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When discussing depression and medication, people use the argument that medication is ineffective because they don’t agree with the chemical imbalance theory (that low serotonin causes depression.) Not only is this an obvious logical fallacy, but the chemical imbalance theory is no longer in vogue in the science circle. It hasn’t been in decades. It mainly gained traction because it was used in a few anti-depressant commercials and is now perpetuated by people who are anti-psychiatry and anti-pharmaceauticals.

Many people don’t realize this but we don’t know how many drugs work. It’s pretty irrelevant to the patient. If a drug is safe and effective according to studies, then the drug may be administered to help a patient, regardless of whether we know exactly how it works or not. If we knew enough about depression, then anti-depressant’s wouldn’t cause so many side effects and psychiatry for depression wouldn’t be hit or miss. But these facts don’t disprove that the medications as effective. If you’re depressed, what choice do you really have? You can suffer from depression for another 10 years waiting for new studies and medications, or you can take whatever treatment(s) work today and live a ridiculously higher quality of life.

There are many plausible theories on what causes depression that don’t involve low serotonin. In fact, a drug called Tianeptine is an SSRE—Selective Serotonin Reuptake Enhancer—meaning it works the opposite of SSRIs and it’s as effective for depression. (“SSREs have been demonstrated to be as effective as SSRIs against depression, have a much faster onset of action (immediate), and have a much better tolerability profile”)

Remember that in psychiatry, meds are prescribed based on the patient’s own experiences. Medication is changed, augmented and doses adjusted purely based on how the patient feels. The patient is not tested for having low serotonin or low dopamine. HOW the medication works is irrelevant to most patients and even to most doctors. Doctors may keep up with the latest studies, but to them, their primary goal is making you healthy again.

Let’s look at a scenario:

Jane is depressed. It gets worse over the years, to the point where she lost her job and cannot emotionally work anymore. She’s overwhelmed and chronically fatigued, and cannot bring herself to do much anymore. Just taking out the trash feel’s like a hard day’s work, and most of her time is spent surfing the net or asleep. She can see her life turning to shit day by day, but cannot muster up enough motivation and enthusiasm to do anything about it. She may not be suicidal, but death by atrophy or homelessness is preferred to the efforts of living.

She has friends that insist that prayer, exercise, “going out” and so forth will cure her depression. Jane likes her friends but takes her advice with a grain of salt. They’ve obviously not been depressed, otherwise how do they expect a depressed person to go out and exercise? When you’re overwhelmed, there’s a feeling that there are far bigger things to worry about and philosophize over than going out to exercise.

Things get so bad that Jane considers seeing a doctor. She feels somewhat embarrassed but knows that it’s for her own good.

Jane begins taking Prozac (or Zoloft or Celexa or any other SSRI) and feels even worse for the first 2-3 weeks. She expects this and remains persistent in taking her meds. She wakes up one morning and things begin looking up. Things are different, though she can’t quite put her finger on why. Things aren’t as bad as she had been seeing them the past few months. Living may not feel easy, but it certainly feels feasible. She gets out of bed and her house and room look different. When did it become such a mess? When did she stop caring about the stench coming from the piles of laundry all over her room? Did breakfast always taste this good? She steps outside and notices how beautiful the world is. Trees, people running about, a breeze of fresh air, was the world always like this? Just last week this same scene was monochrome. Today it’s vivid.

Now would it really matter to Jane if the chemical imbalance theory is wrong? If she were to pick up a newspaper that says in bold “Scientists Prove Low Serotonin is NOT the Cause of Depression” would that suddenly make Jane’s world monochrome again?

Jane may feel great and then one day decide to stop taking the meds. Her life goes to shit within 3-6 months. When she starts the medication again, her life is fixed, again. That’s all that really matters to Jane.

Whether the Prozac helps her depression by inducing neurogenesis (growing new neurons,) increasing serotonin, reducing the damage caused by cytokines (stress), whether it’s a placebo, or whether it signals for Zeus to zap Jane’s brain with a lightening bolt, none of that matters. Jane probably doesn’t care how Aspirin, Penicillin, her Ipod or her microwave works. These serve functions to Jane, much like the function to live offered by her anti-depressants.

Posted in Depression, mental illness at October 4th, 2010. 1 Comment.

Thinking about doing something, but never actually going ahead and pursuing it is actually more common than you think. I’ve met very very few people (none I can think of off the top of my head) who will take an idea, no matter how simple or grand, or what the potential is, and then implement it. Some start, but most will lose hype in the idea within days if not a few weeks.

When we feel hyped about an idea we have (a new project, a business plan, etc), we feel the idea is brilliant, perfect, etc, and we feel determined to begin working. This hype never lasts however, no matter how brilliant the idea is in an objective sense. We eventually sober down and will easily begin pushing the idea further back on our todo list, if not completely disregarding it as being unfeasible or stupid. Every idea is stupid unless it works.

Being a Doer instead of a Thinker requires an excruciating amount of discipline. 99.9% of people can’t do it. Stop thinking you have a mental illness or any sort of problem, disadvantage or misfortune. You don’t even have a lack of discipline, if you’re comparing yours to the average person. Sure, Amphetamine might help, but it doesn’t mean you have ADD. Depression and anxiety can hinder progress and stop you from doing pretty much anything, but it doesn’t mean not being depressed or anxious will necessarily mean you will begin knocking big projects off your list.

Understanding this may give you a more accurate picture of yourself and put you in a more positive mindset. You don’t want to be normal, you want to be exceptional. Suddenly, there’s nothing ‘wrong’ with you — instead, you have a drive to work beyond your limits and excel at what most people cannot – Doing things when you absolutely don’t feel like it. Skipping naps and other enjoyable things to get shit done.

Most people suffering with depression or anxiety never think about trying psychiatric drugs. Medications like Zoloft, Prozac, Effexor, etc are something some of the most depressed people I know would never consider trying. Can you fix depression without meds? Of course. Keyword here is can as in it’s a possibility, but there’s nothing more futile than trying to fix depression on your own; Here’s why:

Depression makes you indifferent, unmotivated and mentally blocked. It disables you. When you’re depressed, you don’t feel like doing anything. In this state it’s nearly impossible to fix your sleep schedule, exercise regularly, get out and socialize, and do anything else you might try as a ‘natural alternative’ to hard pharmaceutical chemicals. How many people that refuse to take meds because they can fix depression “on their own” actually get anything done? Nearly all the ones I know have been doing… literally nothing for the past 5 years.

Most people shouldn’t take meds, but there’s a certain number of people who are disabled because of depression. They’ve been depressed for years, probably decades, and have no idea how bad their situation is, or how much potential (and time) they’re wasting. It’s only after you’ve experienced depression, gotten over it, and fell back into it, that you realize how evil and paralyzed depression can be. It pushes your attention inwards, forcing you to just sit and think, not about fixing a problem, but about how many problems you have. About all the should ofs and and how you could of been had you did this instead of that. All the things you missed out. The last thing on your mind in this state is to get up and do.. anything.

Some people can drive themselves out of the hole, but some people can’t. These people need a kick. Sometimes a life changing experience (a death, a major accident, an acid trip etc)  can be a strong enough kick to completely turn things around. But when that’s not possible, consider fixing your brain chemistry the modern way.

One reason people are against psychiatric medication is because they don’t believe the chemical imbalance theory. And that’s OK; It’s shaky and there are numerous other (some more plausible) theories centering around brain chemistry and external/psychological issues. But so what? That doesn’t mean medication doesn’t work. Food, exercise, alcohol, Cannabis, ‘shrooms, a hit to the head, and plenty of other things can alter your state of mind chemically. There’s nothing wrong with that. Psychiatric drugs work pretty damn well even if you’re not depressed. The goal is to get you out of the loop you’re in and back on track. Drugs don’t need to be taken permanently, but in most cases, doing so isn’t even harmful. It’s normal to feel like eating natural foods is safe, while taking synthetic drugs isn’t, but there’s no logic behind this. It’s just something people believe instinctively and never bothered questioning.

Another reason people might be against meds is the cost. Pills are expensive. The cost of 1 year’s supply of some medications might be more expensive than taking an organic chemistry course and buying the equipment and precursors to synthesize the drugs yourself. Even some generic meds go for hundreds a month. Doctor visits are also pricey. Truth it: whether you’re unemployed, freelancing, 15 or 25 or 55 years old, you need insurance if you’re living in the United States. And nearly every plan (Medicaid too) covers antidepressants and anxiolytics.

Hell, Walmart has $4 generics. Point is, the cost isn’t an excuse. Most of us don’t mind paying $200-300 a month for gas, we do it because it’s a necessity, or it’s just convenient. When you’re depressed, you’ll end up failing all your $700 courses anyway, you won’t be able to work, and you’ll be spending money constantly on other health related problems stemming from the depression. Pay on credit. If you can’t make a few hundred dollars a month (those that have to), don’t you think you certainly need help in one form or another? See it as a necessity. There’s help if you seek it but unfortunately, it’s unlikely you’ll seek anything if you’re depressed. You need to make the first move. Take intiative. Do instead of think.

Another common excuse for not trying drugs is the negative stigma attached with having a mental illness diagnosis on your permanent health records. It’s a valid excuse (if you’re a paranoid schizophrenic), but ultimately it doesn’t make any sense. Nobody is going to see your records, and if they do, who cares? Who cares if you don’t get hired at some shitty firm just because the employer thinks you’re weak because you’re depressed? You’d be surprised how many people you find healthy, active and happy have a slew of mental disorders on their papers. It’s fine. It’s probably stylish. Either that or spend 10 years brooding around in your room living your entire life in your head and hoping things will get better on their own eventually – basically what depression is like.

I remember reading mental illness is usually diagnosed after 4-8 years. Way too much time to waste; To spend sitting around doing nothing. Get medicated. It rocks. And for those that still refuse to, make a note of how you’re situation is now, and then go over that note 5 years from now, and then take meds. I have a friend who’s depressed. He’s talented, but nearly all his potential is going to waste. He has been literally taking the same courses every semester for the past few years (fails them), and is always on a pattern of being social, then blocking everybody out, closing off communication for a few weeks/months, and going back into a major depression. It’s only getting worse, as all his friend’s graduate, and he beats himself up over wasting half a decade – he has no memories of the past 5 years because he’s been doing nothing.

There’s nothing worse than sitting around reading all the negative side effects of antidepressants. There’s a lot. Nobody doubts this, but you’re naturally looking for reasons you could use to justify not trying them. There’s nothing scarier than reading the negative effects of any drug you’re thinking about taking, even if you’ve been taking it for years with no problem. Sad thing is, depression itself is worse than 99% of the side effects you might (but probably won’t) experience. Just because you read a forum post with 200 comments saying “didn’t work for me!,” “made me a zombie” etc, doesn’t mean you will have the same experience. The people the drugs worked for are unlikely to be sitting around reading about the drugs anyway. And the people with bad experiences most likely didn’t give the drugs a chance. Took them for a week, had a headache and quit.

Many people who are depressed might have fantasies of running away, starting over, going to live in places like Tibet, “nature,” etc. This is common and many people suffering from mental illness have this. It’s considered a symptom. Give it a try – it won’t work. You’ll feel depressed where ever you go because your brain chemistry is broken. The brain is a physical thing. It’s very complicated, and there’s no guarantee it’s perfect. Your arms aren’t the same size, your face isn’t perfectly symmetrical, and your brain isn’t 100% perfect – and certainly not performing at its peak. This isn’t that big of a deal, and it’s best if you fix it and move on instead of dwelling on what you can’t change.

Not everybody who’s depressed needs medication. In fact, most don’t. This argument is for those who are unable to get out of the hole they’re getting themselves into. Finding justifications for their problems by blaming society and the government. Your life is in your hands and it’s up to you get up and fix it. If you feel medication isn’t right for you, then don’t bother trying it, but try something. Don’t just sit there thinking problems get fixed on their own. I’m all for the “I’ll just ignore it and eventually it’ll fix itself” solution, and that works for many things, but not for mental illness. It’s easy to hope your brain can magically fix itself, but half a decade of depression should be a big clear signal that it can’t. No matter how much the man with no arms believes he can become a pro boxer, it won’t happen.

The evil thing about depression is that it poisons your logic. We can justify anything to ourselves. Getting over depression first requires getting over the idea that you’re mentally capable of fixing yourself. Admit to yourself that your brain is temporarily out of order, and currently unable to form logic that fits the framework of a (mentally) healthy person. Outsource all your thinking and opinion forming to somebody who’s trained enough for the job. Don’t become a helpless zombie. Just accept the fact that you need help.

Posted in Anxiety, Depression, Drugs, mental illness, Rants at March 16th, 2009. 1 Comment.