Slashdot Mirror
New MRI Studies Show SSRIs Bring Rapid Changes to Brain Function
A story at the Los Angeles Times reports that researchers at the Max Planck Institute have found that Selective Serotonin Reuptake Inhibitors, various of which are widely used in anti-depressant medications, cause changes in healthy subjects' brain architecture just hours after ingestion. As the article mentions, one reason that this rapid change is surprising is that patients taking SSRIs to treat depression typically take considerably longer (weeks) to perceive a change in mood. A slice from the story:
When more serotonin was available, this resting state functional connectivity decreased on a broad scale, the study found. This finding was not particularly surprising -- other studies have shown a similar effect in brain regions strongly associated with mood regulation. But there was a two-fold shock: Some areas of the brain appeared to buck the trend and become more interdependent. And all the changes were evident only three hours after the single dosage. ... The rapid connectivity shifts noted by the study might therefore be precursors to longer-term changes, perhaps starting with remodeling of synapses, the microscopic gaps where chemical neurotransmitters such as serotonin flood across to an adjacent brain cell, the study suggests. But this type of brain scanning can’t pick up changes at such a scale, so the hypothesis will have to be tested other ways[.] ... Study subjects did not have diagnoses of depression, so researchers will need to generate similar maps among those diagnosed with depression, and re-map them during and after depressive episodes, as well as after treatment, Sacher said. Comparisons might then show whether a certain initial architecture predicts treatment success.
I found that the SSRI that I took for a total of about 18 months (for diagnosed depression) was mostly helpful in allowing me some clarity to so that I could identify, build and grow the coping mechanisms that helped me maintain clarity without the SSRI. I've been free of needing the drug now for about 8 years and have found ways to cope on my own (changing my mind among others as Tim Leary used to say)...
The study is interesting however, it is notable that no one studied had a diagnosis of depression. It so happens that I am autistic and have Autistic Spectrum Disorder and suffer from Major Depressive Disorder. Being autistic, I have certain stimuli that I am very sensitive to and others not so much. I noticed almost an immediate difference when I started to take Prozac. I've always been sensitive to medicines and I noticed some initial feelings along the lines of things seemed clearer somehow.
You cut up his brain, you bloody baboon!
SSRIs are also the preferred treatment for PMDD and in small doses, about 5% of the usual dose for depression.
In this application it also works almost immediately, no waiting 6 weeks for something to happen. The original article I saw speculated that it affects the amount of GABA in the brain.
http://en.wikipedia.org/wiki/Premenstrual_dysphoria
http://www.ssristories.org/
When I took an SSRI ( Prozac ) prior to taking the stuff I had trouble
conecntrating on on thing at a time. The analogy I would use to describe
this among the folks who read Slashdot is : it was as though my brain
had too many "apps" open at the same time. Or perhaps "too many
open windows on the desktop".
Within a few days of starting the drug I experienced a dramatic increase in my
ability to think about one and only one thing without unrelated thoughts intruding.
Feelings of depression and helplessness were also reduced significantly. Having
said the preceding, I still faced the same real-world problems but the SSRI somehow
made my situation seem far less overwhelming and I had a feeling that things were not
as hopeless as they had seemed mere days before.
One other thing --- I was left with a nagging disquieting feeling that experimenting with my own
brain chemistry could have long-term consequences which would not become apparent
until much later. Sure, these drugs were approved by the FDA, but that doesn't mean
all these chemicals which affect neurotransmitters are safe. Only time will tell how safe
these substances really are or are not.
/
.
Same reason why those of us who take tramadol go through serotonin withdrawal.
Om, nomnomnom...
SSRIs can increase suicidal tendencies when initially starting treatment. This is because SSRIs improve motivation before mood, and it is the reason you start a dose under close observation. Additionally, SSRIs can have a whiplash effect when stopped cold turkey, potentially increasing anxiety and depression. SSRIs MUST be tapered in order to safely withdraw from them. This are all well-known, studied effects of this class of drugs. Though these effects don't occur in all patients, it's frequent enough to warrant caution.
http://www.mentalhealth.umn.edu/medication/pdfs/antidep_bro.pdf
http://www.mhra.gov.uk/PrintPreview/DefaultSP/CON146583
Is mood a state-to-be achieved (intentional in some way), or is it some symptom of the total complex and state of brain chemistry at a certain moment.
'Mood regulation' to me smacks too much of some homunculus.
Tthe summary says:
Study subjects did not have diagnoses of depression
If they do not have the problem, how could we hope to see something about the problem improvement?
I, on a personal level, am skeptical about the usage--or at least the possible over-usage--of mood-altering medications primarily because we know so little about the way they work. See TFA as an example. I'm doubly skeptical on using SSRIs and other drugs on childrens, adolescents, and even young adults, as there are even more uncertainties about these drugs on still-developing brains!
Having said that, SSRIs are common medications today. The kind of people who are suicidal or have such a mood-disorder that going on a shooting rampage seems like a good idea are exactly the people for whom you would expect SSRIs to be prescribed! In other words, are SSRIs causing these issues (and earning your blame), or were the problems there to begin with?
I don't know, and I don't know of any studies or other medical evidence that points either way. IMH(and not not scientifically grounded)O, I would, like you, suspect some causal relationship.
Is figure out why so many who are on SSRI's or had recently stopped taking them, become suicidal or go on shooting rampages, or both.
Seriously, what the fuck? What an idiotic, close minded, asshole of a comment. 13% of the population are on anti-depressants, and go off them regularly. They do not shoot anyone or get suicidal. Sometimes, the mentally deranged end up shooting people or committing suicide. Is it any wonder that they had been medicated prior to going off the rails?!?! It's not the drugs, it's the asshole that took them. He had a general 13% of had take them even before you counted the fact they were crazy enough to commit murder.
Now stop making rude and insensitive comments about a group of people you clearly have no knowledge of what-so-ever. I took these drugs for over 15yrs and did not kill anyone, especially not myself, when I stopped taking them. If there is any one worst thing about SSRI's its the stigma people like you have put on people who take them.
The premise of the story is flawed. While SSRIs take a week or two to show positive results, the initial effects of the drugs are almost immediate. I've taken anti-depressants and I can say that there is a very quick emotional reactions to them. Not a positive reaction, but there is one there. Friends who have taken the drugs and I agree, there first few days brings a roller coaster of emotions and a sick-to-the-stomach feeling. That eases off after a few days followed by a dull fuzzy feeling, followed by the realtive calm around 10 days into the experience.
This idea that researches were surprised that SSRIs started affecting the brain immediating is either bad reporting or a sign the researches had no idea of what anti-depressants do to people. Any shrink or SSRI patient could have told them the affects on the brain are almost instant.
This is no secret to anyone who has popped one of his GF's Lexapro pills to last longer in the sack with said GF a few hours later.
Not much is known about how they work, but plenty is known about their effects. Millions of people take them safely and effectively. I'd avoid newer drugs for a time... I like the buffer of a few hundred thousand people ahead of me in line... That said, I've taken them in the past. Make no mistake, they change who you are. Sometimes that's required though, so you should think logically about the situation.
A long time ago, I took an SSRI called Luvox in order to treat OCD. Within a month, the drug had turned pain signals into pleasure. Headaches, burning myself via a hot water faucet--I would literally feel pleasure from these normally painful experiences. I stopped right away, and those effects lingered for a decade. Prior to that, I had taken Prozac and Zoloft without significant effects that I remember. But after seeing an SSRI make my particular brain sadomasochistic, I never popped another SSRI pill and I never will again. They really do change the brain, and I'm convinced that the outliers (read: really smart people with non-normal brain chemistry perhaps--at that time, I was pretty damn smart :)) have brain chemistries that react in vastly different ways than the baseline. I know this isn't exactly on topic, but it was shocking how much my brain changed from what should have been just the early trial period of the drug and for how long that lasted, and frankly how much it pushed me into brand-new areas of being f'ing crazy. I would heartily recommend against using these things, especially to the types of people that are going to read 0-level comments on slashdot. :) I'm also convinced that even if it seems kinda normal, it could very well not be and be royally messing up other parts of your consciousness that just aren't as apparent as suddenly pain=pleasure. And I highly suspect this kind of thing is happening when kids who see psychiatrists and are on drugs, smart loners, go f'ing nuts and kill people. Random rewiring of the brain because they have unique chemistries. That's just my theory though, just knowing how "crazy" I got. I figure it more or less follows from giving these things to so many people and knowing how drastically wrong they can go. And sadomasochism may not be the right term as it didn't involve sexual feelings or anybody else. It's just like my wires got crossed and stayed that way, tapering off, for a decade.
We know how they work. We don't know why they work. It is right there in the name "Selective Serotonin Reuptake Inhibitor". It causes excess amounts the neurotransmitter Serotonin to be not reclaimed
"When life gives you lemons, don't make lemonade. Make life take the lemons back!" -- Cave Johnson
Is figure out why so many who are on SSRI's or had recently stopped taking them, become suicidal or go on shooting rampages, or both.
Seriously, what the fuck? What an idiotic, close minded, asshole of a comment.
Perhaps the question could have been phrased a bit more delicately. But there's a actually a serious legitimate question there.
There is strong reason to believe that SSRIs alter a person's brain to make them more motivated and less concerned about the consequences of their actions. For someone whose core problem is feeling too hopeless to get out of bed or for someone whose main problem is crippling social anxiety, it's useful to biochemically alter their brain so they feel more motivated and less concerned about negative consequences of their actions.
There are also people out there in the world who have have successfully suppressed powerful desires to kill themselves and/or others over the course of their lives. For such people, there are legitimate serious questions about whether biochemically altering their brains to make them more motivated and less concerned about the negative consequences of their actions is potentially very dangerous.
I suppose it's understandable that you would wish to differentiate yourself from those who are burdened with the fight against such inner demons. But you should be careful not to promote the stigma against that they face or to undermine the legitimate serious questions that are matters of life and death for them.
Is figure out why so many who are on SSRI's or had recently stopped taking them, become suicidal or go on shooting rampages, or both.
Some possible explanations that are better than "SSRIs make people go on shooting rampages":
They were misdiagnosed, and mistreated.
They were depressed (duh) and became more depressed when the SSRI did nothing to help. (Suicidal ideation is a major reason for starting SSRI treatment in the first place.)
Some people do that for inexplicable reasons, whether on SSRIs, withdrawing from SSRIs, or having never taken SSRIs.
Not that many people on SSRIs do anything violent and your perception is based on misunderstanding and poor media reporting that you have no real statistical basis for.
Clearly more research needs to be done, but to me this sort of anti-SSRI argument seems like the anti-seat belt arguments you used to hear. In a few very, very rare cases people may have been injured, and even killed, by seat belts crushing internal organs, causing strangulation, prohibiting exit from burning vehicles, and what have you. People who cite cases like this are willfully oblivious to the fact that seat belts are much, much, MUCH more likely to prevent serious injury or death than they are to cause injury. Given that so many people take SSRIs and do not become murderers, and so many of them credit SSRIs with keeping them alive or improving their lives, my estimation is that they offer a huge net benefit.
This is a hacked account, for which the owner can not be held responsible.
People suffering from anxiety, panic attacks, and long-term depression are already at a high risk of suicide. Life often sucks. Depression kills.
And once you've experienced serious depression, you're more at risk to have repeat bouts.
People who seek help are often in crisis - that they have a higher risk of suicide when they first take a drug to try to get better isn't a surprise (and the increased risk is only for the first few weeks. If the drugs didn't have a positive effect, the risk of suicide would not go down with time).
There's so much stigma and stupidity around mood disorders. People will demand antibiotics for a cold (totally ineffective), but will then tell someone with depression to "just get over it." Biochemically impossible.
"Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
Is figure out why so many who are on SSRI's or had recently stopped taking them, become suicidal or go on shooting rampages, or both.
It's people like you who encourage the stigma that we're in this mess where people go untreated for decades/lifetime, in spite of the fact that over 1/4 of everyone suffers from a diagnosable mental illness in any given year.
-- NAMI http://www.nami.org/factsheets...
I ask you, where the fuck is the Ice Bucket Challenge for mental illness? That's something I asked last Wednesday at my DBSA meeting. I'm asking it here. Where the fuck is it? We've got the Susan G. Komen foundation for breast cancer, yet more women suffer from mental illness than have ever had breast cancer. But there is pink everywhere.
Unfortunately, NAMI is only there for caregiver support and even for that they are absolutely silent in the media. They do absolutely bupkis for people who actually suffer from mental illness. Support is nearly nonexistent. I don't know of any foundation that supports the treatment of mental illness, raises awareness or even works to end the stigma. And for people who suffer from mental illness, there is not anything in the way of patient support/guidance (like who you should see for what). It's all "fly by the seat of your pants" stuff, and when you are in the middle of a major depressive episode even asking for help from anyone is daunting or even impossible.
I came here to call you a jerk, but I figured I'd say something more informative.
Bye.
--
BMO/Dan
"it has to be emphasized that if the pain were readily describable most of the countless sufferers from this ancient affliction would have been able to confidently depict for their friends and loved ones (even their physicians) some of the actual dimensions of their torment, and perhaps elicit a comprehension that has been generally lacking; such incomprehension has usually been due not to a failure of sympathy but to the basic inability of healthy people to imagine a form of torment so alien to everyday experience."
-- William Styron, Darkness Visible: A Memoir of Madness
Is figure out why so many who are on SSRI's or had recently stopped taking them, become suicidal or go on shooting rampages, or both.
Seriously, what the fuck? What an idiotic, close minded, asshole of a comment...
Whoa, whoa, whoa! ...
Let's not go on a rampage here.
--
Sorry, I had to. For the record I agree with you.
Look where all this talking got us, baby.
But we don't know if that is all there is to it. What does the brain do about it? Nothing? Does the brain just allow its equilibria to be swayed?
There is HUGE evidence that it does not just allow drugs of nearly all types to permanently alter its equilibria, but instead reacts to perturbations by adjusting various feedback effects so as to somewhat cancel the effects of the drug. This is the basis of the development of tolerance. The processes often involves *other* neurotransmitter pathways than the one targeted. The mechanisms can involve processes leading all the way down to the genes. There may even be higher order effects whereby gene expression is itself affected. Despite there being evidence of these phenomenon, there is little understanding.
Then what happens when the drug is removed? Are you worse off than you were before? Anyone who thinks they know is either ignorant or lying.
The truth is that it is extremely complicated.
We know only the tip of the iceberg.
Worse, we market dumbed down summaries about the known information about how they work, leading people to remain mired in overly simplistic (mis)understandings of how mood and mind are related to the physical brain.
I think SSRI's (& others pharmaceuticals like it) are extremely dangerous. I would rather them be prescribed Indica or Sativa depending on the need...
That said, I have to agree with this part in theory...I mean to say it sounds plausible:
Again...fsk pharma companies...but given what TFA has to say about its effect on brain structure it may very well do almost the same thing at the cellular level
1. I can imagine a scenario where, given a secure living situation and support system, the SSRI's function to help your mind heal itself more quickly
2. I need to see alot of studies before I credit this neurological behavior only to SSRI's...in other words, we have to by default investigate other drugs to see how they compare
It bolsters your positive case study.
Also, I have a friend who was stressing about how SSRI's change your brain chemistry. I suggested she tell the psychologist about her concerns and she already had done so. Her counselor showed her that her dosage was 1/6th of what they normally prescribe for one dose...and she was only taking half of one of those every few days...
So I'm happy to hear that big pharma doesn't destroy everyone's life who uses these drugs...I'm just saying let's get scientific and compare it with weed.
Thank you Dave Raggett
I gained 180lbs. in two years while I was on Zoloft and Paxil. I wasn't a small person to begin with. I was doing things like eating two large take-out pizzas a day when I could afford to do it. The sick thing was that I was under care of a psychiatrist, a psychologist and my primary care physician, and none of them thought my weight gain was an issue worth addressing.
I got debilitating headaches, spent a good chunk of my 20s with absolutely zero sex drive, only slept about four hours a night and had trouble stringing together a coherent sentence. For all of that, the meds never actually made me feel any better. I just took them because my doctors told me they were helping.
Eventually, I did get fed up and just stopped treatment. I had a few months of even worse headaches, but at least for me it's easier to just deal with depression and anxiety than all the problems that came along with the meds.
-- I wanna decide who lives and who dies - Crow T. Robot, MST3K
I've been on various SSRIs, and I must add to this that even on the same person some SSRIs have different effects than other SSRIs. The first one I took (I don't remember the name atm) made my situation far worse in the beginning and I was given valium (or another -zepam) to mitigate the sideeffects in the beginning. However, later it turned out that same medication took my bloodpressure through the roof (250/150 instead of 120/80) and changed medication. I have changed medication a few times since. However, the best antidepressant I've added is bupropion, which is not a SSRI.
On July 2, 2012 UK-based GlaxoSmithKine (GSK) agreed to plead guilty to criminal charges of fraudulent promotion of its drugs and pay the US Government a settlement of US$3 billion. If accepted, this will be the largest fine imposed on a drug company, surpassing the $23 billion paid by Pfizer for inappropriate marketing in 2009. The amount adds to GSK's $750 million settlement in 2010 over manufacturing quality. What is particularly egregious about GSK's fraud is the calculated deceit and potential human cost of its aggressive and misleading marketing. For instance, while evidence was emerging that showed an increased suicide risk in adolescents prescribed selective serotonin reuptake inhibitors SSRIs for depression, GSK was actively encouraging off-label prescription of paroxetine to individuals younger than 18 years. This was not an isolated incident; off-label use was also encouraged for bupropion. For rosiglitazone, safety data were withheld from the US Food and Drug Administration and altered, potentially delaying restrictions on the drug's use and putting people to whom it was prescribed at increased risk of cardiovascular complications. The company is also accused of cheating Medicare. Such behaviour is not only illegal, it is immoral.
work in progress
Yes, whenever I started taking antidepressants I could feel SOMETHING happening within a few hours, so that's not a surprise. But as others have said, the depression doesn't lift for a while - weeks to months. In fact, the nervousness and anxiety gets worse than ever for the first week. (No surprise that suicide is common soon after starting them.)
I think the reason is that at least some kinds of depression (anxious depression) are like having over-sensitive ears, and being bothered by the random noises that occur in daily life, which make us fearful and easily hurt, and hence we avoid certain kinds of situations, taking chances, socializing, etc.
SSRIs are like turning on a loud, steady noise, which at first overwhelms those sensitive ears, making us even more uncomfortable. But after a while, the body adjusts, and the ears become less sensitive, effectively turning down the volume until the loud noise is barely noticeable. After that, all the little, random noises that happen throughout the day are also barely audible. And those background noises were what was making us nervous before, but now that we can't hear them, they don't. (Of course I'm not talking about actual noises, that's just an analogy, but rather anxious/emotional/fear-based stimuli.) This process of physical adjustment takes about two weeks. (A number which has been validated directly in other experiments on how quickly the brain adapts by changing receptors. In this case, the receptors for serotonin recess into the cell wall and deactivate - the "turning down the volume", making them less sensitive to stimuli.)
Then, after we're no longer extra sensitive, we start taking more chances, being bolder and more outgoing (maybe without realizing it), because we stop anticipating the fear and hurt of rejection or failure. And after a while, we realize we can actually achieve things, have friends, be confident... and that's when we start feeling good about ourselves. This process can take months or years.
SSRIs can increase suicidal tendencies when initially starting treatment. This is because SSRIs improve motivation before mood,
I am actually 100% sure this is not the reason, that's just the BS response idiot psychiatrists and hopeful medical researchers who have never taken an antidepressant in their life made up.
I never once experienced any change in motivation immediately after starting antidepressants (which I've done several times in my life). What I DID experience a change in, every time, was an increase in anxiety, agitation, and nervousness. More or less the symptoms I already had from feeling anxious, scared and depressed. And that's because the way these drugs work is to basically make the whole thing worse, forcing your brain to adapt, which takes about two weeks (the receptors for serotonin recess and deactivate). It's sort of like the SSRI turns on a loud noise, and over the course of a couple of weeks, the brain turns down the input volume control until it's inaudible again. And after that, the various normal everyday situations which would have made an oversensitive person react negatively or fearfully, are now also too "quiet" for that person to notice (now that the "volume" has been turned down).
And SOME SSRI's have a pretty severe withdrawal effect - Paxil is probably the worst, I don't think it should be prescribed to anyone, it's absolute hell to get off of, even trying to taper very gradually. Probably best to just go cold turkey and know you're going to suffer horribly for a week or so, rather than drag it out and suffer for months. It has to do with its extremely short half-life. Prozac, on the other hand, with a half life many times as long, does not have that problem. If you're going to take an SSRI, get fluoxetine (prozac) - which is generic now anyway, not to mention about the oldest and most tested of the SSRIs. Only try another if Prozac doesn't work for you or has intolerable side effects after a few months of taking it.
I have to agree with you in general.
Something else I've wondered about is why do we have so many people on antidepressants. If anything I suspect that depression might actually be underdiagnosed, but we really have no idea what it actually is.
When you have substantial percentages of the population requiring a medical treatment you have to start asking why. Have so many people always been depressed, or is this something new? If it is new, what is the cause?
Sometimes I wonder if the brain has a natural feedback loop that leads to depression. I tend to find myself feeling down when I should probably feel the most comfortable. If something bad happens or something good happens I tend to snap out of it. However, if everything is going just fine and I'm in some kind of routine, I start to feel less and less satisfied with it. Perhaps there is some survival instinct that just makes us feel continuously uncomfortable if we aren't improving our living conditions/etc.
this error isn't as common as "weed makes you lazy" or "weed gives you the munchies" but I've seen it
Indica and Sativa are two main species of Cannabis (the third, Ruderallis doesn't get you high but is good for hemp)
For many reasons, Indica is probably the first and/or only kind of weed most users in North America have smoked.
First I'll tell you *why* and then why it matters...
> Indica is easier and cheaper to grow...it flowers noticeably more densely and grows faster. Since weed is still illegal in most states, most low to mid level growers plant Indica (or Indica-dominant hybrid) because it is easier to grow surreptitiously and it yields a higher profit margin.
> It matters because Indica's effects on the body are relaxing and the mental effects cause long daydream-like thoughts...it's not a "stimulant/depressant" binary. Your mind is very active but your body is relaxed, as if you are in a sauna. These effects combined typically cause the user to sit or lay down for long periods of time...which may or may not involve video games, movies, or music.
Also, Indica lowers your blood sugar...which makes you hungry...
Sativa is virtually the opposite on all counts...it's like caffeine almost...
Most weed is a hybrid of course, but they usually have a noticable dominant characteristic...which also can help explain all the interesting names given to weed strains...
**the name of the weed strain is a clue to its effects**
maybe techies should name their creations in the same manner ;)
Thank you Dave Raggett
someone publishes a study that says weed does more or less the same thing and 10 million stoners jump up and shout 'science is fucking bullshit, man'
I'd love to read the original article. I am not sure how they detected structure, but fMRI most certainly was not it. If fMRI was used, then it can only be a functional difference, there is no way to observe a structural change with fMRI unless it is something gross (like a 5x5x5mm cube of brain tissue suddenly went missing). If T2-weighting was used, then one is still limited to fairly gross changes (lets say a cube that is 1 mm^3 in volume). Finally, we arrive at the various diffusion MRI techniques, which have no established ground truth, but whose models can provide sub-voxel resolution. Not enough information to really evaluate in the OP.
Thanks to heavy marketing, serotonin uptake inhibitors were wildly successful when they first appeared. After a few years that success fizzled out. Many, many studies have established that the placebo effect is extremely powerful. The money drug manufacturers shovel into promotion is also at work in another important way. Researchers who get the right results get invited to speak at conferences in exotic countries, where they are put up in 5 star hotels and offered the finest food and women. Their research is underwritten and they are offered high paying prestigious positions. So it pays to get the right result.
Very good answer. In the case of SSRIs, the brain's reaction, its developing tolerance to the dosage, is exactly how the beneficial effects for anxiety and depression occur. And this physical adaptation takes about two weeks. But it happens by initially introducing something that's pretty uncomfortable, essentially making the problem worse (increasing anxiety, agitation and nervousness) until the brain has a chance to adapt (in this case by making serotonin receptors less sensitive, recessing them into the cell wall or whatever specifically they do).
(And the other beneficial effects - feeling happier and more confident - come over time, weeks, months, years, as a result of being less sensitive.)
And you're right, it's a good question what happens after it's withdrawn. And the answer is usually that eventually the depression comes back.
You're also spot on about the oversimplification and denial and misunderstanding of how they work, and that's lead to all kinds of problems, like all the confusion over "if they make you happier, how can they increase suicide?" question, which is no mystery at all, and even expected, when you understand how they work.
Essentially we've twisted society up in knots until increasing numbers of people can't tolerate it and then rather than fixing the thing, we prescribe drugs to make it sort of tolerable.
When you're really depressed, you're unlikely to kill yourself. That takes initiative. Something that increases initiative without seriously reducing the emotional pain will make suicide more likely. Moreover, you're unlikely to get monotonically less depressed. At some point, you're going to feel the depression coming back, and you will have not only motivation and initiative but a very strong reason to do anything necessary to not get depressed again.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
You're arguing from your own experiences. They don't apply to everybody. (Specifically, they are considerably different from my experiences.)
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
I'm sorry. If you think "how" and "why" are the same question, you need to go back to school. Start at the very beginning
"When life gives you lemons, don't make lemonade. Make life take the lemons back!" -- Cave Johnson
I'm going to pick a nit with "really have no idea what it actually is". I suspect that there may not be an "it" there, but that there may be different causes with the same effects.
I had a heart attack. The doctors made a final diagnosis with a blood test, then stuck a catheter up my groin to pull the clot out of the artery, stopping the heart attack. (Then, for the next couple of days, it seemed almost everybody coming into my room wanted to check my groin.) I've had other diseases where the doctors did some tests and concluded what was going on and knew the physical cause.
Depression is a collection of symptoms, normally diagnosed from the patient's self-reporting. I haven't seen or heard of any objective test. Serotonin level won't do it: you can be depressed with a high level or just fine at a low level, but it appears that increasing the serotonin level does reduce depression in quite a few cases. There could well be several physiological causes.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
Given the number of people who have been on SSRIs, I suspect you could construct a similar collection with innumerable other common factors (as long as they're reasonably common). Sort of like somebody looking at all the suicide reports during the big anti-D&D hysteria, and pointing out that, if those were all the suicides associated with D&D use, D&D must be reducing the suicide rate.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
Sometimes, the mentally deranged end up shooting people or committing suicide. Is it any wonder that they had been medicated prior to going off the rails?!?! It's not the drugs, it's the asshole that took them.
I think this demonstrates a really poor approach to the problem. For one, it ignores the question why just about every single case of a shooting rampage, the perpetrator had either been on SSRI's or recently came off. I know correlation is not causation, but constantly have this message ignored, when, if these people are usually reclusive, yet they're not so reclusive that they go to a psychiatrist who is convinced that they justify a prescription for a SSRI. So you're really begging the question as to how and why these people are slipping through the cracks! If it was the person and not the drug, then you'd be seeing quite a few more instances where they weren't taking SSRI's.
Also, if your point that they're mentally deranged to begin with and therefore all get medicated, having to go to a psychiatrist to get a prescription, then how and why aren't they being spotted by medical professionals?
I don't place a stigma on those who take the drugs, as they're just seeking help. I think the problem is more with the medical and pharmaceutical industry who stand to lose significant amounts of money if adverse findings were made for these drugs.
I'm not saying that we should ban them, it's clear that to a large extent they help. But, there's also clear evidence that among a subset, they don't appear to help. The medical profession can hide behind "the treatment was a success but the patient died", but forgive me in saying that it's not good enough. This is a failure on one level, because even if it wasn't the drug, then you really have to question, why just about all the shooting rampages, for instance, the people were or recently had stopped taking SSRI's, are not getting sufficient treatment to stop them hurting other people, when they had to seek treatment from someone to get the prescription. It's a failure on numerous levels, and whichever way you look at it, not enough is understood about these drugs. Statistically they offer a net benefit, but that shouldn't make it a cure-all for depression.
I think the point is lost on you. These worst cases were people seeking treatment and got it, yet the treatment has failed.
As for where is the support for mental illness, well it's simple, there doesn't need to be any because for instances of depression, we have these wonder drugs called SSRI's that solve the problem. How much more support do you need when popping a few pills make the problem go away? That was sarcasm by the way.
I think that the point of /my/ message is that maybe you should not be painting with such a broad brush and implying that anyone taking SSRIs is a time bomb waiting to go on a shooting rampage.
Asshole.
--
BMO
The doctors made a final diagnosis with a blood test, then stuck a catheter up my groin to pull the clot out of the artery, stopping the heart attack. (Then, for the next couple of days, it seemed almost everybody coming into my room wanted to check my groin.)
That isn't such a bad thing. I know somebody who had stents placed and the doctor didn't wait long enough when removing the sheath (or whatever they call the thing they insert catheter through). She was lying in bed and felt damp and looked down and there was blood all over the place. Good thing she hadn't taken a nap - she was bleeding from her femoral artery - not exactly a minor vessel. When she finally managed to get the attention of a nurse there was quite the stir.
Depression is a collection of symptoms, normally diagnosed from the patient's self-reporting. I haven't seen or heard of any objective test. Serotonin level won't do it: you can be depressed with a high level or just fine at a low level, but it appears that increasing the serotonin level does reduce depression in quite a few cases. There could well be several physiological causes.
No argument there - I suspect that once they figure out the brain the whole DSM is going to need a MAJOR refactor...
Where did I imply that? I think you're making stuff up and behaving like a precious little snowflake. That or your command of English is woeful at best.
Paxil is garbage for a majority of people for the reason you mentioned. I had a neighbor friend that was OCD and he would become a train wreck if he let his script lapse or decide to quit taking them. It got to the point where I dreaded hearing him knock on the door because you don't know what he had been doing and how long I would be trapped in his presence.
I have had my run of anti-depressants and they help for a while until the underlying conditions self-corrected then I would go manic. They tried to claim I was bipolar but it is more like I am too sensitive to my surrounds so dealing with idiots who argue with you or try to slow your progress can lead to manic behavior. The meds I took for bipolar turned me into a unambitious dull person. I had no drive so doing anything with computers other than grinding in a MMORPG was tedious and frustrating. This was not a good outcome for a Software Engineer at the beginning of a career.
I have since retooled and gone into the IT world. The best thing I did was to get off those three meds that kept me zombified. I did some online school and took some interest into repairing computers. I am married and have 4-year-old son now. However, I have had a few episodes of depression but a Vitamin D deficiency was discovered and treating that was significant. My depression cycle was seasonal so it made sense. However, there is still something else at play that I am trying to understand with my diet and physical activity. It seems that carbohydrates and protein in my diet may push me one way or the other. On the more manic side, a high protein diet keeps me tame but too much simple carbs or coffee without a good breakfast can be a bit crazy if I don't find some nuts or other protein. When on the depressed side, the carbs are a comfort but make me go into hibernation mode (no ambition and coasting through life).
Psychiatrists that see you one a month and do no testing (not even basic bloodwork) are the pill-pushers that should not be in the mental health industry. Sadly, the USA health insurance industry thinks that handing out happy pills is enough and anything more is doctors padding the bill.
I Cater to the Needs of Stupid People. - from a coffee mug Christmas gift