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Comment by sillysaurusx | Hacker News Reader

they struggled against the dehumanising notion that their thoughts, feelings or behaviour were mechanistically caused.

Finally, a thread where I can point out my own experiences.

Around four years ago, it would be fair to call me slightly crazy. It was a harmless sort of crazy, but it was quite self-destructive. I used to wake up wishing to die, genuinely, and not knowing why.

All of that changed after going on Prozac. I don't know why, and I've heard from many others that Prozac was harmful to them. But from my point of view, it was nothing short of a lifechanging miracle. I can't remember the last time I've had suicidal ideation.

Most people keep this sort of thing quiet, and I think silence is part of the problem. When I was younger, I might have looked down on someone for saying what I just said. When you have a broken leg, everyone notices and can relate; when you have a broken mind, no one can see it, and so no one can feel sympathy, let alone empathy.

So what's the takeaway here? One: do not lose hope. I came very close to losing hope, and it would have denied me so much. Two: make a doctor's appointment. There's a chance that you'll wind up on something that makes the situation worse; you need to make a followup appointment ahead of time.

Support networks only got me so far.

View on HN

I started having disturbing, invasive thoughts a few months before the pandemic hit. I’d be watching a movie with my family after dinner then boom, I’d feel insane. It wasn’t suicidal just things like “soon you will be DEAD!” kind of stuff. Turned out it was me reacting to some of the food we were eating at home.

The GP I saw suggested Lexapro which I’ve taken before and it’s not for me. I told him the problem had a strong correlation to food; if I fasted I didn’t get these thoughts. Doctors look at you weird when you say you think asparagus is driving you mad. He just sort of ignored me, I think the fact I saw him right after the pandemic hit just made him assume I was depressed and anxious because of the lockdown.

The really crazy thing to me is that Nexium has basically made the problem go away (Prilosec worked but wasn’t quite as good) I saw a GI specialist and he showed me the low FODMAP elimination diet and suggested I eat low FODMAP foods and that has helped it the rest of the way. So crazy how much our gut can affect our mood and psychological profile.

Many neurological disorders are at least linked to gut bacteria, including autism and schizophrenia.

https://www.sciencemag.org/news/2019/05/gut-bacteria-may-con...

https://www.psychologytoday.com/us/blog/balanced/201903/schi...

Initially I suspected carbon monoxide poisoning, because it correlated to when I’d come home. The symptoms were that bad. Turns out it was the dinner I was cooking every night for the family, I’d sit down to relax and eat and just a few minutes after eating asparagus feel completely bonkers. I went to the emergency room, they gave me a few Xanax; then the GP who wanted to prescribe me Lexapro and referred me to a Gastroenterologist. It wasn’t until I got to the specialist that I felt like he “believed” me.

So what's in asparagus to cause this?

Sounds like you have some enzyme defect. Do you know any specifics?

Well I know asparagus is on the list of high FODMAP (fermentable) foods along with beans and flour, which also cause similar problems for me.

Have you been allergy tested? I found out last year (midway into my 30s) that I'm actually allergic to half the foods my mom used to prepare for me. Like tomatoes/nightshade fruits. I would always get itchy, confused and generally feel inflamed and terrible and my mom made me tons and tons of spaghetti as a kid. I had constant GI issues in school and did pretty poorly, bad memory, etc.

Prior to allergy testing I got really obsessed and into probiotics, lifehacking etc just to make myself feel better and I feel like nothing really helped my GI problems which always feel like they're sapping the energy out of my entire body. Turns out a huge portion of my problems were food allergies.

I haven't gone full FODMAPS but I eat much more keto/paleo nowadays when I can (I've been loose since quarantine) and feel so much better when I do. Meat and lettuce is my prime meal now.

Aren't there a lot of pseudoscience-based food allergy tests out there? I've seen ones where you drop blood onto paper cards and mail them in. Somehow they test your old dead blood and then they send back a list of foods and tell you if you're allergic to them... Seems fishy to me, and I could not find how it worked or anything that these tests are legit. Every other type of allergy that causes inflammation in the body is done live, on your body with a test where they prick your skin. But I've never heard of this being done with food. Where did you end up getting your food allergy test done?

I went to an Allergy clinic in a hospital and just got the entire test where they prick sample sites into your back (it doesn't hurt at all). I don't have my paper near me but I hit something like 80-85% of the allergens they tested me with which ran the gamut from pollens to bugs, a few common common foods (tomatoes/nightshades for sure, I forget what else) were also on the list although not that many.

IIRC it was either stupid cheap or covered by insurance. I was a little annoyed my parents didn't take me in when I was younger for it.

It was completely hassle-free and maybe 30 minutes.

Now when I eat pizza with tomato sauce and start scratching my arms and my mouth is burnt and my stomach is destroyed and I have wild brain fog for 3 days I finally know why! Not sure how I never equated it before, I always thought it was the bread and never got gluten tested (could still contribute, but I'm not going through that test).

This is a dogs results but my results looked similar, I just had a food section; https://i.servimg.com/u/f11/18/49/47/07/kyeall11.jpg

You should seriously look into mast cell activation disorder (~30% of the general population has this) along with histamine intolerance.

I had a panel for foods and came back as not allergic to any of them.

You should check out this company studying the gut brain axis :)

https://www.kallyope.com/

> So crazy how much our gut can affect our mood and psychological profile.

This is anything but crazy. It has been well known for a very long time and is very well supported.

I started taking Prozac a few months ago. It might just be a coincidence but I checked myself into drug addiction treatment a couple months later. I’ve stopped taking almost everything but the Prozac and my life is immeasurably better and my depression is gone. I’m happy for the first time in many years.

This to me hints at the effect of Prozac possibly being far more complex than “chemical imbalance”. I’ve never found that terminology that useful. Fixing my depression required a lot of chemical changes yes, but also major changes in my voluntary behavior. All of it was connected in an intricate tapestry and Prozac only plays one part. If I tapered off Prozac, I suspect I would still be happy, but I don’t know that my depression would have ever resolved properly without Prozac. The side effects are mild so I am in no rush to discontinue.

Hold up. Is the specter of existential angst, rising to outright horror if left unchecked, not just, like, a normal part of life that rises to conscious thought as soon as you’re not distracted, for the entire non-religious population?

It depends on whether or not you engage with your hobbies.

Nah, we just ignore this stuff for the most part. People are really good at compartmentalizing things, and pretty much feel they are immortal. A lot of us suffer from stockholm syndrome and think death is somehow good -- just look at a common reaction to many transhumanist notions.

Those who do take it seriously but are not strong enough to bear, end up joining cults.

I don't think it is.

I've had times in my life when I certainly didn't constantly distract myself, and being of a contemplative type, sometimes also delved into existential thoughts. But I didn't automatically (or generally) feel angst about it.

I'm not religious and haven't been since I was 15 or so. (I don't deny possibly having something of a mildly spiritual side, but I consider that different as it doesn't require belief in anything other than various kinds of feelings and experiences being part of the human experience. It also doesn't provide an externally assigned meaning.)

In times when my mental health and wellbeing have generally been worse, existential questions have also become much more distressing.

So yeah, maybe for some or even many people, existential questions may amount to angst, but in my experience it has depended a lot more on my other emotional and psychological state.

No man, that's just one line of thinking. I'm not religious in the least, and I love spending time alone and unoccupied. I know about existential angst and have indulged in it in the past, but my mind just wanders to other more pleasurable things when it's undistracted.

> When you have a broken leg, everyone notices and can relate; when you have a broken mind, no one can see it, and so no one can feel sympathy, let alone empathy.

This hits home and almost moved me to tears. I went through a trauma about 3 years ago, I was Kidnapped/abducted from a gas station at gun point and was forced to drive my attacker for nearly 30 minutes at gun point under threat of death before opening the door and diving out of my moving vehicle to escape. During that experience I considered purposely crashing my car believing it would kill both me and my attacker, but I wanted to live and ultimately took my chances diving onto the street from the moving car knowing I might get run over.

I can’t explain it other than I know I should have been thankful/grateful/happy I escaped with my life, but I knew immediately the trauma was real and sure enough it has been a downward spiral of cutting off every single relationship in my life and extreme isolation/avoidance. I’ve sought help/treatment (both therapy and meds) to no real benefit.

Even 3 years later I have to relieve the trauma because I’m suing the gas station for negligent security (turns out the guy had been loitering at the gas station for 2 hours prior to targeting me, even hanging out in the store talking to employees without ever making a purchase). The insurance attorneys are victimizing next worse than my kidnapper, they have destroyed the surveillance video, Claimed the kidnapping didn’t happen on their property (when I was literally approached while at the gas pumps), and telling me my damages aren’t real. This goes directly to your point, if I were shot they would have settled the policy limit ($2M) but because it’s not visible damages they are doing everything to claim it didn’t happen on their property, if it did they aren’t liable, and if they are liable the damages aren’t real but self inflicted. They either have no clue what kind of additional trauma they are causing or they actually do and are trying to cause me self harm so this goes away for them.

I humbly admit while I always felt for people who went through traumas (soldiers, child abuse, sexual abuse) I realize now I was incapable of actually empathizing...I won’t say I have suicidal ideations, but I often feel I’d have been better off not surviving.

I’m so sorry to hear that. Keep fighting the good fight. Don’t give up. You survived for a reason. You have a purpose. Only you can figure out what that purpose is.

I'm very sorry to hear about your ordeal, it sounds absolutely horrible. However, it's surprising to me that a commercial outlet in the US is basically responsible for keeping the bandits away. In my country I really doubt such thing claim have any chance in country, as public security is seen as a role of the police. I'm not 100% sure on the law, but I believe that, here in Poland, the security guards are there to protect the company's property and have no legal obligation to protect anyone else.

> as public security is seen as a role of the police

In the US police have no duty to prevent crime, also the gas station is private property not public and police are not considered public security. In short just like slip and fall cases in The US, businesses owe a duty to invitees to remove foreseeable dangers such as a slippery surface (in the case of a slip and fall) or a suspicious person loitering on premises for 2 hours. They also owed a duty to preserve the video evidence but they destroyed that as well.

I have a hard time believing in Poland a business might allow a rapist to just hang out on the property and identify potential victims all while a security guard is standing by that does nothing. That said laws wildly vary from jurisdiction to jurisdiction

Thank you for sharing. I'm glad your still here to relate your story. I think speaking these things is an important part of the healing process. Pax et bonum.

I also got ptsd in a domestic setting. Please remember it gets better with time. I’m sure you already know this, but MDMA has been shown to be effective in treating ptsd. I was personally able to get rid of most of the symptoms with large doses of propranolol. Try both of those before killing yourself.

Thanks for sharing. I've always been firmly grounded and positive person. And then a few years ago riding my bike down the road, I felt a immense wave of anxiety coming over me so intense that I felt like jumping off my bike and running away from myself. As an ex army special forces guy I found this particularly disturbing. And this was just the beginning. My situation continued in that general direction until I started experiencing pain in my liver area. I hoped it would go away but it didn't, so two months ago I decided to face it head on and get full tests done. Xrays, CT scans, ultrasounds, blood work. urinalysis the works. All came back clear. But I just felt it was not me... and searching my symptoms pointed to parasites. So I did a 6 day liver cleans (cant recommend this enough) followed by adjusted diet and two rounds of combantrin I'm please to be back to a very good place.

Depression and anxiety are nasty. I was surprised to learn they are symptoms of parasites. They've evolved in such a way that they can manipulate the host into craving foods that are beneficial for them (not for the host). Symptoms among others include anxiety, depression and irritability.

What parasites are we talking about and what's a 6 day liver cleans ? (I mean, the procedure).

Do you mean to say you had depression for a few months (with anxiety on top) ?

I had ups and downs after the first anxiety attack occurred but if normalized it was certainly a gradual decline into depression. Anxiety would come and go and although i never considered suicide I did wonder if I would be better of dead.

The liver flush I did involved a morning celery and lemon juice. 5 light meals. 1L of apple juice spread throughout the day. After dinner a glass of water with epsom salts (tastes like pool water but has epic muscle relaxing effects so amazing sleeps) and psylium husk. On day six involves some more epsom salts, then drinking half a glass of olive oil with lemon juice. There's more to it but you can find this protocol pretty easily. Its quite common to pass a lot of stones in stool the next day which is old bile that has been hardened after being purged from the liver. It's important to check you don't have gall stones before doing the liver flush. An ultrasound will tell.

In terms of parasites I cant say 100% but combantrin works on 4 main types (mostly parasitic worms) [1]. There's also liver flukes which seemed to be explain some symptoms.

[1] https://en.wikipedia.org/wiki/Pyrantel

"Also, people who try gallbladder cleansing might see what looks like gallstones in their stool the next day. But they're really seeing globs of oil, juice and other materials."

https://www.mayoclinic.org/diseases-conditions/gallstones/ex...

Thanks.

Wow, this is a very interesting story. Another person might have just resigned themselves to their angst-ridden fate, and never gone beyond psych meds. It seems like generalist doctors (I’m sure lot all!) think, or at least act, as if there’s no link or causal relationship between mind and body. I did a three day fast which reduced my anxiety symptoms immensely for months, glad you sorted this out.

> Symptoms among others include anxiety, depression and irritability.

It wasn't until the late 1800s that the miasma theory of disease was overturned in acceptance by germ theory. At some point in the next century, computers will become powerful enough to closely simulate the entire human body. We'll be able to hook up our bodies and compare them to a common model in a sort of "debugging" process. I think what we'll find is a diverse host of viruses and parasites, or other curable abnormalities that are responsible for mental health problems.

> All of that changed after going on Prozac. I don't know why, and I've heard from many others that Prozac was harmful to them.

SSRIs are some of the most widely-used medications. Tens of millions of people in the United States alone use SSRIs regularly with good results.

No medication is perfect, obviously, and at scale we're bound to see a percentage of people have negative experiences. The problem is that when tens of millions of people have tried SSRIs, even 1% significantly negative reactions adds up to a very large number of people. If 1% of those negative reactions make a point of blasting their negative experience all over the internet, we'll see thousands of negative reports everywhere.

Combine this with the fact that few people are willing to publicly admit that SSRIs helped them, and the bias toward negative reviews online is huge.

SSRIs are a particularly difficult topic, because they have a noticeable treatment lag (can take up to 1-2 months for positive effects, with positive effects increasing up to 6 months out) and can, in some cases, temporarily worsen symptoms during the initial ramp-up period.

Even more difficult, not all SSRIs are the same. It might take 2-3 trials before someone finds the SSRI that works best for them. It might also take several dose adjustments to find the right tradeoff between efficacy and side effects. Unfortunately, many people go online and seek out horror stories before they have a chance to go through a few rounds of medication adjustments to make it work for them.

Thanks for sharing your positive success story online. SSRIs aren't for everyone, but it would be a shame for people to spend years suffering from depression when a few SSRI trials might reveal an easy improvement to their lives. Worst case, they can taper off (tapering helps avoid discontinuation effects) and move on to different treatment avenues.

Great comment, I mostly agree. There are clearly many people who've been helped.

Some of the other contraindications (for the disparate group in that 1% you mentioned) are still important to mention, I think.

If you're not certain you'll always have health insurance. If you may ever want to try MDMA therapy, or just about any type of psychedelic therapy (or use them recreationally). If you're uncomfortable with being on something like this super long term and/or are concerned about withdrawal issues. If you can't stand the thought of risking becoming a happy-ish, functional zombie with no sexual interest in your partner. If you're worried the doctor won't diagnose you correctly. If you're not sure you can emotionally handle going through potentially a year or more of trial & error and having to wait months each time for results. Then think twice.

I am extremely glad for the people SSRIs have saved, especially those who wouldn't have made it otherwise. It is also incredibly clear to me that despite my continuing issues with depression, they are probably the wrong approach for me.

When a patient's symptoms are treated instead of the cause, most people will have subpar results.

The SSRI Lexapro [0] helped my girlfriend relapse on cocaine, before i met her. Cocaine is a much stronger anti-depressant than the SSRI's due to its effects as a Mono-Amine Oxidase Inhibitor [2] (1st generation anti-depressants).

Eventually the professionals figured out she is a poor methylator, and can't convert folic acid into Folate. Folate (Vitamin B9) is important for DNA synthesis. Food companies fortify with folic acid because it's more stable than other forms of Vitamin B9, even though we now know that some people are harmed by this fortification [1]. On the whole, fortification seems to be beneficial (fewer deformed babies), but poor methylators and old people seem to have negative side effects from getting their vitamin B9 from folic acid.

She said adding the L-Methyl-Folate was like flipping a switch between "depressed" and "normal". Her involuntary medical professionals didn't say, "hey sorry we made a mistake, you're not actually broken", and continue to ignore the actual causes of her condition.

[0] https://en.wikipedia.org/wiki/Escitalopram

[1] https://now.tufts.edu/articles/folic-acid-too-much-good-thin... / https://www.futurity.org/folic-acid-too-much-of-a-good-thing...

[2] https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor

(edit - added bit about cocaine being an MAOI)

What makes you think cocaine is an MAOI?

I read something that compared cocaine's mood-lifting effects to those of the MAOI's. I remember it further said the MAOI's were generally safe for short-term use, unless you consumed certain types of fine cheese, and that they fell out of favor as their patents expired, not because they didn't work anymore.

I have a hard time keeping track of where I read what; I haven't found a source on a cursory search.

You make a lot of great points.

If I could add anything to the SSRI topic it would be that mental health treatment is incomplete without a form a therapy. If a person's treatment plan includes SSRIs, that's great, but it should always include therapy.

There are also other categories of medications which people forget, with the spotlight being on SSRI. Off the top of my head there's also SNRI[0], NRI[1], MAOI[2], RIMA[2], and TCA[3].

Arguably for low to moderate depressive disorders there hasn't been conclusive evidence that psychiatric prescriptions work, however there IS conclusive evidence that for major depression the benefits are at a minimum "small" and up to "substantial" ([4],[5]).

So as soon as we discuss depression, everyone might mean something different. It's a sad state of affairs because now people think they're talking about the same things but they're really not - they just happen to have had different psychiatrists who assessed things and behaved perhaps differently, and where one might have really mostly needed therapy and the other both therapy and antidepressants, in the end everyone went home with a prescription for the fancy SSRI of the year. Psychiatrists as a whole need to reevaluate the rate of prescriptions, the tools to assess major depressive disorder, and the actual array of treatments that are available to them.

I've had wrong diagnoses. I've had appointments that my doctors missed without rescheduling even though I was there. I've had those 15-minutes-and-you're-out meetings with a psychiatrist, whose prescriptions for what conveniently is the "newest pill" were given along with free samples until one day you have to pay for something you can't afford or switch treatment and deal with weeks of uncertainty, and so on.

I have been saved from death and cycles of immense self-destruction by a healthy relationship with a knowledgeable and experienced psychiatrist willing to take me, when my legal troubles had by then reduced my options and driven me further to the edge. Some real discussions, a carefully explained switch from SSRI to RIMA, which worked. "Is that what it is to feel somewhat normal? I can't believe people feel like that most of the time!!"

It allowed me to truly know what therapy is, because there was more to the day than being unconscious or wanting to be dead or death-by-proxy. Therapy gave out some tools to live and interact in a healthy way with myself and others, and to seek more tools too.

The struggle still exists entirely and comes back in heavy waves some days. A lot more difficulties are now an inherent part of my life and rebuilding things will take time and struggles. But psychiatric treatment gave me legs I had lost for nearly all of my life, and therapy taught me to walk again, and I'm well intent on walking out of everything I fell into - regardless of how long and arduous the path is. And whenever I'm able to, to take others out of the pit too.

[0] https://en.wikipedia.org/wiki/Serotonin%E2%80%93norepinephri...

[1] https://en.wikipedia.org/wiki/Norepinephrine_reuptake_inhibi...

[2] https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor

[3] https://en.wikipedia.org/wiki/Tricyclic_antidepressant

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712503/

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253608/

I was "lucky" to have been majoring in psychology right before getting diagnosed with major depression. So I went into treatment knowing things like this that helped me stick with it.

Which was a literal lifesaver, because the first SSRI I took gave me severe stomach pains. I spent at least 2 hours every night spitting into the dorm room sink with the lights out.

Instead of quitting, I knew to ask for a different SSRI. I also knew to switch therapists when the first one just talked at me the whole time. I then got one who listened a lot at first, then started challenging things I said after we had some trust.

And one more helpful thing J knew: medication was like a crutch. And, despite that usually being a negative metaphor, I saw it as a positive. If you break your leg, you use a crutch while it heals. Your treatment should be the crutch (meds) and therapy. The therapy works better when you can think better.

I ended up not needing my meds anymore. I still have overall flattened affect and bouts of depression, but I can deal with them. To torture the metaphor, it's like having a slight limp from the broken leg. I'll never be "back to normal" but still find life worth living.

One of the ways that Prozac helps people is by increasing allopregnanolone in the brain [1]. This is a well-known effect of Prozac, and perhaps the other SSRI's. Allopregnanolone "is a neurosteroid and acts as a positive allosteric modulator of the GABA-A receptor, the major biological target of the inhibitory neurotransmitter γ-aminobutyric acid (GABA)" [0]. GABA -> relaxation [2]. GABA supplements don't work very well on account of the blood brain barrier...

An evil pharma company recently got their version of allopregnanolone approved to treat postpartum depression. Cost of treatment: $34,000. It's cheaper to go upstream: progesterone, pregnenolone, or figure out why the body is having trouble making pregnenolone from cholesterol... Vitamin A? Thyroid?

One theory of why women experience postpartum depression is that their progesterone levels "fall off a cliff" after they give birth. In theory supplementing progesterone would help postpartum depression better than allopregnanolone. No one can afford to do that study because there'd be no pay off, as all the important patents have expired.

[0] https://en.wikipedia.org/wiki/Allopregnanolone

[1] https://scholar.google.com/scholar?q=allopregnanolone+fluoxe...

[2] https://en.wikipedia.org/wiki/Gamma-Aminobutyric_acid

So market incentives are provably not the way to best outcomes for humanity?

>Most people keep this sort of thing quiet, and I think silence is part of the problem.

For the sake of this, I post about it online on occasion when the topic comes up -- an SNRI, Effexor XR, was life-changing for me, too. I suffered from crippling anxiety; my therapist diagnosed me with generalised anxiety, social anxiety, and major depressive disorders. Cognitive-behavioural therapy helped me live me life instead of letting it be controlled by these issues, but the issues were still there, and quite intense. There were some nights it just totally overwhelmed me. On Effexor XR, that never happens. Anxiety and depression are not only no longer constantly looming over me, but they are completely gone.

However, the first thing I tried was citalopram, an SSRI. It mostly got rid of them too, but I never felt quite like 'myself'. I felt like a zombie and like a bit of my soul had been taken out. Plus it wasn't entirely effective like Effexor.

(For what it's worth -- diet, exercise, and so on were tried too. No benefit to my mental health. I've also given more time than they're worth to various supplements that people report as helping their own issues.)

I'm glad it helped, and I think offering up stories from all angles is really beneficial, especially when it comes to mental health. The reality is, there is no one size fits all solution, so the more people talk the better off everyone is.

I took one of the offshoots of Prozac for three months and it took my suicidal thoughts to a whole new level. For me it's all about therapy. A lot of what I'm facing is less about hormones and more about emotional trauma, so these pills are trying to fix the wrong thing. It's like fixing your breaks when the engine doesn't start. Sure, they are both parts of a car, but they couldn't be doing more different jobs.

My experience with therapy has been really eye opening. I think everyone can benefit from some form of therapy. I think the world would be a much better place if people were able to feel their emotions, explore them with curiosity, and learn from them.

Lastly, take care of yourself, friends. If you're not feeling well, please talk to a professional. They can help you.

I've suffered with depression my entire life, or at least as far back as I can remember. Even as a young child I felt that way - despite the fact that my mother was a manic depressive (with multiple suicide attempts and stays in psychiatric hospitals over the years), I didn't recognise it as depression until I was much older; firstly because it was how things had always been, and secondly I guess because I got so good at hiding it that I'd subconsciously convinced myself.

I was always sad, and saw little meaning in my life, or in life at all, really. I cried lot. I frequently fantasised about killing myself, though I never got close to actually doing so.

I never talked about the way I felt. I felt ashamed, and I felt that people wouldn't understand - I've often heard "normal" people talk of how depressed people should "man up" or "get over it". Over the years, I got very good at hiding my true feelings. AFAIK, nobody ever guessed.

Maybe 5 years ago I started taking 5-HTP, which I believe has an SSRI effect (but one that is more short lived than pharmaceutical SSRIs). I actually started taking it for another reason (neuropathic pain, which has of course not helped with depression!), as I'd never considered treating the way I felt with chemicals, but within a few weeks the difference in me was incredible - I realised I hadn't cried in a while, and hadn't felt the immense lows that I felt every couple of weeks or so.

I still take 200mg twice a day, and get immense benefit from it - it's not a cure by a long shot, but after a lifetime of feeling miserable, the change is amazing. I seldom cry for no reason, and I rarely experience extreme lows (and when I do, they are less severe and shorter lived).

More recently I also started taking ketamine for my neuropathic pain, but it's actually further enhanced the anti-depressive actions.

I've tried SNRIs and SSRIs for my neuropathic pain, but am unable to tolerable them. If anyone else is in the same position, I'd very strongly recommend reading about 5-HTP and thinking about trying it. If you've tried SSRIs and they've failed for you, then it might be worth looking into ketamine (though I realise that may not be an option depending on where you live).

they struggled against the dehumanising notion that their thoughts, feelings or behaviour were mechanistically caused.

The realization that thoughts think themselves was one of the most profound moments of my life.

Identification with your thoughts is a recipe for unhappiness.

You don't have to listen to everything your brain tells you

I've seen bumper stickers: "Don't believe everything that you think."

My wife just started Prozac after years on other medications, and has had a similar “miracle”. Her mood has been the stablest of the last 10 years I’ve known her. It’s been life changing for her and thus myself, as selfish as that feels. Anyway just really glad to hear another’s similar story.

I'm the same way with ADD, getting on medicine changed my life. Unfortunately, i waited until my 30s to actually go to a doctor (at my poor wife's demand, i mean suggestion). All my life I had been told i wasn't smart enough nor studious enough to do the things i wanted and so struggled through it all. Getting on a medication changed everything for me. I use the analogy of imagining your day as a good, solid, sprint. You finish tired but you did it and feel good about it. For an unmedicated person with ADD it's a good, solid, sprint but up hill. Everything is just that much harder and exhausting than for a normal person.

ADD drugs obviously get abused and so I think they get a bad reputation and, for sure, can be dangerous and have side effects.

Same goes for pain medication. For real, genuine, chronic pain sufferers Oxycontin and the others are life changing. However, the drugs also get abused and are addicting so the real benefits can get masked.

The last thing i'll say is it takes a disciplined prescriber when dealing with these kinds of drugs. As software engineers, I'm sure we're all guilty of just throwing code at a problem. Many prescribers are guilty of just throwing Adderall at a problem or throwing Oxycontin at a problem without really understanding the root issue.

As a counter point, I was on prozac (fluoxetine) for about a year after being diagnosed with major depression. Everything seemed better at first, but my personality changed in a way that, when I looked at it objectively, I did not like and eventually I felt as though the drug was merely masking depression that never actually went away.

My personal opinion having talked to doctors, therapists, and other depression sufferers is that the medical industry's treatment of depression is basically just throwing darts and hoping. They only kinda have a rough idea of how to treat some of the symptoms of depression and care not for any potential underlying causes. The "chemical imbalance" language, in my considered opinion, really does enforce this world view that depression is something you just throw drugs at until you're fixed, and I don't think that's helpful.

As far as I can tell, there isn't a clear consensus on the precise causes underlying depression. It's challenging to treat causes when you lack a mechanistic understanding. So, yes, they've developed treatment protocols that use the tools they have available that sometimes work.

I don't think anybody considers this ideal, but many consider it preferable to no ability to treat at all. A world in which a deeper understanding of fundamentals enabled full treatment would be best for everyone.

It's not like nobody is trying! But setting a bone doesn't require a deep understanding of how bone knitting happens, and therefore comes well before.

This plays nicely into the idea that human consciousness is really just our brain meats way of resolving the internal understanding of the world with the outside understanding of the world.

Mental health, and any issues you have with it, are a hitch in that system. But to assume that you can fix is by only affecting one part(the internal understanding of the world) seems flawed for me. Same can be said, like in the article, of only fixing the outside understanding of the world (chemical changes).

So let me add my voice to your message, don't lose hope! We are a ball of walnuty textured jelly that tracks changes between the inside view of the world with the outside input of the world using lightning and chemicals. Its complex, hard, and the fault surface is huge.

Keep going, try new solutions, find someone one who helps you build the solution for you. But please, _try_.

That's fantastic you found the right SSRI for you immediately, that's incredibly rare. I second the sentiment that when you find the one for you and everything clicks, it's a truly life-changing experience.

One thing to watch out for with Prozac is diminishing sensitivity in the nether regions, that's probably the biggest reason I tried a few others and transitioned to another medication.

> That's fantastic you found the right SSRI for you immediately, that's incredibly rare.

It's not accurate to say that it's "incredibly rare". Most people can expect at least some dosage adjustments, if not a few trials of different medications.

However, most people will see some improvements from any antidepressant treatment, even if it's not full remission. Getting to full remission is the challenge that requires fine-tuning.

Practically speaking, antidepressant medication shouldn't be viewed as a one-stop solution to depression treatment. It should be used as a larger treatment regimen involving therapy (ideally professional, but even self-directed with books is helpful) and lifestyle changes to identify and address the source of the problems.

As such, even a minor boost from an antidepressant can help move a person in the right direction, even if it isn't a one-stop cure for the depression. We need to collectively get past this idea that antidepressants are an all-or-nothing cure all and start viewing them as an adjunct to getting back on your feet and staying there.

> It's not accurate to say that it's "incredibly rare".

¯\_(ツ)_/¯

Both my psych and GP said it generally takes at least three different medications to find one that's effective for someone.

I had a similar experience with Prozac, albeit less extreme. I was depressed and very anxious about anything and everything. Started Prozac + CBT therapy, it had no side-effects and I was feeling really much better in a matter of weeks.

I’m glad you got help. Sometimes the only thing keeping me going is that suicide is a permanent solution to a temporary problem, and there is something else to try. Medication also helped to prevent me from going too low

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