[op00to]

This article is absolute bullshit and quite frankly dangerous. It seems to me this woman was emotionally vulnerable and taken in by a snake oil huckster masquerading as a doctor.

> Shortly after I started seeing him, my new doctor had me read the book Anatomy of an Epidemic by Robert Whitaker.

Robert Whitaker's theses in that book have repeatedly been scientifically disproven. It's anti-science drivel.

> The pharmaceutical industry also says that mental illness represents a physical problem with the brain that needs to be fixed. There are no studies that prove that this is true.

This statement is untrue. Literally three seconds of googling showed me this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471964/

Which basically says that when we deplete the body of certain neurotransmitters, people get depressed. That sounds like a pretty clear statement that there are biological processes at play in mental illness.

[ma2rten]

I am quoting from your link:

"The serotonin hypothesis of depression has not been clearly substantiated. Indeed, dogged by unreliable clinical biochemical findings and the difficulty of relating changes in serotonin activity to mood state, the serotonin hypothesis eventually achieved “conspiracy theory” status, whose avowed purpose was to enable industry to market selective serotonin reuptake inhibitors (SSRIs) to a gullible public."

[adrice727]

Johann Hari covers a lot of the history of antidepressants in "Lost Connections." Per the studies he covers in the book, most of the benefits are placebo effect. The remainder is somewhat of a mystery. Whether you give someone a medication that increases the level of serotonin in their system (i.e. an SSRI), or that decreases the level of serotonin, the effect will the be same. Replace the drugs targeting serotonin with drugs that target dopamine and you can expect the same effect.

https://www.theguardian.com/books/2018/jan/17/lost-connectio...

[Alex3917]

> Replace the drugs targeting serotonin with drugs that target dopamine and you can expect the same effect.

Anything, drug or non-drug, that has any effect on the senses will have roughly the same effect. E.g. hot therapy, cold therapy, meditation, float therapy, aromatherapy, massage, acupuncture, etc. There's nothing at all special about serotonin, it just happens to sit at the intersection of several different areas of pseudoscience and a lot of marketing dollars. The research that lead to the monoamine hypothesis in the first place was faked.

[subcosmos]

There is something special about serotonin - throughout evolution, it has been an important part of regulating social emotional processing in animals and humans. It strongly regulates the function of the salience network in the brain, alterations of which are associated with anxiety disorders.

Like other neurotransmitters, serotonin is specifically synthesized in a specific brain region, the raphe nuclei. (Dopamine is from the substantia nigra)

Brain circuits have lots of overlap but they definitely have specialization. Case in point, genes associated with serotonin processing have SNPs for depression-like illnesses.

Sapolsky gives one of the better lectures on the specific features associated with abnormal serotonin, dopamine, or neuropinephrine signaling, and their associated symptomology. Ultimately it's the job of the psychiatrist to figure out what's out of balance based on behavior.

https://www.youtube.com/watch?v=NOAgplgTxfc

[smolder]

MDMA easily proves on it's own that there is "something special" about serotonin.

[frereubu]

Although this is largely correct, there was pushback when that book was published, mostly to do with Hari setting up straw men: https://www.theguardian.com/science/brain-flapping/2018/jan/...

"Now, if your baby dies at 10am, your doctor can diagnose you with a mental illness at 10.01am and start drugging you straight away."

While this is meant as an attack on the modern absence of the “grief exception”, where grief reactions are used to rule out depressive symptoms, it’s at best a staggering exaggeration, at worst an active fabrication to support a narrative. Grief is complex and the medical community is still not agreed on how to deal with it, but the idea that you can be diagnosed with a mental health issue after showing symptoms for one minute is ludicrous. People typically require weeks of symptoms to be officially diagnosed, to suggest otherwise can only damage the perception of medical professionals.

It's a nuanced critique that's worth reading - it's in agreement with a good deal of what Hari writes rather than just being a hatchet job. My take from it (as someone with an MA Honours in experimental psychology and a neuroscience MSc) is that in those parts of the book Hari is criticising outdated practices and opinions in the field that hardly exist any more, if at all.

Having said that, the pharmaceutical industry does have a lot to answer for...

[sibeliuss]

Highly recommend this book. The way it opens, describing the discovery of placebo, was quite eye opening.

[Alex3917]

> Robert Whitaker's theses in that book have repeatedly been scientifically disproven.

The book doesn't even have a thesis. Good job not even reading enough of the Wikipedia article to plausibly pretend to have read it.

Also, did you even read the link you posted? It says exactly the opposite of what you're claiming it says. The conclusion is literally, "Simple biochemical theories that link low levels of serotonin with depressed mood are no longer tenable."

[rhizome]

Hasn't it been decades since a pure serotonin theory was tenable?

[Alex3917]

It was never tenable. The research showing that reduced levels of serotonin ameliorate depression didn’t come after the fact, it came from the original paper. The authors just ignored that when writing the conclusion.

[curun1r]

> Which basically says that when we deplete the body of certain neurotransmitters, people get depressed

Your statement represents a logical fallacy. I can also prove that depleting a car of gasoline causes it not to run, but fixing the fuel situation won't make all non-running cars functional. Just look at the more recent research that shows a connection between our microbiome and mood disorders to see that depression is often far more complex than the simple neurotransmitter model favored by big pharma.

The causes of depression are varied and what works for some won't work for others. As someone else that lost a decade of my life to the numbness of anti-depressants, I've seen first-hand the psychiatric industry's strong preference for directing patients towards medication-based approaches. Taking medication was the worst mistake I've ever made in my life and I believe that more people need to hear messages like the one in this article. In particular, I very much wish that I, like the woman in the article, had started meditation much earlier as it has become, by far, the most effective thing I've done to deal with my depression.

[iliketosleep]

It does seems as though SSRIs shouldn't be used as first-line therapy. They are powerful drugs that alter brain chemistry in ways that aren't properly understood. There are a number of low-hanging fruit which can be tried first, such as increased exposure to sunlight, exercise, change in diet, meditation, CBT and so on. But if all of these fail, an SSRI is definitely worth trying - they do work for some people.

[curun1r]

This is exactly my view. I see medication as the nuclear option. It's important to have it in reserve, since it can work, but you should try everything else first because of how badly the medication route can go. The "first do no harm" doctrine is violated by taking a medication-first approach.

[DanBC]

Depression is a sometimes fatal illness, and advice like this causes real harm.

[tomnipotent]

> I see medication as the nuclear option. It's important to have it in reserve, since it can work, but you should try everything else first

For many people this isn't an option - medication is required to even get them to a stable enough baseline for other treatment options to be effective.

Views like this are very unhelpful and help to perpetuate shame, which can prevent people that need help from seeking it because the treatment doesn't line up with the views, morals, and general opinions of the people around them.

[curun1r]

> Views like this are very unhelpful and help to perpetuate shame

No, my view is a hard-earned perspective that I've gained through personally having the system fail me. I lost a decade of my life to the medication-first mentality and I resent your implication that trying to help others avoid the same outcome is in any way dangerous.

I do concede that drugs work for some people, but views like yours that lead to over-medication are what is truly dangerous. What we need is well-rounded advice that allows patients to make informed decisions about their road to recovery. Medication is one possible path, but it's not the only path and it's not without it's downsides. It can ruin lives just as much as it can save lives, and people need to know that. It permanently alters brain chemistry, so it's an irrevocable choice, unlike almost all other approaches.

[tomnipotent]

> I resent your implication that trying to help others avoid the same outcome is in any way dangerous.

I resent bad medical advice offered on a public forum. An absolute position in anything is always bad advice when the facts are not known. Parents let their children down, I'm not suddenly going to eschew all parenting because of it.

> What we need is well-rounded advice that allows patients to make informed decisions about their road to recovery. Medication is one possible path, but it's not the only path and it's not without it's downsides.

I think we're actually on the same page, then. Recovery is complicated and we all need to do our best supporting everyone in whatever unique journey leads to their recovery. Medication and therapy (along with family, meditation etc.) are all critical to the process and you don't always get the choice of one without the other. I'm sorry that medication and mental health professionals let you down.

I grew up a little differently than most. Drug-dealing parents, foster care, hoarding, crime & violence, and much worse. I escaped it during the late 90s because I learned to do things other people couldn't (build websites), but I brought my trauma with me as an adult until - as the VP of a start-up that raised over $300MM - lost my shit and then disappeared for 2 years on a "spiritual journey" that included seeing over three dozen mental health professionals.

If it hadn't been for a chance recreational encounter with MDMA the day before my dad died of a sudden heart attack (which precipitated me losing my shit), I would have withdrew into drugs & alcohol instead of seeking the help I needed. I'm especially glad I didn't listen to all the people around me that offered bad advice ("you're fine, look how successful you are") because they couldn't possibly have known the extent of my problems.

[subcosmos]

They saved my life after a decade of trying everything else.

[loceng]

Do you mind sharing what "everything else" you tried included?

[shoulderfake]

The entire medical profession is medication-first... my brother was diagnosed with MS and none of the many doctors he talked to mentioned ANYTHING regarding diet. Meanwhile as soon as you do your own research you find out that diet is your primary means of battling it. I was also diagnosed with depression few years ago, these fucking monkeys instantly gave me some ssris...I wasn't depressed. I had a sleep problem that wouldn't go away and had anxiety but they gave me those pills first and foremost. I didnt take that shit, but you get my point.

[jschwartzi]

What was insane was me being prescribed Paxil as a teenager by a family practice doc with no psychiatric experience or consult, without any therapy, and with only a 20-question questionnaire. What was even crazier was what happened when I quit it cold turkey several months later. The whole experience makes me very skeptical of anyone telling me medication can help me because of how awful my life became.

[danmaz74]

You really trust your data point of 1.

[dang]

Please don't be a jerk on HN.

[mgamache]

There are issues with the simple Serotonin model:

With SSRIs it takes weeks to see an effect, but Serotonin levels are elevated within days why the delay? (There are theories, but all point to Serotonin as a secondary effect)

Also, antidepressants work in a minority of people (20%-25%), but Serotonin levels are effected in almost all users. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0087089/

[subcosmos]

Elevated serotonin levels drive synaptic plasticity, stimulating neurons in key brain regions to wire up. It's this increase in grey matter over weeks that is associated with better outcomes, particularly in PTSD.

This has been shown in several studies that use MRI before and after treatment, and explains the lag time.

[op00to]

That's correct - Serotonin is not the only factor. That still refutes the author's hypothesis that mental illness is some sort of personality defect.

[anyfoo]

Who’s asserting a personality defect? There are plenty of people whose depression stems from real, tangible issues in their present or past life. Solving these problems or, if they don’t actually have any active relevance to present life anymore, just processing them, has also been shown to be very effective. You don’t have to have a “defect” to have a problem.

Depression spirals and is self-perpetuating, so it has a nasty tendency to stick, but assuming that all depression only stems from a simple chemical imbalance, with no correlation to anyone’s life situation (again, past or presence) is very simplistic.

I’m not arguing for the article, but against the opposite view that all depression is rooted in chemical instead of psychological causes.

[tomnipotent]

Our society considers it a personality defect because people suffering from mental health issues have behavior that deviates too far from the average.

It wasn't that long ago that people thought cancer patients were contagious.

[subcosmos]

Viral infections are thought to contribute to 15-20% of all cancers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2267909/

[baumgarn]

I think you're stepping into a fallacy here. Of course every thought process is bound to biological processes in the brain. So we can see this as some sort of biochemical mapping of our understanding and perception of the world, and our social status in it. Why should the solution to a negative outlook be to mess with the chemistry alone, through drugs?

You can just as well ask the other way around, what kind of world and experience is leading to such a detrimental biochemical mapping. The woman in the article describes this herself, she was called fat and ugly by her father throughout childhood. This has to do with social status, not brain chemistry. I find it quite frankly disturbing that the solution to such a learned insecurity should be just drugs.

[thomasfedb]

> Why should the solution to a negative outlook be to mess with the chemistry alone, through drugs?

Well perhaps because it works?

> We identified 28 552 citations and of these included 522 trials comprising 116 477 participants. In terms of efficacy, all antidepressants were more effective than placebo, with ORs ranging between 2·13 (95% credible interval [CrI] 1·89–2·41) for amitriptyline and 1·37 (1·16–1·63) for reboxetine.

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Of course there's issues with publication bias, but this is the best evidence we have to work with. Psychotherapy ("talking") also works, and so the teaching I've received tells me to prescribe both in tandem, although the drugs "alone" do help. I'm a student doctor.

> I find it quite frankly disturbing that the solution to such a learned insecurity should be just drugs.

I think your implicit suggestion here is that the correct treatment is unlearning. I suggest that this is not always possible. The plausible mechanism is that damage during development might result in "built in" changes that can't be talked away.

[Alex3917]

> all antidepressants were more effective than placebo

Comparing them to placebo isn't appropriate, you need to compare them with an active placebo and only look at studies that continue longer than two years. Of which there are all of like 2 studies.

[thomasfedb]

You should remember that we do research on real humans. Sometime this means we can't have the evidence we'd like to have.

Active placebos are designed to cause detriment to the patient - to cause side effects to convince them they're not on the placebo. Getting ethics approval to do randomised trials in depressed patients is hard enough without harming your control group.

[Alex3917]

> Active placebos are designed to cause detriment to the patient

Patients on active placebos have reduced depression symptoms as compared with patients on non-active placebos.

[rhizome]

I find it quite frankly disturbing that the solution to such a learned insecurity should be just drugs.

Who besides you is saying "just drugs?" From what I've read, the greatest success comes from drugs and therapy.

[Retra]

Perhaps drugs are just easier? You spend 30 years learning how to be depressed, do you really want to spend another 30 learning how to unlive the last 30?

[HBlix]

If you had a childhood full of physical abuse, and your right leg was frequently broken until it became malformed, then the solution might involve crutches. All of which is to say, just because the damage done is in the past, doesn’t mean that it can’t have lasting effects you can’t just wish away. The developing human brain, it has been shown time and again, undergoes permanent changes associated with abusive environments. Those are real, physical changes that may require interventions beyond talking or therapy. It’s not just learned insecurity, it’s the biochemical changes wrought by years of stress during a formative period.

[jschwartzi]

The thing you're missing is that it is learned insecurity that is associated with the biochemical changes, and that by doing the work to unlearn the insecurity as the author did you can reverse the biochemical changes. You can't make the statement that the biochemical changes are the cause of the insecurity, only that they are associated with it. And that's very important, because an "if-then" statement does not imply the converse. That is, if you reverse the biochemical changes you do not necessarily make the learned insecurity go away.

A broken leg is way less complicated than the synapses that form your perception of yourself, and far better understood. You can't really conflate the two without committing a logical fallacy. Treating the broken leg and the brain changes as identical in complexity is akin to treating the construction of a rivet the same as the construction of a Boeing 737.

The fact is that you can change, and you can feel better, but you also have to put in the work to change yourself. It's the hardest thing you will ever do if you grew up in a dysfunctional family because it requires you to deny years of your experience in favor of the received wisdom of how the world really works, and not everyone can do this. But if you do the work the reward in the end is that you're not permanently crippled by addiction to psychiatric medication.

[HBlix]

Some people can change to some degree, some can’t. Some people for example can recover from PTSD with time and talk therapy, and if you insist on others doing that they’ll end up killing themselves. Not taking medication is just as much of a fallacious “one-size-fits-all” solution as insisting that everyone take medication.

[jschwartzi]

Parent was originally dismissing the complexity of the situation mentally and emotionally by insisting that there's just a simple biochemical thing that needs to be changed, like adding more gasoline or oil to a car engine to make it run longer. The reality is way more complex than that.

Change is really fucking hard and there's no silver bullet solution.

[dwaltrip]

Unless you believe she is lying about doing much better after quitting her meds and trying other treatments such as meditation and group therapy, the article is not complete bullshit.

That being said, I would not be surprised if there is truth to what you said about that book.

[kryogen1c]

> Unless you believe she is lying about doing much better after quitting her meds

This is an unscientific and inaccurate. The placebo and nocebo affects are real with actual health effects. Sometimes drugs don't make it to market because they have positive effects less effective than placebo.

[chillacy]

The new drugs coming to fda trials, Psilocybin and MDMA, have a huge non pharmacological component to them. The resulting experience and effect is vastly different when administered in a soft lit cushy room with relaxing settings vs a clinical lab. In that it’s only effective in the right “set and setting”. It almost looks like a strong placebo effect amplifier.

Both compounds work with the serotonin system in the brain. I’m wouldn’t be surprised if SSRIs had a similar caveat, where life circumstances and personal narrative are another factor in the effectiveness of the drugs.

Another lesson from these new drugs is that the results are delivered and pretty durable even long after the drugs leave the patient, which has interesting implications as to how it induces these changes (again not strictly pharmacological).

Which is all to say that science is still learning more, and I hope will bridge the huge gap between pharmacology and psychology.

[jm__87]

With depression, the measure is always subjective since you're trying to resolve a problem with someone's subjective experience. You can say this isn't useful since N=1, but I think it is safe to say we can take her word for the outcome - she has clearly tried many things and this has been her best outcome.

[darkerside]

Let's assume you are right and the positive effects were completely attributed to placebo effect. If placebo effect is an effective treatment that results in a cure, what exactly is your complaint?

[kryogen1c]

> If placebo effect is an effective treatment that results in a cure, what exactly is your complaint?

It's not reproducible because it's not medicine.

[darkerside]

Did you mean it's not medicine because it's not reproducible? I don't really understand the statement either way tbh.

Let's acknowledge that my question also assumed the most favorable scenario for your argument. Most objective observers would agree there is a nonzero chance that the treatment was not totally based on placebo effect, but rather on undiscovered science. You do understand that, right? That not all science has been discovered, there are many things we do not know or understand, and yet are true. If we cling to what has been proven and refute anything else, we freeze all progress. I can think of nothing less scientific.

[blurbleblurble]

Your idea of medicine is missing something important: the complex, messy, slippery, irrational, dynamic process called "healing."

[subcosmos]

It's not so much that neurotransmitter levels are just lower than they should be - reuptake inhibitors fix that problem very quickly....

A more nuanced modern understanding that we have now is that the increased levels of neurotransmitters in the brain signal the neurons to form more synapses, and this increase in grey matter in key brain regions, over months, is what has been repeatedly shown to improve the condition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790407/

https://www.ncbi.nlm.nih.gov/pubmed/23988273

Specifically, serotonin-induced synaptic plasticity changes in the anterior cingulate and orbital prefrontal cortex allow the old brain (limbic emotional areas) and new brain (neocortex) to communicate better.

[philwelch]

This sounds a lot like an indirect form of the same mechanism as TMS.

[loceng]

I am not agreeing or disagreeing with anything the author said, nor any references she makes to books or otherwise, however that's such a shallow/basic view of the brain you're putting forward as a counter-point.

The brain and physical-mental-emotional-spiritual body are far more complex than a single physical lever being pulled and a single affect happening; neurotransmitters are the transaction layer, the currency, the current/flow itself.

Likewise, there isn't only a single mechanism or cause of dis-function or dis-ease - the only possibility isn't simply because of a lack of or too many neurotransmitters needing a counterbalance; this isn't to say people some people won't experience benefit from something as simple/basic, however to dismiss other possibilities is naive, and likewise if they can so simply be helped - I'd be curious to see what simple situational-environmental impact has lead them to feeling depressed or lethargic, and whether something like a yoga practice (up to practicing all 7 branches of yoga) would have a greater impact short-term and long-term -- vs. keeping someone in a holding pattern or making them worse; the problem here then is on a societal-economic level, whereby in the short-term it's cheaper to give someone $10 worth of pills every month vs. getting them into a routine with yoga or other; it's also lazy and an extension of how we still as a society treat people - and don't take care of everyone, and that you're lucky/fortunate if you are born into a healthy (physically-mentally-emotionally-spiritually) family with adequate supports and finances, reducing your chances of being negatively impacted by the stagnant, the status quo.

SSRIs/SSNRI's themselves force a change in function by being re-uptake inhibitors, meaning they cause more neurotransmitter to linger in an area - and this doesn't seem to be evenly distributed and/or there is more going on with coping mechanisms, otherwise you could 100% predict the behaviour changes via an increase or decrease. As the author points out, there is relatively short period of testing required for these medications - and they are heavily controlled for vs. when they hit the wild for distribution [and the list of problems there is far too long for me to get into here].

There can be coping mechanisms, blocks, setup by other functions of the brain - purposefully - as a way to protect oneself from something (the ego mind, for survival purposes), e.g. insufferable conditions/experience and overwhelm that the brain/mind can't handle, and so it goes on lock-down. These drugs/medications, from my own experience, and observations of/with others - if it is such a condition with something underlying/suppression/repression going on, protecting oneself from a variety of potential things (injury from physical pain, or other).

Did you know there's a higher rate of suicide (and suicide ideation) if you take certain medications vs. placebo? This can tie into the theory that these medications force changes against self-protective mechanisms. Likewise, it shouldn't be difficult or a stretch to understand someone could be protecting themselves (from consequences), by protecting others, by blocking overwhelming anger and impulses that they learned to suppress/repress to hurt others - resulting in them hurting others, and perhaps in super violent/extreme ways due to not having coping mechanisms blocking them from doing so.

Contrast drugs like SSRIs (et al) with what I will call medicines - like Ayahuasca, psilocybin (magic mushrooms), or MDMA (reference to recent MAPS.org recent study) - that instead of forcing change in mechanism by inhibiting, it floods the brain with higher levels of serotonin that the brain normally doesn't release or have on its own (or mimics closely the serotonin transmitter). Likewise with Ayahuasca ceremonies or MDMA-assisted psychotherapy (or recreational-therapeutic MDMA-assisted dance party with friends you trust in a good environment), there is a contextual setting that will make these safer or more impactful - allowing positive and social pathways to open up (or language pathways relating to talking) - vs. a doctor spending a very short period with them out of context of the life of the person, prescribing an SSRI or other to them and putting them back into their daily life.

I was severely fucked up in different ways because of doctors prescribing different SSRIs (and the like) starting at the age of 17, and the peak/tipping point at 21-22 after more unexpected (or unknown at the time) side-effects - is when I realized I can't trust those doctors, nor those medications, because the industry doesn't actually have a proper fucking clue about them, and it's all an experiment on each individual. The medications had a cascade and accumulative affect on symptoms/problems, making me permanently worse until I could start solving the underlying problems - which ended up being in part food related, in part hearing related, in part from underlying physical injuries I had that I didn't realize I had - and I'm simplifying, it's more complex than that - and hard to believe on the surface, which is why I am writing a book to explain as much detail as possible.

I'm 35 now and only recently had significant healing of physical injury that was an underlying problem since I was a child, through stem cell injections, and will return to the US soon for another treatment to heal more of the remaining physical pain.

I hope you can appreciate your literal "three seconds of Googling" allowing you to come to a conclusion is less trustworthy (on the surface anyhow) than someone who experienced how anti-depressant medications impacted them for 24 years - and then who considers that they had to recover from that experience. I don't disagree that it is complex - and therefore difficult to understand - especially because you have the interplay of what depression, anxiety, and other, can cause behaviourally in someone without the various impact and side-effects of medications.

It looks part of her recovery was finding people she could start building trust to, who then helped her learn about emotions, meditation, and other self-awareness and social-relationship building practices. She also connected to her "inner guide"(or God, whatever she feels most comfortable or comforted calling it) which could perhaps be labeled as intuition, or as an autonomous nervous system working together well on its own without logical mind being engaged; enough learning happened via mind and analysis, to start trusting herself autonomously (trust is or is a part of autonomy), allowing the body to relax, allowing the mind to relax - as there's a feedback loop between the two: the more physical stress - the more mental stress, the more mental stress - the more physical stress.

Linking back to MDMA-assisted psychotherapy gaining benefit by tapping into language and memory pathways of post-traumatic experiences, there are other talk therapies like Innerchild Regression therapy which, in part, explores similarly early childhood relationships and learning to connect or reconnect to those - and understand them better, to process emotion that you may not have been able to before, due to an unsafe environment at the time - allowing those experiences/unhealed emotional wounds, to now start to come up and be healed-processed/learned from.

Anyway, I'm writing a book to share my full story, my experiences with healthcare, the problems I encountered and explain the solutions I propose. It will take me awhile. It will fill in a lot of details here to what I mentioned, perhaps making it easier to understand - or believe. I'm also beginning to put together applications for different stages of research, to be able to reference hard evidence relating to a protocol I've developed based on my understandings and experiences healing, recovering.

[bigmit37]

Would you be able to share how you were able to solve your problem and what the actually underlying cause was? Just a brief overview.

I’m currently on SSRIs and they actually do help me sleep, but it’s not really helping with the underlying problems.

As for SSRIs they are transformative for some people, and science doesn’t really understand the mechanism. They seem to think that there are secondary effects that are the reasons for the effectiveness of SSRIs on some people.

However, doctors seems to be too quick to prescribe SSRIs. I’ve read horror stories about people with some sort of iron-ferretin deficiency as their underlying problem and they were prescribed SSRIs instead of getting a simple iron test which would have pinpointed the cause of the symptoms.

These days you really need to do your own research and bring up all these points to your doctor.

[loceng]

It's more of a conversation that I'm willing to have with someone to, in part, see where they're currently at and what might be best to focus on first - than putting general knowledge out there, which will require a book to adequately/fully explain everything as there are many interconnected factors. To note, I'm not a doctor and don't have a medical degree.

I can say that there are non-medicative practices, along with diagnostic tools available to show concrete evidence relating to showing problems, that are transformative. The difficulty can be that if certain issues are not dealt with in parallel, or in a proper order may prevent/limit/block another therapy/practice/treatment from being beneficial/giving permanent improvement - that otherwise would be beneficial.

1) There's removing agitations from your physical body - in part, starting by getting a food sensitivity test (food panel) to check for up 184 foods that your body may be negatively responding to; also cutting out certain foods that may not show on these tests but may greatly impact you - like do you eat wheat or potato (sweet potato is fine)? Likewise, vitamin D3 liquid form is also good to take, as most of us are lacking it - 5000 to 8000 UI is good for most people, taking an initial 15-20k UI per day for a few days to load up; vitamin D3 is a steroid.

2) You/everyone should also get their hearing checked for imbalances, which can be used as a diagnostic tool to know what is going on; the brain/mind is a system of homeostasis, so it should be able to balance out to hear frequencies at even decibel levels in both ears. There's a sound therapy you can then do to unlock these behaviours, developmental blocks/delays - and resulting imbalances in sensory systems and how that can impact a person and their thinking/behaviours; this can also unlock and allow other sensory to balance out, that may be hyper- or hypo-sensitive. I know on the surface it can be difficult to believe that a sound therapy (listening to specially modified sound/the way its output) could be "magical" or so transformative, however I have my own personal experiences with such - and observing others rapid improvements. There is research as well.

3) Likewise, there's breaking down any ego mind coping mechanisms that may have solidified deeply over your lifetime - since childhood that could be causing a depressed state, or anxious, or other; ego dissolution is another term being used for this, which can be achieved in a few ways, some ways less or more rapid than others - like Ayahuasca ceremonies.

Relating specifically to sleep, it could be any amount of the above 3 influencing/impacting it enough to cause problems, or it could something in your living situation and environment as well - consumption of caffeine (stimulant) or alcohol/weed (depressants), it could be too much noise (or you're hypersensitive currently) - it could be a buildup of emotional . It could be too much energy built-up by not getting enough movement during the day or a few hours before bed.

It could be a weight issue as well or something like sleep apnea (which could be caused by or worsened by any of the above). It could be that you're trying to fall asleep when your body doesn't naturally want you to fall asleep, and then pressures from your day-to-day life of when you're expected/expecting to be awake are the problem/difficulty; the Ayurvedic clock can be interesting to look into to learn about these cycles better.

Also to point out that different medications may interfere with allowing a system to reach its normal, non-dis-eased and balanced state, once trying these treatments/practices. For Ayahuasca ceremonies for example, you shouldn't be on certain medications for at least 24-48 hours before the ceremony - different shamans have different guidelines they follow - otherwise it can be unsafe. If you eat wheat regularly, you may actually be addicted to wheat, which may be difficult to stop eating - otherwise you'll get more and more agitated because of withdrawal (another specific reason why you may have trouble falling asleep); Ayahuasca is showing to be good at breaking addictions.

Regarding your last sentence, from my experience the majority of doctors are terrible at critical thinking. I realized they are selected primarily for their memorization skills via testing, and not critical thinking. Indoctrination of old, stagnant knowledge via current academic systems, and human error are the crux of the problem.

I realized I didn't actually mention underlying problems I encountered. As I child I would have been considered to have Asperger's - however I never was formally diagnosed, it wasn't really a thing back then. I was hypersensitive - though I didn't realize it at the time - it was only after medications caused me to become severely hypersensitive to sound (hyperacusis) that I realized sound was an issue. It turned out I had developed a hearing imbalance due to painful ear infections when I was a child - primarily in my right ear; it's not the hearing imbalance itself that is the problem, it's a tool to show signs of function. Likewise, when I was 5 or 6 years old I had an painful injury to my right big toe pad - which later on I realized my ego mind had created a coping mechanism to block me from that pain and/or from the emotion of the pain, and then my development continued abnormally with that block; until I did a number of Ayahuasca ceremonies which broke down my ego mind and its coping mechanism, reintroducing me to intolerable levels of pain from many sources. Through trying different healing practices I had been doing elimination diets relating to food, and eventually did food sensitivity testing, allowing me to refine and remove what foods I could eat - and by removing all of those foods, I would feel much better, and then introducing just one again allowed the contrast for me to realize just how much pain it was causing me in my GI tract. Acupuncture was another way to get energy flowing again properly. Yoga was another way getting my body healthier, of developing self-awareness by putting pressure on the systems that signal pain and such. I'm probably missing a few things, a bit tired now from writing. I should include the tipping point related to physical pain, and that lead me eventually to exploring and finding Ayahuasca ceremonies, is that 5+ years ago - the pain from LASIK eye surgery really fucked up my nervous system: a strong tension started down the right side of my neck, and my balance on the right side became notably worse; I had been practicing yoga for 5 or 6 years by that point, so I was very familiar with single-legged balance postures.

[bigmit37]

Thank you for this. What food allergy panel do you use to get such a vast amount substances included? I was looking into food allergy panels and I was seeing blood tests for most common food allergies which included only 8-9 substances.

As for the hearing test,do I just request my doctor for one?

I’ve tried lots of accupuncture but never felt true relief. I went to some of the best accouncturists but no real relief.

Most of my anxiety seems to be somatic in form. My mind is hyper aware of sensations in my body and I get a lot of interrupting anxious thoughts that break my train of thought and cause an anxious symptoms.

The main somatic symptom is pressure on my chest which with meditation I’m able to dissolve a little a bit but can never fully open up, it takes too much time and patience and the sensations are too strong. There are also sensations on the left side of my head connect to the chest— mri was negative.

I think intense exercise might open up my chest but I don’t want to do too much damage to my knees.

I’ve started stretching everyday and hoping the head to kneees , hand to floor stretch might open up the chest more. It feels like when I stretching, some of emotional tension in my body gets released. I really need to push myself a little more though.

[loceng]

Thank you for asking! Do you have an email I can reach you at?

[loceng]

Followup: It can be a new email that keeps your identity anonymous, just want to make sure I'm sending the info to you.

[pasabagi]

I don't think an idea of depression that's based on anecdote and opinion is deeper than the mainstream account - which is limited ('shallow') because of the complexities of brain function you've mentioned. The fact is, for the vast majority of depressed people (including myself), anti-depressants work. For some people, they don't. Granted, the healthcare system is as fucked as any other system in our society, but the basic science is, if not absolutely sound, at least playing the odds.

[loceng]

Hence understanding the need to, and wanting to, do research for hard evidence relating to my so-called anecdote.

Also, do you realize you just gave a very short, one-liner anecdote - "The fact is, for the vast majority of depressed people (including myself), anti-depressants work." - while calling my long post, an anecdote? Interesting to say the least.

I'm curious, if you're open and willing to share, what else you tried relating to helping depression prior to trying medication - and what life circumstances were you in or had happened previously?

[Arbitrary4657]

Your kneejerk defensiveness is an indication that maybe it isn't "absolute bullshit" or "quite frankly dangerous." Not everybody has had the exact same wonderful experience with SSRI medication, and personally I can relate to the problems described in the article. Please don't immediately assume someone who disagrees with you is "anti-science". This isn't anti-vaccination nonsense we're talking about here.

[JustThrowMeAway]

    a pretty clear statement that there are
    biological processes at play in mental illness

It's a statement that biological processes can cause mental illness. That does not mean that mental illness has to be caused by biological processes.