[slothtrop]

> Some brains are neurologically misconfigured

This is almost always symptomatic. There's a fair amount of research on dopamine depletion. Addiction, including but not limited to drug use (e.g. high-fat-high-sugar food, pornography) can show deceases in receptors. Vitamin D3 deficiency can pose a problem. Sedentary behavior. etc.

I'd recommend CBT principles to anyone, research shows they're as effective as prozac. The point is many changes can be implemented before resigning to perpetual medication.

[zxexz]

I'd be cautious of the claim that CBT is 'as effective as Prozac', or another chemical solution, in general. A cursory glance at the Wikipedia Criticisms section for CBT points out at least several concerns with the existing research[0]. Anecdotally, a family member of mine went through a complete round of CBT, for a mental health disorder, and they said that it seemed mostly just like standard therapy, and perhaps increases mindfulness a bit, but definitely felt it could not hold a candle to standard treatment. I should point out that they followed the protocol quite rigidly, and embraced the therapy with an open mind.

No doubt CBT has varying effectiveness between individuals. Somewhat tangentially, I find this[1] article cited in the Wikipedia page[0] to be an interesting read; a meta-analysis of ~70 studies, showing a seeming decrease in effectiveness of CBT over 30 years.

[0] https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy#C...

[1] https://www.semanticscholar.org/paper/The-effects-of-cogniti...

[slothtrop]

A single study is listed as being challenged. Have others:

From 2010 - "In this 36-week study, partial and nonresponders to placebo, and responders and partial responders to Prozac, CBT, and combination treatments in the 12-week trial were openly treated (TADS Team, 2007). As in Phase 1, Prozac and combination groups received additional encouragement and contact (medication management). Despite this, all treatment conditions converged by 30 weeks and remained so by Week 36, with significantly more suicidal ideation in the Prozac-alone group. The percentage of suicidal events for those on Prozac, whether in combined or alone groups, was nearly 12%, double the 6% in the CBT group. Despite the convergence of efficacy and continued risks, TADS is often cited as evidence that combining psychotherapy and medication produce superior results (e.g., NIMH, n.d.)." -- https://www.researchgate.net/profile/Dickson_Adom/post/What_...

"Collectively, the findings detailed inA.C. Butler et al. / Clinical Psychology Review 26 (2006) 17–3127 this review suggest that CT is highly effective for adult unipolar depression, adolescent unipolar depression,generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, PTSD, and childhooddepressive and anxiety disorders. The comparison-weighted grand mean effect size for these disorders when compared to no-treatment, wait list, or placebo controls is 0.95 (SD=0.08). CBT is associated with large improvements in symptoms for bulimia nervosa, and the associated effect sizes (M=1.27, SD=0.11) are significantly larger than those that have been found for pharmacotherapy. CBT also has shown promising results as adjunct to pharmacotherapy in the treatment of schizophrenia." -- https://www.get.gg/docs/Empirical-Status-of-CBT.pdf

Prozac yields a risk of side effects, and ceasing use brings a strong risk of relapse. Comparatively CBT offers a lasting solution.

[heavenlyblue]

Do you have any sources suggesting pornography leads to the reduction of your dopamine receptors?

[slothtrop]

Directly, less so. I imagine it will come because other addictive behaviors have been linked to dopamine depletion.

"Another metabolic parameter strongly supporting a neurobiological basis for natural addiction is found in studies examining dopamine receptor depletion. Wang et al., demonstrated dopamine (D2) receptor downgrading with obesity similar to that seen in drug addiction, and the levels correlated with BMI.[31] An animal study recently published by Johnson and Kenny found that rats exposed to “palatable, energy-dense food develop a profound state of reward hyposensitivity and compulsive-like eating. The maladaptive behavioral responses in obese rats probably arise from diet-induced deficits in striatal D2R signaling. Overconsumption of drugs of abuse similarly decreases striatal D2 receptor density, induces a profound state of reward hypofunction, and triggers the emergence of compulsive-like drug taking behaviors. " -- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3115160/

[diehunde]

How can be almost always symptomatic but at the same time run in some many members of the same family? When you go to see a psichiatrist one of the first questions the ask is if there's history of mental illness in the family.

[slothtrop]

That's still not causation. A history of depression doesn't mean these members all had inherent brain misconfigurations. The brain's chemistry is not static in the first place. There could be afflictions, deficiencies, environmental conditions or cognitive biases spanning generations that could lead to these issues. Everything we experience is expressed as a chemical reaction in your brain, whether you're happy or sad. No one looks at an ecstatic person's brain and assumes they're wired to be ecstatic. Grief and depression can run long.

By virtue of the success rate of therapies such as CBT and others, the evidence for inherent "bad" brains runs thin.