[ckw]

There is no effect which is more long term than death. It is incredible to me that this is not obvious. But if you want other potential long term effects:

Lower bone mineral density, increased risk of fractures, osteoporosis

Sexual dysfunction / PSSD (Post-SSRI Sexual Dysfunction)

extra pyramidal symptoms (akathisia, Parkinsonism, dystonia, tardive dyskinesia)

emotional blunting / apathy

slowed thinking, brain fog

increased risk of gastrointestinal bleeding

QT prolongation

[robertakarobin]

I, like every other person who hasn't been living under a rock, am abundantly aware of corruption in Big Pharma and medicine. If my mother and I have both taken a given well-known medication for decades and found it effectively treated a condition that may be hereditary with no negative side effects, and my son is demonstrating symptoms similar to mine and my mother's, is it unreasonable to tolerate my son trying the same medication? That's a far cry from committing to forcing him to take the medication his whole life, or trying some mystery drug with which I have no familiarity.

[ckw]

My deepest views on this subject are personal, subjective, and more controversial. I have watched several family members take antidepressants for upwards of four decades, and I myself suffered terrible depression throughout my childhood and teenage years. Despite my depression, I always avoided antidepressants for some ineffable reason-- a hunch, a nebulous suspicion, I'm not sure what to call it. Somewhere in my mid twenties my depression lifted and never returned. I look back on my life, which has been filled with hardship, and I feel positively disposed to the suffering. The suffering made me who I am. I feel strongly that my character would be diminished had I not experienced it.

On the other hand, I watched family members take these drugs, and their lives seem somehow dulled-- filled with banal tragedy, like staying in a bad marriage, or not being particularly interested in their grandchildren. I have a theory that the drugs make palatable that which otherwise wouldn't be, hence they stay in the bad marriage, the bad job, and they watch their bad TV and eat their bad food and everything is fine. I've also seen one of them go off the drugs, and for a couple months they were a much more vibrant person. I saw them express joy. I feel a low grade rage toward the industry that I've been deprived of this version of them. I do entertain the possibility that I'm imagining it all. Maybe things really would have been worse without the drugs. But I am glad no one ever insisted, or even strongly advocated I take them myself.

[robertakarobin]

To be clear, nobody ever insisted or strongly advocated that I take medication — suggested maybe, but it was entirely my decision. And I completely agree about the importance of hitting "rock bottom." That's something I struggle with as a parent: wanting to make sure my kids have plenty of opportunities to fail, yet fail in a way that isn't irreversibly damaging. If at rock bottom I had simply killed myself rather than starting Prozac I wouldn't be around to have benefited from it.

A large part of me dislikes being on any sort of medication long-term, and think most people have the same dislike. I have gone off of Prozac a few times and always found that I gradually became frustrated and depressed again, and as you said the reason for the dislike is ineffable, so I chose to go back on. I'm fortunate to have a life with no bad marriage, no bad job, and very little trauma at all, which is also unfortunate since it means despite years of therapy and introspection and travel and hobbies and other varied experiences I've never been able to find any cause for the depression and therefore no way to fix it, other than medication. It makes me think of Captain Picard: "It is possible to commit no mistakes and still lose. That is not a weakness; that is life."

[ivell]

> palatable that which otherwise wouldn't be

Medication does not remove the need for therapy. If they are stuck in a bad situation and do not have the tools to come out of it, then in therapy they can learn about the tools and techniques.

Medication avoids having that particular day where everything hits rock bottom and the only solution seems to be suicide.

For some people just therapy is not sufficient but need also medication.

Psychiatric illness is something where many people have misunderstandings. Since many people go through depressive episodes, they feel that their experience is the same as others who are facing chronic depression. And since it is not physically visible, it is also hard to empathize with.

No one says you can come out of heart disease or diabetes by just bearing it bravely. Somehow for psychiatric illness people assume that it is something that can be braved out.

[wredcoll]

> . Despite my depression, I always avoided antidepressants for some ineffable reason-- a hunch, a nebulous suspicion, I'm not sure what to call it.

Yeah, I did that too, then I took some and I was less goddamn depressed aftwards.