(Just my personal, anecdotal experience - I have strong family history of depression and anxiety on both sides of my family and it's something that's afflicted me since I was a teenager.)
I will be extremely hesitant to take antidepressants and anti-anxiety medications ever again after my last experience with them. For me, the medications helped by tempering all of my feelings - I no longer felt sad or anxious, instead I just felt mellow and apathetic about everything. And feeling apathy is an incredibly scary thing because I also no longer derived any joy from my hobbies, from sex, from exercise, etc. I could no longer feel sad but I could no longer feel happy, either.
Even worse, I found myself engaging in behaviors I would never have engaged in otherwise, like compulsive lying. My moral code was compromised because I no longer felt the guilt and shame that normally inhibits unscrupulous behavior. I look back on that time now and I think about some of my actions and I feel nauseous.
There is value to medications that inhibit or regulate serotonin, and every individual's experience will be slightly different based on their genetics and the circumstances of their life. However, for me, even though I benefited from them at various points in my life (especially as a teenager), as an adult now I'm much more likely to depend on coping strategies I've learned through therapy than medication when it comes to dealing with my mood.
My experience was the opposite. In fact, after taking medication to fix it I later stopped because of this naturalistic fallacy. I knew it was bunting some of my emotions and I figured whatever the drugs are doing I can do with lifestyle changes. 10 years later, a daily habit of exercise and cold showers, a variety of daily natural supplements like turmeric and magnesium, and a career later.. I was no different.
I'd wonder why everything felt so hard for me, why I was so stressed out all the time. And how it could be that no one else seemed to be horrified by the existential realities of life. At the same time I wanted to participate in life so I could help change things for the better-- but damn every morning was a new battle. And then I decided to start the same medication again, and boom.
About a year later and I feel normal. It's amazing. I'm like.. is this how people feel all the time? You guys just wake up and don't dread the day? Lol it's almost funny now. They blunt my emotions.. but turns out i was hyper sensitive to everything. In an awful , stressful way. I still have white hair from that period of life.
Sometimes, medication is the answer. I had a perfectly fine life on paper yet couldn't be happy. My theory is this was because of some adverse childhood events I experienced, that seemed to change something in me. Thank God for modern medicine.
And I learned sometimes the best advice is don't listen to others-- only you know what's best for you. People are complicated and therapy doesn't always work.
Exactly my experience. I can't forget the intensity of the shock when I realized that people around me do not 'normally' dread the day. I am still excited about my hobbies and family, but do not find myself going into fight-or-flight mode for perceived fears. An added bonus that enhances my quality of life: I do not get my weekly migraines while I'm on the pill - they do return to normal as soon as I stop.
> My theory is this was because of some adverse childhood events I experienced, that seemed to change something in me.
Have you considered some sort of regression therapy such as hypnotherapy or if more adventurous, plant medicine? I sat next to a pretty senior FBI guy on a domestic US flight once. He was a hypnotherapist who claimed that in almost all cases they were able to use hypnosis to get information about what happened even if the conscious person was completely unable to recall any details.
In most shamanic traditions, a lot of work is devoted to bringing up and purging out past trauma. Examples include plant vapor baths to sweat things out, purgatives to release emotional trauma (often present in the stomach / belly) and plant medicines such as ayahuasca that act as both a purgative and help form new perspectives of past experiences.
>He was a hypnotherapist who claimed that in almost all cases they were able to use hypnosis to get information about what happened even if the conscious person was completely unable to recall any details.
There's no guarantee that the information they received was true. I imagine hypnosis is in the same category as lie detectors with respect to its...interpretability.
Even if hypnotherapy only brings out incorrect tales if there is improvement in the patients wellness I would view that as a valid treatment, but obviously there are a lot of metrics that are impractical to measure to make valid scientific statements about it. I'm not a hypnotherapist, not do I visit one.
Except for the folks accused of doing things in said made up memories - like all the poor bastards railroaded in the 90’s as part of the crazy satanic panic Bs.
Fair view. But I dont think lie detectors is a reasonabke compare. IIRC lie detectors ask questions with a true or false answer. These hypnotherapy sessions involve the individual under care to tell a story. They're typically not even aware they spoke at the end of the session.
I appreciate many think it's snake oil, I did too years ago. But have seen first hand great results.
> in almost all cases they were able to use hypnosis to get information about what happened even if the conscious person was completely unable to recall any details
In the 80s we had Satanic Panic because of false memories "retrieved" with hypnotherapy. It turned out that the "memories" were implanted unknowingly by the hypnotherapists themselves.
I'm not sure they would help as I don't actually have traumatic memories from back then. I went through stressful times when young, where I was in a society I didn't fit into and dealt with a lot of stress. I don't know why this should make me permanently unhappy, but since then I've felt this way. But no memories of that time are particularly bad, in fact I have plenty of fond memories of that time. Maybe too much stress just has some certain effect on developing brains, is my personal theory
I find those ideas intriguing in their own ways, but I'm not sure if they'd help in my situation.
Have you ever tried EMDR? If your mood issues are a result of childhood trauma or trauma-like experiences, EMDR has been researched heavily and has a good track record.
I’m not anti-medication by any means. I will probably need medication to feel OK for the rest of my life, but EMDR has augmented my treatment in a meaningful way. If you haven’t tried it, it’s at least worth looking into.
Effexor. Which is the one I hear people complain the most about in terms of discontinuation symptoms. I'm glad I tried it though, as it's perfect for me
As a contra-point to this (I feel like these sorts of threads bring out everybody who ever had negative experiences with xyz drug and that can be very harmful to those with mood disorders):
The only reason I'm still alive is due to SSRIs, they have definitely taken away some of the highs of life but they also took away the incessant thoughts of suicide. They have side effects. They suck and the idea of being physically and mentally addicted to a mood stabilizer is a huge bummer. But I know that the people around me (and you) want us around, even if it's not 100 percent of who we really are. If your meds are working for you, messing around with them because you want to "hack" your brain isn't necessarily the best course of action. Be smart.
Since calling it "talk therapy" might be off-putting to some people, here's my perspective. I've been participating in cognitive-behavioural therapy sessions for 4 months now, and the results have been genuinely astounding - I'm speaking as someone that would previously dismiss such things as nonsense. I've had trouble with sleep for the past 2 years, as in: I can't really recall a week where I slept well, without waking up. I had panic attacks. I had (anxiety-like) difficulties when talking with others that would qualify as a disability. I've had incredible trouble with stress. By now, all of that is nearly gone, just thanks to talking about my problems and figuring out the emotional patterns that are behind them.
Side comment: doing a PhD in a foreign country is no joke. First rule of doing a PhD is: don't do a PhD.
No, I continued to decline and created a plan to end my life. I told my psychologist and she referred me to a psychiatrist to begin a concurrent pharmaceutical treatment to go along with talk therapy.
> There is value to medications that inhibit or regulate serotonin, and every individual's experience will be slightly different based on their genetics and the circumstances of their life.
Not just slightly different. It can be extremely variable from person to person.
It’s well-known in medical research and clinical practice that medications likes SSRIs range from helpful to neutral to net negatives depending on the patients and situation. Sadly, too many people fixate on the potential negative side effects and avoid trialing treatments altogether.
For anyone suffering: It’s true that medications might not work out for you, but if they do address your condition and you’re one of the many people whose lives benefit greatly, then it would be tragic to avoid medications based on fear of potential negative outcomes.
> Not just slightly different. It can be extremely variable from person to person.
Not just SSRIs. I had a very bad experience with Mucinex D (or DM?) about 12 years ago, the first time I tried it. I can only imagine it was what clinical depression is like. For two days (until I stopped taking because I was so scared) I lost all interest in my life. I wasn't interested in my young children, ow my wife, or watching anything on TV I usually like, or playing a game. I was questioning my work life choices as well because nothing at work held the slightest interest. I would go home, do what was required of me, then sit in bed and stare at the wall until I went to bed.
That is, to this day, one of the scariest experiences in my life. I've since heard of one or two other people that had similar experiences with it.
It's much stronger effect is as an NMDA antagonist, similar to Ketamine. This blocks one of the primary excitatory neurotransmitters in the brain. That would be a better candidate for a depressant effect than its minor SRI property
Well, that makes sense then. Thanks for the additional info. Honestly have been kinda scared of the whole class of medication that affects mood since this experience, but I've been lucky enough to not feel the need for medication nor been prescribed any of that sort, so haven't had to make that choice.
I'm not exactly an expert on psychiatry, but I've looked around quite a bit and have yet to see any method claiming to treat "the root cause" whose evidence base isn't even sketchier than that of SSRIs.
What is the root cause of depression? That's a huge subject, and for some people even with community and a job and hobby they still feel depressed. Sometimes the underlying condition really is a chemical imbalance.
For example, adverse childhood experiences are highly correlated with depression. What's the underlying problem to tackle with a 50 year old adult who is depressed as a result of abuse as a child? Some things just change you and no amount of therapy can undo that
Within the first 10 minutes he speaks of the fact that rational thought as we see it simply does not exist. All our choices are based on the ability to distinguish a preference and that ability is based on emotion.
It would only make sense that medication impairing our emotions would also impair our choice making.
Not only that, but if meditation has taught me anything, it's that your "conscious rational thought" isn't really conscious. ...like, basically at all. The decisions are getting made unconsciously and then kicked up to your conscious attention, already made.
There is a proof for this - when you're dreaming and hear some noise that wakes you up, in many cases the plot of your dream in last second or so will be constructed around that sound - in other words, your brain would have to know the future if it was all realtime, it leaks out faking reality perception.
For additional insight, try floating this idea when the topic of discussion is something other than psychology. Better, test it on a variety of demographics (education level, etc) and see if you detect substantial differences in reaction.
This seems leading enough that I'm curious if you have more to add on the subject?
In general, I've found this idea was quite natural to me, but always seems quite foreign to others except those with a background in neurology, meditation, sometimes physics, and Buddhist circles.
People seem especially hostile to this when you start talking about the criminal justice system.
Oh, I was discussing this phenomenon whereby intelligent people can have substantial knowledge of the various complexities involved in human perception, bias, etc, and discuss it freely and competently.
However, if you take the same people and (at some other point in time) change the topic of conversation to some object level issue, they then behave as if they have no knowledge whatsoever. And if you remind them, it isn't just that they get angry (as would be expected), but they seem literally unable to recall the knowledge that they do possess.
I genuinely believe that to some degree, the default human mind can't really multi-task abstract and object level thinking, so if you throw a bit of emotion and cognitive quirks [1] into the mix, add it all together [2] into one big system, you have a half decent model for explaining why the world is the way it is.
I'm leaving a ton of stuff out of course, but this is one of the more fundamental ideas in my hypothesis.
> In general, I've found this idea was quite natural to me, but always seems quite foreign to others except those with a background in neurology, meditation, sometimes physics, and Buddhist circles.
Agree....I truly think its possible that things like Buddhism are an important aspect: if a person can't "get" Buddhism (or can't take it seriously), I suspect they will also not be able to properly understand this topic.
> People seem especially hostile to this when you start talking about the criminal justice system.
I agree and for me it is, but what I learned from that experience is how powerful and influential our emotional state is. It really made me feel like a psychopath at times because I would understand how I "should" feel or do in a given situation, but without a strong emotional signal it felt like it didn't matter what choices I made.
I think you learned something really profound (you could use it to understand others or why people even accept acting without conscience sometimes), thank you for sharing, too.
Tangentially related - I had the experience - from being in a depression - of empathizing more with people down on their luck, people who are chronically grumpy or unlikable etc, or maybe those that are afraid of unknown people. I'm not sure how to explain it, but it made me see different sides of the human experience and I got out alive.
Morals are (at least in part) based on generalising instinct. Most people would be instinctively repelled and outraged if they saw an adult torturing a child – morality is not that instinctive feeling itself, but when we reflect upon that feeling intellectually, especially when in doing so we universalise it, moving from "I am repelled and outraged by this, so I won't do it and do I what I can to stop others from doing it" to "everyone ought to be repelled and outraged by this, therefore nobody ought to do it and everybody ought to do what they can to stop others from doing it", that's when we've turned instinct into morality.
Is morality "entirely subjective"? When someone says, "Torturing children is immoral", do you really want to reply "That's entirely subjective". The very reply itself seems morally compromised, even immoral.
A good philosophical argument for the objectivity of morality is the "companions in the guilt" argument. Most people accept the objectivity of rationality, even those who deny the objectivity of morality. And yet, when we examine the two in detail, we can find a great many similarities between rationality and morality – morality says "don't do X", where X might be torturing a child, rationality says "don't believe X", where X might be the QAnon conspiracy theory; morality values states of affairs positively or negatively (moral vs immoral), rationality does the same (rational vs irrational) – in light of these similarities, how is it not special pleading to affirm the objectivity of one yet deny it of the other? To justify treating them differently, you'd need to give a good reason for doing so – but rarely is any reason given at all, and I don't think any of them are good. Rationally, we must either affirm the objectivity of morality or deny the objectivity of rationality. I think, to affirm the objectivity of morality is the better horn to take – we might even conclude it is the more rational one, if we believe that rationality itself requires belief in its own rationality. Hence, morality is objective.
> Most people would be instinctively repelled and outraged if they saw an adult torturing a child
This, regardless of how you feel about the subject matter, is a factually false statement. That's not how instincts work, or what they are. Additionally, even without that error, the statement holds false.
Not sure if you ever tried a DSRI but it could be your serotonin levels are fine but your dopamine levels are out of whack. SSRIs are just one class of drug. Speaking from a history of anxiety and depression, the wrong drugs were not helpful, but the right drugs opened up a whole new version of self. In my case, that was buproprion.
Same situation as you. SSRIs seemed mostly ineffective, or sometimes had crazy side effects (will never forget Effexor-induced zaps despite tapering off following the directions to the letter). Bupropion has been fantastic for me since I started and I wished I'd found it 20 years ago.
That’s great! Bupropion caused a psychotic episode for me maybe ten years ago. Most terrifying day of my life, when the razor blades were calling out to me telling me to cut myself. To be clear, I’ve never had anything like that happen before or since. My daughter spent 9 months in the NICU and got genetic testing for various drugs, with 1 being the baseline expected (I’m going off memory here) and 9 or 10 being “wtf this is super weird”. She got a 9 for bupropion. I’m assuming she got that from her father.
> My daughter spent 9 months in the NICU and got genetic testing for various drugs, with 1 being the baseline expected (I’m going off memory here) and 9 or 10 being “wtf this is super weird”. She got a 9 for bupropion.
I've never heard of that. Why would they be testing an infant for their reaction to an antidepressant drug? Just curious.
The genetic tests use genotypes to make statistical inferences about efficacy and metabolism for certain drugs. Wellbutrin is a common medicine, and the testing company probably had it as part of their panel.
Wow, sorry. Bupropion is an SNRI, not SSRI. SSRIs are 'dangerous' IMHO, except for the special cases mention here (suicide ideation, extreme non-functioning).
I would have hoped clinicians would start at the lowest possible dose, and titrate up. I've certainly heard of the "you need about xx mg, use this dose" first doses, tho.
To me, this is Yet Another reason one should never receive medical advice alone, especially when thinking is impaired. That trusted friend / partner needs to ask the hard questions of the prescribing clinician; but rules make any 3rd party except spouse difficult for adults.
> I think anxiety and depression are related. I was prescribed SSRI for anxiety.
They often accompany one another. I've had panic attacks in the past, and was diagnosed with generalized anxiety disorder. I can't claim that bupropion fixes panic attacks proper, and I'm not a doctor, but it does help me with my depression. (I haven't had a panic attack in a long time.)
It's not a silver bullet; you can still find yourself in mentally stuck states, the difference is the physical side of things seems to be 'gated' at the low end so that your spiraling down isn't as deep as it is before. There's still a lot of work to do to recognize + slow that descent, but it is a tool to help with that.
Mirtazapine can help with depression, anxiety and panic, and it isn't an SSRI. There are also newer drugs that are marketed as SMS drugs instead of SSRIs, like vilazodone and vortioxetine. Buspirone binds to 5HT1A directly, instead of inhibiting the serotonin transporter like other drugs.
Wellbutrin and NDRIs typically aren't that great for anxiety, but they can help.
True. But it won't be easy. You will mostly likely be put on combination therapies first. Then onto combo SSRIs and Antipsychotics, then maybe you might get something that ups dopamine, maybe. If you look a bit bipolar though you'd likely go onto a mood stabiliser (i.e. calm the f down you over-active neurons, have some more gabba/ block those calcium channels etc). and personally that's what worked best for me, over active mind induced perpetual exhaustion -> anhedonia from the stress of a mind that never stops.
I've used SSRIs a long time ago with therapy, and without a few years ago.
In my opinion, SSRIs should only be used as a tool to help make the patient more receptive to therapy.
It should never ever be used a substitute for therapy. I too have noticed that without someone to help keeping your behaviour in check, some undesirable (but not necessarily dark) personality traits could take over. Not to mention that someone needs to be there to check on you during the first weeks of use when the drug actually causes a deeper depression before it starts mellowing your feelings.
BTW. My second SSRI use also left me with permanently dry eyes and nose: me needing eye drops and to avoid dusty, dry environments for the rest of my life.
I loosely agree. I feel SSRIs should be used in cases where someone feels so down they cannot function. Once they are functional enough for therapy and other support, they may want to consider carefully stopping.
Anecdotally I had the same response. I found they helped anxiety a lot, but did not help depression as I just felt even more disconnected and apathetic to things.
What helped me was switching away from a first-line SSRI and onto something a bit more niche: Mirtazapine. It's definitely worth trying a variety of SSRIs because everyone is different and it's really common for the first one or two that you try to not work well.
I agree that ultimately therapy/coping strategies are the right cure, medicine is a way to bootstrap otherwise incapable people into persuing exercise, therapy, social stuff etc. If you can achieve that without the help of meds, more power to you!
Had similar. Was suffering from clots and doctors decided it was anxiety. I stopped caring about anything. Saw a love one injured. I felt nothing at all. Someone whom I was normally very protective.
Never took another pill.
Regarding lying, I actually brought this up in my last therapy session because an SSRI gave me the opposite effect. Taking sertraline greatly reduced my ability (or rather, willingness) to lie. My psychiatrist attributed it to my improved self-confidence while on the drug. I'm not totally convinced. I do feel greater confidence indeed, but it seems like I'm less worried about what others think of me. It feels like there's not too much to gain from lying.
I have taken other SSRIs before, but it is puzzling how each one has its own particular behavioral effects even though they all are increasing serotonin.
I strongly encourage anyone reading this to watch Dr Ben Sessa's lecture on using MDMA to treat addiction and trauma.
https://youtu.be/11u7iX4j1tA
The reality is, SSRIs and other pharmaceuticals that have been used to treat common psychiatric illnesses (anxiety/depression) have dismal outcomes and fail the vast majority of patients that they have been given to.
Fortunately, there is a growing body of evidence that MDMA and psychedelic assisted therapy could revolutionize the treatment of mental health disorders.
Unfortunately, for the last 50 years, governments, industry and the military industrial complex (together with the MSM) have spread lies and scaremongering to block the therapeutic use of these life-changing therapies.
Here is another video for anyone wanting to know more about the topic:
(Lecture by Prof. David Nutt: The New Psychedelic Revolution)
I'm optimistic that the next few decades will bring about better approaches to these massively underserved (and largely exploited and discarded) people.
> I will be extremely hesitant to take antidepressants and anti-anxiety medications ever again after my last experience with them. For me, the medications helped by tempering all of my feelings - I no longer felt sad or anxious, instead I just felt mellow and apathetic about everything.
For some folks this is actually roughly the ailment that they suffer from:
> Anhedonia is a diverse array of deficits in hedonic function, including reduced motivation or ability to experience pleasure.[1] While earlier definitions emphasized the inability to experience pleasure, anhedonia is currently used by researchers to refer to reduced motivation, reduced anticipatory pleasure (wanting), reduced consummatory pleasure (liking), and deficits in reinforcement learning.[2][3][4]
For me, serotonin blockers just made me asexual. It was a flat organ even when activated. It also defeats the purpose of taking antidepressants to enter a more positive spiral with girls… But it is also very frightening as a man.
Ironically, it is actually serotonin blockers that can help with SSRI sexual side-effects. Activation of 5HT2C via SSRIs is what is hypothesized to be responsible for those specific side-effects, and blocking 5HT2C can help alleviate them.
That truthfully sounds like symptoms of hypomania, which can be exacerbated by antidepressants. If that's the case, then antidepressants alone were not a good choice for you, because they are meant to only treat depression.
Sounds like anomie. What did your therapist say about this? Different anti-depressants have different effects. Not sure what you were on, but if it was an SSRI, perhaps a tricyclic would have been better, or vice versa.
The symptoms you explain are why it is important to pair therapy with antidepressents.
I'm very surprised your therapist did not alter your scrip.
They did. If it's prescribable as a medication to treat anxiety or depression in the United States, I've tried it. I try and keep a very open mind, so even when many medications didn't work, I continued to try new ones and combinations with sufficient trial periods, but in the end what worked best for me (at that point in my life) was just not taking anything at all.
I'm not saying medication is not effective - it was extremely effective for me in different phases of my life and probably saved me from suicide, however in my adult life I found the emotional blunting and apathy that came with not just SSRIs but DSRIs and other classes of medications to be extremely concerning.
Psychedelics seem very promising for the treatment of PTSD at some point down the line, but it’s not even close to studied enough. E.g. a recent promising study in Nature was 90 participants. Taking street MDMA is not the same as being administered MDMA in a clinical setting as an aid to talk therapy.
I am enthusiastic about the advancement of research in this area and frustrated that it was delayed for so long due to political reasons, but please keep in mind that people with mood disorders or trauma can be desperate and may not make the best choices for themselves on their own.
Are you familiar with the Maps.org study and results? 100 participants with 17.5 years average of treatment resistant PTSD. The placebo at the end of 1 year: 80% had no improvement, 20% some [expected], the group who did just 2-3 sessions with therapeutic dose of MDMA (100-120mg) at the end of 1 year: 80% no longer qualified for PTSD diagnostic, 20% had some or no improvement; MAPS released/published their 69 page guide for therapists - the two main important components being varied music selection (with more specific definition/explanation given), and an empathetic listener - someone present who will actually fully listen and respond whole-heartedly if the client needs to share something.
Your final sentence also rings true for any remedy including SSRIs which many people have been harmed by, likewise your pointing out to this research not advancing due to political reasons - including system and regulatory capture - can be applied to existing treatments that were approved but perhaps should not have been; the conspiracy hypothesis that's becoming mainstream is that things like MDMA, psychedelics et al, were suppressed by for-profit industrial complexes via "the war on drugs" because pharma's patented daily-use recurring business model products couldn't compete with the very cheap to make, administer "2-3 times per year" chemicals that don't have anything close to the same "side" effect profile.
You can see how this regulatory capture still has a hold in Canada for the alcohol industry, where alcohol's a known carcinogen, and as a society we put warnings on tobacco products but no such warnings on alcohol - and this isn't the only incongruence in Canadian policy/culture.
As someone who has done both on multiple occasions and not come out of the experiences suffering any less, I can say that these are by no means the panacea they're often held out to be. It's fantastic that these options seem to be very helpful to many, but I feel that MDMA and Ketamine - as well as Psilocybin - are suggested with far too much confidence on the outcome.
Lot's of cases of depression actually start with inflammation in the gut or in the brain, or other gut related diseases. Diet and lifestyle is a safer and better treatment.
Caveat: If you have dissociative symptoms, are prone to anxiety, have a family history of psychosis or have a psychosis in your symptom profile, seriously reconsider the above advice.
Ketamine (as its S-isomer) is approved by the FDA for treatment-resistant depression.
Note that while the evidence for Ketamine's antidepressant effect is actually strong, that does not mean you should get into the habit of snorting a gram of special K a day.
Ketamine abuse is known to cause serious, practical damage to the GI tract, the urinary system, the liver, and the brain.
Although a ketamine treatment plan for depression requires subanesthetic doses once a week at first, and then once every two weeks. It's also habit forming enough that it's difficult to not overdo it due to its effects on dopamine. It has some definite utility, but it's the kind of medication that is hard to use alone
Experimentally, it works. There are theories (google will give you a couple vaguely plausible mechanisms), but it's too early to say. And it's likely that the antidepressive effect of ketamine has nothing to do with its NMDA antagonism, given that other NMDA receptor antagonists do not work as antidepressives.
Neuroscience theory lags far behind applied psychiatry, so all know is people whose depression resists normal treatment now have another very promising option, with a very different mechanism from normal antidepression treatment.
Dissociatives are the most under-appreciated class of drugs.
Mechanisms of action are difficult to be objective about. It is a lot more complicated than dopamine and serotonin regulation and uptake, receptors and antagonists.
Today was pleasant, despite every reason not to be. It's like the "hope" qualia.
Thank you, this is what I was looking for. So - on biochemistry level we don’t know why it works. But somehow, controlled temporary disassociation seems to… interrupt negative ideation?
The assortment of medication available for depression is laughable. Even for other neurological disorders, they're so unselective and "broad spectrum," affecting numerous other systems, that it turns into an absurdity: how are we this far behind? Wasn't modern medicine supposed to equal better living?
It's like zero thought has been put into quality of life by practitioners, so long as their metrics are met
E.g. "x, y, z attributes on the ABC scale went down. Looks like you're in remission!"
"But doctor, my dick doesn't work, I've gained 40lbs, and everything feels flat."
"We can prescribe a stimulant for appetite suppression, a vasodilator for the libido... but the 'flat' is all in your head. I'm going to write you a recommendation to a psychologist so they can talk to you about it."
Absolute ninnies.
I understand what you mean about engaging in out-of-personality behaviors, lack of moral code, and the nausea and panic that accompanies the memories of "who you were" on a certain medication (they do go away, with time. And they lose their emotional impact once you accept that it was due to medication, and rationalize it away). They warn you that there might be personality changes, and you'll feel different, but I don't think they understand the absolute gravity of what that means. Even pharmacists go on their soapbox every time you ask for a different brand (because X brand doesn't feel the same, and the FDA has issued numerous warnings about quality control): "the only thing different about brand name medication is the marketing. They're all bio-equivalent and it's all in your head." Fuck off.
This isn't even addressing that it's likely most of the "anti-depressive" effect is placebo in SSRIs and the like. "Oh I feel very different now from this medication. That means it's strong, and effective, and I should be getting better now"; it's in the same vein as chiropractic, except with more woo-woo and theatre ("modern medicine!!!").
There are better substances that can be used off-label/aren't "copyrighted" that actually solve emotional issues by (properly) regulating neurotransmitters and genomic expression to achieve pro-humanist results, instead of soulless pro-metrics and "quantitative" results. But they're not being marketed, because the current batch of psychoactive chemicals is riding on decades of marketing and "works" (see: generates outsized profits).
In my opinion, almost all of these have been a net-negative on society. Opiates, benzos, "anti-psychotics," "anti-depressives," and the like: they're all shit.
There are better chemical (and lifestyle solutions) to these problems, but right now the medical complex has a hard-fought monopoly on health treatment; so anything that would usurp power from them is a no-no (a la "fuck pro-consumer, I'm getting mine").
Most people's androgen:estrogen balance (and levels) are absolutely off kilter, if they live a modern life (no exercise/only exercise is the gym, lack of sunlight, sitting down all day, living in a city, braindead birth control protocols with only estrogens, etc.).
Tuning that would be the most beneficial. And it would get to the root of the problem viz. fixing a mismatched upregulation/downregulate of neurotransmitter receptors (f.e. increasing sensitivity of GABA receptors, decreasing sensitivity of noradrenaline receptors, and so on) -- instead of just a simple and stupid "hur dur lets flood the synaptic cleft with serotonin/dopamine/catecholamines."
Barring that, there exist others that do not disrupt one's natural HPTA, and are more "targeted" towards neurons, rather than the whole body.
Peptides:
There are an assortment of peptides, but their main uses are specifically in gene expression/and cell signal tuning. They're hit or miss. A lot of woo-woo shit going on, and many people hype them up as a cure-all (because there's money to be made); when that's taken into account (and the lack of extensive research), you'll find an assortment of chemicals to play around with.
Russian synthetic adaptogens:
These are their own category of "adaptogens" popular in the Russian medical community (and seeing Western adoption). E.g. semax, bromantane, selank etc. They act as hormones/signaling molecules by changing the expressions of genes (leading to downstream changes of natural peptide levels, behavior of psychological/catecholamine systems, and so on).
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All of these, in my opinion and experience, are leagues better than the garbage that is peddled by the U.S's medical community -- because this actually changes shit on the genomic level, rather than fucking with the physical processes outright (ex. imagine the difference between cloud seeding to get more rainfall vs. diverting rivers, to fill aquifers. One of these is much more sustainable and has less side-effects).
Someone else took a look at your [0] and reported that your description doesn't match what [0] actually says. So I thought I'd take a look at [1].
[1] is a letter to the British Journal of Psychiatry by one Gordon Parker. It does two things: first it briefly mentions a study by Kirsch et al which you can find at https://journals.plos.org/plosmedicine/article?id=10.1371/jo... and then it makes some comments on the significance of that study's results.
It's the results of Kirsch et al that you're referring to here (Parker says that they found that "newer antidepressant drugs are equivalent to or no better than placebos"; the rest of Parker's letter is concerned with the question of what the study's findings mean.
So, two questions. First, since Parker rather than Kirsch is what you cited, does Parker in fact say that "long term outcomes on psychiatric drugs are no better than placebo"? Nope. He says there are three possible explanations for results like Kirsch's: (1) the drugs are ineffective, (2) the analyses are no good, (3) something about randomized controlled trials makes them unsuitable for answering this sort of question. "The third explanation – that there are substantive limitations to current procedures for testing antidepressant treatments – is argued here as the most sustainable."
OK, so the source you're citing doesn't agree with your claim, but maybe the source he cites does? I linked to Kirsch et al above, and have two observations to make. The first is that "no better than placebo" is better than it sounds, because it seems that placebo is actually pretty effective against depression! The second is that what they find is, unequivocally, not "no better than placebo". It's "not very much better than placebo". Their exact words: "Although the difference between these means easily attained statistical significance [], it does not meet the three-point drug–placebo criterion for clinical significance used by NICE."
(Kirsch et al also looked at whether these effects differ depending on how bad the depression is. They do: if you are more severely depressed, the effect of antidepressant drugs isn't very different but the effect of placebo decreases as the severity of the depression increases. Which again looks to me as if the situation is more "placebo is pretty good for depression" than "antidepressants are no good".
So I'd say you're zero for two at this point.
I took a quick look at [2] as well, because why not.
Right in the abstract it says: "There are no placebo treatments." so this is definitely not offering any support for a comparison between antidepressant drugs and placebo. Maybe it's intended instead to support your claim about relapse rates after long-term use followed by discontinuation? Doesn't seem possible, given the study's purpose and structure.
They were trying to answer the question: if you're suffering from depression, and the usual antidepressants don't do a good job of treating it, what else might work well?. So the plan was to take a bunch of patients with major depressive disorder, and give them 8-12 weeks of citalopram. If that works well, they're out of the study. If not, they get some other treatments, involving some combination of other medications and/or cognitive therapy. If that doesn't work, they try some other drugs. If that doesn't work, try some other drugs. And then, if the first antidepressant didn't work well but one of the later things did, keep them on that for the next 12 months and check monthly on how it's going.
You will note that nothing in this description offers any way to look for relapse rates for patients who use an antidepressant drug for a prolonged period and then stop. The only patients who are using an antidepressant drug for a prolonged period in this study aren't stopping.
So what did the study find? Well, the page you linked to says ... "No results posted".
Maybe you just posted the wrong link. It appears that the study was actually done. There is some information about the results here: https://www.nimh.nih.gov/funding/clinical-research/practical.... I don't see anything there that looks like it supports any of your claims.
Zero for three. At this point I don't feel much enthusiasm for checking your other two links.
Your source for your last point has the conclusion of:
“Although these biases did not significantly inflate estimates of drug efficacy, reporting biases led to significant increases in the number of positive findings in the literature.”
Which is literally the opposite of what you’re citing on efficacy.
This person’s citations don’t agree with their claims at all. It’s disappointing that the comment was so highly upvoted when it was so obviously falsified.
Insulin is a bad example. Research has shown that many type-2 diabetics no longer need exogenous insulin after they make the correct lifestyle changes.
The person you're replying to has multiple sources to defend their comment. It's not a big secret that antidepressants are overprescribed and extremely easy to obtain. Sure, they have their uses and may be life saving to some, but their use should also be questioned from time to time.
> The person you're replying to has multiple sources to defend their comment.
Click their first citation. It’s a study that shows that people who discontinue their antidepressants are more likely to relapse than people who continue taking them.
It also says that relapse is more likely if the person was depressed for longer before receiving treatment (e.g. excessively delaying treatment made relapse more likely)
It doesn’t support their wild anti-psychiatry rant at all. Don’t be fooled by off the wall comments that try to overload you with a list of citations that they know most people won’t read.
I spot-checked your first citation and it doesn’t support your claims in the slightest. It literally says that patients who continued taking their medication had lower relapse rates than those who stopped:
> > Compared with patients whose antidepressants were discontinued, those with continued treatment showed much lower relapse rates (1.85 vs. 6.24%/month), longer time to 50% relapse (48.0 vs. 14.2 months), and lower 12-month relapse risk (19.5 vs. 44.8%) (all p < 0.001).
It literally says that antidepressants work.
> The common belief that these drugs are effective treatments (esp. in the US)…
They diverge from placebo and are effective treatments. It’s not a US thing at all. I don’t know why you think it’s limited to the United States, but then again the rest of your post is full of misinformation.
Please stop parroting this anti-psychiatry nonsense and trying to use studies that say the opposite of the misinformation you’re trying to spread.
I don't think it's very helpful to vaguely bring up "supplements" like that. There are so many, and they range from being harmful, to being placebos, to being actually helpful. Plus there's a huge amount of utter quackery around them.
Do you have any specific "promising" ones in mind?
This is why antidepressants should only be used during periods of crisis when a person is at risk; in my opinion, for no longer than 3-6 months at most, after which they should be tapered off and transitioned to a more sustainable long term treatment modality.
Lost Connections is a very good book on the topic. Read it, the author points out in countries where people don't have 3k a month for pysc meds, somehow they aren't all miserably depressed. One story is really sweat, a poor farmer is helped by his community after being left unable to work. In the west we'd say file for SSI and get some SOMA.
The entire mental health industry is focused on extracting as much from vulnerable people as possible. Unless you have a spare 1200$ to 1600$ a month laying around you won't be able to afford therapy anyway...
This article was published in 2010, he had to resign his faculty position at Harvard in 2011, and was found guilty of scientific misconduct in 2012 by the government Office of Research Integrity.
> They concluded that Hauser had fabricated data in one study, manipulated results in multiple experiments, and incorrectly described how studies were conducted.
Huh, given that something like 15% of Americans are on SSRIs, I wonder how this affects the political landscape (which seems overrun with a new kind of moralizing in the last few decades)
You should be more concerned with the psychological effects of birth control, which in my opinion are drastically understated and underesearched. We are toying with the hormones of tens of millions of women and the vast majority are unaware of the potential differences in decisionmaking and behavior.
There are secondary effects as well, for example, women have been shown to select for more dominant, aggressive men when fertile and meeker providers when not - how might that shape our social landscape, if a sizable proportion of women are kept permanently in a hormonally induced infertile state?
not to mention the risk of blood clots. my wife had thrombosis and nearly died because of birth control meds, and once you look into it, it's more common than you'd think and women do not get nearly enough warning about the risk. All her friends went back to condoms and those more localized IUD hormone things
If millions of women haven't noticed a change in behavior in real life my default assumption is the change of behavior only occurs in the artificial conditions created by the researchers themselves.
This assumes most people notice most changes in their behavior in real life. Some may subtly change over time, others may be in blind spots... and it's not like many people are tracking themselves in this kind of way. You might be overestimating people's introspection here. Think of all the people who start overeating without noticing or even start doing something radically different without reflecting.
And you may be overestimating the reliability of brain science studies.
If scientists had a camera and microphone in every room on earth (which is of course impossible) they would learn a lot more about humans than they would with studies in artificial lab environments where they have to guess if the results have any applicability to real human behavior in real human environments.
When did society have a lot of empathy? We're nowhere near as crazy right now as 1970, 1930… not even 1990, you should see the violent crime stats then.
There is something like Serotonin Irritation Syndrome which can cause aggressive feelings and thoughts. Personally I tried to increase my serotonin twice, once with Tryptophan a few years ago and recently with Inositol. Both times I felt very aggressive. Maybe I should use it right before a chess game, who knows it helps ;)
It is sometimes mentioned that for people who are sensitive to psychosis (like me) this can be a tipping point towards aggressive behaviour.
I tried an SSRI for a month, after the first week I was getting into more arguments for no reasons. Usually I'll have some (at least vague) lucidity as to why I'm upset, but at that time I didn't and it made me feel quite stupid. Never doing those again.
> They’ve been linked to road rage, pathological gambling, and complicated acts of fraud. Some make us less neurotic, and others may even shape our social relationships. It turns out many ordinary medications don’t just affect our bodies – they affect our brains. Why? And should there be warnings on packets?
> We’re all familiar with the mind-bending properties of psychedelic drugs – but it turns out ordinary medications can be just as potent. From paracetamol (known as acetaminophen in the US) to antihistamines, statins, asthma medications and antidepressants, there’s emerging evidence that they can make us impulsive, angry, or restless, diminish our empathy for strangers, and even manipulate fundamental aspects of our personalities, such as how neurotic we are.
> If these claims are true, the implications are profound. The list of potential culprits includes some of the most widely consumed drugs on the planet, meaning that even if the effects are small at an individual level, they could be shaping the personalities of millions of people.
Mirapex, given for Parkinson’s, it’s truly scary. There are entire forums dedicated to the broken families due to the gambling auctions caused by it. My brother has been on it for two decades, so my family has gotten to watch the effects first hand.
It's crazy how our brains and bodies are just a cocktail of hormones and neurotransmitters. Change that mix, and it can change the very nature of who we think we are. Things that you might associate with your very identity, like optimism/pessimism, ability to focus, moral judgment, how collaborative or generous you are, aggressiveness, all can be influenced by hormones or neurotransmitters.
Yes it brings up uncomfortable questions about free will. Like “why did he murder that guy? did he choose to do it or did the chemicals in his brain force him to?”
Uncomfortable questions indeed. It is honestly hard to comprehend how people believe in it at all. I understand that people do, but it’s mystifying, like a belief in god or even Santa Claus.
Regardless, justice systems (incentives and accountability) and incarceration (incentives, and ideally rehabilitation) have nothing to do with free will. Any connection between free will (presence or absence) and the justice system seems to stems from some weird idea that it is about “punishing bad guys” or balancing some cosmic ledger. It is not. It is about controlling people just enough to ensure the long-term maintenance of society, as imperfect as our current implementation is. Look up Restorative Justice for approaches that focus on restorative outcomes for all involved, eschewing punishment and eye-for-eye thinking.
The cancerous cell does not carry any moral value; and neither does the immune system that destroys it. The cell infected by a virus is a victim of its circumstance, but that does not mean the immune system is should not destroy it.
Who is the Creator’s creator? If you can accept that the Creator came into being and created the universe, you can skip a step and just say the universe came into being.
This is why we should think in terms of problem solving rather than "responsibility" in the traditional sense and punishment. The person is "responsible" in the sense that it was their body (i.e. them) that did the crime but that doesn't actually tell us anything. If the point is to prevent further such crimes then the conditions that caused it have to be prevented in some way or another. That's the original problem that retribution (and it's later reforms) was solving.
Until we have effective behavior-altering treatments that 'correct' people we have to insist on personal responsibility so that they can be put in prison.
I think you've missed a step jumping straight to prison.
If you accept a lack of free will, the solution does not need to immediately jump there but rather to finding a way that is fair to all to prevent the bad behavior thing from affecting others negatively while not locking someone up in a cage. There are many lines in between and some penal systems have adapted, but the US is way far behind there.
The optimization is no longer about revenge / punishment but about altering the scenario of the world to make everyone work together better. Sometimes people need to be fully separated from society, but not often. I think we do have effective behavior altering treatments, but they just aren't drugs and take time. But it's not a straight line from "it takes time to help people and its unreliable" to "we're giving up on finding a way for society to work with the people who did not choose what they are".
We need to not only correct people but environments. The people themselves only contain half the conditions that lead to their behavior, their environments contain the other half.
We choose to ignore that fact. Another scary statistic is the drastic reduction in testosterone levels in the west in men and women, which probably accounts for many of the recent social changes.
The question is if it's OK to adapt to the new landscape, or to consider it a crisis that needs to be solved.
The reality is, SSRIs and other pharmaceuticals that have been used to treat common psychiatric illnesses (anxiety/depression) have dismal outcomes and fail the vast majority of patients that they have been given to.
I'm optimistic that the next few decades will bring about better approaches to these massively underserved (and largely exploited and discarded) people.
I’ve suffered from depression for 20 years with no relief from many different traditional antidepressant medications and many different modalities of therapy. I received my first MDMA therapy treatment in October of last year. It changed my life. It is the most important thing I’ve ever done in my entire life.
It feels like I’m feeling emotions for the first time in my life. I had completely lost hope for any kind of improvement in my symptoms, until this. I am so, so thankful I found this, and am so glad that it will (most likely) be becoming legal for use in treatment outside clinical trials in the very near future. So many lives will change for the better. For the first time in a long time, I’m excited to wake up and ring in each new day.
Fortunately there is a growing body of evidence that MDMA and psychedelic assisted therapy could revolutionize the treatment of mental health disorders.
Unfortunately, for the last 50 years, governments, industry and the military industrial complex (together with the MSM) have spread lies and scaremongering to block the therapeutic use of these life-changing therapies.
Here is another video for anyone wanting to know more about the topic:
(Lecture by Prof. David Nutt: The New Psychedelic Revolution)
I wonder how long before people propose to use it for happier society. Just like Stanisław Lem predicted in short story about Altruzine in Cyberiad [1] :)
"Harm aversion" is an interesting lens through which to view people's motivation and behavior. (They mention aversion to social harms specifically, but some of the examples are physical harms.) I've heard of loss aversion and of course risk aversion, but that's a new one for me.
"Enhancing serotonin made subjects more likely to judge harmful actions as forbidden, but only in cases where harms were emotionally salient. "
"Together, these findings provide unique evidence that serotonin could promote prosocial behavior by enhancing harm aversion, "
I object to the notion that 'less harm' is necessarily 'pro social'.
You can see the emotional attachment to 'harm' which confirms my biases in that people have difficulty mapping the moral issues with harm against their emotional reaction.
Case and point: A man robs a bank, is running from police, shooting at them, the police shoot the man, he dies.
I believe the 'seratonin' response is to condemn the 'terrible harm' done by the police officers.
It takes second order rationalization to contextualize the situation.
>This harm-avoidant bias after citalopram was also evident in behavior during the ultimatum game, in which subjects decide to accept or reject fair or unfair monetary offers from another player. Rejecting unfair offers enforces a fairness norm but also harms the other player financially. Enhancing serotonin made subjects less likely to reject unfair offers.
So essentially a subject with enhanced serotonin was more likely to be exploited?
>Enhancing serotonin made subjects more likely to judge harmful actions as forbidden, but only in cases where harms were emotionally salient.
"A single death is a tragedy, a million deaths are a statistic."
- Joseph Stalin
It's saying that serotonin doesn't make you a better person or more fair in an objective sense, it just strengthens your feelings of empathy, which makes you a better person whenever the good and your feelings about it are by chance aligned.
Maybe we are living in the world of "Brave New World" where there will soon be "Soma" pills of different colors depending on how we feel and how we want to feel.
The big question is ethics. How far do we go to understand, engineer, and change the very nature of what makes us human? Changing the very negative emotions for the future generation would change the world of great art like the next Poe, Van Gogh, Plath, and more.
This changes the very nature of what makes us unique. If everyone is happy, nobody is happy, right?
Insert yet another HN thread of people who happily support the covid vaccine because doctors say to get it, but yet in this thread those same people recommend a bunch of alternatives to what someone's doctor suggested/recommended.
Medication has absolutely saved my life, and made my life and those around me significantly better. I'm triple vaxxed. Doctors recommended both. YMMV.
not at all trying to contradict you, but I think the discrepancy may be due to people's trust in virology vs psychiatry. Psychiatry has a bad reputation (we were giving people lobotomies not that long ago) and even today, the literature often fails to be as scientifically rigorous as other fields, in my opinion.
> the literature often fails to be as scientifically rigorous
I don’t think that’s true. I think the sciences of psychiatry/psychology/neurology have several problems that are very unique that make them challenging fields. The literature is scientifically sound in methodology and data-analysis, but these challenges have the field progress slower, and have many false paths.
1. The brain is inherently complex. It might not be the most complex thing we study scientifically, but it’s complexity is a very big issue.
2. It’s really easy for the third-variable problem to have in impact in psychology/psychiatry. A classic example of this is the generalization problem. A study done in the US or France or another Western Democratic Educated country often will have findings that do not apply in Asia or African countries. Large swaths of the literature have questionable generalization, to the point this is often acknowledged inside the literature itself.
3. We have limited tools for studying these fields. The gold standard, the FMRI, requires people to be completely still and in a very artificial environment. This clearly will influence test results. This lack of tools is everywhere. We cannot directly measure happiness. We can ask people if they are happy. We can ask their friends and family if they seem happy. We can measure how much time they smile. If our sample size is large enough we can compare life outcomes like suicide. Every way we have to measure happiness has flaws, which makes drawing conclusions harder.
4. Ethics plays a huge role. We cannot, for example, randomly assign 100 children to play violent video games for 20 hours a week from age 10-18 and assign 100 children to never play these games. Thus any data we have about violent video games and children will not be as clean. We can assume that children that decide to play violent video games probably share other traits and would differ in a lot of ways to children that do not decide to play violent video games. Thus, it will be hard to determine if the violent video games had any impact, or if it was a third variable that many in the violent-video-games cluster share.
5. This happens everywhere, but this field especially is prone to journalists misreporting and misinterpreting the literature.
I get what you're saying, but that's a sloppy equivalency.
The evidence in favor of the mRNA-based COVID vaccines is overwhelmingly positive in terms of efficacy and lack of side effects. (Yes, they exist, but they are extremely rare) And neglecting to vaccinate one's self has serious risks for those around you, particularly at-risk folks. There aren't real alternatives, besides physically separating one's self from all human contact.
Psychiatric medicines are way, way, way more of a mixed bag. The side effects can be massive. The process of finding the correct one is very trial-and-error. For many people there are alternatives.
Please don't misunderstand: I know many who have massively benefitted from these meds. They can be positively transforming and lifesaving. I'm just questioning the value of comparing these two things.
The use of the word "prosocial" in the abstract is very confusing to me. They seem to be using it to describe actions which sound good but result in much worse real-world outcomes, right?
It increases IQ, histidine, a precursor for histamine, doubled the IQ of people with downs syndrome in an experiment over several months, but histamine also increases aggression which probably explains why you dont see many aggressive people with Down Syndrome.
Aged food & drink is higher in histamine.
Red wine more than white wine.
Dark spirits more than clear spirits.
Red meat more than white meat.
It can cause spontaneous erections, 60mg of histamine can be used for erectile dysfunction.
Histamine can increase blood saturation levels and help reduce the symptoms of COPD and other respiratory problems.
If you consumed alot of histadine, like several heaped table spoons with meals throughout the day, depending on your age and health you will notice some or all of the above.
Its one of the fastest amino acids into muscle, its untouched by the liver.
I dont know why you are taking anti-histamines, histamine helps the white immune cells move through tissue, it causes inflammation, there is also a histamine feedback loop in the brain which affects sleep patterns, which is why anti-histamines can help people get to sleep, but lots of histamine can improve sleep conversely.
Loads of studies exist that can be found on Google Scholar, but multiple chemicals affect peoples personality, and their health.
If you want to read up on this, also look at the pathways and other chemicals which work with histidine (or any other amino acid) for that matter.
I take antihistamines from April to September. Loratadin absolutely has a negative effect on my mood. Mostly because I feel tired I believe. Switched to Ebastin and no more tiredness. However, I am starting to suspect that it also does affect my mood in some way or another.
During winter I take a pill as a precautionary if I’m going to be in any dusty spaces. The day after I sometimes experience mood swings that I cannot explain.
Bacteria that's crossed the blood brain barrier can affect behaviour.
In European woman, the most common bacteria in a woman's vagina's is Lactobacillus largely due to the milk product consumption in their die.
However whilst Western medicine considers Lactobacillus to be a probiotic, other cultures who do not consume milk products in as large a quantity have different bacterial profiles in their vagina's.
Japanese people claim to be able to smell gone off milk oozing from the pores of westerners.
The presence of a particular strain of bacteria (whose name I dont have to hand right now) in a woman's vagina will also predict whether they have freckles or not.
Biology is a fascinating subject and very much open to debate.
An old antihistamine¹ was used as the blueprint for development of the first commercialized SSRI. Similar first generation antihistamines² also have a significant effect on SERT (serotonin transporter).
Reciprocly, the weight gain induced by certain SSRI is tought to be caused by an antihistaminic effect³.
It would not be surprising if other antihistamines (at least those that cross the BBB) had similar effects because antihistamines are frequently promiscuous (i.e. they have significant affinities with a lots of targets other than the one that make a drug effective) but I would be surprised if histamine, or its inhibition, was directly (with the exclusion of the miserable feeling that comes with allergies) implicated in moods changes.
I will be extremely hesitant to take antidepressants and anti-anxiety medications ever again after my last experience with them. For me, the medications helped by tempering all of my feelings - I no longer felt sad or anxious, instead I just felt mellow and apathetic about everything. And feeling apathy is an incredibly scary thing because I also no longer derived any joy from my hobbies, from sex, from exercise, etc. I could no longer feel sad but I could no longer feel happy, either.
Even worse, I found myself engaging in behaviors I would never have engaged in otherwise, like compulsive lying. My moral code was compromised because I no longer felt the guilt and shame that normally inhibits unscrupulous behavior. I look back on that time now and I think about some of my actions and I feel nauseous.
There is value to medications that inhibit or regulate serotonin, and every individual's experience will be slightly different based on their genetics and the circumstances of their life. However, for me, even though I benefited from them at various points in my life (especially as a teenager), as an adult now I'm much more likely to depend on coping strategies I've learned through therapy than medication when it comes to dealing with my mood.