How Prozac sent the science of depression in the wrong direction | Hacker News Reader

How Prozac sent the science of depression in the wrong direction

boston.com

27 pointsgrotius12 comments

So depression is the sensation of my brain atrophying. Actually, that explains a lot.

First thing I did after reading this? I went for a short, but hard run.

Same, except a six mile bike ride.

Depression as my brain cells dying scares me (motivates me) a lot more than depression as a chemical imbalance..

Exercise was the only thing that kept me from getting really depressed during the middle part of grad school. There's just something magical about beating yourself silly for an hour or two that helps to clear the mind....

I've had therapists/counselors tell me that exercise programs are one of the first interventions they try for depressed patients.

So depression is the sensation of my brain atrophying.

This comment makes it sound like you read that and just accepted it as true. Surely that's not the case?

When orthodoxy shifts it doesn't mean that the new orthodoxy is right. These things seem to come in 20-30 year cycles (remember the one about how saturated fat caused heart disease? or how breast-feeding was really bad... I mean, really really good?). It occurred to me that maybe one reason for these cycles is the rise of new generations of researchers (it fits the cycle length). The best way to make your mark is by discrediting the theories of the earlier generation. (I'm not suggesting all of science works this way.) This sort of churn is perhaps an indication that skepticism is appropriate. Otherwise you end up with that amusing illusion of how stupid people always were 20-30 years ago.

A new generation brings not only new researchers but also new evidence (new studies, new experiments)

Actually, as no one had yet posted a comment, I tried to sum up the gist of the article in one short sentence, thinking it might provoke actual discussion. I think we're probably both pretty skeptical about the latest orthodoxy-challenging discovery.

Nonetheless, the mechanics of brain atrophy (not that I understand them, but I understand how muscles atrophy a bit from wearing a cast on my arm) do seem genuinely helpful in explaining what it feels like to be depressed. It really does feel like something is happening to your brain. And these people seem to think so. No idea if its true or not, but its helpful to have that idea out there.

Heh, now I see what made your comment unclear to me. It was simply the word "So". If I had read it when it was the only one I bet I would have gotten your meaning.

Incidentally, I like how you're processing this information through your own experience.

Consider how much of this stuff has been pushed into people by white-coated authorities over the last 20 years and the onslaughts of expert derision against questioning it. Meanwhile it turns out that the studies on which the drug's reputation was based were cherry-picked out of a much larger set, the negative ones having been suppressed and only recovered after years of freedom-of-information litigation.

Drugs are bad! Don't take drugs! The war on drugs! I mean, drugs are good! Take the drugs we tell you to! But not those ones we gave you before!

This sort of debate (good rugs vs. bad) will only become more complex as we discover and build new drugs. What is now an illicit drug (cocaine, meth, heroin etc.) will look downright silly compared to the new custom tailored get-high drugs that come out of the drug company labs.

All I can say to people who are on both sides of this fight now is to "enjoy it while it lasts". The lines are only now becoming slightly blurred, in 20 years we'll look back on these times with great fondness. When we worried about blunt-instrument fun drugs and could tell the difference between a "steroid user" and a gifted athlete.

How do they explain why depression comes back when the meds are withdrawn?

Well, they'd probably make a comparison to weight gain. Once you get off the diet, unless you're living the right kind of lifestyle, you're going to gain the weight back.

Unless you're exercising, having regular social interactions, keeping busy with work that you find meaningful in some way, you're probably going to get depressed once you get off the meds. That's my guess.

They can't, and that's kind of the point. We don't understand the why yet, and are far from discovering the "why not".

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