I did therapy alone and it helped. But therapy with meds CHANGED MY LIFE. I had been depressed for so long that I didn’t know what the absence of depression felt like.
@@danielkanka495I’m 3-4 decades in. Currently between treatments. I’ve often found the right meds. That lasted for a while but they would lose effectiveness. CBT helps to a degree but I’m inconsistent at applying it. ECT was pretty effective but I was only able to do it for 4 weeks. I lack the social support I’d need to do it again. It greatly reduced-nearly eliminated-suicidal feelings but I can still reach severe depths of depression.
The therapy wasn't as helpful as your retrospective would report . The meds worked and then the overall perspective changed in a positive way . Hopefully, the medication will continue to work for you . However , you should have a contingency just in case .
i am a woman in my thirties who has been suffering from PSSD for 8 years, one of the many people ruined by SSRIs who don't know how to recover their sexuality and all that revolved around it (no small feat!). There are young people in the PSSD community who have taken their own lives because of the syndrome. Many have taken SSRI drugs for mild issues and are now ruined. There needs to be a lot more focus on this topic...PSSD could happen to anyone who takes SSRIs, because with current knowledge it is not predictable, the etiology is not even known, and there is no cure. Patients are trying to raise money for scientific research because they are abandoned by the health care system that has harmed them instead of making them better. It is an absurd reality from many points of view.
It continues to surprise me that you don't have millions of followers yet - your videos are so brilliantly insightful, and are quickly becoming the highlight of my week!
Well guess what this dude is wrong too. SSRIs do not work but do give suicidal thoughts when getting off not ever worth getting on. Numbs all feelings even at low doses. You sit there with a straight face while you cry and can never experience happiness while on them. Plus the side effects aren't worth it even if they did work even somethimes when in reality they just don't work ever it's a Netflix subscription for sugar pills pumped with random chemicals. Fucking idiots think they're smart bc they went into 10s of thousands of dollars and years of their life for a piece of paper and no knowledge of medical practice. Therapists and psychologists are the worst they are just guessing what to say to try to make you feel better and confirm your every feeling. I mean they do therapy and exams of CHILDREN to see if they have mental illness and then they cut up and mangle their bodies and worsen their mental health so bad they kill themselves. For sure doctors def heros no doubt in my mind
When I prescribe meds, I typically explain what the medicine does and why that is good for the patient. When it comes to SSRIs, most people have good reason to be depressed. They have stressful work, relationship problems, etc... I don't tell them that depression is causing their problems, I say that depression is making it harder for them to cope and deal with their issues. Like how propranolol can prevent the rapid heart beat that people feel with panic attacks, it takes away the symptom they are having a hard time with. So taking SSRIs can make it easier for them to sleep, or improve their appetite, help their pain, so that they can then deal with the issue they have they feel is causing their depression.
How about considering what their "problems" are and using that as a starting point. Those issues are setting the stage for "depression" to form, build, and become debilitating. No doctor knows exactly WTH those medicines do and trying to explain it by regurgitating and propagating the same stories is doing a great disservice to your patients. I recommend you treat people holistically. Understand the many factors impacting their lives. But this takes more than a physician listening to a customer for ten minutes and sending an escript to a pharmacy. Most people need to feel valued, have a purpose, earn enough money to feel financially balanced and feel connected and a sense of belonging to feel emotional balanced. Consider Abraham Maslow's theory of motivation starting with meeting psychological needs and reaching self-actualization. There are many things in life that can become ANTI-Depressants. People need to find the trigger to motivate themselves to find root causes which can be achieved more effectively than drugs through connecting with people who can help. Spiritual wellness cannot be dismissed either as it grounds people in purpose or self-worth. However, drugging people despite having solid evidence and understanding of its effects is destructive and irresponsible. This should be rare, but sadly, is not.
You’re giving people something that changes their brain chemistry. Yeah it might make them feel better but changing your brain chemistry is almost always going to have negative effects.
@@stevenslater4395 not compared with how bad the depression is in the first place. It has to be bad enough to have to take them.it can only improve things.
About 3 years ago my doctor and I - after years of trying - finally found an antidepressant and dosage that literally changed my life within a couple of months. It made the difference between simply not being able to function most days, to being able to, most days. I described it to a friend at the time as feeling as if there was suddenly a lot more space in my mind in which to think and feel - space which hadn't been there before. It sounds like this paper and the media reporting of it is highly irresponsible, and the author's response to the interviewer's "some people don't" was shocking.
Wow, I REALLY appreciate you explaining in more depth about this, especially on a topic so many people struggle with. I wish everyone could watch videos like this when pretty much any news article comes out to have a real understanding of it rather than just extremely reacting to it.
I have had to dance with the devil/depression for over 10 years now. I can tell you that a person doesn't just "grow out" of depression. It's an utterly debilitating condition that feeds on itself. It has destroyed huge and important parts of my life, both career wise and personal, and I wish this on no one. Thank you for this analysis and explanation on how our understanding has changed over the last few decades
I’d say that some people do and some people don’t. Everyone’s depression is different. I’ve been struggling with it for over 30 years. That doesn’t invalidate the fact that some people are able to get over it in months. I’m just not one of those people. It is unfortunate that a lot of the literature makes it seem like that’s the norm. I’m guessing the optimism helps people cope and get through it. Unfortunately optimism is hard to maintain through decades of failure. The best I can say is despite everything, I’m still standing in my early 50s. Something I would not have thought possible. Though I wouldn’t wish my life on my worst enemy.
In my case it was a life or death decision to take antidepressants. I tried many times to come off them in the hope I was somehow cured after doing talk therapy. It took ten years of trying to find ways to recover from my depression without the need for antidepressants to realise that I was just existing and was unable to work, be a parent and live any sort of meaningful life without antidepressants. So I needed talk therapy and antidepressants. I was playing Russian Roulette with my life.
Hiya Dr Carthy As a person who has battled with depression for > 30 years and also studied through the OU SK298 "The brain, the mind and mental health" everything you have said has made so much sense! Thank you for this video, it will be helpful in so many ways 🙂
I had a conversation about this paper, and this is why I came to see this vidoe. The other person said that SSRI work only b\c of placebo affect. I said that if that was true, then the medication would affect immediately, which it does not.
I take both an SSRI (sertraline) and a dopamine RI (bupropion) among one or two others for other issues, and while sure, it's changed some things about my "default" disposition, I wouldn't ever say it's "curing" my depression. Literally just yesterday, I had a rather bad mental health day akin to something I would have experienced before treatment. Mind, it wasn't nearly as severe as it would have been unmedicated, but while I know these chemicals are giving me a bit of an assist, they're not directly targeting the issue and addressing it the way I know a lot of people think antidepressants do. I'm thankful that this paper is being reviewed and interpreted with the grain of salt it deserves, as while it ~technically~ has the correct direction in mind, the conclusion of "meds don't work" is absolutely more harmful than helpful. I'm grateful that my chemical crutch is helping at all, if not to simply extend my longevity until a better solution comes to light. Much love
That's why a combination of medication + therapy has the best outcomes in research. The medication is the crutch, but the crutch doesn't help you walk again in, the therapy does.
Antidepressants worked for me but not for depression. My depression was always circumstantial/situational and I would probably call them meltdowns and shutdowns now I know I’m autistic. The antidepressants worked more for anxiety and ocd tendencies associated with ASD. I also always needed the highest dose because my body metabolises drugs different due to hEDS, and some doctors weren’t comfortable with that due to my low weight. It’s such a complicated topic. My GP wants me to go on amitryptaline for migraines and nerve pain, so again not for depression. My mum, her dad, and her brother have all done great on Sertraline and that was the one that helped my anxiety the most. So they definitely can work!
I am bipolar, and its so hard for me to know if its the medicines thats helping, or the changes i make to my life, or if its a combination of the medicines and the changes to my life they enable me to make. Also having friends and family that are understanding of you and why you behave the way you do sometimes is a lifesaver, cant imagine going through all this withour social support. What I felt was the biggest help for me though was when I finally had the chance of getting the same doctor for more then a couple of visits. Ive now had the same doctor for years and that just makes it so much easier, no more explaining entire backstory to new and stressed (now only stressed, haha) doctors that dont know more then they managed to read on your journals shortly before your visit.
What is outrageous is that General Practitioners are prescribing a medication that even specialists like yourself know almost nothing about. They are writing out these prescriptions after spending just 10 minutes with a patient. I know this from personal experience. I spent years seeing a various GP's and psychiatrists both of whom had no idea what they were doing and knew nothing about me. They would up the dosage of my medication beyond the point of being therapeutic. When I brought this up they just said "some people just need more". Based on what??? What is the likelihood that I am an outlier amongst the hundreds of thousands of people who would have been in the medical studies that state otherwise? It became clear to me that this was all just a guessing game. After years of "experts" telling me my problems were caused by a chemical imbalance in my brain I felt like it was all beyond my control, nothing would get better and I would be like this forever. I asked my therapist once what was wrong with me and why wasn't this getting any better and she responded by saying "what if there's nothing wrong with you and that the thing that is 'wrong' is thinking that there is". It wasn't until I accepted that idea that things started to improve for me but it took a lot of work. The problem is, people don't want to do the work. They want a quick fix which is why CBT is so popular but ultimately, pretty ineffective. Very few people are willing to put in the effort it takes to really work on yourself.
Yeah they set you up for believe it's beyond your control, when in reality it's not that way. It's pretty obvious efficacy was not a concern when SSRIs and CBT are the first line treatment.
Exactly. What is also outrageous is how long science/medicine/academia have known that there is no concrete link between depression and serotonin and admitted to knowing despite doing anything about it. Allowing millions upon millions to be told it is a chemical imbalance and used as a Guinee pig for the plethora of drugs that pharma is pumping out to gain billions in profit is disturbing yet not surprising knowing how manipulative humans are. These companies were forced to provide consumers with side affects only after being sued. A case where a husband murdered his wife after stopping an anti-depressant. Turned out, there was no warning about the violent tendencies and suicidal thoughts that they can produce. What is outrageous is doctors still supporting this myth instead of working on root causes and admitting they are not God and don't fully grasp what the brain and conscience is capable of. Moreover, do not want to even consider the social aspects that contribute to one's mood and emotions.
@@roadtonever CBT is so popular because it's what insurance wants to pay for. If your insurance only pays for 10-12 sessions/year, therapists want to try to give you the skills as quickly as possible to handle what's going on that's making you depressed.
"What is outrageous is that General Practitioners are prescribing a medication that even specialists like yourself know almost nothing about." That's not quite true. When scientists say "We don't know precisely how", they mean "We don't have every single chemical mechanism in the brain mapped out and/or we don't know every implication of those mechanisms, so we can't precisely tell you how this works". However, they do have the randomized, double-blind studies to show they do work, and scientists are working every day to keep mapping out mechanisms and finding how medications and life experiences impact them. Heck, they've even got machine learning in on it, trying to help speed up the process. So they don't know "almost nothing". They know a lot of things. Just not everything.
Pills helped me and I don't care how they work just that they work. I do get worse before they kick in so to speak but depression is very real and some of the reporting has been so problematic
Getting the right medication is important! When I still used medicine, one of the first I tried made me itch all over and got me agitated, but the next one helped (sertraline) as it also shrunk my anxiety. Communication with your doctor is important!
Before I started taking anti-depressants, I would have crazy nightmares at night that would result in me waking up and have a panic attack. I would have panic attacks at work. I had issues entering buildings without getting a panic attack. One week after taking my meds it all started going away and I haven’t had a panic attack since. That was four years ago.
I’m pretty open about taking a mood stabiliser, antidepressant and stimulant for ADHD. I have therapy every other week and a lot of work by myself and honestly I’m in the best mental health I’ve ever been. I don’t think I’d be anywhere near as well and dare I say happy without one aspect I don’t think I’d be anywhere near to where I am now. Medication does and always will have it’s place and is really beneficial for me!
I've seen quite a bit of the coverage on this paper and all I can say is that it appears to really skip over a lot of key elements around the current understanding of the brain and neuroplasticity. In short just a very quick and easy headline to guarantee clicks without trying to understand what the depth and breadth of psychiatric conditions. Edit: I believe your comment about the communication about the science to the patient being ineffective, is absolutely correct. Many friends of mine and even my own experiences have shown GPs AND Psychiatrist's quickly use the lack of Serotonin as the cause of the issue and SSRI's fixing depression by correcting this imbalance. It's the go to and quickest explanation everyone gets
@@dumbstudent7673 Hi, I'm afraid PSSD can happen whether your sexual, emotional, and cognitive function were affected whilst ON the antidepressant or not - you only find out for sure a few months after you stop taking it. BUT, on the upside, most people experience sexual dysfunction whilst ON an antidepressant and many/most recover once they stop taking the drugs. Good luck and I hope everything resolves for you.
I have lived with depression since my teenage years however I didn't know what it was until my mid 20's when the treatment I had for alcoholism and getting sober didn't cure my low mood. I have used quite a few antidepressants over the years and admittedly some affected me and some didn't. So if an antidepressant is affecting you sexually, tell your doctor and they can change the type you take and/or they can give you advice about how to minimise that affect. The question to be asking is was yours sex drive normal before the antidepressants?
Wow, thank you. This video is actually the first I’d heard about this paper and I’m glad that’s the case. I think my psychiatrist explicitly said the chemical imbalance was the cause of depression. It’s possible he gave me a more detailed explanation and I mapped it to the popular chemical imbalance theory. I appreciate the nuance that we don’t know why, but SSRI’s are effective anyway.
This is true in so many different areas of science: we don't know why gravity is a thing. we just know that mass attract mass, and we measure it and work with it, building planes and rockets.
Thank you for this! I have treatment resistant depression and the stigmatisation around medical treatments for an illness in the brain is so harmful and inescapable at times. I have been in therapy for years, which was life changing, but without my medication I would not have been able to work through therapy, and without my medication my mood plummets despite the therapy. Both in combination are needed, each as important as the other. I still have a lot of cognitive damage from decades of dealing with unmanaged and barely managed depression. And that takes so long to repair, plus the high dose of the meds I need, doesn't help. But there is so little understanding of this, even from some doctors.
I've suffered horribly trying to taper off my SSRIs. I ended up with PAWS and akathisia after an 8m taper - it was NOT a return of my original depression - it was much different and much more severe. I don't know if I'll ever be able to completely stop my AD and the normal side effects over the years have been difficult - loss of libido, loss of emotional range, GI issues, brain fog, horrible and chronic fatigue - but at least I was warned these could happen. The fact that I wasn't told I would possibly be chained to the meds for life was never disclosed and I am very angry about this. My depression was situational and I should have tapered off when my life circumstances changed - I wish it had been suggested by my Dr, things might be different for me today.
Its interesting that you have called the affect of withdrawing off antidepressants "PAW's". In my experience that stops after you stop them. Its temporary. Have you heard of the "Nocebo Effect". That is what is caused by people using scare tactic's about taking antidepressants and the fear of remaining on antidepressants for life may be what is causing your symptoms.
@@lulunz6809 - Ha, I wish. I had 4m of happiness and health and truly believed I was home free. After all, I tapered much slower than recommended. Thanks for attempting to further gaslight my experience - but there are too many of us out here. Withdrawal and damage from these meds are real.
@@kristgo2001 I'm sorry you are experiencing such a terrible reaction and I am sorry you feel like I gaslighted your experience. I didn't mean to do that. I do believe your symptoms are very real and didn't doubt that and still don't. Good luck with moving forward from that terrible experience. I hope you find a solution to your symptoms.
This is also potentially dangerous in terms of NHS funding and guidelines. With the service already being under immense pressure to reduce cost and increase efficiency my first thought was that it'll be used to justify the removal of funding for such meds on the NHS and as someone who has been on several over the past 20 years it's a truly terrifying thought, especially as waiting lists for CBT etc become worse by the day.
Well naturally serotonin can work as a treatment despite not being causative to the issue; serotonin does so many things, I'd believe you if you said it works as laundry detergent
i'm glad you debunked this paper's theory that antidepressants don't work, because it really annoyed me.. There's already a lot of people who hate on psychoactive drugs for no reason, so I'm really afraid this paper could make it worse for people who should/already take them, as it's very hard to face discouragement of treatment from the environment. Personally, I find antidepressants life-changing, so whenever I talk to someone with symptoms of mental illness I encourage them to seek help from a professional, because I know that taking meds can make the healing journey a lot easier (I'm on venlafaxine for almost a year after months of experimenting with SSRIs and i've never felt better than I do now :))
Nothing was debunked, I've tried all SSRIs on the market and they did nothing for me. That's expected as there are a number of studies showing SSRIs a no more effective than placebo. If you got through something give your self credit and not the drugs.
@@roadtonever there are also SNRIs, and many other psychoactive drugs so I doubt you actually tried them all! of course everyone is different, and drugs are not working for everyone, but for me they did a lot and helped so much to have great results in therapy. Without them it would be way more difficult and longer
@@vanessak6590 SSRI's, SNRI's, NRIs, TCAs. For years I was expecting my mood to improve every time I tried a new medicine, per my doctor's word, and nothing.
The paper doesn't claim that antidepressants don't work. It just argues that the serotonin theory (which *is* still influential, despite what Carthy says) is poorly substantiated by the evidence and so we should be more critical of widespread antidepressant use. P.s. I'm not attacking your decision to use SSRIs and I'm glad they work for you!
I appreciate this breakdown but would like another video on it. Please address the ways in which the use of antidepressants such as serotonin reuptake inhibitors are overly relied upon. In the few cases where I have been close to people receiving treatment, or recommended treatment, there was little discussion of other means of managing the depression. They would mention counseling but beyond that there really wasn't much discussed. You responded to the exaggerated idea that the recent research review paper proves current methods for treating depression are not grounded in science. Taking a look at this from a different angle would reveal why people are jumping on this paper and help highlight what is problematic with current efforts for treating depression.
One of things I would love for there to be more research on is hormones - I’ve mapping my symptoms of both reflux and depression definitely correlates to my menstrual cycle. To the point where my currently wonky irregular cycle I can tell when I’m ovulating or about to start menstruating due to my reflux meds stopping working for a few day each time. In May I was so depressed I couldn’t get out bed or eat - within 2-3 weeks of being on citalopram I was able to. And if I’m honest I didn’t think it would. My GP took one year of giving me information and reassurance to nudge me into trying it - it took the worst depression and anxiety I’d had to agree to it. Would happily take part in studies to see if researchers can work out how they work!
I get anxiety and depression one week before menstruation, and get relief as soon as my period starts. I don't want to take antidepresants. If my hormones are involved, I just want to regulate that. I am tired, I want to be ok :(
Thank you so much for this video. It's always important to remember that everyone cannot be lumped into one group and given one treatment. Also, I agree that this paper is absolutely dangerous and just bad science.
@@foolishlyfoolhardy6004 Dangerous could be the right word. Efficacy is no higher than placebo and risk of persistent dysfunction is well acknowledged. And yet the profession still defers to more prescription over less prescription. Irresponsible at best, corrupt at worst.
Personally, I'm really glad that the antipsychiatry movement is picking up steam at the moment. I spent a good 5 years in and out of hospital, on various drugs I wasn't permitted to stop. It was by very good fortune that I was finally able to escape a section 3 and hide at an understanding friend's house while going cold turkey. In hospital, I met many people who ended up similarly trapped by the psychiatrists who view themselves as the arbiters of human experience, and I am furious with the fact that many of them will still be there, and that people defend this atrocious extirpation of human rights with a smile and an assurance that they are "helping." Voice hearers groups, psychiatric survivors groups, patient advocacy groups - these have all really been growing in both number and strength, and that heartens me, but there will be no wider societal improvement until the general public also begins to dismiss psychiatric doctrine. I'm really starting to see that happen more and more. It's become more common on the political left, as they have become more focused on issues of social justice and so are naturally drawn to the views of people like Foucault who was openly antipsychiatry. And then this study seems to have captured the imagination of the more libertarian right. I really hope that the tide continues to turn, and we may well see an end to psychiatry in my lifetime.
The way I see it is that meds can help some people treat a symptom of depression (chemical imbalance) that makes recovery very difficult for them. They just aren't necessary or a good option for everyone because the chemical imbalance itself isn't the cause. It's also helpful for people to know that you don't NEED medication to recover because not everyone has access to treatment and medication. I didn't, I had to overcome it all on my own. People just need to know that they have other options.
I really love your channel mate! just subscribed, I think it is very good we have voice against all the hogwash that is around now in antipshychiatry. And support it with real facts which you do very well
Perhaps because I live in the US, I had a different take on this study's release. Several people in my life currently take SSRI's at increasing amounts, while not addressing any other type of treatment. These people genuinely believe that all they need to do is keep upping their dose and they will "cure" their depression. Also in the US we are flooded by TV commercials from pharmaceutical companies that perpetuate this idea. I am hoping that showing them this study might encourage them to pursue therapy to do more for their problems. I would be curious about your thoughts on the use of psilocybin treatments that are currently being studied for those with treatment-resistant depression.
I've always heard that treating the bio without also getting the social and psychological it can be dangerous as you've now treated the symptoms but the suicidal thoughts are still there are more dangerous because now the have the energy to act on those thoughts.
The US has a real big problem with this. Primary Care Physicians constantly prescribe drugs with NO referrals to mental health professionals. Anti-anxiety in particular. All bio and no psycho-social. It's not necessarily dangerous because it gives someone energy per se, but I would speculate the outcomes are MUCH worse than someone who is prescribed drugs along side therapy.
Psycho social intervention is underutilized but will hopefully be given more attention just like how SSRI treatment is being questioned recently. I think mental health care is slowly going through a shifting paradigm. Science isn't static, what's controversial now will eventually be the new normal. That's what I've gathered between my own experiences with caregivers and discussing the issue with friends that are professionals in the field. Depression is starting to be less mystified and viewed more as a direct consequence of specific life events and evolutionary psychology is giving more direction. This is a good thing, for instance, a middle aged women now gets sympathy for feeling grief about not having kids while she was fertile, before she would get brushed off because ideologically based ideas about gender used to have more influence about how a caregiver addressed the patients feelings.
Meds are for people who aren't on HRT (hormone deficiency or disregulation can cause depression) or need to treat disorders like arthritis or multiple sclerosis or diabetes (which cause depression especially when untreated) and need adjunctive treatment due to disease not being able to be well managed. Getting one's life in order with exercise and a good career and friends addresses any want for meds unless you're short or ugly, then surgery for height or better looks to get rid of the loneliness from being perpetually single and unloved fixes that.
I know I have depression.. But whenever I mentioned it to my doctor they tell to call helplines and talk or ask of I need meds.. As you know in the UK, its quite difficult but I don't want meds or therapy and talk about my life bcoz I cannot bear to go through my feelings and my past, I would rather just smile and get through life.. It used to be horrible but now it's just emptiness and anxiety... I don't know why I have written this here 😅
I can only speak from an American cultural point of view based on our history, but a part of me believes that most of the conversation and (in my opinion) the obsession with the usage and hunt for a drug related solution and what does and doesn't work from anyone outside of the medical field is based on the need for there to be a CATCH all one size fits all, this is what you need and will fix everything solution that Americans love. It applies to many issues and problems in American culture that have multi-tiered, multi-branches segments but it's so overwhelming and information and access to even basic help is so restricted that people just want a nuclear option to deal with it all rather than deal with the many steps and vectors to address them. That was much longer than I realized now that I have typed all that out. Addition: It also doesn't help that we're profit driven capitalists in many cases and a drug related solution to problems means something you can keep people needing to buy if it's a chronic condition that can't be cured, only treated. It's also why many are against solutions that can be used that aren't limited by monetary access or solutions that actually might solve the problem or permanently help the issue (even if drug-related) because that cuts off the supply of consumers buying the solution if progressively less and less people have the problem. It's a huge reason I think funding for HIV was so hard to obtain since treatment for it was better for profit than curing it.
Hi! I have a question, maybe too specific but I think it’s a problem for a lot of people. I have bipolar disorder type2 and I feel good with my treatment (Quetiapine Lamotrigine Diazepam and paroxetine ) but It made me take a lot of weight and no one has ever been able to tell me how to lower the impact of those medicines concerning Weight. And it is one big reason why people stop taking their treatment. Thank you 🥰 Have a good day
I heard a piece on The Economist blog. The interviewer asked no probing questions. I came away from it thinking that if there is no connection between seratonin and depression, what in ssri's makes them effective? This question not even asked. Very disappointed in the lazy journalism
SSRIs have changed my life. I wasn't even able to leave my bed a few months ago due to crippling anxiety and now with the help of Citalopram and therapy I am going to University in September.
My thoughts (before watching the whole video) are that antidepressants on their own aren't going to solve a person's depression. I see them as a way to help the individual get to a place where they are more able to engage with therapy and other treatments. It's the combination that works. Unfortunately, antidepressants are more readily available than therapy and counselling (on the NHS, that is. Private therapy is available but it is too expensive for most.) This leads to people being on antidepressants for a very long time, perhaps to the point that they become less effective or are on such a high dose that the side effects begin to negatively impact the person's mental health. Now I'll watch!
I’m a psychiatrist in Brazil and I a patient of mine sent this to me. My first thought was “oh no… another “fake news” we have to justify and explain the terms and misguiding information…”
It's not fake news, read the actual study, not the clickbait articles. It is extremely unfortunate the psychiatric community is so unwilling to admit they might be wrong about something to the complete detriment of their patients and the general public.
Psychiatry is shit because it is founded on pseudoscience there are no test than isolate these illnesses they prey on weaknesses and vulnerabilities of people
being Bipolar 1 with psychotic features and can't take antidepressants because they cause me to go into manias even more than I usually do. So I can't answer your question. But, I wish I could
Ignorant comment coming up. Take with a grain of salt. In mathematics, dynamical systems can stay on a stable state, until some force moves them away from the initial stable state and into a different stable state. Imagine a bowl with a marble; the marble will tend to keep at the bottom. Now imagine the bowl has a small crest at the bottom, so there are actually two cavities where the marble could sit. Shaking the bowl a bit will keep the marble in the original cavity, but shake it enough and it may end up at the other one. I've always had the idea that many things in medicine work that way. Your nose is fine until you smell pollen, then it gets runny; the irritation is just positive feedback that will keep it runny. You take an antihystaminic not only to palliate the symptoms, but to ease out the irritation: that gives it the little push it needs to go from state B back to state A. Maybe antidepressants work that way too: the reason a dynamical system goes from B to A need not be directly related to the reasons that moved it from A to B in the first place.
there are plenty of medications that we don't understand the exact mechanisms for, but if there is good evidence that they work, we keep using them. If our previous understanding of how a medication works is incorrect, it doesn't magically mean that the medication doesn't work anymore. (commenting at the start of the video when you requested opinions, so you may well address this in the video!)
thank you so much! I read about the paper and it seemed like a bunch of BS. I'm glad to have an expert dispute, what will surely become another way for people to stigmatize psychotropic drugs.
Thank you for this!! I have bipolar affective disorder II. I'm a clinically-trained social worker. My mother firmly believes that she did something to me in my childhood to cause the BPAD. She did not abuse me. I've been trying to explain to her that 1. BPAD and other MH disorders are caused by chemical imbalances of some sort. 2. There was nothing she could have done about it, as I didn't develop symptoms until my 20s, when she had no control over my treatments. (if I had been a minor when my symptoms started, it would've been her responsibility to get me into treatment) News coverage of this article has not been good for Mom's situation, so I really appreciate that someone trustworthy has confirmed it.
Hi, an ex MH S/W of 30 years in the UK here. Important points you have made. Have you ever examined whether there has been past mood "disorders" in any of your ancestors? If you are still doing S/W...take care! In the UK it is now an ever increasingly social policing role
So for me, that paracetamol analogy is really unfair and mocking. Nobody believes that because the brain doesnt make paracetamol. SSRIs specifically are said to balance the serotonin in the brain. If it does in fact do that, increases the overall amount of serotonin, and increased serotonin supposedly isnt what is treating depression, that suggests that the way we measure serotonin is wrong. What seems equally likely is that SSRIs are named incorrectly and we dont actually know what they do. You see what Im saying? It cant be both ways. It either does or does not increase serotonin. If increased serotonin doesnt help depression, and SSRIs indeed do increase serotonin but still work, that serotonin increase is a side-effect of whatever its actually doing. Like imagine if I called strong laxatives a "dehydration drug." Like yeah, it could make you dehydrated, but thats because you are pooping out all your water. Its a side effect of whats actually happening
Good review of this paper. Depression is variable & complex, likely antidepressants work better for some folks than others (for reasons it would take too much space here). You have to admit that there are no biological markers for depression. However, you recall the once called endogenous depression, rarer through better assessments, but it still exists and is a serious mental health problem. A close relative experienced this, and being a once MH SW in the UK for years, with knowledge of psychodynamic and 2 & 3 wave CBT, - her 3 episodes during her lifetime were not explained by psycho-social triggers. Possibly childhood issues, but even without these, could have still experienced them. There is a history of serious mental health problems in my ancestors. Would not wish a serious depressive mood "disorder" on any poor soul. (ps...ECT worked).
Fine enough. I would be extra mad that all types of depression is lumped together as endogenous. But likely it's a rarer form. At the same time, it's hard to control completely for absence of psychosocial issues. Everyone on ,y mothers side of the family engage in a type of mutual antisocial behavior which seem to be causing emotional stress for everyone, but it's normal to them. If they weren't the types to shun mental health care they would probably assume endogenous.
Another excellent video, thank you! I find it a challenge to explain to patients complex conditions, like depression and Schizophrenia. People like simple, easy to understand explanations, and while it's tempting to give them one, they are necessarily wrong. My approach has been to explain a little of what we know, and why we know it. Such as that we know dopamine plays a role in psychosis, because when it's increased in certain parts of the brain it can cause psychotic features. The example I give is of parkinsons medications. In general I find patients are more frustrated with being given oversimplified explanations, which might conflict with later information they get, then being included in the discussion about what we know, and what we're uncertain of.
The pills work for me, whether that’s psychosomatic or not, who cares. I’ve been in analysis for 25 years as well. That also works for me. I found my route out. It’s extremely hard work though.
I have read the paper, I went through the data and the conclusion I found to be correct from a neurochemical perspective but psychiatry is not neurology.
@@roadtonever what I mean is, some people can be helped neurochemically with their depression, and some can't, and psychiatrists should take the neurology into account but our knowledge has been clearly demonstrated to not be at the point where they should be totally confident in pharmacological solutions
So SSRIs antidepressants are effective, we just don't know yet the exact mechanism of action. It may be anti inflammatory, or something else. We all saw in the TOGETHER trial in The Lancet how the SSRI Fluvoxamine is effective in covid.
Depression is a real bitch. I've dealt with it more than half of my life, since early adolescence. SSRIs I have a mixed relationship with. They don't feel "good" but the days are, at least, tolerable. Weirdly, when in mild-moderate physical pain that I feel more alive.
My therapist claims I have PDD, but I ask her for proof and she has none outside subjective observations. Until there are objective tests, psychiatry is a dart game. Sometimes it is helpful, but they are only throwing darts. That includes both diagnosis and medication. Yes, withdrawal off psych meds suck. I took Darvocet(a now-banned opioid) for 5 years and it took 3 days to ween off it and was painless. It takes weeks of mental and physical pain to get off psych meds. Just say no.
SSRIs look about 10 percent more effective than placebo . Not a great increase over placebo considering the side effects and potential long term problems.
I've been taking a mild dose of a SSRI for a little over a year now. I definitely feel a lot better than I did and my mental health has improved a lot - I'm sure it isn't just the pill but it must be having an effect. I didn't see that news story. I did probably believe the treatment was as simple as increasing serotonin levels because it vaguely sounded like that. This video really helped my understanding. I do want to know more now though... Any suggestions where to look?
We’ve always known this before that fucking news story. But SSRIs work when if that’s not the mechanism through which depression works. Another example of the news trying to make something old and we’ve already know over and over and turn it into something big lol 😂
ssri work on serotonin we know that depression is not caused by the way serotonin work so what actually ssri do that is helpful - we dont know i dont understand the justification for that and with considering the side effects i feel that we should look to decrease the use of ssri
Bro give some scientific evidence that these medicines work, because you left out that they are also correlated with higher risk of suicide. The article was not meant to be for the general audience but rather for medical professionals. Elaborate in your claims with evidence.
To be fair there's no biomarker to be measured before and after, to check if it's really working. It's all based on personal observations (i.e. what people feel, think, Hamilton scale, standardised mean difference etc etc). To me, this is not science at all. Being on Pristiq for 4 months now (which is kind of working), after 3 years of trying without success few other antidepressants or a combination of them, I'm starting to believe that the chemical imbalance theory is not so accurate. Because if it was, there was no need for people to try few medications until finding the right one. Or if it's working, it's not taken seriously, and the medical schools should go back to square one and re-write their approach that a psychiatrist should take when prescribing an antidepressant.
@@RaRa-eu9mw if that's the case why are they so hard to come off. These are very powerful drugs which is why they are on prescription. Placebo surely wouldn't cause the horrendous withdrawal symptoms you get when stopping them.
Ugh ugh ugh Meta-analysis is so annoying. The researchers doing meta-analysis literally get to choose their "subjects" (ie, the research papers that they want to analyze), and then exclude the ones that don't fit their narrative. So many of the safeguards against researcher bias go out the window, even if they actually do the work "correctly".
First of all, I have not read the paper. I've had several experiences with anti-depressants. Fisr time I got them was at only 15 years, and I can't even recall if these really worked. The agent in them was Mirtazapine, and they made me sleepy and (being anorexic too) I was terrified by the common side effect of weight gain. Later a psychiatrist (all in all not the best experience either) changed me to Fluoxetine. Another doc was a little worried to give those to a16 year old, saying there were hardly any studies for this age group, and wanted to change me to Sertaline. WHich was the worst. They totally knocked me out, which was even worse because I first had to take them in the morning (instead of in the evening). I have a bad memory where (maybe even the very fist day, but sure at very early in threatment switch) I had a presentation in french literature and felt incredibly sick. I was basically drugged... and even got badly blamed afterwards for leaving shool and returning home after that TERRIBLE speech (they accused me of simulating as so very often. I wasn't). I was don't even remember what exactly I said, but I know I was worried to throw up during it, or pass out. At home, I went to bed, and was still feeling all weird and had widened pupils in the afternoon when my sister woke me up again. Anyway, a while after that, switching to taking the Sertaline before going to bed, at some point I had enough and stopped taking them. I was just a teen and had a hard time to disobey my mother, but on that point she lost. During years I was without meds, and the more I had to witness my mother abuse them (sleeping drugs mostly. No need for details of what situations I found her in. She has BPD and other issues too) I only found myself confirmed more and more that I don't want to ever take these kind of drugs again. So when I got worse and worse, after years at university without any treatment or therapist at my hand, I had to get help, and found the psyciatrist who treats me since then. It's over a decade. It was a really long process to give antidepressants a chance again, still fearing the side effects and being warned of bc of my mum, but he was very understanding and patient, and finally I decides to take Escitalopram. And for the first time I can say, I may not be happy to take those, but I'm sure they help. They don't keep me from depressions at all, but I still believe that they help and I woul be worse without. He even had to slightly hignten the dose at some point, me again being very reluctant at first. But they will never "heal" me, that's a totally different challenge. Sorry for the long post, and thanks for your content once more. I don't know why some agents worked, maybe worked, or took a bad toll on me. Every case is different and seems to need some time of testing out. I thought it would be common knowlegde that the brain and its functioning respectively its bad functioning causing depression has to be too complex to rule it down to just one single body-generated substance regulating it all.
I was given mirtrazapine as a teenager as well and it sucked. I stopped taking it after two weeks. Recently, I've looked it up and found out that it's also not recommended for minors...My psychiatrist prescribed it on top of my other antidepressant (duloxetin) to treat the side effect of night sweats cause by that medication. But mirtrazapine made me really groggy and I hated it. I don't blame the medications, though, I just had a shitty psychiatrist who didn't listen to me.
Could you make a video about how depression is diagnosed? Most people believe it's some magic of modern science and only "experts" can understand it. Based on my knowledge it's just a simple interview. So I could easily lie myself into any diagnose I would want. And if that's the case, wouldn't testing antidepressants be fundamentally flawed, because maybe instead of treating depression they just increase motivation, or decrease insomnia, which leads to better answers on the interview?
Literally the major problem researchers and healthcare providers have (and have had) with these medical interventions overly advocated like the man who runs this channel. It's easy to sell a pill, difficult to create a community of health.
This video is really shoddy work. Carthy's explanation of the recently published study is sloppy and misleading. Worse, he suggests some of the authors of the study are ideologically motivated, providing no support whatever for that accusation. He's no better than he says the authors of the study are. Carthy argues that psychiatrists no longer believe in the chemical imbalance theory of depression, so the study's findings are, essentially, trivial. The study itself cites what it claims are two current, leading psychiatry textbooks and several recently published papers that either endorse or give qualified support for the theory. It would appear the theory is still at least somewhat influential if not more so. Carthy provides no evidence to the contrary other than his own statements. He completely sidesteps the authors' argument on this point. Carthy might be right about the overall trend in psychiatry - that the chemical imbalance theory of depression is generally viewed as outdated - but the authors of the study don't claim the theory is universally accepted or the leading theory or anything so grand. They make the relatively modest claim that the theory is still influential and still used as a justification to prescribe medication that doesn't operate the way the theory suggests. As for the authors being ideologically motivated, a claim which Carthy provides no evidence to support, we could very reasonably question Carthy's own biases as a psychiatrist who, apparently, has prescribed the medications at issue. I don't state that Carthy has a bias just that it would be a reasonable question to ask. Humorously, Carthy says he'd have more respect for the authors of the study if their premise were that the science isn't reflected in the way we communicate and disseminate information to patients. While that isn't the major focus of the study, the authors actually make that exact point in the discussion section the study: "The general public widely believes that depression has been convincingly demonstrated to be the result of serotonin or other chemical abnormalities [15, 16], and this belief shapes how people understand their moods, leading to a pessimistic outlook on the outcome of depression and negative expectancies about the possibility of self-regulation of mood [64,65,66]. The idea that depression is the result of a chemical imbalance also influences decisions about whether to take or continue antidepressant medication and may discourage people from discontinuing treatment, potentially leading to lifelong dependence on these drugs [67, 68]." Finally, Carthy gives the clear impression that the study suggests that anti-depressants don't work and that it's dangerous to recommend that patients immediately stop taking them. Every one of you who watched this video came away with that impression - I did, too. Carthy states outright that the authors of the study claim that anti-depressants don't work. Perhaps the authors have done media interviews or published other statements claiming that anti-depressants don’t work, but the study itself doesn't say that. To quote the conclusion of the study, "This review suggests that the huge research effort based on the serotonin hypothesis has not produced convincing evidence of a biochemical basis to depression. This is consistent with research on many other biological markers. We suggest it is time to acknowledge that the serotonin theory of depression is not empirically substantiated." Nowhere in the paper do the authors claim that anti-depressants don't work.
I'm glad I found your comment, it saved me the time of writing all this myself! I read a lot of Joanna Moncrieff's work while doing my Masters thesis. As far as I'm aware, she doesn't claim that anti-depressants don't work, rather she claims that we should be far more careful with their dissemination to the wider public given all of the unknowns. And yeah, I found Dr. Carthy's work in this video incredibly shoddy too. Particularly, his assumption that antidepressant research (heavily funded by the pharmaceutical industry) wouldn't have any ideological biases of its own. Or that *he* is just following this neutral science that has no history of getting things dead wrong... Again, great comment, thanks!
This is interesting and reassuring. Like many, I read about this paper - and the government's apparent desire for the NHS to act on it - with a sense of dread, because it really seems like a "just pull yourself together and go for a run" advocate's wet dream. I'd say that they were being irresponsible, but they don't seem to be doing this by mistake.
I mean, the author of the recent paper herself has been adamant and vocal about this very conclusion since she first published her work way back in 2009. Sounds like you haven't done your homework.
I heard about it... and have read many comments on a post stating that SSRIs do not work... I am currently on Zoloft which is an SSRI I take that with Lamictal for bipolar and this combination works very well for me. My mom takes just Zoloft. She gets extreme anger reactions before she was on it and if she stops taking it. She fights alot, black outs, and for some reason small things can make her fly off the handle. It has worked for now for 20 years.
@@muirgirl i am not sure where you get drug addiction. The medication works for us... you have no idea what we are like without medication. but thank you for your uninformed opinion. So many people are going to be harmed by people saying that these medications dont work. They may not work for some people but, there are many out there that they work for and that need them
Can you become addicted to antipsychotic medication? Are antipsychotics addictive? Drugs that are addictive produce a feeling of euphoria, a strong desire to continue using the drug, and a need to increase the amount used to achieve the same effect. Antipsychotics do not have these effects.
@@faithoverfear1722 You are extremely misinformed about the drugs you take.. Please stop spreading such harm. Absolutely long term use of these compounds was never actually studied for safety much less efficacy. Again, I repeat myself and wish you health.
I have severe anxiety disorder which ruined my life and caused me to be agressive. I found a new psychiatrist about half a year ago and I like how he treats me based on my symptoms. He prescribed Escitalopram for my violent urges and also agomelatine, since I wasn´t sleeping well. It´s currently been six months and I feel like myself again.
I have only been happy for a few years after the age of 12. Those have been thanks to meds. It is hard to find something that works. It works, until it stops. I am 40. I keep hoping that I will find the right meds. Thinking I won't will make me lose hope. I just want to not be in pain. When I lose hope I try and kill myself. I still have hope.... I am scared of death, but if I do not want to live in pain all my life. I still think there are a lot of meds I can try before resorting to shock therapy. I will keep trying. If I stop, death is the only solution.
Have you read the actual study or just the clickbait articles? Continuing to only listen to those within you echo chamber is only going to harm you in the long run.
