I hope that this doesn't come over as sarcastic, but the pharmaceutical industry is a business, and they will always operate like one:
A business is about making the most money possible: Maximizing revenue is about minimizing the main costs which are generated by the activities of:
(a) acquiring the customer (through: advertising and marketing) and,
(b) retaining the customer (in this case: through dependency).
There are alternatives to anti-depressants. Some people quit depression for good with a well researched and planned LSD trip combined with long-term daily mindful meditation.
You are suggesting that depressed people may want to take LSD in lieu of SSRIs, which is horrendous advice that can, for example, trigger panic attacks in those with comorbid anxiety. Please don't.
> What study shows LSD is more dangerous than SSRI’s?
Except that's not how it works.
How it works is that SSRIs have been tested in trials, and are approved.
LSD isn't. When someone says "try LSD" (or psilocybin which seems the newest rage these days) it means they'd illegally acquire the drug (who know for sure what drug they bought? [EDIT: and who knows the dosage/strength of active substance(s)?]), and administer it recreationally without the aid of a professional.
SSRIs, in contrast, are clinically tested, legally acquired, and administered under the guidance of a professional.
> Antidepressants can also cause psychotic episodes, panic attacks, suicide, etc.
Yes, but these side effects are widely documented. There are more common side effects, btw. These are the extreme ones you mentioned, and also the most rare ones. Many side effects are temporary. And if you are suicidal, it is unlikely you get SSRIs prescribed. Unless you lie about that, of course, but if you lie to your MD you're on your own.
My recommendation is simple: seek professional help. If you don't want to take SSRIs, fair enough; your MD won't force you. Heck, they might even be reluctant to prescribe them. But professional help is much more than drugs. Think about CBT, mindfulness, under the guidance of professionals; not self-medicating new age hippies.
I agree with everything in your comment but take issue with your dismissive attitude toward psilocybin as "the newest rage these days."
Western medicine is famously puritanical toward hallucinogenic drugs. Human social history is long and hallucinogenics being illegal is comparatively recent. It's an insult to the study of science that such an interesting and powerful drug is taboo to even study. Thankfully this seems to be reversing in my lifetime.
You keep saying "professional" as if that means anything here.
The professionals that without any evidence promoted the low-serotonin theory of depression. Who, after over a decade of prescribing SSRI's finally admitted that low serotonin doesn't cause depression. Yeah, those professionals. They don't know what causes depression yet they're happy to keep prescribing drugs. But it's the "self-medicating new age hippies" that are irresponsible?
It means a lot, it means that the person who's responsible for your therapy (which might involve drugs) has studied for years (it takes a while until one's a psychiatrist!). It means they understand the fundamentals required for their title. Such credentials are worth a lot in our societies, hence the high wage. Perhaps not in the alternative medicine field where you're flocking around but realise you are the exception here; not the norm.
Also, those professionals aren't necessarily the same people. Do you fault Linus Torvalds for a bug in the Windows NT kernel because he's a software developer? Science is constantly in motion and questioning itself. The drug usage in the past before drugs were illegal (pre-2nd part of 20th century) was more irresponsible, and its thanks to science and law this has reduced. And specifically, SSRIs are more safe than antidepressants used before SSRIs such as TCAs and MAOIs.
> Such credentials are worth a lot in our societies, hence the high wage.
Lots of professionals with great titles and affiliations steer people down a totally incorrect path.
An easy example of this is Harvard study published in the New England Journal of Medicine promoting dietary fat reduction, shaping what every credentialed person would advise for diet for the next 50 years: https://www.npr.org/sections/thetwo-way/2016/09/13/493739074...
Drug companies shoulder the rep of being cold evil capitalists. Psychiatrists also become extremely wealthy as part of this medical complex, and get to keep a positive reputation. It reminds me of ticketmaster essentially being paid to shoulder negative PR for excessive ticket fees which are often largely passed on to performers.
> Lots of professionals with great titles and affiliations steer people down a totally incorrect path.
Not knowingly, and they're expert on the field. There's a few exceptions, but those people are not 100% in the head. Diederik Stapel [1] being a recent example in social psychology.
The chance that you have a sitter without a clue is much higher. Especially because those are usually "friendz". The chance a professional knows better than a self-proclaimed expert is simply too high to discount all professionals.
> Drug companies shoulder the rep of being cold evil capitalists. Psychiatrists also become extremely wealthy as part of this medical complex, and get to keep a positive reputation. It reminds me of ticketmaster essentially being paid to shoulder negative PR for excessive ticket fees which are often largely passed on to performers.
In The Netherlands, you first try the drugs which are most likely to solve your problem but also you need to consider what gets reimbursed by insurance. Insurance also wants you to go for cheapest generic brand if possible (if patents expired, and the drug is known to work for your ailment). Example: something like Concerta doesn't get reimbursed because Ritalin exists and is considered the generic form. Even though the yo-yo effect is more severe with Ritalin.
Another example, I had the option of going for a SSRI or a SSRI plus antipsychotics. The former has a good track record for people with autism; the latter combo better but it also has more impact. Regular blood checks, and basic insurance doesn't cover the antipsychotics.
As for the positive reputation, when I went for my autism diagnosis I had an anamnesis from an asshole of a psychiatrist. He was working there temporary because they fired their regular psychiatrist very recently. I don't know exactly why, but I do know it was directly related to his functioning as a psychiatrist.
Ticketmaster problem is different (and offtopic though I don't mind analogies). It can be solved by putting a cap by law on how much percentage profit (e.g. 25%) second hand market may earn. That does require political willpower and enforcement of such regulation.
That's hardly the reason for why antidepressants cause what's known as "dependency." I don't think there is malice or nefarious nature to the state of drugs in psychiatry - it's moreso that almost all the drugs that have non-subtle effects, also come with dependency. And thus, doctors' want to prescribe something that has immediacy, because most patients will have doubt and abandonment of a treatment plan if it isn't strong enough to cause immediate change.
But I would agree that the field of psychiatry (not psychology which doesn't require a medical license) has it in their interest to say that antidepressants aren't _narcotics_. And they aren't. But the cruel thing is that the difference between a narcotic and a dependency-causing-drug is blurred.
For example, Wellbutrin is a norepinephrine aka noradrenaline agonist and reuptake inhibitor. It's a stimulant - to call it an antidepressant is a bit of an ongoing joke. If someone has no energy and lacks willpower, any stimulant will get them to do things they might not otherwise have done.
The reason Wellbutrin isn't considered a narcotic is mainly because being full of adrenaline is often a shitty experience - whereas being full of a 10%/90% adrenaline/dopamine mix is quite pleasurable (ADHD stimulants - amphetamines/phenidates.) But it's entirely unscientific to say that an antidepressant cannot be addictive to a person that likes the effects more than the average neurotypical person. Just google Wellbutin abuse and you'll find a ton of personal stories.
And then lets talk about dependency. Dependency is just a rebound effect by the body to adjust its endogenous feedback in order to find homeostasis again. It's why most drugs that have large immediate "gratifying" or noticable psychological effects, also come with a downregulation in the same areas by the brain and body. So when you stop taking the drug, your body is actually BELOW baseline and it will take quite a bit of time before you are back to baseline. In some cases of extreme use, the brain can be structurally changed and permanent damage can result. See "parkinsons from stimulant abuse" for a typical example.
Dependency and addiction only have a difference in a psychological way. The physical withdrawal and rebound effects are mutual. Don't be fooled when you are told that an antidepressant drug is not a "narcotic" and isn't habit forming. It is a lie.
The only psychological drugs that are truly therapeautic are upregulators like Cordyalis, known as Yan Hu Suo in Chinese medicine. It causes neurogenesis and upregulates dopamine. It is quite a beneficial drug to consume when withdrawing from any type of stimulant or dopamine agonist.
A business is about making the most money possible: Maximizing revenue is about minimizing the main costs which are generated by the activities of:
(a) acquiring the customer (through: advertising and marketing) and,
(b) retaining the customer (in this case: through dependency).
There are alternatives to anti-depressants. Some people quit depression for good with a well researched and planned LSD trip combined with long-term daily mindful meditation.
No, I'm not saying everybody should take LSD.