Researching alternatives to the chemical imbalance theory of depression | Hacker News Reader

Researching alternatives to the chemical imbalance theory of depression

huffingtonpost.com

45 pointsnradov19 comments

No serious scientists have thought depression was caused by any simple story of chemical imbalances that drugs were directly fixing. The author acts like everyone has been assuming that depressed people have an ssri deficiency. And that's it's a huge insight to consider therapy.

And people have tried therapy for a very long time. The best studies show it's as effective as anti depressants. But here's the rub, it's very expensive to go the therapy.

My wife had a condition that is more amenable to therapy than drugs and that cost us $500/week, and the only reason she could make her appointments was because she didn't need to work. I have no idea how a working family would have been able to afford it.

Her ssri's are 15$ a month and she has to see a psychiatrist every 3 months.

It is environment + chemistry.

"Underdog" animals develop a low serotonin state.

http://www.ulm.edu/~palmer/TheBiochemistryofStatusandtheFunc...

Many of the behaviors and attributes associated with "poor" people are similar to the low-serotonin state described above.

If you are "ground down like a minion", SSRIs attenuate the negative impacts of that.

A better catch phrase is "affective neurology," the simplified explanation of which is phenotypical expressions causal to the organism's nervous system and apparent behaviors. Here, our working models of the nervous system obviously involve a considerably higher level of abstraction than chemistry.

https://www.independent.co.uk/voices/johann-hari-depression-...

"But I wish that I, or one of my colleagues, had a chance to meet him on this voyage. He suggests that depression is treated as if caused by “broken”, chemically imbalanced brains and so sufferers are treated with antidepressants, without question. This treats a patient like a “machine with malfunctioning parts”.

This is far from reality. Rather than seeing mental illness as annexed from the rest of people’s lives, helping patients through assessing their social and psychological situations, as well as biological aspects, is the bread and butter of the work of psychiatrists and other mental health professionals."

Especially in the UK where IAPT (Improving access to psychological therapy) makes available a short course of cognitive behaviour therapy, free at the point of delivery.

While the article raises some good points, the title is such clickbait. We've known for decades that many mental disorders have psychological roots, and that a combination of psychotherapy/CBT and medication is far more effective than medication alone.

Brain chemistry is certainly important in depression but we don't know enough about it to rely on it for treatment. A large investigation was done into genomic links to depression and there were no markers related to serotonin / dopamine genes. SSRIs were discovered through serendipity largely and nothing new has really been developed since bc we don't know much about the brain (though we think NMDA receptor agonists and some allosteric modulators of GABA r may work)

Therapy is the right way to handle a lot of depression cases, but very few people get it because of stigma and the fact that psychiatrists can't make money doing therapy unless the patients are rich

And it just leaves us hanging. It says there are 9 major causes, and then only discusses one of them. A quick Google doesn't come up with an obvious list, and little agreement on the number 9.

That title was bad. We've updated it with representative language from the article.

Meh writing. There are nine causes of depressions? What are they? Which one is he going to focus on?

And for those of us who had nothing bad happen to them during childhood, but still feel depressed?

Bad can be just as well defined as a lack of good, much like depression itself. Consider that it may be an exercise in futility to try to discern the "true cause" of your emotional state, and that it may be more worthwhile to begin implementing solutions than to attempt to further deconstruct your problem. Human psychology is much like software save for one very important distinction: you cannot read the code. As such, trial and error remains the best strategy.

>> Human psychology is much like software save for one very important distinction: you cannot read the code. As such, trial and error remains the best strategy.

And there are many models of what may be wrong. You can often fit a model onto your situation, but it helps most when you find the "right one" for you and deal with it appropriately. The software bug in the brain can look like a number of things, but they are not all correct. Trial and error is correct here.

As someone who is hypersensitive to chemicals and fragrances of all kind, I can say without any doubt that in my case depression is caused by environmental toxicity.

I can become suicidally depressed with the flip of a switch, if I'm exposed to the right toxin. In my case it is mold and certain fragrances or perfumes.

And I have no history of depression, and no childhood trauma of any kind. This all happened after severe mold exposure and development of chronic ME + chemical hypersensitivity.

From my point of view I posit to argue that scientists are clueless of the real causes of depression. From my point of view, and repeated own experience and experience of others who suffer from MCS, it is crystal clear that toxicity is a major trigger for depression.

If you are depressed, and don't know why: consider your environment. Are you being exposed to mold or strong chemicals, building materials, furniture VOCs (Volatile Organic Compounds)? You should also consider your diet as being one potential source of toxicity.

Modern healthcare and psychiatry has almost completely disregarded environmental toxicity as potential for disease. I think there is an enormous gap in knowledge here, that is yet to be filled.

Hari's book on depression had another thread recently (https://news.ycombinator.com/item?id=16092975) but perhaps this article is different enough.

It's useful to discuss mental ill health on HN, but Hari isn't a good starting point for these discussions.

He's mostly wrong; he misrepresents the current thinking; he mangles the science; etc.

We spend so long correcting his mistakes that there's little room left for discussion.

https://amp.theguardian.com/science/brain-flapping/2018/jan/...

The author, Johann Hari, recently had a Guardian piece on depression. His representation of psychiatric research and clinical practice was so cartoonish that he has burned up his credibility with me. Steven Novella (a clinical neurologist) discusses that article here: https://theness.com/neurologicablog/index.php/more-mental-il...

This article is similar, in that Hari is claiming, without evidence, that depression is always caused by life events. It's a strange claim to make, not only because it's made without any support, but because modern psychiatric research and practice most certainly incorporate traumatic life events as potential causes of depression.

In the original article Hari doesn't claim depression is always caused by life events. Rather he says this:

"The more I investigated depression and anxiety, the more I found that, far from being caused by a spontaneously malfunctioning brain, depression and anxiety are mostly being caused by events in our lives."

Emphasis on _mostly_.

At least in the article above, Hari never claimed life events were the sole cause of depression. But he did claim---in my experience accurately---that doctors around the world push the idea that depression does have a single cause, "chemical imbalance". My doctor never asked what was going on in my life---and there was plenty. He just gave me drugs and told me I'd have to take them for the rest of my life. That story is very common, and that's why I find value in an article like Hari's. And the mischaracterization of normal human reactions to painful life events as "illness" is odious to me. It's like saying a suffocating person is "ill" because they're not doing well without oxygen.

> doctors around the world push the idea that depression does have a single cause, "chemical imbalance".

This sounds like something a scientologist would say. I remember actor Tom Cruise talking using these words

https://www.csicop.org/si/show/tom_cruise_scientology_bash_p...

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