Ask Lemmy
A Fediverse community for open-ended, thought provoking questions
Please don't post about US Politics. If you need to do this, try !politicaldiscussion@lemmy.world
Rules: (interactive)
1) Be nice and; have fun
Doxxing, trolling, sealioning, racism, and toxicity are not welcomed in AskLemmy. Remember what your mother said: if you can't say something nice, don't say anything at all. In addition, the site-wide Lemmy.world terms of service also apply here. Please familiarize yourself with them
2) All posts must end with a '?'
This is sort of like Jeopardy. Please phrase all post titles in the form of a proper question ending with ?
3) No spam
Please do not flood the community with nonsense. Actual suspected spammers will be banned on site. No astroturfing.
4) NSFW is okay, within reason
Just remember to tag posts with either a content warning or a [NSFW] tag. Overtly sexual posts are not allowed, please direct them to either !asklemmyafterdark@lemmy.world or !asklemmynsfw@lemmynsfw.com.
NSFW comments should be restricted to posts tagged [NSFW].
5) This is not a support community.
It is not a place for 'how do I?', type questions.
If you have any questions regarding the site itself or would like to report a community, please direct them to Lemmy.world Support or email info@lemmy.world. For other questions check our partnered communities list, or use the search function.
Reminder: The terms of service apply here too.
Partnered Communities:
Logo design credit goes to: tubbadu
view the rest of the comments
The idea that SSRI antidepressants work by increasing serotonin levels. If that were the case, why don't they start working immediately? Instead, most people don't see positive effects for several weeks.
Plus the idea that SSRIs work, period. They only work slightly better than placebo, and they count them as "working" as long as they help with a single symptom. So if they don't help your depression at all, but they do help with your insomnia, they put that in the "it worked!" pile. That's why suicide risk sometimes increases on SSRIs. They do nothing for your crippling depression except increase your motivation, so before you were depressed and couldn't accomplish anything, and now you're depressed, but also have the wherewithal to follow through on your suicide plan.
I have been having some mental health issues, and I was reading about this the other day. I was going through wikipedia with the various types of antidepressants, and it seems that SSRIs are just barely better than placebo, or even in studies not even better than placebo.
I know there are multiple classes of antidepressants out there. Are there any that do a better job, even if they are not as common?
There's different definitions of depression, for one.
And "do a better job" is going to be defined by the individual.
But there are SSRIs, SNRIs and SDRIs like Wellbutrin. They have vastly different side effects and play on different systems (serotonin, norepinephrine and dopamine) many people find SNRIs to be more effective, but again it's all the individual.
Placebos just prove that your body can heal you, it just chooses not to.
So then what does one do to heal it?
senzu bean
If you're suffering from depression, look into Transcranial Magnetic Stimulation (TMS). After over a decade on SSRIs and other meds had failed, it turned my life around in six months. Literally life saving.
The effectiveness is proven (at much better rates than SSRIs), but the exact mechanism is under study.
But... There was a recent study that suggested that many cases of depression are caused by misordered neuron firing, where the emotional center of the brain fires before the "imagine the future" bit finishes firing. Normally, when a healthy brain imagines a future state, the emotional center fires in response to our anticipated feeling. (Imagination: We're going to the movies. Emotions: FUN) But in a depressed brain, the emotional core fires immediately, resulting in the current, crappy mood being applied to every imagined future. (Emotions: Everything is shit. Imagination: We're going to the movies?)
TMS may work as well as it does because one of the things it does is increase neuroplasticity, allowing the brain to correctly order the firing of our emotional response to imagined futures.
Anyway - TMS is right at the edges of our understanding of treating depression, but it really does work for a supermajority of patients.
For me, I went from having literally lost all emotions and being essentially dead (and being willing to die), to feeling... normal. I haven't had a major depressive episode in the two years since. It's been liberating.
I duno about any that work, but if a dr offers you effexor tell them hell fucking no. Everyone I have talked to about it agrees its fucking absolutely awful. Worst drug I have ever taken.
What sort of problems did you have with it?
Effexor has some awful side effects. I have seen people complain about brain zaps but I didn't get them. For me I kept getting this weird lagging feeling in my body, like my perception of my limbs was lagging behind where they were in this very weird feeling way. Its very hard to explain but it was very uncomfortable feeling, every movement of my head was accompanied with this weird feeling. After I quit the drug the issue persisted for months after, it was legit fucked I was scared it would never go away but eventually it did.
Also effexor triggered multiple manic episodes where I was hearing voices and didn't sleep for a week. Like legit psychosis. I haven't had any episodes that bad before taking effexor and none since I quit it as well. I can honestly say it made my mental health issues infinitely worse, shit is a demon drug. TBH I don't fuck with psych drugs anymore because of my experience with effexor.
actually studies have shown SSRIs make you more depressed than placebo
I was listening to a sleep scientist the other day and they were saying that one thing we know is that depressed people have more rem sleep on average, and SSRIs decrease the amount of rem sleep.
If it is something sleep based that goes some way to explaining why it takes time to have an effect. Building up or wiping out a sleep debt can't happen instantaneously.
That’s interesting… because I always thought that REM sleep was the most important part of sleep, and more was better.
In fact, I read an article once that suggested that REM sleep was when our spinal fluid flushed all the waste material out of our brains at night (which leads to the types of dream that occur during REM sleep), which is also a process that prevents brains from being clogged with waste material.
I always thought that our brains being filled with waste material was part of depression, and that flushing out that waste material would help our brains function more correctly.
Sounds like the opposite - like, our depressed brains are depressed because they think too much?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386825/
Yeah, I think we have multiple types of sleep because we need them, and if you're getting too much rem sleep at the expense of other types it's going to cause problems.
Interesting!
Serotonin hypothesis never really held water. Congrats on guessing right, probably, we'll only see in some years from now https://www.science.org/content/blog-post/how-antidepressants-work-last
They can't work immediately because the body isn't producing enough serotonin to have an immediate effect, nor would you want that. Over time serotonin reuptake is slowed and eventually this has a cognitive effect. That doesn't help everyone but that doesn't make them ineffective.