Do you believe in psychiatric medication?

[cantthinkofusername]

Is it worth compromising who/what you are in order to be happy and/or functional?

 

[Holu]

Do I believe in the science behind it? Absolutely.

But is it worth sacrificing who/what you are in order to be happy or function, that depends.

I'd say no, but sometimes who you are is also not great. I'm bipolar. If I don't take antipsychotics then I suffer greatly, just for being who I am. But taking the meds doesn't make me ideologically different, nor does it alter my identity. It just keeps me from going as batshit. It really depends on how the meds affect you. Realistically there shouldn't be any major side effects, and certainly not perspective and identity altering ones.

But if you are asking me if I'd cure myself entirely with some super pill, but it costs my identity of who I am, that's a no. I grew up with my mental illness, it's quite literally shaped my identity, my relationships, my beliefs, and my choices. I'd rather die sad and bitter but be authentic lol.

 

[cantthinkofusername]

i just feel like theres more to life than maximizing happiness and minimizing pain and while medication makes me happy i feel like it also makes me dull and with it ill never be whole and i dont wanna go back on meds but life is barely bearable as is

 

[Holu]

i just feel like theres more to life than maximizing happiness and minimizing pain and while medication makes me happy i feel like it also makes me dull and with it ill never be whole and i dont wanna go back on meds but life is barely bearable as is

What meds are you taking? SSRIs? NDRIs? Antipsychotics? Antidepressants?

Just tell me the brand or chemical name. I'm guessing you are taking SSRIs, since the " emotional blunting" is usually a common side effect. The good news is, there isn't much risk for stopping your medication aside from your mood worsening again. SSRIs are first line mediation, meaning low addiction + withdrawl risks. There is the possibility you get erectile dysfunction if your a man, but that's not really common.

 

[cantthinkofusername]

im not on anything right now
i just got prescribed latuda but i dont wanna take it
before i was on seroquel and before that lamictal

 

[Holu]

im not on anything right now
i just got prescribed latuda but i dont wanna take it
before i was on seroquel and before that lamictal

I'm on Seroquel lol. Those are not really first line meds unless you are getting really small dosages. I'm assuming bipolar or schizophrenia, or European lol since ik they like to give out low dosages of some stronger meds..

And my recommendation is, if you don't feel comfortable taking the meds, then don't. Communicate that with your psychiatrist, and if you can't work things out then oh well. It's most important that you are comfortable and consenting.

 

[cantthinkofusername]

unspecified mood disorder

for me happiness without meaning is just as unbearable as being in misery and when i take my meds im happy but nothing is okay
i just want to be whole and as long as i am happy and/or content i never will be whole.

 

[Apokryphiel]

Medications only work when your problems are purely psychological and not circumstantial. Regardless, even if my problems were only in my head, I wouldn't sacrifice who I am and become a slave to drugs. Anyone who has had bad experiences with drugs themselves or in their family knows exactly why I feel this way.

 

[lament.]

As someone who was on Anti-Depressants for a 4+ years and has been off of them for the past year and a half or so I truly believe it depends on the person and what your specific issues are. For me they definitley numbed the sadness quite alot, to the point where I could not even cry, no matter how hard I tried, but this also meant they numbed my other emotions too so as a whole I was feeling less sad but ironically I was enjoying life less. I could definitley see how this would be useful for people on very low dosages who just need to take the edge off a little.

It's worth saying aswell that since coming off the anti-depressants my mood swings have been consistantly crazy (I can be euphorically happy for a couple minutes then go completely numb / depressed the next), which they weren't before taking and stopping the anti-depressants, so it's worth looking into the long term effects of taking them before you actually commit to it, my doctor never told me about the side effects, maybe because I was a minor at the time so essentially didn't have a choice whether or not I would take them, but regardless it's something I would probably have never taken had I known the long term effects.

 

[Hollowman]

I believe they damaged me more. PSSD sucks.

 

[Griever]

The only medication that helps me is Seroquel, but everything else is just a waste of time

 

[Holu]

As someone who was on Anti-Depressants for a 4+ years and has been off of them for the past year and a half or so I truly believe it depends on the person and what your specific issues are. For me they definitley numbed the sadness quite alot, to the point where I could not even cry, no matter how hard I tried, but this also meant they numbed my other emotions too so as a whole I was feeling less sad but ironically I was enjoying life less. I could definitley see how this would be useful for people on very low dosages who just need to take the edge off a little.

It's worth saying aswell that since coming off the anti-depressants my mood swings have been consistantly crazy (I can be euphorically happy for a couple minutes then go completely numb / depressed the next), which they weren't before taking and stopping the anti-depressants, so it's worth looking into the long term effects of taking them before you actually commit to it, my doctor never told me about the side effects, maybe because I was a minor at the time so essentially didn't have a choice whether or not I would take them, but regardless it's something I would probably have never taken had I known the long term effects.

Ya, that's normal, it's refereed to as emotional blunting.

Also if your psychiatrist or even general physician didn't tell you this, then that's a failure on them. Minor or not, they owe it to you to be transparent, even when it's not a requirement.

 

[alivefornow]

I would take them if they worked for me. Sadly they don't. I have bpd + depression and extreme anguish and hopelessness is my default mood. I tried different combinations of prescribed meds that eventually fucked my brain to the point of inducing daily panic attacks, so debilitating that I was forced to quit work. So no, I don't believe in psychiatry anymore.

 

[Daenerys Targaryen]

No, it provides temporary relief, and that's all. But it doesn't cure anything; sometimes it leaves us even worse off than we already are.
It's a hoax

 

[GhostInTheMachine]

The problem with these medications is less with the substances themselves, and more with the system of prescription behind them. Their mechanisms of function carry a lot of risks, and whoever writes the prescription needs to analyze who they're giving it to and take great pains to ensure that other venues are sought out first. For some people, it may very well be the thing that saves their lives, but for most people it would be a completely inappropriate treatment that may end up making them worse.

We saw the issues with just handing medication out when it came to the opiate crisis, but we still haven't learned our lessons with psychs. Even something more mundane like cannabis has risks that will outright fuck some people up.

 

[LostLily]

Personally it is working. But it a hassle to find one that both works and doesn't give you side effects

I was on celexa for 10 years but it's effectiveness was wearing down. So they switch me to Zoloft and I'm feeling better

 

[6138]

What meds are you taking? SSRIs? NDRIs? Antipsychotics? Antidepressants?

Just tell me the brand or chemical name. I'm guessing you are taking SSRIs, since the " emotional blunting" is usually a common side effect. The good news is, there isn't much risk for stopping your medication aside from your mood worsening again. SSRIs are first line mediation, meaning low addiction + withdrawl risks. There is the possibility you get erectile dysfunction if your a man, but that's not really common.

That's not quite true.

Sexual side effects (and weight gain) are actually very common with SSRI's. Most people who take them experience *some* form of sexual side effects or weight gain.

Women can also experience sexual side effects, not just men. Women can experience "Anorgasmia", which is difficulty achieving orgasm. I don't know how common this is, sexual side effect may affect men more, but it does happen.

In addition, sometimes the sexual side effects (For men at least, I'm not sure if this occurs for women) can persist even after you stop taking the SSRI. This is somewhat rare, and was previously denied by the psych industry, but recently it has been acknowledged officially, and is called "Post-SSRI Sexual Dysfunction, or PSSD").

In addition, suddently stopping ani-depressants that you've been on for a long time can be very dangerous. They need to be tapered off slowly, or you can get severe withdrawal symptoms.

Whether medication is worth it or not is up to you to decide (I'm not saying "Meds are bad"), but the side effects should not be minimised, and in our society, they very often are.

 

[Diceroller90]

I was in academia, it is very cliquey. Its hard to get published unless you flatter the right people. So you end up with an increasingly larger echo chamber where a lot of data cannot even be reproduced. Smoking, Lobotomies, Thalidomide, we have a long history of professionals saying things are great for us and silencing anyone who says otherwise. The body is a delicate system. I am skeptical of the idea of shoving mind altering chemicals in it, especially when their a profit motive behind it all. I do not fault people who do go down that route, it may work for them, but I prefer to look for other options than a shrink.

Is it worth compromising who/what you are in order to be happy and/or functional?

That said, what you wrote here is key. Who are you? What are you compromising? If the parts of you that you are tossing away make you miserable, is it worth holding on to them?

 

[milkteacrown]

The interesting thing about mental illnesses like depression are that we don't quite fully understand the mechanisms or pathology of them yet. Medications touted to treat it are, more or less, bandaid solutions that have been found to increase levels of happiness in general, thereby mitigating the effects of depression. From a very technical level, they do work, even though we don't fully understand why they work the way that they do.

That being said, I've been on every class of medication for depression and have tried out several of each to no avail, so it isn't as though it works for everyone. It's not a perfect science. For me personally, most of what I've gained is an inability to get off my medications because SNRI withdrawals are notoriously so bad you will not be able to function with them.
I don't mind the side effects, but that may be related to the fact that I'm disabled and the pain my own body creates for me is worse than anything a medication could provide (with the exception of SNRI withdrawals).

 

[Holu]

That's not quite true.

Sexual side effects (and weight gain) are actually very common with SSRI's. Most people who take them experience *some* form of sexual side effects or weight gain.

Women can also experience sexual side effects, not just men. Women can experience "Anorgasmia", which is difficulty achieving orgasm. I don't know how common this is, sexual side effect may affect men more, but it does happen.

In addition, sometimes the sexual side effects (For men at least, I'm not sure if this occurs for women) can persist even after you stop taking the SSRI. This is somewhat rare, and was previously denied by the psych industry, but recently it has been acknowledged officially, and is called "Post-SSRI Sexual Dysfunction, or PSSD").

In addition, suddently stopping ani-depressants that you've been on for a long time can be very dangerous. They need to be tapered off slowly, or you can get severe withdrawal symptoms.

Whether medication is worth it or not is up to you to decide (I'm not saying "Meds are bad"), but the side effects should not be minimised, and in our society, they very often are.

The key word is "some" though, and studies really vary. It's around 20-70% depending on which source you go to or which survey you read. Let's still assume that above half the people experience a sexual side effect(I'll go with Serreti 2020 and assume 59%), we have to determine what that means. ED, which is the most severe side effect, it sits around 20% of men. Most often it's just a decrease libido, which yes while a side effect, is not nearly as harmful as actual withdrawl. As for Anorgasmia, it's around 35-40% of people, who report reduced orgasm intensity, but it's worth noting that this doesn't mean full blown inability to feel orgasm, it just feels less satisfying. But again, these are not permanent. Let's go with Sheetrit 2023, and assume that 0.46% of cases have had irreversible post SSRI sexual dysfunction. That is very much rare.

The lack of withdrawl is another important thing to discuss, because SSRI discontinuation syndrome is NOT the same thing as addiction. It's simply your brain responding to the decrease in serotonin levels. There are no cravings and certainly no dopaminergic reinforcement. Which again, is why stopping SSRIs or other first line medication is not dangerous and does not need to be tapered off. If we are referring to second and third line antidepressants, then yes these are a different story and I will always recommend thoroughly talking with you psychiatrist and general physician regarding side effects. These very much do need to be tapered off and treated with caution for withdrawal symptoms.

Weight gain is absolutely true though, and that's for a variety of reasons. Appetite tends to increase as mood improves, and many SSRIs for slow your metabolism. However, this isn't usually seen as a negative side effect from a health standpoint assuming the individual isn't already overweight, though I understand for many why weight gain is seen as a negative. That said, normally if this is a concern, you are given fluoxetine which has weight loss effects but is generally weight neutral.

All that said you are absolutely right about minimizing the severity of side effect with first line medication. They absolutely are there, but they generally aren't life altering like more serious medication which can be addictive and make you dependent. Still, you are very very right to put emphasis on cautioning people, since a side effect is still a side effect no matter how small or low impact it is.

 

[6138]

The interesting thing about mental illnesses like depression are that we don't quite fully understand the mechanisms or pathology of them yet. Medications touted to treat it are, more or less, bandaid solutions that have been found to increase levels of happiness in general, thereby mitigating the effects of depression. From a very technical level, they do work, even though we don't fully understand why they work the way that they do.

This is very accurate, and I'm glad someone said this.

The old hypothesis was that low levels of serotonin in the brain cause depression, so we need to increase those levels by preventing the serotonin from being absorbed by the brain too quickly, effectively incresaing the amount of serotonin in the brain. This resulted in SSRIs, or selective serotonin reuptake inhibitors.

The problem is that, at the very least, this theory is woefully incomplete, and at best, totally inaccurate. Scientists know that neurotransmitters have something to do with mood, and anti-depressants do something with those neurotransmitters, but that's all.

Psych drugs basically work by just trying out different chemicals and seeing what works and what doesn't, the truth is, noone really understands why they work or why they dont.

That's not to say that they never work or people shouldn't take them (I'm not here to judge or advise anyone!) but the science surrounding them is far less certain than people think.

The key word is "some" though, and studies really vary. It's around 20-70% depending on which source you go to or which survey you read. Let's still assume that above half the people experience a sexual side effect(I'll go with Serreti 2020 and assume 59%), we have to determine what that means.

That's absolutely true, the studies on these drugs are hugely variable, and your number (20 - 70%) are exactly what I have heard as well. That means that "cherry picking" becomes a huge problem. A 20% chance of a side effect is very different from a 70% chance of a side effect, but there are reputable studies "proving" both. So, which is correct?

There is a lot we don't know here, and yet these drugs are being touted as "safe and effective", which is a little worrying to me.

ED, which is the most severe side effect, it sits around 20% of men. Most often it's just a decrease libido, which yes while a side effect, is not nearly as harmful as actual withdrawl. As for Anorgasmia, it's around 35-40% of people, who report reduced orgasm intensity, but it's worth noting that this doesn't mean full blown inability to feel orgasm, it just feels less satisfying. But again, these are not permanent. Let's go with Sheetrit 2023, and assume that 0.46% of cases have had irreversible post SSRI sexual dysfunction. That is very much rare.

I absolutely agree with all of that, it looks like we're pretty much on the same page.

The lack of withdrawl is another important thing to discuss, because SSRI discontinuation syndrome is NOT the same thing as addiction. It's simply your brain responding to the decrease in serotonin levels. There are no cravings and certainly no dopaminergic reinforcement.

Again, absolutely agreed. I never said that people can be "addicted" to SSRI's.

Which again, is why stopping SSRIs or other first line medication is not dangerous and does not need to be tapered off.

This is the only thing I would maybe disagree with, but you seem to know more about this than I do. Based on my (admittedly limited) research, it *is* reccommended to taper off SSRIs? Are you saying that you can take an SSRI for a long time, and then suddenly stop taking it without issue?

Personally, if it was me, I'd still prefer to taper off, rather than just suddenly stop.

All that said you are absolutely right about minimizing the severity of side effect with first line medication. They absolutely are there, but they generally aren't life altering like more serious medication which can be addictive and make you dependent. Still, you are very very right to put emphasis on cautioning people, since a side effect is still a side effect no matter how small or low impact it is.

Yeah, it seems like we're pretty much on the same page after all.

On a side note, I am deeply encourage that we were able to have a discussion about such a contentious issue without getting angry with each other, this forum here is... It's certainly different from others, isn't it?

 

[Holu]

This is very accurate, and I'm glad someone said this.

The old hypothesis was that low levels of serotonin in the brain cause depression, so we need to increase those levels by preventing the serotonin from being absorbed by the brain too quickly, effectively incresaing the amount of serotonin in the brain. This resulted in SSRIs, or selective serotonin reuptake inhibitors.

The problem is that, at the very least, this theory is woefully incomplete, and at best, totally inaccurate. Scientists know that neurotransmitters have something to do with mood, and anti-depressants do something with those neurotransmitters, but that's all.

Psych drugs basically work by just trying out different chemicals and seeing what works and what doesn't, the truth is, noone really understands why they work or why they dont.

That's not to say that they never work or people shouldn't take them (I'm not here to judge or advise anyone!) but the science surrounding them is far less certain than people think.

Absolutely. The serotonin theory of depression has never been complete, because depression like basically every other mental disorder, is very multi factorial. Addressing serotonin imbalances does not solve the problem if someone has hormone imbalances, a thyroid deficiency, glutamate deficiencies, norepinephrine or dopamine imbalances, any numerous physiological issues which can result in agitation and depression, vitamin deficiencies, inflammation of the brain or gut, trauma, and about 1000 other things.

Meds are not supposed to be used as a cure all for depression. Often, meds are used in combination with the PHQ-9 or another questionnaire to monitor changes within the first few weeks. It takes about two weeks for your body to adjust to the medication in general, which is why you meet up with your clinician at the two week deadline for most medication. Then if after another 2-4 weeks no improvement is made then the med is generally swapped although some clinicians may just never out of laziness which is problematic. But even if you get the perfect med, you most likely still need every other solution in the book. You need to eat healthy, you need to exercise, you need attend therapy, you need to regularly socialize, you need to have some sort of hobby/work, and so on lol.

The reality is we don't understand how to "cure" depression, so the best thing we can do is just throw as many evidence based practices at it and hope something works. This by all accounts is not a viable solution for most people, since every solution takes time, money, and effort, something which the majority of people can't even hope to do.

Maybe someday we will have a silver bullet, but for now we have rubber buckshot, and we are moreso hoping to knock the issue out not kill it entirely.

This is the only thing I would maybe disagree with, but you seem to know more about this than I do. Based on my (admittedly limited) research, it *is* reccommended to taper off SSRIs? Are you saying that you can take an SSRI for a long time, and then suddenly stop taking it without issue?

Personally, if it was me, I'd still prefer to taper off, rather than just suddenly stop.

So, it depends heavily on the half life of the meds and the dosage. Something like fluoxetine can be immediately and abruptly stopped, since iirc it's a 5 day half life. But if it's something like paroxetine then ya, it's best to taper.

Also, it's still generally standard practice to want medication because it does reduce the impact SSRI discontinuation syndrome. 25% dosage reduction every week tends to be enough. Still, if you stopped abruptly taking it, it's not as serious or damaging as second or third line medication, even if it's not recommended.