Ridiculous. SSRIs are literally life saving medication. Millions of people have seen themselves and their family members go from suicidally depressed to normally functioning due to SSRIs.
Your appeal to reductio ad absurdum here fails because it's not established that SSRIs work by restoring an imbalance. SSRIs are only little more effective than a placebo, suggesting there's something deeper at play with regards to depression. Yes they may be an effective measure in serious cases of depression but they certainly are not a cure and many people do not just turn "normal functioning" after SSRI treatments like you're suggesting. The disease model of depression simply is not true.
> SSRIs are only little more effective than a placebo, suggesting there's something deeper at play with regards to depression.
Alternatively, that there is more than one cause of what we call "depression", and that SSRIs are only effective against some (but not all) of those causes.
"Little more effective than a placebo" conflicts with the large number of patients who claim SSRIs have been a life-changing treatment for them.
One way to reconcile this is by observing that if (just making up numbers here) 50% of people have no effect and 50% have a good effect, the overall effect is going to probably appear small, despite the fact that 50% of the patients had a very real positive effect.
"Little more effective than a placebo" conflicts with the large number of patients who claim SSRIs have been a life-changing treatment for them.
That statement only makes sense if tested against placebos. A lot of folk on placebos make identical claims.
The notion that it's not much better than a placebo is partially true. Short term; placebos and SSRI's aren't that dramatically different. Also, for unknown reasons, the effectiveness of SSRI's is diminishing somewhat (not due to tolerance - diminishing in results given to new patients). This makes it all a bit muddled.
If you pop out a much further distance though - placebos lose their effeciveness faster than SSRI's (and some people on both never lose effectiveness).
The SSRI's are definitely doing something, often something useful. Maybe for some people they are the long-term solution. I'm generally as suspicious of over-generalization in any direction. People are all different so blanket statements aren't likely the most correct.
Something I've heard a lot of clinicians repeat (though I don't know where the statement originates) is something to the effect of: "If you have someone who is terrible depressed - get them on SSRI's because you can't help them if they're dead; and then begin the work of addressing the issues that lead to the depressive states."
Again - a bit of a blanket statement - but probably the best general course of action. Start with staving off the immediate threat, then see if you can work on a solution that doesn't involve medication forever. If you can't you can't and shouldn't get hung up on that, but if you can, you probably should.
Let's keep some perspective here: They're mildly better over an inactive placebo, come with many very serious side effects, and are dangerous to withdraw from. Plus, "normally functioning" is a very questionable term to use.
Also, many psychiatrists prescribe them out like M&Ms, stating that they "believe" in them. Meanwhile - and this is the point of the article which you seem to have missed despite it being right there in the headline - we have no idea how they "work", just some very iffy guesses.
I wonder... SSRIs seemed to work for me in the short term, but over the long run, anhedonia has made a rather strong comeback. Most things don't seem worth pursuing - it's not actually despair, but a torpid languor.
