7 ms·

Or avoid medication for anything but treatment resistant depression. SSRIs are not well understood. Their side effects are not great. Getting off them is miser

by stuffn 8mo ago

Or avoid medication for anything but treatment resistant depression. SSRIs are not well understood. Their side effects are not great. Getting off them is miserable. I had them. I felt dead inside. Mission accomplished. Depression was gone, so was my desire to eat, have sex, or do anything else. I wasn’t depressed, I was a zombie. 8 adjustments and medications later I got off them and realized they’re yet another pill to fix a problem 98% of people can fix other ways if they tried. I do not understand this intense desire to be medicated. Exercise, go outside, talk to people. Get good sleep. Once the rest of your life is squared away get some meds if necessary. Psychiatrists and psychologist walk the razors edge of quackery every single day. Talk therapy is a program to take tremendous amount of money from people and funnel it into their account. It’s absolutely nuts the average talk therapist bills at over 300 dollars an Hour. There is no reproducibility in mental health. in their “science”. Therefore, there’s no reason to believe their magical pills will fix problems they barely understand at a biological level. As a final note people in the military do a ton of cardio because running and rucking is hard work you train for. It is certainly not to “stay sane”.

nineteen999 8mo ago
100% I have found the same, SSRI's definitely make things worse and I stay away from them, and regular exercise has offered the biggest consistent/persistent improvement in mood.
PaulHoule 8mo ago
yeah... i did forget to add meaningful community and spiritual activities to that list but people can have just as strong objections to them as they do to the other things on my list!
wombatpm 8mo ago
Medication is the fastest way to make some positive progress before you completely spiral and majorly fuck up your life. Would you rather take a pill and keep working while you sort things out or would you try to rebuild everything after you burn it all down? Talk therapy and exercise may be just as effective or more so long term, but may not be effective enough in the short term.
- stuffn 8mo ago
  [flagged]
  - dang 8mo ago
    Whoa, you can't post like this to HN, regardless of how wrong someone is or you feel they are. We ban accounts that do this, and I'm afraid you've been breaking the site guidelines (https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html) in other places as well, including other personal attacks: https://news.ycombinator.com/item?id=46530967 https://news.ycombinator.com/item?id=46530967. It also looks like you've been using HN primarily for ideological battle, which is not something we allow here (see https://hn.algolia.com/?sort=byDate&dateRange=all&type=comment&storyText=false&prefix=false&page=0&query=primarily%20test%20by:dang https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme... for past explanations of this point). Would you mind reviewing https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and sticking to the rules? We'd appreciate it. You're welcome here as long as you do that, but we really need commenters to stay respectful, avoid posting in the flamewar style, and (above all) use the site primarily for curiosity, not smiting enemies.
skywhopper 8mo ago
[flagged]
- stuffn 8mo ago
  [flagged]
  - PaulHoule 8mo ago
    Pfizer ad or not I'll say my AD experience was positive. I got it prescribed by a psychiatric NP in a time when my job situation was about to go to hell but I was planning to tough it out till I got the project done. I did get the sexual side effects but because men often come too quick it can be a blessing as much as a curse, personally I found it took longer to orgasm and when it did happen it was a much more complex and richer experience with a definite periodization I haven't had before or since. When I was taking ADs I did have problems I blamed on the ADs that really had to do with the "non-drowsy" antihistamine I was taking crossing my blood brain barrier anyway. When I did stop ADs I tapered over a month and the physical effects were not bad at all. It was the beginning of a time of personal growth that I can look back on now and think it worked out great but was challenging for the people around me for a while.
    - cindyllm 8mo ago
      [dead]
  - dang 8mo ago
    Please don't respond to a bad comment by breaking the site guidelines yourself. That only makes things worse. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- dang 8mo ago
  We've asked you to stop posting like this to HN. I understand that the topic is sensitive and personal, but being this aggressive in HN comments is not ok and we ban accounts that do it. You've been a good contributor to HN for a long time and most of your comments aren't like this, but there is also a long history of us asking you to stop posting personal attacks: https://news.ycombinator.com/item?id=46012112 https://news.ycombinator.com/item?id=46012112 (Nov 2025) https://news.ycombinator.com/item?id=21867262 https://news.ycombinator.com/item?id=21867262 (Dec 2019) https://news.ycombinator.com/item?id=21327013 https://news.ycombinator.com/item?id=21327013 (Oct 2019) https://news.ycombinator.com/item?id=17371604 https://news.ycombinator.com/item?id=17371604 (June 2018) https://news.ycombinator.com/item?id=16017705 https://news.ycombinator.com/item?id=16017705 (Dec 2017) Moreover, your account has continued to be in the habit of posting aggressive comments recently, including personal attacks (e.g. https://news.ycombinator.com/item?id=46478121 https://news.ycombinator.com/item?id=46478121, https://news.ycombinator.com/item?id=46463522 https://news.ycombinator.com/item?id=46463522). This is not cool. I don't want to ban you but it's important to preserve this place for its intended purpose of curious conversation (which depends on thoughtful, respectful comments), so if you'd please review https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and stop doing this going forward, we'd be grateful.
D-Machine 8mo ago
Dunno why you are being downvoted, probably cope. It is well known by now that antidepressants are only marginally effective on average [1-2]. You're right they should probably only be prescribed for quite severe or treatment-resistant depression. Although the treatment-by-severity effect has been somewhat disputed [3-4], it has rough support [5], and makes sense since it is dubious that we should be giving ineffective medication with serious costs and side-effects to people with moderate depression. [1] https://ebm.bmj.com/content/27/2/69.abstract https://ebm.bmj.com/content/27/2/69.abstract [2] https://ebm.bmj.com/content/25/4/130.abstract https://ebm.bmj.com/content/25/4/130.abstract [3] https://link.springer.com/article/10.1186/1744-859X-12-26 https://link.springer.com/article/10.1186/1744-859X-12-26 [4] https://doi.org/10.1192/bjp.bp.116.187773 https://doi.org/10.1192/bjp.bp.116.187773 [5] https://jamanetwork.com/journals/jama/article-abstract/185157 https://jamanetwork.com/journals/jama/article-abstract/18515...
- PaulHoule 8mo ago
  My take is pessimsitic estimates of AD effectiveness assume you get one Rx and don't follow up and adjust dose and medication choice. I was lucky when I took ADs to have a good primary care doc who had a psychiatric nurse practitioner working at his office and being a good self-advocate.
  - D-Machine 8mo ago
    The "sequential treatment" or "tailored treatment" approach is at least plausible and what is done in practice, yes, if the prescribing doctor is good, and if this is feasible for the patient. However, since this takes time, and most depression is temporary, it is hard to know if you really are tailoring the medication to the person in many cases, or it has just been long enough you are seeing regression to the mean (or a placebo response, which is still strong even in treatment-resistant depression https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784479 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...). There aren't really any double-blinded or even just properly placebo-controlled / no-treatment controlled studies to test this, but the closest thing to looking at the sequential approach also doesn't find very impressive results (https://bmjopen.bmj.com/content/13/7/e063095.abstract https://bmjopen.bmj.com/content/13/7/e063095.abstract). I do believe the drugs help some people, and almost certainly take some experimentation / tailoring. The average effects are just very weak.

by stuffn 8mo ago

nineteen999 8mo ago

100% I have found the same, SSRI's definitely make things worse and I stay away from them, and regular exercise has offered the biggest consistent/persistent improvement in mood.

PaulHoule 8mo ago

yeah... i did forget to add meaningful community and spiritual activities to that list but people can have just as strong objections to them as they do to the other things on my list!

wombatpm 8mo ago

Medication is the fastest way to make some positive progress before you completely spiral and majorly fuck up your life. Would you rather take a pill and keep working while you sort things out or would you try to rebuild everything after you burn it all down? Talk therapy and exercise may be just as effective or more so long term, but may not be effective enough in the short term.

stuffn 8mo ago
[flagged]
- dang 8mo ago
  Whoa, you can't post like this to HN, regardless of how wrong someone is or you feel they are. We ban accounts that do this, and I'm afraid you've been breaking the site guidelines (https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html) in other places as well, including other personal attacks: https://news.ycombinator.com/item?id=46530967 https://news.ycombinator.com/item?id=46530967. It also looks like you've been using HN primarily for ideological battle, which is not something we allow here (see https://hn.algolia.com/?sort=byDate&dateRange=all&type=comment&storyText=false&prefix=false&page=0&query=primarily%20test%20by:dang https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme... for past explanations of this point). Would you mind reviewing https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and sticking to the rules? We'd appreciate it. You're welcome here as long as you do that, but we really need commenters to stay respectful, avoid posting in the flamewar style, and (above all) use the site primarily for curiosity, not smiting enemies.

skywhopper 8mo ago

[flagged]

stuffn 8mo ago
[flagged]
- PaulHoule 8mo ago
  Pfizer ad or not I'll say my AD experience was positive. I got it prescribed by a psychiatric NP in a time when my job situation was about to go to hell but I was planning to tough it out till I got the project done. I did get the sexual side effects but because men often come too quick it can be a blessing as much as a curse, personally I found it took longer to orgasm and when it did happen it was a much more complex and richer experience with a definite periodization I haven't had before or since. When I was taking ADs I did have problems I blamed on the ADs that really had to do with the "non-drowsy" antihistamine I was taking crossing my blood brain barrier anyway. When I did stop ADs I tapered over a month and the physical effects were not bad at all. It was the beginning of a time of personal growth that I can look back on now and think it worked out great but was challenging for the people around me for a while.
  - cindyllm 8mo ago
    [dead]
- dang 8mo ago
  Please don't respond to a bad comment by breaking the site guidelines yourself. That only makes things worse. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
dang 8mo ago
We've asked you to stop posting like this to HN. I understand that the topic is sensitive and personal, but being this aggressive in HN comments is not ok and we ban accounts that do it. You've been a good contributor to HN for a long time and most of your comments aren't like this, but there is also a long history of us asking you to stop posting personal attacks: https://news.ycombinator.com/item?id=46012112 https://news.ycombinator.com/item?id=46012112 (Nov 2025) https://news.ycombinator.com/item?id=21867262 https://news.ycombinator.com/item?id=21867262 (Dec 2019) https://news.ycombinator.com/item?id=21327013 https://news.ycombinator.com/item?id=21327013 (Oct 2019) https://news.ycombinator.com/item?id=17371604 https://news.ycombinator.com/item?id=17371604 (June 2018) https://news.ycombinator.com/item?id=16017705 https://news.ycombinator.com/item?id=16017705 (Dec 2017) Moreover, your account has continued to be in the habit of posting aggressive comments recently, including personal attacks (e.g. https://news.ycombinator.com/item?id=46478121 https://news.ycombinator.com/item?id=46478121, https://news.ycombinator.com/item?id=46463522 https://news.ycombinator.com/item?id=46463522). This is not cool. I don't want to ban you but it's important to preserve this place for its intended purpose of curious conversation (which depends on thoughtful, respectful comments), so if you'd please review https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and stop doing this going forward, we'd be grateful.

D-Machine 8mo ago

Dunno why you are being downvoted, probably cope. It is well known by now that antidepressants are only marginally effective on average [1-2]. You're right they should probably only be prescribed for quite severe or treatment-resistant depression. Although the treatment-by-severity effect has been somewhat disputed [3-4], it has rough support [5], and makes sense since it is dubious that we should be giving ineffective medication with serious costs and side-effects to people with moderate depression. [1] https://ebm.bmj.com/content/27/2/69.abstract https://ebm.bmj.com/content/27/2/69.abstract [2] https://ebm.bmj.com/content/25/4/130.abstract https://ebm.bmj.com/content/25/4/130.abstract [3] https://link.springer.com/article/10.1186/1744-859X-12-26 https://link.springer.com/article/10.1186/1744-859X-12-26 [4] https://doi.org/10.1192/bjp.bp.116.187773 https://doi.org/10.1192/bjp.bp.116.187773 [5] https://jamanetwork.com/journals/jama/article-abstract/185157 https://jamanetwork.com/journals/jama/article-abstract/18515...

PaulHoule 8mo ago
My take is pessimsitic estimates of AD effectiveness assume you get one Rx and don't follow up and adjust dose and medication choice. I was lucky when I took ADs to have a good primary care doc who had a psychiatric nurse practitioner working at his office and being a good self-advocate.
- D-Machine 8mo ago
  The "sequential treatment" or "tailored treatment" approach is at least plausible and what is done in practice, yes, if the prescribing doctor is good, and if this is feasible for the patient. However, since this takes time, and most depression is temporary, it is hard to know if you really are tailoring the medication to the person in many cases, or it has just been long enough you are seeing regression to the mean (or a placebo response, which is still strong even in treatment-resistant depression https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784479 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...). There aren't really any double-blinded or even just properly placebo-controlled / no-treatment controlled studies to test this, but the closest thing to looking at the sequential approach also doesn't find very impressive results (https://bmjopen.bmj.com/content/13/7/e063095.abstract https://bmjopen.bmj.com/content/13/7/e063095.abstract). I do believe the drugs help some people, and almost certainly take some experimentation / tailoring. The average effects are just very weak.