[HN Gopher] Researchers treat depression by reversing brain sign...
___________________________________________________________________
Researchers treat depression by reversing brain signals traveling
the wrong way
Author : CharlesW
Score : 195 points
Date : 2023-05-17 14:03 UTC (8 hours ago)
(HTM) web link (med.stanford.edu)
(TXT) w3m dump (med.stanford.edu)
| e79 wrote:
| It's fascinating how many potential modalities are at play with
| depression. Serotonin, inflammation, direction of brain signals.
| This suggests that depression may be a label that points to one
| of many underlying conditions, which could also explain why it's
| so tricky to treat for some individuals.
| jaggederest wrote:
| I have a pet theory that much of what we call mental health and
| chronic illness will eventually be traced back as a symptom of
| some causative factor - most likely infectious or environmental
| - rather than being a base illness as we think of them now.
|
| Much as we don't think of "fever" as an illness any more, I
| suspect "depression" will become descriptive rather than
| predictive - which, to an extent, it already is, at least
| according to the DSM as I understand.
|
| It's also possible that we'll see it as something that is
| multifactorial - some genetic susceptibility combined with
| environmental and/or infectious triggers.
| UniverseHacker wrote:
| I agree but I think we will find that emotional trauma is
| also a big component of the multifactorial causes.
| bitL wrote:
| I think they should first stop treating depression as a
| single illness. There are likely thousands different reasons
| for brain to end up with similar symptoms. Many forms of
| nutritional deficiencies likely turn into something that can
| be symptomatically classified as depression and sometimes be
| fully reversible by just restocking that missing nutrient or
| reducing its intake. Yet we clinically classify such
| conditions the same as ones caused by some brain injury or
| mentally horrible experiences that rewire brain circuits in
| weird ways.
| asdfman123 wrote:
| As someone who has more or less successfully learned to deal
| with depression, ADHD, anxiety, etc., the trick is basically
| doing everything considered "healthy."
|
| We don't understand all of the mechanisms of long-term
| illnesses like depression, diabetes, heart disease,
| Alzheimer's, etc. but we do know how to fight them: exercise
| and good diet. *
|
| Some processes in the human body obviously get disrupted under
| modern conditions, so it's important to give your body
| something it's a little more used to: more movement, more
| traditional foods.
|
| * (Obviously, it's not going to automatically fix depression in
| all cases, but it's absolutely worth fighting the good fight if
| you can. Other treatments are definitely worth trying too.)
| e79 wrote:
| Agreed, but with the caveat that depressed people often
| struggle with making the changes they need the most. Similar
| thing with obesity. There often needs to be some kind of
| intervention, such as a medication, to offer enough relief
| for someone to break the cycle and start making changes.
| Willpower alone isn't always realistic.
| hirvi74 wrote:
| My issue is that the disorders/symptoms interfere with my
| ability to do "everything considered healthy."
|
| The ADHD makes it impossible for me to stick to exercise
| routines as well as other routines. The depressive symptoms
| make me feel like I am carrying a ball and chain and every
| little thing requires so much energy.
|
| The worst part is that I am treated for ADHD, and even that
| has basically any negligible difference anymore.
|
| I feel like I am trapped in a negative feedback loop that I
| cannot escape.
| asdfman123 wrote:
| Does your ADHD make you feel antsy, like you need to get up
| and move around?
| hirvi74 wrote:
| Absolutely.
|
| It's part of the reason why office work is so difficult
| and working from home is not. Sitting in a office is
| quite tiring since I have to use a lot of energy to
| restrain myself. I'm the type of person who paces when
| thinking/talking on the phone, talks with their hands,
| bounces my leg when sitting, fiddling with something in
| my hands when talking, etc..
|
| The best description I can give is it feels almost like a
| bad itch. I cannot control when something itches, but
| once the urge to scratch presents itself, it's almost
| impossible to resist. Trying to force myself to not move
| doesn't make the "itch" go away. It just gets worse.
| asdfman123 wrote:
| Learning to get into the exercise habit is a night and
| day change for me.
|
| In fact, my body now demands that I go to the gym every
| day of the week, either for weights, cardio, or both. On
| my one rest day, I feel riddled by anxiety at 6 pm
| because I'm not doing any real physical activity. (Now
| that I write this, maybe I should walk on my rest day,
| but oh well.)
|
| It's hard work to form the habit, but it's the best
| treatment for this sort of thing that I've found. Once
| you start associating exercise = relief, it becomes
| welcome.
| leksak wrote:
| > But I also believe that if you don't exercise, eat
| nutritious food, get sunlight, get enough sleep, consume
| positive material, surround yourself with support, then you
| aren't giving yourself a fighting chance."
|
| - Jim Carrey
|
| Sometimes though, any one of those or all of them can end up
| seeming impossible because of the depression one is fighting.
| [deleted]
| asdfman123 wrote:
| Absolutely. I will point out that depressed people struggle
| with black-and-white thinking, so just taking the smallest
| steps in the right direction are a good start.
|
| Slowly build up incrementally better habits over years. It
| might start with a 10 minute walk.
| spacephysics wrote:
| Fully agree, to me depression is a common symptom that the
| system of biological processes "outputs", if you will, when
| some process isn't running optimally.
|
| Stopped sugar suddenly? Inflammation from food you're eating?
| IBS in general? Traumatic upbringing leading to entrenched
| "thought loops"? Undiagnosed disease?
|
| These all and more can have depression as a symptom.
|
| My armchair psychologist opinion is the DSM 5 category process
| isn't fitting correctly to how humans operate. I believe
| there's a completely different modality that has yet to be
| discovered (or known in mainstream science) that gives us a
| better way to diagnose people.
|
| I find it nuts that you subjectively, in most cases, ask the
| patient if they fit in usually 3 of 5 categories, or what not,
| and that determines the diagnoses. Countless times it's like
| "okay, what does hyper _mean_?" "What does intense rumination
| _mean_?"
|
| We need a more objective way to measure these criteria.
|
| I was diagnosed with depression for a while, tried a bunch of
| drugs, none really worked. Then for shits I do a neurological
| adhd battery and lo and behold, seems like that's it.
|
| Now using the correct behavioral changes leads to the
| depression going away, and far higher quality of life.
|
| I know the system, DSM 5, is best we have now, but we need more
| innovation in this space
| franl wrote:
| Which behavioral changes got you there?
| simonswords82 wrote:
| Not OP and I can't speak for the entire human population
| but for me it was changing the relationship I have with
| myself.
|
| Make a mistake? No big deal it'll be better next time.
| Learn from it rather than beat myself up for it.
|
| Hit that red traffic light? Time for self contemplation and
| putting the heated seats on rather than being pissed off
| I'm delayed 30 seconds.
|
| Get an email that triggers my threat response? Take a
| breath and think about who I have around me who can help
| rather than take it all on myself.
|
| Have a read of learned optimism. Great book.
|
| Get therapy. Hit the gym. Go for walks. Brush your teeth
| for 2 mins. Moisturise. Show yourself as much self care as
| you can.
| Choco31415 wrote:
| I went through a few different versions of depression myself
| and it absolutely feels that way. Each was caused by a
| different trigger, and the strangest thing is, despite all the
| tests doctors ran, everything came back normal. They couldn't
| figure out what was happening.
| kypro wrote:
| I hate this idea that signals can move the "wrong" way.
|
| There have been few days in my adult life that I wouldn't have
| preferred to not be here. Depression sucks. Yet, I don't think
| people are right when they tell me I'm wrong to be depressed.
|
| I hear that some people feel their depression shouldn't be there
| and that they should feel happy, and in those cases I think this
| sounds like it could be an excellent solution, but in my case
| (and I think others too) I could give you very well reasoned
| arguments for why I would prefer to not to be here and why I feel
| a sense of sadness as my default state. At least in my case I
| believe arguments for optimism are more wrong than my depression.
|
| Interestingly, my girlfriend is the total opposite to me. She's
| the happiest person ever met and I often wonder why she isn't
| also considered to be suffering from some kind of mental defect -
| I guess in her case the signals must be moving the "right" way
| because obviously the "right" way to feel is happy 24/7 and
| prolonged sadness is "wrong".
|
| I guess I always kinda liked the idea that any advanced
| intelligence would end up as some iteration of Marvin the
| Paranoid Android, since the logical conclusion should perhaps be
| that life is pointless and hard, so therefore why bother? Perhaps
| the "right" way for signals to travel is in the direction of
| depression and hopelessness.
|
| Sorry I know this isn't really on topic and I sound like a
| complete downer. I'm certainly not trying to diminish this
| research. I've guess I've just always found it interesting how
| some people feel they can categorise mental states as "right" or
| "wrong".
| MadcapJake wrote:
| You are entering Buddhism and philosophy territory with this
| take. At one point after the depression, you should arrive at
| "why should I feel bad that there's no purpose when I am a
| master of--and one with--the universe and can create and/or
| observe any meaning that I want?"
|
| Don't stop at nihilism, take the next step towards absurdism!
| goda90 wrote:
| >since the logical conclusion should perhaps be that life is
| pointless and hard
|
| Even if one concludes that life is pointless, depression is not
| the logical direction to head. Depression makes it harder, and
| full of pointless suffering. The logical direction to head
| would be maximizing pleasure despite the pointlessness. Of
| course that opens a whole can of worms about hedonism, but the
| point is that depression isn't logical unless you conclude that
| life should be as miserable as possible, which I wouldn't say
| is a logical thing to conclude.
| airstrike wrote:
| I have full sympathy for people dealing with depression but I
| don't think this logic holds. People who are depressed have
| suicidal ideations, suffer in quality of life and generally
| struggle to accomplish otherwise simple tasks.
|
| It is "wrong" in the sense that it has all of these objectively
| negative consequences whereas being blissfully happy does not,
| so it can be claimed to be "right" in relative terms.
|
| I think you are attributing to the word "right" a sense of an
| _obligation_ to feel happy, with "wrong" therefore being a
| deviation from that True Path, but I don't think that is the
| intended meaning when people use those words to describe
| depression.
|
| I would argue that "right" in this context means something
| closer to "nominal", as in "working as intended". Nobody is
| faulting you (or me or others) for constantly feeling down.
|
| I hope that helps.
| kypro wrote:
| I'm not sure I agree with your use of "nominal", but if
| you're saying right means something like "typical" then I'm
| fine with that. I guess I'm not sure what "working as
| intended" or "nominally" would mean. If the "intention" of my
| emotions is to approximate my true state then they're doing
| that just fine. Why would they tell me the world is great
| when I don't believe that to be true?
|
| > It is "wrong" in the sense that it has all of these
| objectively negative consequences whereas being blissfully
| happy does not, so it can be claimed to be "right" in
| relative terms.
|
| Obviously I can only speak for myself but depression has
| manifested both as hyper-productivity and hyper-defeatism for
| me. I've never felt content so a lot of my life has been an
| endless struggle to just feel okay which made me unbelievably
| productive when I was younger and naive enough to think I
| could fix things.
|
| It can be negative at times though, but my perspective on
| this that optimising for my own happiness is not an
| achievable goal. All I can do is optimise so that my
| suffering can be a net-positive for humanity and those I
| love. So although I might feel like I don't want to go on and
| I don't want to be productive I do because if I'm not
| productive or kill myself then I'm letting everyone down and
| my existence then truly was a net-negative both subjectively
| and objectively. I have to at least make this objectively
| positive.
|
| So the reason optimising for other people's happiness is
| everything to me, is because my own means nothing. But that
| does get destructive when I'm letting people down because
| then I suddenly start trying to calculate if my life is a net
| positive to the world and things can go "bad" quick when
| convince myself I'm doing more harm than good.
|
| I think I'm atypical to be fair, but I would argue my
| depression isn't objectively negative at all which is exactly
| why I put up with it.
| throwuwu wrote:
| Not OP but I view happiness as nominal because I get more
| done when I'm happy, I find it easier to take small
| failures in stride, I resonate more with other people and I
| just get more satisfaction out of life. If I'm feeling down
| then pretty much the opposite is true.
|
| I don't really feel like my emotions are representation if
| my mental state since they are a part of it as well as an
| influence on the more rational side. They also don't
| correspond perfectly to the outside world, I can be
| cheerful even when things are objectively bad which lets me
| celebrate the small good things I can find in those
| situations. I can also feel terrible when things are going
| great sometimes but maybe that's because I really should be
| doing something different.
| digging wrote:
| I believe I have some insight as someone who only recently made
| a breakthrough with lifelong on-and-off depression, and as
| someone who has had tons of therapeutic conversation (paid and
| otherwise).
|
| Once I finally realized that depression was something happening
| to me, literally an illness, and that it wasn't an intrinsic
| part of my personality, I sought medication. That medication
| had a near-immediate effect of making me feel ok. I wasn't
| depressed, I was able to just get through a day without
| thinknig too much about it. But it didn't work perfectly, and I
| found I could still slip into depression a couple times a year.
|
| More recently I got on a new medication that seems to actually
| work. It's not giving me a fake happiness and it's not taking
| away any of my very real concerns about how "good" life is. I
| am not optimistic about my state, my country, the future of
| humanity, or very much in general. But I am not depressed. I
| find it easy to enjoy things that I love in life. I can take
| real pleasure in disconnecting from work and foraging
| blackberries in the woods. It _is_ pointless to do so (I have
| plenty of food), but it doesn 't feel pointless. It feels fun
| and interesting.
|
| To me that's the biggest difference with depression. I can be
| extremely sad, and I often am. I can even believe that the
| world would be better off without me (I go back and forth), but
| I still feel satisfied to be alive. Even on my bad days, I can
| take small pleasures.
|
| I do think that staying depressed is "wrong" insofar as I would
| say it is "right" to seek comfort, pleasure, and health. I also
| think that it's fair to say these signals are moving in the
| "wrong" direction with respect to the direction that they move
| in non-depressed people. If the goal is not to be depressed,
| and something is causing depression, it's a "wrong" action.
|
| But I don't want this to sound like I'm chastising you. I get
| it. I am still a pretty pessimistic person and everything
| you're saying is logical. The difference is, I can think about
| and believe those things without it changing how I feel on a
| fundamental level. It is extremely hard to see that without
| getting treatment. And I also understand that it sucks to be
| told you're "wrong" or there's something "wrong" with you for
| being depressed, because it's happened to me plenty. So I
| understand your qualms with the language. Again, though - you
| don't have to feel bad. You can think the world sucks (my state
| government wants me and my community eradicated) and still feel
| good.
| stuckkeys wrote:
| what medication did you use? I am on the waiting list for
| controlled shrooms. Also you are not alone. Depression runs
| in my family (mother side) it is a rollercoaster. I have
| found drone flying FPV to be relaxing. But yeah, hang in
| there. The world is a better place with you, do not give up.
| digging wrote:
| Wish I lived in a state that would let me use psilocybin! I
| first tried bupropion, and now I take a smaller dose of
| that + fluoxetine. I suspect the bupropion is superfluous
| at this point but I'm making slow, controlled changes.
| [deleted]
| iandanforth wrote:
| What does "brain signals traveling" even mean? The brain is
| highly interconnected with both forward and feedback connections
| at all levels. Both of the mentioned regions are always active
| and always sending signals bidirectionally. fMRI is a slow, low
| resolution approximation of brain activity, so I'd really like to
| know what they are actually measuring as opposed to some clearly
| reductive analogy of what they suspect might be an underlying
| cause for that observation.
| udev wrote:
| Very interesting, so it could be that depression is essentially a
| race condition in the brain.
| robotburrito wrote:
| We are always trying to solve this problem while avoiding the
| elephant in the room, the current state of society is not very
| healthy for most people.
| walleeee wrote:
| There are two truths here which are often taken to preclude one
| another, but I think they can coexist
|
| 1. Depression can be treated and even overcome in some
| circumstances
|
| 2. There are very justifiable reasons many people might be
| depressed
| throitallaway wrote:
| What I find most troubling is how resources and power get
| concentrated in hands of the few, and the rest of us (99%+ of
| the population) are left to deal with the consequences. The
| few laws that do exist to prevent benefiting parties from
| raping and pillaging the earth and society at large are slaps
| on the wrist at best. The default is to toe the line and/or
| overstep legality and morality. That's what's so depressing
| about it all.
| somebody78978 wrote:
| Yeah, but that's also been the case for thousands of years.
| eastof wrote:
| I commented about this above since this type of thinking is
| what I see most commonly in my anxious/depressed friends.
|
| Really think on it deeply for a bit and you'll realize this
| belief can't possibly be justified rationally. Who are you
| to say that resources and power _shouldn 't_ be
| concentrated in the 1%? You say they overstep morality?
| That's _your_ morality and you can 't defend it rationally
| (no one can). Plus you can't change these things anyway, so
| you have no moral responsibility to do so (my morality).
|
| Media, politicians, advertisers, etc. all instill FUD to
| make you feel this way so the default option is pessimism.
| Try optimism. It may be wrong, but pessimism may be wrong
| as well and no one will ever find out so why even care who
| is right?
| pessimizer wrote:
| > Who are you to say that resources and power shouldn't
| be concentrated in the 1%?
|
| Who are _you?_ Everybody has the right to say this, or
| the opposite. If you think that people need some sort of
| permission to critique the morality of murderers, or that
| there are no rational arguments for any sort of morality,
| I 'm here to inform you that neither you or they need
| permission, and maybe read or think a little more about
| secular morality. _Feel free, however, to continue giving
| your opinion without my permission._
|
| > Plus you can't change these things anyway
|
| This isn't rationality, it's just learned helplessness.
| To say the least, people have changed things before, and
| will change them again. You have changed things, even if
| they were very small.
|
| > Try optimism.
|
| This comment is 100% doomer. Maybe try some optimism
| yourself.
| dandanua wrote:
| Messing the brain to solve a problem caused by outer factors
| looks like a new iteration of lobotomy to me.
| bjt2n3904 wrote:
| What you say here will be deeply unpopular.
|
| I have found that people treat depression and anxiety like a
| medical condition -- diabetes, or high cholesterol.
|
| Yet I can measure those numbers, compare them with other people
| similar to me, determine what ranges are outside the norm, and
| observe changes as I try different strategies to manage them.
|
| Depression, like physical pain, can neither be measured nor
| compared. And if this analogy holds, then there are those who
| would rather dull their pain with medication and claim
| victimhood, rather than find the source of it.
| aszantu wrote:
| Don't know who needs to hear this. I started a food diary after
| an elimination diet which restored my energy levels.
|
| I don't know the reasons, but you're looking in a time window of
| four-seven days.
|
| When I stray from my diet (meat and water) one day. I become
| mentally unstable after 4 days. It says for 3 day, then gets good
| again.
|
| Crying for no reason, ruminating, poor sleep, strong sour smell
| that can't seem to be removed by washing but can be suppressed by
| a strong anti transpirant.
|
| Going for sibo testing soon, if it's not hereditary, enzymes
| might be a solution. If it is, Pankreas is up for investigation
| next.
|
| Been looking for solutions since 2018, no doctor could offer an
| explanation so far.
| stuckinhell wrote:
| thank you for this! I have something very similar
| aszantu wrote:
| Have you noticed something else? I seem to tolerate sour
| apples and 1 teaspoon of sauerkraut per day, but not much
| more.
|
| Also garlic seems to be okay, but not onions, chilly powder
| is okay but not chilli-peppers or pepper, or tomato or seeds
| in general.
|
| Allergy tests all came back negative
| NeuNeurosis wrote:
| Definitely have experience with the same thing with food. I did
| end up finding out it was my Pancreas and take enzymes with
| every meal. Really really helps and has given me way more
| energy and my guts feel 90% better. Still have to watch certain
| foods and drink plenty of water but it is way better. Good
| luck.
| agnosticmantis wrote:
| Curious to try this but I'm unfamiliar. What kind of enzymes
| did you find helpful? (What's the name of the product if you
| don't mind sharing?) Are they over the counter or
| prescription?
| aszantu wrote:
| Oof it's some basic reasoning. I've seen an add for a d a
| test that can determine missing enzymes.
|
| This triggered brain to make the connection between sibo
| and enzymes.
|
| Basically: if crbs trigger depression AND it takes 4 days
| to do so, it has to do something with fermentation.
| Bacteria and yeast do fermentation and they can only settle
| in the long intestine if there is enough to eat. ergo: I
| might not be making enough enzymes to get rid of glucose
| and fructose and after 4 days the ferments get through the
| gut lining into the bloodstream or whatever and I'm
| basically hangover for the next few days.
|
| This led me into looking into enzymes to break down sugars,
| (veggies are secondary concern right now)
|
| At least what I found after 30 mind of googling was that
| you shouldn't just take them cuz it could be hereditary -
| that's when I stopped reading and decided to get tested for
| sibo first.
| aszantu wrote:
| Did u ever get around to find out why the enzymes aren't made
| by your body?
| [deleted]
| fpgaminer wrote:
| Other comments have proposed that depression may have multiple
| underlying causes, and thus may require different treatments.
|
| I'm curious about the other direction of thinking. What do SSRIs,
| psychedelics, CBT, and TMS all have in common? Suppose that there
| is one common cause, or one at least one cause that applies to
| 90% of cases. And it's treated by all these seemingly disparate
| methods.
|
| That's what tickles my curiosity the most, as it begs a more
| fundamental question about the functioning of the brain.
|
| Maybe the author's theory is correct: brain signals between
| certain regions are going the "wrong" way in depressed patients.
| That would imply that SSRIs are causing the same shift. God, I
| would love if the authors tested that. And then we can finally
| dig into why SSRIs work (we don't current know). If they're
| causing shifts in brain activity flow, then we can find out how.
| And from there maybe we can treat other mental diseases with
| better pharmacological or TMS solutions. Are things like
| schizophrenia arising from a similar bad pathing of information
| around the brain?
|
| Psychedelics is also a weird one. People have proposed many
| theories as to their mode of operation for treating depression.
| But now I wonder, based on this research, if the key factor was
| just the disassociation from one's body and altering of senses.
| The other effects like connecting disparate thoughts, forming
| more brain connections, ego death, etc may not be related at all.
| That could lead the way to more targeted drugs.
|
| Really cool stuff. If if pans out, of course. But unlike other
| theories of depression, at least this one is easy to test.
| opportune wrote:
| If you consider that CBT scratches a need for deep
| socialization, they all basically act on serotonin in different
| ways. I don't buy the oversimplified "depression is when your
| brain doesn't make enough serotonin" model but it does seem
| there is a strong connection.
|
| Maybe there is some kind of local optimum your serotonin-
| mediated pathways can get stuck in and need help getting out
| of. In fact, this (generalized outside of just serotonin) is
| something I do buy as a basis for depression: your brain enters
| some local optima or learns some poor but good-enough coping
| mechanisms that keep you going but prevent you from fixing
| underlying issues (whether it be due to maladaptive behavior,
| framing or interpreting things negatively, low self esteem
| leading to poor social performance and consequently lower self
| esteem). That's also kinda what CBT is about addressing
| endisneigh wrote:
| disclaimer: I acknowledge depression as an illness and state of
| being.
|
| that being said, if you take someone who is objectively "not
| depressed" and apply these same depression treatments, what would
| happen? some state of euphoria? heightened mood? happiness?
|
| suppose that _new_ state is now the normal state in which people
| are judged against. now, the before-mentioned person who was not
| depressed, may be considered depressed, _relatively_. so you now
| apply the same thought experiment again. clearly this can be
| recursively done infinitely...
|
| such is an inflationary view. so my question really is around the
| cultural vs. biological construct of depression. what if it's
| _ok_ to be depressed? this is not to say that we shouldn 't be
| trying to "treat" it (and the symptoms), but I do wonder at what
| point do we say it's OK.
| jordan_curve wrote:
| one common effect of SSRIs is that they can dull emotions. This
| is helpful and can be a positive effect if you are very
| depressed or get stuck in anxious spiraling.
|
| If you're very stable and happy emotionally, then that dulling
| might be unpleasant.
|
| Beyond that, while SSRIs tend to have fewer side effects and be
| more safe than many other classes of anti-depressants, even
| SSRIs have very noticeable side effects. They are very easy to
| stomach if they make a dramatic difference in your mood and
| quality of life, but if you were already mentally well the side
| effects will be more impactful than whatever benefits you might
| get.
| throitallaway wrote:
| Or, SSRIs dull you to the point of feeling like an observer
| (rather than participant) of your own life, which makes one
| even more depressed and hopeless.
| tokyolights2 wrote:
| Exactly this. I take a low level of SSRIs because I am an
| otherwise highly functioning person who has a tendency to get
| into severe anxious spirals that can last days on end and
| induce vomiting. I do all the things that a person should do
| to mitigate, including meditating, exercising, lots of
| friends, etc etc.
|
| I know that my medication dulls my most intense emotions, but
| that is the point. It is slightly sad knowing that I don't
| experience the highest highs that I used to, but it is
| completely worth it to stop experiencing the lowest lows that
| were completely debilitating. I would stop taking them
| immediately if I could be assured that I wouldn't fall back
| into physically debilitating anxiety.
| fpgaminer wrote:
| This line of reasoning reminds me of a common misunderstanding
| of depression I've seen from people who've never been
| clinically depressed (1). It's an understandable mistake,
| albeit potentially dangerous (2).
|
| Depression isn't on the happiness-sadness scale. It's quite
| tangential to that. In fact, perhaps quizzically, you can be
| happy and depressed. It's fairly common for people who learn
| about the loss of a loved one to recall how happy them seemed
| the day before.
|
| Depression treatment, therefore, doesn't make one "less sad".
| And consequently it wouldn't make a healthy patient "more
| happy".
|
| (1) I don't mean this in a negative way towards the comment I'm
| replying to. Nor am I implying that the commenter believes
| this. I just noticed a pattern and I'm responding in the spirit
| of education.
|
| (2) It's okay to not understand depression; not everyone has to
| be an expert on everything. It only becomes dangerous when
| providing ill formed advice. Which is unfortunately common when
| it comes to depression.
| endisneigh wrote:
| The point I was trying to make isn't about happiness or
| sadness per se, rather they depression has mental analogs
| that presumably are improved after treatment.
| mtlmtlmtlmtl wrote:
| I think the more accurate way to conceptualise this is that
| treatment works by interfering with processes in the brain
| that cause depression, not that it cancels out the
| depression by adding enough euphoria/mania/happyness to
| compensate.
|
| Antidepressants don't typically cause mania in healthy
| people, but they could paradoxically cause depression.
| endisneigh wrote:
| I was referring more to the article in the OP that
| "reverses bad signals".
| carabiner wrote:
| It doesn't need analogs. Depression is mental.
|
| Legitimately what dialogue are you attempting to start?
| [deleted]
| d_tr wrote:
| Some symptoms are not OK in an absolute sense. For example, the
| exhaustion. It can be disabling (along with all the other nice
| things that go on inside your head) and go on for months
| without a break.
| supernikio2 wrote:
| What brain signals would you reverse on a non-depressed person?
| carabiner wrote:
| > apply these same depression treatments, what would happen?
| some state of euphoria? heightened mood? happiness?
|
| No, usually nothing happens which is why people don't bother
| abusing antidepressants. These aren't like cocaine or alcohol.
| throwuwu wrote:
| It's ok if it isn't purposeless suffering which clinical
| depression most certainly is. Having an occasional low mood or
| a temporary bout of depression due to a bad event is ok because
| it is informing you that something bad has happened and maybe
| you should retreat from normal life a bit to deal with it. Just
| being depressed all the time because your brain got messed up
| somehow is not a state anyone should be left in.
| admax88qqq wrote:
| It's not okay to be depressed because it sucks to be a person
| who is depressed. Being depressed is not a nice state to be in.
|
| This isn't an "ooo society is wrong" type of situation. Sure
| there are some societal pressures to appear happy which can
| make depression _worse_, but depression is still awful
| regardless of those and we treat it because it's awful.
| ebolyen wrote:
| Instead of imagining that it works like a number line and then
| observing that you can use induction, you could measure
| outcomes: suicide, suicidal ideation, quality of life, etc.
|
| That puts a pretty reasonable lower bound on what is or isn't
| depressed. It is absolutely an altered state of mind, and an
| information processing disorder.
|
| For anyone who might feel like "it's ok to be depressed", this
| is not a normal thought, and there _is no normal amount of
| suicidal ideation_. Seek professional help or strong social
| support; just ask for help anywhere it might exist (go to an
| emergency room and just have a seat if you must). If you aren
| 't depressed, these thoughts literally don't happen, as strange
| as that may sound if you are in the thick of it.
| endisneigh wrote:
| > , this is not a normal thought, and there is no normal
| amount of suicidal ideation
|
| being depressed doesn't mean you have suicidal ideation,
| though.
| chresko wrote:
| I would propose the following analogy as an answer:
|
| 1 - Person A has the flu
|
| 2 - Person B does not have the flu
|
| 3 - Person A treats the flu with rest, fluids and antiviral
| medications
|
| If person B also rested, drank fluids and took antiviral
| medications, they would not become an unusually healthy person.
| Person B would not become the new normal.
|
| What you're proposing is that it's OK to be sick. We treat
| every other form of illness with aggressive treatments.
| Depression is often ignored, poorly treated or treatment is
| inaccessible to many people due to cost.
| johnfn wrote:
| Analogously, what if we took someone who was already full, and
| then fed them food?
|
| > what if it's ok to be depressed?
|
| I dunno, what if it was _ok_ to be hungry? I don't think this
| question makes much sense.
| endisneigh wrote:
| But it is ok to be hungry. What's the depression equivalent
| of having a completely, literally, full stomach?
| brainmagnets wrote:
| I recently went through a round of rTMS and participated in a
| study that used EEG to attempt to find biomarkers for responders
| vs non-responders. This was largely based on previous findings
| that altered functional network activity in the brain (namely the
| default mode network) is correlated with depression in some
| people, and that EEG could relatively inexpensively detect
| functional network changes over the course of treatment. This
| study seems to follow a similar vein and I suspect we'll see more
| like it in the near future. I'm really glad to see more research
| being done with TMS - the particular protocol mentioned in this
| study (SAINT protocol) has had truly amazing success with 80-90%
| remission rate in already treatment-resistant individuals in a
| couple of studies. Even ECT, which is currently considered the
| most effective treatment for treatment-resistant depression, has
| only a 70-80% response/60% remission ("regular" rTMS is about 60%
| response/30% remission). The only problem is that SAINT requires
| fMRI which is expensive and complicated, on top of already
| expensive rTMS treatment. Hopefully as more research is done
| it'll become more accessible, personally it was very helpful for
| me in overcoming many years of intractable depression.
| mynameisash wrote:
| My son, who is diagnosed with ADHD, anxiety, depression, and OCD,
| and who has been in talk therapy, on SSRIs, and other
| interventions for years, recently started LENS therapy, also
| called neurofeedback. (I'm on mobile device, otherwise I'd find
| the link.) It sounds a lot like a form of TMS.
|
| He's had something like 7 sessions, each lasting maybe 15
| minutes. The results are nothing short of astounding for our
| family. He's typically been... Extremely difficult to parent.
| After his LENS, lasting about a week, he is a pretty happy kid
| who participates in family and social life. His anxiety
| previously prevented him from engaging with friends for more than
| an hour. Just the other day, he was out at a birthday party for
| eight hours and still cheerful afterward.
|
| I'm very hopeful that there is a long term, lasting effect for
| this kind of thing.
| ShamelessC wrote:
| > He's typically been... Extremely difficult to parent.
|
| Yikes.
| fourg wrote:
| That's wonderful that it's helped your son so much. I have done
| TMS and am curious about LENS for myself and family who have
| symptoms similar to what you shared. We too have tried most
| everything else and daily life is an absolute grind.
|
| How many sessions did your son require and how long are the
| results expected to last?
| mynameisash wrote:
| To be honest, I don't know how long LENS will be for us.
| We're doing weekly sessions. It's not supposed to be
| indefinite, but I don't know at that point we taper down or
| stop.
|
| Results were pretty much immediate, though. After his first
| session (maybe only a few hours later), he self-reported
| improvements and we noticed a definite change in his mood and
| attitude.
| alex-moon wrote:
| Really fascinating stuff. I immediately wonder if there is any
| explanation for this reversed flow of signals that might tie it
| into an evolutionary theory of depression e.g. the social
| withdrawal hypothesis - is the brain using less energy doing
| things this way?
| throwuwu wrote:
| Interesting thought. My mind went to the possibility that since
| they reversed signals are allowing your mood to determine how
| you feel physically that it might allow you to leverage a good
| mood to overcome negative signals from your body i.e. power
| through pain or exhaustion. Maybe it became maladaptive when
| more opportunity for rumination became available.
| asdfman123 wrote:
| > "It's almost as if you'd already decided how you were going to
| feel, and then everything you were sensing was filtered through
| that," he said. "The mood has become primary."
|
| This is 1000% what depression feels like, once you've properly
| come to terms with it. Your brain seems absolutely compelled to
| apply the most horrific, negative interpretation to everything
| that happens to you.
|
| Even when you understand it's wrong, or at least heavily
| negatively biased, fighting those interpretations feels like
| trying to swim upstream in a terrific current.
| munificent wrote:
| Anxiety feels similarly.
|
| The most valuable thing I've gotten from the past several years
| of therapy is a better model for how humans actually process
| information. The simple model a lot of people have is:
|
| 1. Receive some stimulus, input, or experience.
|
| 2. Process and understand it.
|
| 3. Respond to that emotionally.
|
| What we actually do is more like:
|
| 1. Receive some stimulus, input, or experience.
|
| 2. This data is _way_ too ambiguous to make sense of on its
| own. So to turn it into coherent information, interpret it
| through the lens of a narrative about who we are and how we
| expect the world to work. This happens automatically and
| unconsciously.
|
| 3. React to that interpretation emotionally.
|
| 4. Watch logical rational brain then scramble around trying to
| come up with a coherent story that explains why we started
| feeling a certain way. The answer it comes up with may or may
| not agree with the unsconscious process that happened in step
| 2.
|
| So much of therapy is "Why does X make me feel Y?" How do I fix
| X? The answer is almost always that X doesn't make you feel Y.
| X _in the context of belief Z you have about yourself_ leads do
| you feeling Y. You fix Z by questioning the often toxic beliefs
| you hold about yourself. But it can take a lot of work and
| therapy to even be able to _see_ Z, much less root it out and
| install a better narrative.
| bombcar wrote:
| This applies to many things, including lots of things we
| think we "got to rationally" - much more than we want to
| admit is rationalization.
| iamacyborg wrote:
| It thinks therefore I am.
| eastof wrote:
| Love the level of introspection going into this post. I'm
| compelled to add my own two cents to your narrative since
| it's helped me.
|
| I think step 4 is where people really get caught in a
| feedback loop. You come up with a reason why you _should_
| feel bad, and then you do (step 3) and before you know it you
| 're back at step 4.
|
| One approach is to try and cut it off at step 2 like you
| mention, but I've found this to be a never-ending rabbit hole
| because installing a better narrative requires constant work.
|
| While of course it's not bad to work toward a better
| narrative of yourself, I've also had great success with
| meditation and humility targeting step 4. My friends with
| anxiety and depression all (somewhat paradoxically) are
| extremely confident when it comes to the rational side of
| their thoughts. They think they've got it figured out and
| it's just their emotions or other people that are the
| problem. I train myself in meditation (don't rationalize at
| all) and humility (recognize that my rationalizations are
| never going to be accurate).
| candiddevmike wrote:
| This is part of cognitive behavioral therapy (CBT), you do
| ABC sheets like this:
|
| https://iveronicawalsh.files.wordpress.com/2012/06/cbtafg_ab.
| ..
|
| To retrain your brain on how to appropriately react to
| things.
| reaperman wrote:
| Thank you for detailing / summarizing your exploration on
| this topic. You've phrased it very well / precisely.
| OptCohTomo wrote:
| That is what depression felt like to me as well. I've written a
| book about it, Can't Be Trusted. It is a memoir about
| engineering, mental health, and aviation. Here is more
| information about me and my book:
| https://cantbetrusted.org/?page_id=262 As a laser engineer with
| an interest in computing, I think this book would be of
| interest to the tech community.
| AndrewKemendo wrote:
| Simply by posting it you'll get someone's attention (like
| myself!)
|
| However you may get downvoted because you asked how to get
| upvoted, which can be counterintuitive if you're
| Neurodivergent (like many of us). It's ok, that's not how you
| intended it, but that is most likely not a helpful part of
| the message here.
| sdwr wrote:
| I don't want to get baited, really don't want to get baited
| here, but here goes. I've had my own struggles with mental
| health, maybe I can phrase it in a helpful way. This reply
| is for the book writer:
|
| All your points may very well be true, but taken together,
| they paint a picture of you as sick and untrustworthy.
| Society puts requirements on people, stuff like
|
| - wearing clothes in public
|
| - <more examples>
|
| One of those requirements is emotional resilience. Being
| able to absorb a setback or percieved slight, and keep
| moving forward in your day. It can also be seen as a game
| of emotional poker - sometimes you win a bit, sometimes you
| lose a bit, but if your bank goes down to 0, you're out!
|
| You are holding on to these slights and injustices, and it
| doesn't matter whether you are right or wrong. It's a
| catch-22, the fact that you keep complaining instead of
| moving on with your day proves that you are unwell.
|
| Trepanning is an analogy for schizophrenia. That's where
| part of a person's skull is removed, and the brain is
| directly exposed to the air. You are exposing your feelings
| to the world, where a normal person would have an emotional
| lid.
| tbalsam wrote:
| (and to add to the other comment too you can edit your
| comment so you don't get dinged for asking about upvotes! ;P
|
| It seems very interesting. You can generally share how
| important it is to you within reason and that's pretty chill
| too.)
| kayodelycaon wrote:
| For me psychotic paranoia was very much like this. No amount of
| reason could overcome the irrational thinking.
| asdfman123 wrote:
| I imagine it's frustrating to describe to people who don't
| understand the degree to which your own brain works against
| you.
|
| Too many assume it's a lack of willpower, but willpower can
| only do so much to fight the tide (depending on the severity
| of the illness).
| amelius wrote:
| I sometimes get this when I'm tired. The solution is not to
| think about it more, but instead to just have some sleep.
| asdfman123 wrote:
| Right. A good approach to depression is to learn to simply
| "turn the TV off" and quiet your brain, but it takes practice
| to learn how to do that.
|
| More broadly speaking though, depression is partially like
| being stuck in your foulest possible mood for years, with the
| full knowledge that it's not going away, at least in the near
| term.
| detourdog wrote:
| wild, this explains a particular relationship. I deliver what I
| perceive as good news and the response is consistently the
| worst interpretation of every detail.
| asdfman123 wrote:
| That actually sounds more like anxiety about the
| relationship, and now that I think of it what I'm describing
| is more like a (very common) combination of depression and
| anxiety.
| detourdog wrote:
| Probably true. Thank you. Could it be anxiety driven by
| their own commitment?
| PragmaticPulp wrote:
| This is why the related concept of "catastrophizing" comes up
| so much in the context of therapy:
|
| > Catastrophizing is a cognitive distortion that prompts people
| to jump to the worst possible conclusion, usually with very
| limited information or objective reason to despair. When a
| situation is upsetting, but not necessarily catastrophic, they
| still feel like they are in the midst of a crisis.
|
| Anecdotally, many of the people I know with a tendency to
| "catastrophize" later suffer from clinical depression. The
| depression only exacerbates the problem.
|
| Even more anecdotally, catastrophizing seems heavily correlated
| to the usage of certain social media platforms in the young
| people I've worked with. I don't know which direction the
| causality flows, but I do know that people who consume a lot of
| Reddit and Twitter seem to think the world is ending and
| everything is terrible. They can tell me about every political
| scandal, every shooting, every tragedy, and every natural
| disaster that happened in the past week. Eventually they come
| to believe their news sources are representative of the entire
| world, forgetting that none of these things are happening to
| them personally.
|
| It's a weird doom loop spiral. Even weirder is that many of the
| people caught in it feel convinced that they "don't do social
| media" because they're not on Instagram or TikTok, yet they
| consume hours and hours of doom and gloom social media like
| Reddit all day.
| SoftTalker wrote:
| This is why the news has always been bad, since way before
| social media. Disasters, war, scandal, and death have always
| been more engaging. Also why gossip is almost always
| negative.
|
| Our brains evolved to deal with what was happening in our
| immediate vicinity. This was usually fairly neutral to
| pleasant, with maybe some moments of sadness, loss, alarm and
| danger. We just aren't mentally equipped to process an
| unending stream of bad news and really keep the perspective
| that these things _are not happening to me._ It 's best to
| just avoid sources of that.
|
| I stopped watching and reading the news a few years ago, and
| generally feel much less stressed about day to day living.
| ajmurmann wrote:
| I think there also is a factor where good things move
| slowly. I always liked the thought experiment of imagining
| newspapers that are published at increasingly long
| intervals. What would the content be in a newspaper that's
| published every 50 or 100 years? Sure you'd cover major
| wars, but so much more space than we dedicate right now
| would go to phenomenal improvements that took a long time.
| Incredible advances of medical improvements, including
| eradication of entire diseases, much higher life expectancy
| and so many fewer famines, massively increased literacy
| rates. One could go on and on. Yet, few of these things,
| unless they are discreet events which is rare, ever go into
| a daily newspaper and certainly don't make headlines.
| hifromLA wrote:
| Reddit is my Achilles heel for the very reason you outlined.
|
| I quit Reddit and I remember the exact day it happened. I
| found myself typing and deleting a reply to a comment that
| was overly negative on something that I was well versed in. I
| knew this person was incorrect and taking a knee jerk cynical
| approach.
|
| At some point I just said what the hell am I doing here I
| need to not be on this website anymore.
| comrh wrote:
| Which makes sense why CBT style therapy has shown effectiveness
| because its main focus is challenging those interpretations. No
| doubt even with those tools it is still a major challenge.
| asdfman123 wrote:
| One interesting thing to point out is CBT is so effective
| because it's somewhat easier to stick to than other
| approaches. Meditation, for instance, is equally effective if
| you keep with it, but most people realistically won't.
| AndrewKemendo wrote:
| This is one of the few times I've heard an accurate and concise
| description of what it feels like.
|
| I like the metaphor of the spiral wishingwell. The coin/ball
| represents the level of depression you sink into. The
| gravitational draw of the void makes the spiral go faster
| unless you figure out a way to pull out of it and the longer
| you wait the harder it is to pull out cause it's moving too
| quickly.
|
| So the trick becomes keeping the coin/ball off of the spiral
| hanselot wrote:
| The only way out is through. One way or another, once you
| reach the shore on the other side, the time spent in the
| water doesn't seem so bad anymore.
|
| Just another perspective to lean on when understanding
| others.
|
| Once you confront it in the most absolute sense, something
| akin to ego-death occurs, and you make a decision about
| whether it is worthwhile to continue.
|
| Everything comes from and swings back to chaos. Embrace it
| and you will be free.
| AndrewKemendo wrote:
| This definitely resonates with me as I've graduated into
| the state you describe and yes "the only way out is
| through" is exactly the way to describe the path.
|
| Not sure I agree fully with the "time spent in the water"
| not seeming bad - I think I simply recognize it for what it
| was, while acknowledging the trauma and cascading effects
| that I'm unwinding 30+ years after the fact.
|
| Perhaps you mean that you are no longer attached to the
| trauma and can view it "objectively"
|
| More important to me now is unwinding the physical
| manifestations of trauma/anxiety that I never recognized as
| well as eliminating the behaviors (people pleasing, self
| deprecation etc...) that attract toxic attachment.
| junon wrote:
| Can relate. I don't know how, or why, or what I did to get
| to the other end, but one day I woke up, and it was gone.
| Years of nearly crippling depression, ruined friendships,
| hardships at work, nights of 'considering', all finished in
| an instant. It was absolutely bizarre and wonderful and
| concerning at the same time.
|
| Woke up and thought "alright this is stupid, I need to get
| stuff done" and as though it were magically manifesting out
| of thin air I had a normal train of thought, my emotions
| were mostly in check, and I had motivation that I hadn't
| felt in years.
|
| Almost like cracking a knuckle, but in my own brain. GP's
| comment resonates very hard.
| agumonkey wrote:
| And none of the actions you used to do are linked to a joyful
| anticipation, it's like all weights have been reversed. That's
| how you end up stuck in bed, there's no idea in your brain that
| can trigger the motivation center, eating, walking to a room,
| standing.. nothing.
|
| The few that remained (in my personal case, can't speak about
| others) was a strange sense of gamification of everything. Lift
| that spoon with only one finger. That allows some influx of
| positive will but it can get drained real fast (to the point of
| physiological collapse .. a bit like narcolepsia)
|
| And yeah, long term management basically teach your brain to
| desensitize to its own bugs so you can at least not drown in
| negative emotions. But it's a double edged sword cause you're
| tapering down your own self in the process.
| proper_elb wrote:
| Spot on.
|
| > Even when you understand it's wrong, or at least heavily
| negatively biased, fighting those interpretations feels like
| trying to swim upstream in a terrific current.
|
| Achieving it still feels like the end of "A beautiful mind",
| where there are people hanging out in the room that are not
| there. They sound like they are they, they feel like they are,
| they smell familiar. But they are not real and will disappear
| some wonderful day, as they always do. So you just nod to them
| and go on with your live.
| burglekutt wrote:
| Sometimes I feel like programming is physically and mentally
| designed to create bad health and mood, at least if you're not
| very careful about how you're _being_ while doing it.
|
| Maybe it's just me, but I have to work hard to avoid:
|
| - Bad posture, hunching towards the monitor
|
| - Scrunching the face
|
| - Feeling impatient because my fingers and the computer can't
| keep up with where I am in my mind
|
| - "Damn you, computer!" frustration in small doses throughout
|
| - Frequent interruptions via email, Slack, texts, coworkers, etc
|
| - In some cultures, it's very hard to have a plan for what to get
| done in the day and then execute on it due to getting sucked into
| meetings and stuff.
| JohnMakin wrote:
| Unfortunately, TMS is extremely expensive and not likely to be
| covered by most insurance plans. Even with a decent PPO, I was
| quoted about $1k a treatment and they said I needed at minimum 30
| treatments.
| tomrod wrote:
| biohacking feasibility?
| bluechair wrote:
| Biohacking is not feasible at this time--at least in my
| opinion: * TMS machine is a powerful precise
| device that is expensive and unlikely to be safe from doing-
| it-yourself * Every brain is different, so, you'll need
| to get an MRI if not an fMRI to understand the structure to
| target * Once you have a target, you'll need to align
| the device with your skull * It's not clear how you'd
| measure or control the regime on the brain, even if you made
| it to here
|
| The last thing I'll say is that you should look for the
| complaints made against TMS device manufacturers. I'm
| optimistic that this approach will work for some people; I
| know many people who could benefit from this technology but
| I'm not comfortable with recommending it to a family member
| when I know there's a risk of permanent brain damage,
| tinnitus, etc.
|
| Please fact check my claims by visiting the US government
| database to find complaints against these TMS manufacturers:
| https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/s.
| ..
|
| Top manufacturers should be a Google search away.
|
| You'll find examples of seizures, etc in there.
| rideontime wrote:
| searching hackaday for "transcranial" turns up a few results.
| have fun! https://hackaday.com/2017/03/31/transcranial-
| electrical-stim...
| radicaldreamer wrote:
| There are effective alternatives which are a fraction of the
| cost: ketamine (sublingual ~100mg every few days), psilocybin
| (free? cheap 2-3g ~4 weeks), rapamycin + ketamine also seems
| promising (https://www.nature.com/articles/s41386-020-0644-9).
| q845712 wrote:
| I was hoping you were going to link to a DIY tms, so i will:
| https://www.instructables.com/Transcranial-Magnetic-
| Stimulat...
|
| Note the disclaimers, especially "TOUCHING THE DEVICE WRONG
| DURING ASSEMBLY CAN INSTANTLY KILL YOU. THIS DEVICE COULD
| KILL YOU OR MAIM YOU OR BREAK YOUR MIND."
|
| However the other things you're posting are alternative
| chemical treatments. People with resistant depression have
| already tried the approved chemical remedies. While I broadly
| agree that there's evidence in favor of both psilocybin and
| ketamine being potent chemical anti-depressants, I also think
| there's a number of valid reasons for someone to reach a
| point where they don't want to try any other chemical
| remedies, and ECT / TMS become more compelling options.
| radicaldreamer wrote:
| Wow, I didn't even consider that there's a DIY version of
| the equipment.
| wizzwizz4 wrote:
| I would recommend against trying to self-prescribe addictive
| substances.
| rozularen wrote:
| I don't think any of those are addictive actually
| wizzwizz4 wrote:
| Ketamine is definitely addictive for a lot of people.
|
| Rapamycin isn't one I've heard of before, but it looks
| like a does-lots-of-things drug: Wikipedia says it's an
| immunosuppressant. I'd recommend against DIYing _that_
| for a different reason.
| radicaldreamer wrote:
| Ketamine at the doses prescribed for treating depression
| has low addictive potential.
|
| The doses used recreationally are multiples of what is
| regimen for anti-depressive effects.
| marcellus23 wrote:
| just because they're not chemically addictive doesn't
| mean they're not addictive. Weed isn't chemically
| addictive but plenty of people struggle with it
| nonetheless.
| kyleyeats wrote:
| Weed is chemically addictive. Your endocannabinoid system
| is downregulated for weeks after heavy use. You get
| withdrawal symptoms which are alleviated by use.
|
| I've never seen the phrase "chemically addictive" used by
| someone who knew what they were talking about. It's only
| used by people who don't understand that
| neurotransmitters are chemicals too. Stop spreading this
| BS distinction.
| hirvi74 wrote:
| Correct me if I am mistaken, but aren't withdrawal
| symptoms more indicative of a dependency than an
| addiction?
|
| Cessation of SSRIs can have all kinds of symptoms
| depending on the time length of usage, but I have never
| heard someone claim to be addicted to SSRIs.
| [deleted]
| marcellus23 wrote:
| I agree with you. I should have put "chemically
| addictive" in scare-quotes to make it clear that I think
| the distinction is silly.
| kyleyeats wrote:
| My bad and no offense. I'm a reader darkly.
| Italics/asterisks are also good.
| mtlmtlmtlmtl wrote:
| Yeah, a lot of the withdrawal symptoms are so mild or
| transient people don't think of them as withdrawal or
| even make the connection. And people seem to think that
| anything less severe than shivering and unbearable pain,
| delirium, doesn't qualify as withdrawal.
|
| The most memorable withdrawal symptom from weed for me
| was the sweating. Cannabinoids tend to affect the
| hypothalamus which is sort of like the brain's control
| module for the endocrine system. And one of the things it
| controls is temperature regulation. So if you quit cold
| turkey that all gets outta wack and the sweating happens.
| Takes at least a couple of weeks to get somewhat back to
| normal.
| blastro wrote:
| same with food?
| marcellus23 wrote:
| Well, yes. That's what "food addiction" is.
| radicaldreamer wrote:
| Psilocybin's addictive potential is limited to at least 1
| week intervals since it would have no effect if taken
| more often.
|
| Most people "addicted" wait much longer than that --
| sometimes months to make sure they have a strong trip and
| offset receptor down-regulation to the point where it can
| hardly be called an addiction.
| supernikio2 wrote:
| That might be the case today, but I reckon it will become
| cheaper as time goes on, if found promising of course.
| JohnMakin wrote:
| Another issue is that the effect doesn't seem to be permanent,
| and additional treatments as time goes on has been observed in
| people who show improvement from the treatment. So, I really
| hope it gets much cheaper.
| flippinburgers wrote:
| I have had what seems to me to be depression for most of my life
| (40+ years). I have been fortunate enough to have a kid and, now,
| I guess I just don't have time to be depressed or something
| because most of my thoughts of ending life etc have, quite
| thankfully, gone away. I'm really not trying to be off-putting
| when I say this but I do sometimes wonder if some instances of
| depression aren't simply a cause of people not having families.
| I'm not totally confident about this, but ... really I think
| having kids gets looked down on for all the wrong reasons and
| maybe our deepest drives are all tied to having them.
| malauxyeux wrote:
| Maybe not even having kids, but being engaged in something
| fully.
|
| From neuroscience, there's the default mode network.
|
| https://en.wikipedia.org/wiki/Default_mode_network
|
| > It is best known for being active when a person is not
| focused on the outside world and the brain is at wakeful rest,
| such as during daydreaming and mind-wandering.
|
| Apparently, activation of the DMN is correlated to rumination,
| itself correlated to depression.
|
| https://pubmed.ncbi.nlm.nih.gov/31655111/
|
| Interestingly, one thing often suggested to counter depression
| these days - meditation - generally says right on the tin that
| you're supposed to get into a wakeful rest state, but
| specifically try to avoid daydreaming and mind-wandering.
|
| (I should say that I'm no expert. Just passing along things
| that I've heard/read.)
|
| Edit: formatting
| blauditore wrote:
| Might also be the additional social interaction (the kid is a
| human, even if a small one). I think many people felt this
| during the pandemic and its lockdowns.
| amelius wrote:
| There are many examples of people who are obsessed by work,
| and at the same time depressed. While the distraction can
| temporarily take away the depressive thoughts, it is by no
| means a solution. I think the social aspects of raising a kid
| could be a better explanation.
| ShamelessC wrote:
| > really I think having kids gets looked down on
|
| It does? As someone who has decided not to have children, I
| feel very much like I'm the outcast. Particularly in the
| southern US. Also, here on HN where there are a shocking number
| of parents compared to say, Reddit.
| bendbro wrote:
| I agree, I wonder if depression is not always rooted in some
| random, mental problem but rather a reasonable reaction to
| reality.
| pessimizer wrote:
| https://en.wikipedia.org/wiki/Depressive_realism
| EGreg wrote:
| I kept saying this for years on HN but until the 2022 study
| it was always voted down and told that NO, it is due to a
| chemical imbalance and that we don't understand
| bendbro wrote:
| I recall that study!
|
| I suspect those downvotes are due to people recognizing
| that it implies depression is sometimes within the control
| of someone afflicted by it and conflating that with blaming
| the person afflicted by it. People seem offended by
| critiques of modern ideas that rationalize away an
| individual's control, agency, and especially culpability
| for their behavior or outcomes. Sometimes these
| rationalizations are fair, other times not.
| ryanklee wrote:
| That study does not support your intuitions on this
| matter, but merely excludes seratonin as the basis for a
| chemical imbalance causing depression. It does not show
| that there exists no material cause for depression, only
| that there is strong reason to believe it is not related
| to seratonin.
| pessimizer wrote:
| I think that it's simpler: people have long been
| encouraged to believe that certain medical procedures and
| practices that lack great evidence are responsible for
| saving their lives, and that anyone who critiques those
| procedures in any way is trying to kill them. People who
| are paid (as often as not by government) to provide those
| procedures and practices encourage these beliefs, and
| spend massive amounts of money in lobbying through
| patients' rights groups and other channels to support and
| encourage people in that fear and anger.
|
| People who are sick either continue to be sick, get well,
| or die. No matter what diagnosis or treatment you give to
| someone, they either get better, don't get better, or are
| removed from the conversation. We never hear from the
| dead again, the people who get better insist that you
| saved their lives, and the people who don't get better
| will be attacked by the people who did _for not believing
| or trusting you enough._
| whats_a_quasar wrote:
| The thing that's dangerous about this line of thinking is
| that most depressed people feel like they have insight and
| are reacting to reality as it really is. But if the
| depression lifts, they usually no longer feel that way.
|
| So trying to figure out whether depression is reasonable is
| usually a trap, and will not improve the person's life. The
| thing to do is to manage the feelings, treat the
| depression, and revisit those topics once the depression
| lifts.
| notnaut wrote:
| There is the chemical imbalance and then there is the
| diagnosis. Complete guess, but wouldn't be surprised if the
| rate of people with the imbalance has climbed less
| dramatically over the last several years than the rate of
| people being positively diagnosed.
| ryanklee wrote:
| This is a misreading of the study which was about
| seratonin. It does not conclude that therefore there is no
| material condition underlying depression and that it's
| environmental and somehow the result of circumstance.
| ryanklee wrote:
| People who suffer from chronic depression do so without
| regard to circumstance. It's a mental plague that follows one
| wherever they go, whatever they do. It has nothing do with
| reactions to anything. There's nothing reasonable about it.
| dgfitz wrote:
| I disagree. Mine set in after my first child.
| ryanklee wrote:
| I did not say that there is no such thing as situational
| depression.
| antod wrote:
| A counterpoint: Speaking for myself who had also been mildly
| depressed since teenage years, it didn't kick off into actual
| breakdowns and medication until after having kids. Previously
| it was probably so mild it wouldn't have counted as depression.
|
| All behind me now that they've mostly grown up.
| makeitdouble wrote:
| I feel we have "depression" the same way we get "colds", try to
| rest hoping it goes away. Most of the time it does, and
| sometimes it's something else completely, but in contrast to
| colds, we have no good tool to properly diagnose the exact
| illnesses, and are probably lumping together myriads of
| different things under the "depression" umbrella.
|
| That also matches how treatment for depression often involves
| throwing spaghetti at the wall and see what method and
| treatment sticks. Even medication usually goes through trying
| different chemistries a month or two at a time and see what has
| any effect.
|
| I've had friends who went out of depression by quitting their
| soul crushing jobs to start solo businesses. I expected they
| would slack a bit more and be more relaxed as self employed,
| but from the sidelines they looked way more busy, working way
| harder and longer than before. Except it seemed to work for
| them and they're still doing i years later.
|
| Your story kind of resonates the same to me, and I assume the
| family building part can be proxied by different goals, stuff
| that actually matter and bring sense to what someone is doing
| in life and/pr a different human environment. It might not work
| for everyone, but I agree there must be a sizeable portion of
| "depressed" people who's cure are not more medication or less
| work, but radical changes in other aspects of their life.
| carabiner wrote:
| The commercialization of this treatment is being handled by
| https://www.magnusmed.com/. Some existing TMS treatment centers
| claim to be performing the SAINT protocol right now, but the
| researchers have never fully revealed the treatment plan (using
| fMRI, algorithm for targeting) and so the claims can't be
| substantiated as being exactly SAINT.
|
| I'm pretty desperate to get onto a trial. Here's hoping that this
| gets FDA approval ASAP.
| poorbutdebtfree wrote:
| Is depression a first world problem? Maybe if we can send over
| our highly trained and effective therapists to the third world
| we'd find that 95% are depressed too. It'd make depression much
| easier to deal with if we knew everybody had it regardless of
| qualify of life issues.
| jiveturkey42 wrote:
| Probably just people with the luxury to sit inside all day in
| climate control, completely disregulating the hormones
| rybosworld wrote:
| It is certainly not just a first world problem. There are many
| problems in advanced nations that get a spotlight on them, but
| that doesn't mean those problems don't exist in less developed
| places. In some parts of the world, getting fresh water is the
| biggest concern. Solving that problem becomes so important that
| topics like mental health may be completely ignored. I would
| wager a guess that North Korean citizens rank especially high
| in prevalence of depression, but it's not even a top 5 concern
| for them.
|
| The historical record has many descriptions of depression
| dating all the way to B.C. times. Depression has been a thing
| that has affected humanity for at least as long as organized
| civilization has existed.
|
| I think a good question to ask is: Do uncontacted ("lost tribe"
| cultures if you will) peoples have differing prevalence of
| depression compared to the connected world?
|
| I don't know the answer to that question, but I wouldn't be
| surprised if the rates of depression in those cultures is
| lower.
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