/201802/do-antidepressants-work-yes-no-and-yes-again

Basically they think that if you have mild or moderate depression SSRI's are no better than placebos. If you have severe or worse depression they may help.

I'm not a doctor but I think that they don't even know what causes depression. A study 50 or so years ago said they think it might be because of serotonin. Since then a lot research and drugs have been assuming that the cause of depression is serotonin. Here's the thing, they aren't sure if they are right. It's just the current prevailing theory.

If you scroll farther in the study they say this:

https://gamefaqs.gamespot.com/a/user_image/5/8/6/AAdVIJAADeji.jpg

So again, not a doctor, but is the study actually saying SSRIs don't work at all? Or is it saying "hey maybe Serotonin wasn't the problem. It may help some people but it may hurt even more. Maybe we need to fund more research into potential causes of depression."

This whole thing is a bit of a strawman. Nobody believes in the chemical imbalance or serotonin hypothesis. The only people that perpetuate it are phamaceutical companies trying to make understandable commercials and general practitioner MDs who just don't know much about psychiatry.

That is to say: we know, and have known for a long time, that depression isn't causes by low serotonin. That doesn't mean SSRIs don't work though.

The_Psyence_Guy posted...

That is to say: we know, and have known for a long time, that depression isn't causes by low serotonin. That doesn't mean SSRIs don't work though.

Im getting conflicting information from you on this then. What are you actually getting at here cause this post kinda derailed your own argument. Kinda played yourself here.

Not trying to come at you but againkinda confusing.

ToadallyAwesome posted...

Im getting conflicting information from you on this then. What are you actually getting at here cause this post kinda derailed your own argument. Kinda played yourself here.

Not trying to come at you but againkinda confusing.

It's only confusing because people have told you a simple story: SSRIs work by blocking serotonin reuptake increasing the level of serotonin, SSRIs help depression, depression is caused by low serotonin.

Without even measuring serotonin in patients, in one way or another, it's easy to see that this cannot be the case. SSRIs are very effective at blocking reuptake channels immediately, but SSRIs take 3 or so weeks to have any detectable impact on depression. So the mechanism there can't really be the direct action of serotonin, but downstream consequences of that action.

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The_Psyence_Guy posted...

It's only confusing because people have told you a simple story: SSRIs work by blocking serotonin reuptake increasing the level of serotonin, SSRIs help depression, depression is caused by low serotonin.

Without even measuring serotonin in patients, in one way or another, it's easy to see that this cannot be the case. SSRIs are very effective at blocking reuptake channels immediately, but SSRIs take 3 or so weeks to have any detectable impact on depression. So the mechanism there can't really be the direct action of serotonin, but downstream consequences of that action.

That makes more sense but it does seem like the days of them being a catch all are numbered. And for good reason. I would much rather have a better understanding for people and use them for who they work for.

It also ties in with my own experience with them and how they made me feel super weird. Again anecdotal which is why I only bring it up now. I have a friend that they do work very well for. And thats my point. Ive seen a lot of doctors kinda just tune out cause you dont want to take their pills.

There will be a lot of hurdles to jump to make the field more inclusive about helping instead of entrenched dogma. And there is a factor of who side your bread is buttered on. The pharmaceutical companies Im sure are going to fight this due to it affecting their greed. But thats another topic and I digress.

Ask your doctor if Ryangrad is right for you.

The_Psyence_Guy posted...

This whole thing is a bit of a strawman. Nobody believes in the chemical imbalance or serotonin hypothesis. The only people that perpetuate it are phamaceutical companies trying to make understandable commercials and general practitioner MDs who just don't know much about psychiatry.

then why would you not just give the results of the study instead of your title?

if no one believed that, you would not have done it.

The only thing it did for me was gain 40 lbs in a month. Then i heard about the brain zaps and i was like nope doc. I want out.
Yoga and meditation for me.

But i am not saying they dont work. I wasnt on them long enough. It just wasnt for me.

WingsOfGood posted...

then why would you not just give the results of the study instead of your title?

if no one believed that, you would not have done it.

Because the study isn't the issue, it's the way the media (and to some extent the authors) have framed the implications of the result.

ToadallyAwesome posted...

That makes more sense but it does seem like the days of them being a catch all are numbered. And for good reason. I would much rather have a better understanding for people and use them for who they work for

The primary thing plaguing psychiatry is something called multiple realizability, the fact that one particular behavior could be caused by many fundamentally different underlying biological mechanisms.

Makes it hard to target behavior biological. So effectiveness of a medication (or scientific inference) seems much lower than it actually is, because it is hard to identify which patients it will work on.

WingsOfGood posted...

then why would you not just give the results of the study instead of your title?

if no one believed that, you would not have done it.

Why are you so aggressively upset over the existence of this topic, chill out man.

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This is, counter-intuitively, because they are in fact effective.

As far as I understand it, psychiatrists generally debunked the "chemical imbalance" hypothesis years ago. While it's true that SSRI's work great for many (but not all) patients, the reverse logic that the initial condition was caused by an imbalance is fundamentally flawed. To think of it another way: a cast will greatly aid the healing process of a broken limb, but that doesn't mean that the fundamental cause of the break was the lack of a cast.

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It doesn't. It makes despondant people a less despondant, which gives them just enough energy/motivation to enact those thoughts.

It's not an "excuse" lol.

One of my psychiatrists explained that the suicidal thoughts thing isn't generally accurate. You're dealing with depressed people who generally have suicidal thoughts, but there's no link definitively proving that the thoughts are caused by the pills and not just by being depressed, but they have to list it as a side effect anyway because of the potential.

I don't know if he meant that's the case with that specific drug or if it's even true though. He was one of my better psychs though so I always took him at his word

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wut?

Literally every psychiatrist I've seen has asked, before prescribing SSRI's, "Are you have any thoughts or feelings of killing yourself/ suicidal ideations? [...] If so, we'll have to prescribe something else or address this somehow else." Psychiatrists won't prescribe SSRI's if you're a suicide risk exactly for the reasons The_Psyence_Guy explained.

I went in for low energy (for all sorts of reasons) and was told, "These pills can give you energy, but if you're having suicidal thoughts they can give you the energy to act on those thoughts before the changes in your life happen that lower your depression."

Wait, so depression isn't the result of a chemical imbalance? I always was told that is the major underlying cause.

Taking lexapro helped my bad anxiety. Of course I also did the whole get better cocktail of exercise, better diet and mindfulness. I think running is what helped me the most, cause if I stop for a few weeks I dont feel AS great.

Then again I take a 5 mg dose

PiOverlord posted...

Wait, so depression isn't the result of a chemical imbalance? I always was told that is the major underlying cause.

No, it was thought maybe this was the case, decades ago. The initial study that kicked it all off was based on blood serotonin, which is entirely disconnected from brain serotonin.

However, some downstream effects of blocking serotonin reuptake seem to help with whatever causes depression.

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I started one for anxiety about 3 months ago.

It hasn't been life changing but it did give me a little push. My pulse hasn't been racing out of control as mulch, and when it does it is for much shorter periods of time. I feel more mentally ready to face challenges as they come up at work. I find myself being more comfortable making jokes, even with people I barely know.

It isn't drastic changes but a little push in the right direction which is what I really was hoping for. I might try to get a higher dose in the future.

I'm glad we have a media that reports academic studies and findings, but in almost all cases, nuanced actual conclusions get boiled down to eye-grabbing headlines that miss the point.

Anyways, my own experience is that SSRIs and similar drugs do help me some, but they always have bad enough side effects that make it not worth continuing. But I don't go in expecting it to be a magic bullet, or the only thing I need to do to feel better.