We can spend a little time cultivating friends and making our communities friendlier, or we can spend a lot of money on ineffective antidepressants because we do not have enough friends and we have not made our communities friendly.
Id say Antidepressants are not a complete answer for depression. I is one of many tools for treatment, but remember depression is lethal and untreated can expose the brain to other risks down stream (plus other factors such as the cost of functional impairment whether it be at home, at work, etc...)... so the risk / benefit discussion is warranted. I appreciate what youre saying here, I havent seen discontinuation symptoms to this degree and dont discount the severity when it happens. Treating people with addictions Id say that substance and behavioral addictions can have higher risks associated with them (compared to the thought of anti-depressants being addictive) - yes I can understand your message on a continuum, in the way (a mundane example) sugar can be addictive... Related to a post below, the more I do general (functional/gegenerative) workups (with labs), I find metabolic, hormone and nutritional issues which impact mood and (in my opinion) explain (some instances) or limited or poor efficacy of treatment modalities (for example, my pts who are extremely insightful and engaged in therapy, but progress doesn't budge much)
I’ve always relied on strenuous physical exercise as a weapon to battle depressive tendencies. In my line or work, I’ve seen SSRI’s cause (IMO at least) suicide and also serotonin toxicity syndrome.
A very thoughtful post, as ever, Peter. I speak as someone who has fought clinical depression most of my life and who has been using anti-depressants on and off (mostly on) since 2002. I usually get annoyed and rather defensive when I hear people having a go at anti-deps, especially when they have never suffered from real depression. However, you sensitive airing of the issue does bring up many valid points. I probably count as one of those people for whom pills are the only real help. I've been through years of therapy and have tried every alternative intervention out there except electric shock therapy! I often try to stop when I feel less depressed, but it always follows the same pattern. I feel good for about 3 months and then the old feelings start to come back. And yes, I do get side-effects such as dizziness. Nevertheless, there is no doubt that docs do often revert too quickly to meds before offering sufferers alternatives such as therapy, and anti-deps are almost certainly over-subscribed. I also feel unease about using such powerful meds over a long period of time after witnessing what the medical profession did during Covid (I'm not vaxxed). As usual, the answer is pretty much what you laid out: a mix of therapy and medication adjusted to personal reactions and needs. Depression brings a terrible feeling of solitude and isolation ("Everyone else is so happy!") so it's absolutely essential to make sure that a depressed person is surrounded by people who love and understand them. Anyway, thanks again for a very rounded exposition of this controversial topic!
I've had my own mental health challenges over the years, and have watched those close to me grapple with them as well.
One of the issues I have with how antidepressants are prescribed is the growing body of evidence which challenges their overall efficacy. For several of them, an argument could be made that the "benefit" which is seen is perhaps little more than a placebo effect--and that is NOT how these meds are being sold to the general public.
I'm in no position to challenge anyone's approach to their own mental health, and will never tell anyone to stop taking a medication just on general principles. However, when we see evidence that people are ending up on medication far longer than originally anticipated, and especially when there is evidence to suggest that at least some patients remain on medication for what amounts to a desire to avoid the withdrawal effects, there is an ethics issue that arises which the psychiatric profession seems loathe to confront.
What I will always say is this: social interaction and stronger communal ties are going to the best and most sustainable way to buffer the mental health challenges life has a way of throwing at everybody. With or without psychotropic medications, we need more friends and friendlier communities.
No argument from me on the points you raise, Peter. I really don't know what the answer is. All I know is that anti-depressants banish my depression and other methods don't.
Hey, Steghorn21, I hope you don’t mind me jumping in with a personal story, because maybe this will be of interest to you.
In my youth, I experienced some terrible clinical depressions. The worst was in my twenties, when my apartment burned to the ground and I was left standing on the street with literally not even a toothbrush to my name. No one came to my aid, except for $50 from the American Red Cross. I ate out of dumpsters. At about the same time, the industry the I was training for completely tanked, and there were no jobs for beginners, so all of my professional dreams were destroyed. My husband of the time responded to my depression by becoming violent. It was not a good time in my life.
But even worse was my monthly cyclical despair (yeah, sorry, I know how guys love to hear about this). For decades, for about four days each month, I would have this huge cloud of despair descend upon me. Nothing but time would alleviate the depression; I learned just to tough it out. But then when I was 45, I happened to buy an unopened bottle of fish oil capsules at someone’s moving sale. I figured, hey I’m getting older and I’d read that the omega-3 fish oils were good for your heart. I started taking one capsule every day, and - without knowing anything about this effect in advance, so there was no chance of placebo effect - that month there was no dark cloud of despair! For the first time in decades! I’ve been taking omega-3 oils ever since, and I’m 68 now. I earned a master’s degree in holistic nutrition, have been taking a whole bunch of supplements for years, and my health - mentally and physically- is rock solid. I haven’t had a headache in 23 years. I haven’t had the flu in 27 years, and I haven’t gotten a flu shot in 27 years. Although not everything in my life is perfect, I never get depressed. The omega-3 oils build healthy membranes on your brain cells, enabling those brain cells to fire and function correctly. Other supplements, such as Gingko biloba, are also super healthy for brain functioning.
I hope you will consider at least trying omega-3 oils, either from fish or krill. They made an incredible difference in my life! I would be happy to answer any questions, of course. Best wishes to you!
Hi Gbill7. Apologies for my late reply. For some reason your most unspam-like response went to my spam box! Wow, that's an incredible story and very humbling! I took a lot of supplements during the Covid nonsense, and despite a weak chest, never felt better. However, I've never taken Omega 3 fish oils. That's probably because of personal bias. I work in special ed and I've heard a lot of talk of them being a miracle cure for ADHD, etc. There are many "miracle cures" in my line of work, and most of them are money-making frauds, so I probably instinctively put O3FO in that category. However, I will DEFINITELY give them a try now. Despite my "defence" of anti-deps, I'd really rather not be on them! Many thanks for your very moving personal story and may your good physical and mental health continue!
Yeah, nutrition is actually highly individualistic. Different supplements work for different people, depending on your personal nutritional deficiencies, your toxicities, genes, microbiome, etc. Our bodies evolved to function best when a zillion things are ‘in balance’, so we just need to try different strategies until we improve. In the long term, natural tactics almost always work better than short-term, artificially-created products. Of course, good sleep, low stress, exercise, healthy relationships, and so on are very important parts of the equation. Every little healthy thing you can do helps, so keep taking those small steps to a better life. Best wishes to you, Steghorn21!
For the past fifteen years or so, most people - the younger ones, especially - have been spending all of their free time on social media. They behave badly, as trolls and gossips, and they yell at each other in endless arguments. This has been highly detrimental to their mental health and that of society in general. But as AI Chatbox- type programming takes over the internet, young people will grow to regard it as mere propaganda, and not worth bothering with. I predict a time will come, probably within ten years, when young people discover how enormously rewarding it is to spend their time cultivating actual, in-person friendships. They will discover how much better it is, in every way, to have long, personal discussions, trust-based friendships, shared laughter, good times, and REAL connection. As you’ve said, Peter, we are social animals. This truth will win out in the end. History will look back on the ‘social media era’ as dystopian and unhealthy. The fact that Big Pharma filled this era with addictive, harmful drugs will also be disparaged as the nightmare that it has become.
I am your friend, Peter. And anyone reading this post: I would sure welcome any new friendships suggested to me!
Agreed! I’m curious - how old are you? I’m 68, and wondering if my perception on this is just because I remember the ‘normal times’ of living so well...
So again I’m curious, since I don’t have any grandchildren myself - when they come to visit you, will they play board games like Monopoly with you, or baseball, or anything other than their ‘devices’? Are they receptive to non-computer activities? (I’m wondering how bad it has become...)
Oh yes, we play board games, card games, etc. but only the youngest two, ages 12&14. They also play sports, basketball, baseball, football and track/field. These two are very active in sports so their parents allow screen time in their down time.
The oldest two, 15&18(18yo has been working since age15) are really good kids(good parenting)but are into video games when home and don’t interact with me much when I visit but they do have a great group of friends they’re very involved with and get together with at least weekly to play dungeons and dragons(🤷♀️)along with cooking for themselves and their guests.
A small blessing.
I also go visit them since it’s easier and they’re older now so no longer a need for babysitting, which I did a lot.
I’d like to add the decline in mental health in younger people the last 15-20 years has a lot to do with parenting and I believe if kids were not allowed phones(emergency only phones)and social media until at least 16 it would be wonderful.
Id say Antidepressants are not a complete answer for depression. I is one of many tools for treatment, but remember depression is lethal and untreated can expose the brain to other risks down stream (plus other factors such as the cost of functional impairment whether it be at home, at work, etc...)... so the risk / benefit discussion is warranted. I appreciate what youre saying here, I havent seen discontinuation symptoms to this degree and dont discount the severity when it happens. Treating people with addictions Id say that substance and behavioral addictions can have higher risks associated with them (compared to the thought of anti-depressants being addictive) - yes I can understand your message on a continuum, in the way (a mundane example) sugar can be addictive... Related to a post below, the more I do general (functional/gegenerative) workups (with labs), I find metabolic, hormone and nutritional issues which impact mood and (in my opinion) explain (some instances) or limited or poor efficacy of treatment modalities (for example, my pts who are extremely insightful and engaged in therapy, but progress doesn't budge much)
There is also some evidence that Vitamin D can help battle depression.
https://www.sciencedirect.com/science/article/pii/S1043661822005515
I’ve always relied on strenuous physical exercise as a weapon to battle depressive tendencies. In my line or work, I’ve seen SSRI’s cause (IMO at least) suicide and also serotonin toxicity syndrome.
https://modernity.news/2024/02/15/new-study-finds-exercise-is-twice-as-effective-at-treating-depression-than-anti-depressant-drugs
Exercise and good nutrition play a very significant role in mental health. That’s been well documented for quite some time.
When you get right down to it, self care is a moral duty we owe ourselves every day.
A very thoughtful post, as ever, Peter. I speak as someone who has fought clinical depression most of my life and who has been using anti-depressants on and off (mostly on) since 2002. I usually get annoyed and rather defensive when I hear people having a go at anti-deps, especially when they have never suffered from real depression. However, you sensitive airing of the issue does bring up many valid points. I probably count as one of those people for whom pills are the only real help. I've been through years of therapy and have tried every alternative intervention out there except electric shock therapy! I often try to stop when I feel less depressed, but it always follows the same pattern. I feel good for about 3 months and then the old feelings start to come back. And yes, I do get side-effects such as dizziness. Nevertheless, there is no doubt that docs do often revert too quickly to meds before offering sufferers alternatives such as therapy, and anti-deps are almost certainly over-subscribed. I also feel unease about using such powerful meds over a long period of time after witnessing what the medical profession did during Covid (I'm not vaxxed). As usual, the answer is pretty much what you laid out: a mix of therapy and medication adjusted to personal reactions and needs. Depression brings a terrible feeling of solitude and isolation ("Everyone else is so happy!") so it's absolutely essential to make sure that a depressed person is surrounded by people who love and understand them. Anyway, thanks again for a very rounded exposition of this controversial topic!
I've had my own mental health challenges over the years, and have watched those close to me grapple with them as well.
One of the issues I have with how antidepressants are prescribed is the growing body of evidence which challenges their overall efficacy. For several of them, an argument could be made that the "benefit" which is seen is perhaps little more than a placebo effect--and that is NOT how these meds are being sold to the general public.
I'm in no position to challenge anyone's approach to their own mental health, and will never tell anyone to stop taking a medication just on general principles. However, when we see evidence that people are ending up on medication far longer than originally anticipated, and especially when there is evidence to suggest that at least some patients remain on medication for what amounts to a desire to avoid the withdrawal effects, there is an ethics issue that arises which the psychiatric profession seems loathe to confront.
What I will always say is this: social interaction and stronger communal ties are going to the best and most sustainable way to buffer the mental health challenges life has a way of throwing at everybody. With or without psychotropic medications, we need more friends and friendlier communities.
No argument from me on the points you raise, Peter. I really don't know what the answer is. All I know is that anti-depressants banish my depression and other methods don't.
Hey, Steghorn21, I hope you don’t mind me jumping in with a personal story, because maybe this will be of interest to you.
In my youth, I experienced some terrible clinical depressions. The worst was in my twenties, when my apartment burned to the ground and I was left standing on the street with literally not even a toothbrush to my name. No one came to my aid, except for $50 from the American Red Cross. I ate out of dumpsters. At about the same time, the industry the I was training for completely tanked, and there were no jobs for beginners, so all of my professional dreams were destroyed. My husband of the time responded to my depression by becoming violent. It was not a good time in my life.
But even worse was my monthly cyclical despair (yeah, sorry, I know how guys love to hear about this). For decades, for about four days each month, I would have this huge cloud of despair descend upon me. Nothing but time would alleviate the depression; I learned just to tough it out. But then when I was 45, I happened to buy an unopened bottle of fish oil capsules at someone’s moving sale. I figured, hey I’m getting older and I’d read that the omega-3 fish oils were good for your heart. I started taking one capsule every day, and - without knowing anything about this effect in advance, so there was no chance of placebo effect - that month there was no dark cloud of despair! For the first time in decades! I’ve been taking omega-3 oils ever since, and I’m 68 now. I earned a master’s degree in holistic nutrition, have been taking a whole bunch of supplements for years, and my health - mentally and physically- is rock solid. I haven’t had a headache in 23 years. I haven’t had the flu in 27 years, and I haven’t gotten a flu shot in 27 years. Although not everything in my life is perfect, I never get depressed. The omega-3 oils build healthy membranes on your brain cells, enabling those brain cells to fire and function correctly. Other supplements, such as Gingko biloba, are also super healthy for brain functioning.
I hope you will consider at least trying omega-3 oils, either from fish or krill. They made an incredible difference in my life! I would be happy to answer any questions, of course. Best wishes to you!
Hi Gbill7. Apologies for my late reply. For some reason your most unspam-like response went to my spam box! Wow, that's an incredible story and very humbling! I took a lot of supplements during the Covid nonsense, and despite a weak chest, never felt better. However, I've never taken Omega 3 fish oils. That's probably because of personal bias. I work in special ed and I've heard a lot of talk of them being a miracle cure for ADHD, etc. There are many "miracle cures" in my line of work, and most of them are money-making frauds, so I probably instinctively put O3FO in that category. However, I will DEFINITELY give them a try now. Despite my "defence" of anti-deps, I'd really rather not be on them! Many thanks for your very moving personal story and may your good physical and mental health continue!
Thank you!
Yeah, nutrition is actually highly individualistic. Different supplements work for different people, depending on your personal nutritional deficiencies, your toxicities, genes, microbiome, etc. Our bodies evolved to function best when a zillion things are ‘in balance’, so we just need to try different strategies until we improve. In the long term, natural tactics almost always work better than short-term, artificially-created products. Of course, good sleep, low stress, exercise, healthy relationships, and so on are very important parts of the equation. Every little healthy thing you can do helps, so keep taking those small steps to a better life. Best wishes to you, Steghorn21!
All true, Peter.
For the past fifteen years or so, most people - the younger ones, especially - have been spending all of their free time on social media. They behave badly, as trolls and gossips, and they yell at each other in endless arguments. This has been highly detrimental to their mental health and that of society in general. But as AI Chatbox- type programming takes over the internet, young people will grow to regard it as mere propaganda, and not worth bothering with. I predict a time will come, probably within ten years, when young people discover how enormously rewarding it is to spend their time cultivating actual, in-person friendships. They will discover how much better it is, in every way, to have long, personal discussions, trust-based friendships, shared laughter, good times, and REAL connection. As you’ve said, Peter, we are social animals. This truth will win out in the end. History will look back on the ‘social media era’ as dystopian and unhealthy. The fact that Big Pharma filled this era with addictive, harmful drugs will also be disparaged as the nightmare that it has become.
I am your friend, Peter. And anyone reading this post: I would sure welcome any new friendships suggested to me!
Well said. I hope and pray your prediction of more human interaction and little or no social media becomes a reality.
It’s sorely needed in our failing society.
Agreed! I’m curious - how old are you? I’m 68, and wondering if my perception on this is just because I remember the ‘normal times’ of living so well...
I’m 67 and yes, I remember well the days before internet and “social”media.
We can see the collapse of society right before our eyes. My grandkids have no idea of what it would be like without internet. It’s terribly sad.
So again I’m curious, since I don’t have any grandchildren myself - when they come to visit you, will they play board games like Monopoly with you, or baseball, or anything other than their ‘devices’? Are they receptive to non-computer activities? (I’m wondering how bad it has become...)
Oh yes, we play board games, card games, etc. but only the youngest two, ages 12&14. They also play sports, basketball, baseball, football and track/field. These two are very active in sports so their parents allow screen time in their down time.
The oldest two, 15&18(18yo has been working since age15) are really good kids(good parenting)but are into video games when home and don’t interact with me much when I visit but they do have a great group of friends they’re very involved with and get together with at least weekly to play dungeons and dragons(🤷♀️)along with cooking for themselves and their guests.
A small blessing.
I also go visit them since it’s easier and they’re older now so no longer a need for babysitting, which I did a lot.
I’d like to add the decline in mental health in younger people the last 15-20 years has a lot to do with parenting and I believe if kids were not allowed phones(emergency only phones)and social media until at least 16 it would be wonderful.