Little evidence that chemical imbalance causes depression, UCL scientists find

[doozwimp]

Am I crazy? OG article isn't paywalled. Unless there was a stealth edit. The guardian doesn't pay wall. You can choose to pay to get rid of ads though.

[rubecube]

Originally Posted by Azure

Well, big pharma is gonna big pharma.

Are people really shocked over this finding?

It is really the first time a 'drug' has been stated to be a fix-all when it really isn't, but big pharma just wants to keep making billions?

Has anyone stated that these are "fix-alls" though? Most doctors will tell you that they're just one piece to the puzzle, and that you still have to actually put in a tonne of work (e.g. exercise, therapy, eating well) to get consistent results.

My one worry about the media coverage behind this is that it's going to cause a bit of regression and ableist conclusions, where depression is viewed as a choice or a weakness rather than a serious medical condition.

Not saying that it shouldn't be covered, but we also need to be careful not to extrapolate or draw too many conclusions from it.

[PepsiFree]

Originally Posted by rubecube

It's also not really available to many people who need it. Is it any wonder we're relying on pharmaceutical band-aids when we have barely any semblance of affordable and accessible mental health infrastructure?

Availability is an issue, obviously, it's tough. My post was really about the surreal nature of people who mock and reject the one thing that, availability aside, probably helps the most with this mental health issues.

Part of the issue is that, because pills are a cheaper "fix all," that is what is covered by the limited plans that include coverage. Hopefully with findings like this, there is a push for more governments and more insurance companies to provide greater coverage for therapy over medication. Normalizing discussions around mental health is one of the best developments that has happened over the past while, but unfortunately, we normalized medication more than therapy as part of the cure. People aren't afraid to pop a pill if they think it's just something physically wrong with their brain, but they are averse to sitting in a room with someone and actually addressing the issues.

[stone hands]

Originally Posted by PepsiFree

This might not be entirely scientific, just a way to explain it in simple terms, but in my eyes the job of medication is to "clear the slate" so therapy has a foundation to work from.

I will always find it bizarre the people who mock or reject therapy, say they don't need it, whatever. It's sad to me. The mind needs maintenance as much as anything else. Therapy, especially CBT, is incredibly effective when people are open and fully engaged.

I agree completely. The reasons we suffer are true in our minds and like raekwon alluded to, you cant just command your mind to stop disastrous circular spiralling. It's both a skill that needs to be taught, but you need that foundation first which medication is helpful to many when the foundation needs to be dug much deeper than you are able to by yourself

I think they should teach things like communication, meditation, understanding your feelings etc in school. Many people(especially men) grow up thinking there is only 2 emotions, or rather, only 2 emotions they are allowed to feel: happy and angry. When you view the world in such a binary way, complex emotions like guilt or insecurity or surprise are viewed through those 2 lenses only and cause people to act in ways that dont reflect how they actually feel,which just causes all kinds of problems

Luckily I think the world is moving more in the direction of acknowledging these things, so I think the amount of "therapy is for the weak" types of people are starting to dwindle as people realize this stuff is just part of being human and everyone has these feelings and it's a learned skill to be able to navigate your own mind

[pseudoreality]

Just because depression is not caused by a chemical imbalance, does not mean that pharmaceuticals cannot be part of a treatment plan. I mean a chemical imbalance doesn't cause infections, but antibiotics can form part of an effective treatment plan.

[rubecube]

Originally Posted by stone hands

Luckily I think the world is moving more in the direction of acknowledging these things, so I think the amount of "therapy is for the weak" types of people are starting to dwindle as people realize this stuff is just part of being human and everyone has these feelings and it's a learned skill to be able to navigate your own mind

Can't forget there are entire grifter industries (natural supplements, self-help, etc.), beyond Big Pharma, that basically rely on "therapy is for the weak" for their income.

[Russic]

Originally Posted by Hack&Lube

...

What finally worked was changing the actual conditions of my life. I don't find this hard to believe as your body naturally gets serotonin and endorphin highs from exciting activities such as roller coasters and doing sports. If your life conditions are mired in misery, rejection, darkness, isolation, and general bad outcomes, you are definitely going to have a distinct deficit of neurotransmitters. In these cases, the medications may simply be artificially trying to top you up but the underlying conditions of your life are still the root cause and not a chemical imbalance for some people.

I do realize that the above sounds like a Tom Cruise thing to say but this is my personal experience.
...

See I think this is a good example of a thing we need to work on... what you did was awesome and not crazy at all. Just because scientology is kooky does not immediately mean we stop asking questions about drugs.

Originally Posted by rubecube

Has anyone stated that these are "fix-alls" though? Most doctors will tell you that they're just one piece to the puzzle, and that you still have to actually put in a tonne of work (e.g. exercise, therapy, eating well) to get consistent results.

...

I would argue while many doctors are aware and will give their patients that direction,

1. There's still many that don't and do in fact treat drugs as a fix-all
2. They only have time to write prescriptions, not ask you about your life history
3. Even if the message is delivered, many patients don't care to hear it

[Matata]

The mind becomes what it is filled with.

[CorsiHockeyLeague]

This appears to be the actual study. I never understand why people want to read newspaper articles about this stuff rather than just look at what they actually said.

https://www.nature.com/articles/s41380-022-01661-0

... What isn't clear to me is how they decided which people to include in the study group. The exclusion criteria is clear. But it seems to me that there are a bunch of people who get diagnosed with depression who simply report symptoms that sound like outward depression symptoms. That would explain why there would be a bunch of noise in the data about neurotransmitter levels... Someone explain to me why I'm off base here.

[rubecube]

Originally Posted by Matata

The mind becomes what it is filled with.

#deep

[Hack&Lube]

Originally Posted by CorsiHockeyLeague

This appears to be the actual study. I never understand why people want to read newspaper articles about this stuff rather than just look at what they actually said.

https://www.nature.com/articles/s41380-022-01661-0

A general rule of thumb is that the conclusions published by newspapers (which are all sensationalist headlines now with little real journalism) are always going to vastly overstate or even mis-state or oversimply the findings of a single scientific study. These come out every week and its always like this. It's usually some young writer (won't even say journalist) working on contract reading all the latest scientific journal reports and eyeballing what makes for good headlines and then writing about something they don't know anything about.

The only value I find in these, is that they draw attention to what could otherwise be obscure studies and they draw out discussion.

[opendoor]

Originally Posted by CorsiHockeyLeague

This appears to be the actual study. I never understand why people want to read newspaper articles about this stuff rather than just look at what they actually said.

https://www.nature.com/articles/s41380-022-01661-0

... What isn't clear to me is how they decided which people to include in the study group. The exclusion criteria is clear. But it seems to me that there are a bunch of people who get diagnosed with depression who simply report symptoms that sound like outward depression symptoms. That would explain why there would be a bunch of noise in the data about neurotransmitter levels... Someone explain to me why I'm off base here.

It's a meta-analysis of 17 meta-analyses (out of 360 possible candidates). Now meta-analsyes are far from useless, but there's no new clincal research here; the authors just took 17 studies of other studies and weighted them based on "quality" to arrive at their conclusion. And even they admit that most of the studies included as part of their analysis were rated as "low quality" by the normal appraisal tool used for systemic reviews.

That doesn't mean the conclusion is invalid at all; they might be totally correct. But one meta-analysis (of a bunch of low quality meta-analyses) doesn't overturn decades of research. Hopefully people who've seen a lot of the science around COVID (particularly the more controversial things like Ivermecticin and whatnot which had meta-analyses showing them to be miracle cures) can understand why it's important to think critically about what they're reading.

[PeteMoss]

Originally Posted by CorsiHockeyLeague

This appears to be the actual study. I never understand why people want to read newspaper articles about this stuff rather than just look at what they actually said.

https://www.nature.com/articles/s41380-022-01661-0

... What isn't clear to me is how they decided which people to include in the study group. The exclusion criteria is clear. But it seems to me that there are a bunch of people who get diagnosed with depression who simply report symptoms that sound like outward depression symptoms. That would explain why there would be a bunch of noise in the data about neurotransmitter levels... Someone explain to me why I'm off base here.

I agree with that. Its very tough to know who really has depression and/or anxiety and who doesn't as there is no blood test or whatever you can do. And most doctors are just going to prescribe you something if you report the symptoms because well what else are they going to do - when its difficult/expensive to get mental health/therapy in most places.

[Erick Estrada]

As a person that's been on an off these medications over the decades I have come to the conclusion that once I found the right medication it was a game changer for me. I simply am better on the current meds than I am without and I see no point in going back.

[TheIronMaiden]

Humans are prone to medicate their mental health with chemicals no matter what. At least anti depressants in the right context is more easily controlled than Alcohol or Cocaine.

[Swift]

Originally Posted by doozwimp

Am I crazy? OG article isn't paywalled. Unless there was a stealth edit. The guardian doesn't pay wall. You can choose to pay to get rid of ads though.

Yep, The Guardian doesn't use a pay wall. They do require you to have a free account to read more than x number of articles a month.

It's worth including some disagreement from that article too.

However, other experts, including from the Royal College of Psychiatrists, questioned the findings and urged people not to stop taking their medication in light of the study, arguing that antidepressants remained effective.

[...]

A spokesperson for the Royal College of Psychiatrists said: “Antidepressants are an effective, Nice-recommended treatment for depression that can also be prescribed for a range of physical and mental health conditions. We would not recommend for anyone to stop taking their antidepressants based on this review, and encourage anyone with concerns about their medication to contact their GP.”

Dr Michael Bloomfield, a consultant psychiatrist and principal clinical research fellow at University College London, who was not involved in the study, said: “Many of us know that taking paracetamol can be helpful for headaches, and I don’t think anyone believes that headaches are caused by not enough paracetamol in the brain. The same logic applies to depression and medicines used to treat depression.

“There is consistent evidence that antidepressant medicines can be helpful in the treatment of depression and can be life-saving.”

[GGG]

I think one thing to note that is very important is this study does not state that anti-depressants aren’t effective at treating depression.

It does not evaluate the effectiveness of any treatment for depression.

It only comments on the cause of depression being low Seratonin is not backed by evidence in the studies they reviewed.

This does not comment on “Big Pharma being Big Pharma”

[flamesfever]

Originally Posted by stone hands

I agree completely. The reasons we suffer are true in our minds and like raekwon alluded to, you cant just command your mind to stop disastrous circular spiralling. It's both a skill that needs to be taught, but you need that foundation first which medication is helpful to many when the foundation needs to be dug much deeper than you are able to by yourself

That's interesting you say that. From my twenty odd years of helping my wife with MDD, I have come to the conclusion that her major depression was like a tiny vortex (in the brain) of downward spiralling negative thoughts. And in order to get out of this vortex, or depression, required finding the right medication, which in itself can be a major challenge. Finally, after many years of trial and error, and with the help of a psychiatrist with a degree in pharmacology, we found the right combination of drugs.

I do believe, for minor to moderate depression, that CBT should be tried before medication. However, I found that for my wife, the suddenness of the onset (like a switch), and severity of the symptoms, tended to rule out CBT.

Thankfully the periods of remission were twice as long as the periods of depression, and we were able to have a good life.