Drugs create highs by manipulating chemicals our bodies produce normally. Frequent drug use can change the way our bodies produce and utilize these chemicals, causing our bodies to produce too much or too little. There is no perfect drug because any substance usage takes our bodies out of chemical equilibrium, causing adverse effects.
Edit: Wow! This blew up. Thanks for all the compliments and insightful responses, I know this is an oversimplification and you guys really helped flesh out my answer. Thanks for the gold!
What about people with mental illnesses who are already out of equilibrium?
Then they take drugs to get back to an equilibrium.
EDIT: This is an ELI5 response. The actual answer is a lot more complicated so you might want to look elsewhere for a more in depth response. There are people below me that seem to know what they're talking about but fuck, this is reddit and ELI5 to boot, you probably don't want to trust everything they say either.
This is a common misconception, but psychotherapeutic drugs don't make you "chemically normal". They compensate for some neurochemical, structural or receptor function issue.
There are exceptions, like L-DOPA for Parkinson's, but even it has huge side effects because your brain isn't a big box you just throw chemicals into.
SSRIs are a great example because they were actively sold to the public as "correcting a serotonin deficiency". Except that's not how they work at all; they take 3-4 weeks to begin relieving depression after this imbalancing serotonin spike affects gene transcription and ultimately triggers the growth of new neurons in the brain. In general, the first few weeks are all side effects and placebo.
You can do the same breakdown for any drug. Benzodiazepines don't treat a benzo or GABA deficiency, they (over)compensate for overactivity in certain neurons. Amphetamines at the right dose make anyone a better student and more active, engaged person - people with ADHD have more issues with various brain systems associated with attention, arousal, alertness, vigilance, etc., so the same thing can be life-changing for them.
There was a deleted response to this that pointed out that the SSRI mechanism I mention would look similar even if it was correcting some kind of insufficiency. It's a good point, but the issue is a bit more complicated, so here's the response I drafted to anyone interested:
Well, the issue with this is that "serotonin deficiency" isn't a defined thing. It's individual serotonin receptor polymorphisms that are associated with various forms of mental illness, and even those aren't very robust correlates. More than that, serotonin acts throughout the central and peripheral nervous systems, particularly in the enteric nervous system. This global serotonin boost causes huge side effects - sexual dysfunction, indigestion, anxiety, and typical effects of serotonin excess (tight jaw, excessive yawning, etc).
If you were boosting serotonin to "normal" in some way, you'd see the kind of effect profile you get with insulin-diabetes or L-DOPA-Parkinson's. Because of their mechanism, the only way SSRIs could actually "normalize" serotonin levels is if you had globally overactive reuptake proteins.
I didn't intend to imply the antidepressant mechanism "proves" that SSRIs don't correct for deficiency, but this is how they work despite the fact you don't see signs and symptoms of global deficiency like you can produce experimentally in treated patients - by producing supernormal serotonin tone globally in order to create this notable downstream effect - the same one created by antidepressants that don't affect serotonin.
Every single person who ever took Ritalin for any ailment felt better after taking it. It's the cocoa leaves of the Us.
I'm sorry, I'm not sure if this is sarcastic or not. My brother took it and became a zombie. Once he even passed out. Not everyone feels better while taking it. He pretty much felt...nothing.
I'm sorry to hear that. I was only considering legit prescriptions in a doctor-patient scenario where Ritalin was prescribed for a condition.
It was a legit prescription, for his (presumed) ADD. Mom finally took him off it.
I just wanted to say that I experienced the jaw-clenching! I had no idea it was common, which is a relief because I had recently discovered this after being on anti-depressants for many years.
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That's a little above my pay grade, but is there anything you take regularly? Do you have other symptoms, anxiety, irritability/emotionality, high body temperature, etc?
If you're not taking anything and really getting hyperserotonergic symptoms then you should probably talk to your doc and maybe try a lower tryptophan diet or take a serotonin template enhancer like tianeptine or something. A lower carb diet might help too, but that's pretty speculative.
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You should probably stop taking lots of over the counter NSAIDs, too, and consult your doctor.
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Long term usage of NSAIDs can be quite damaging. Why don't you move to other medication or treat the underlying cause?
Not being a bitch has a high failure rate :-/ there are other options that don't tear your body up as much as daily NSAIDs. Highly absorbed forms of curcumin, omega IIIs, 5-LOXin, etc - there are all sorts of less toxic anti-inflammatories out there.
The Serotonin boost being referred to here I believe is Ecstasy/MDMA
Did you forget the name of this sub or...
It was a detailed question asking me to clear up the mechanism I described in overly simplified terms but fair enough, I don't usually post here :-D
unless you're an artist in which case it's a chemical black hole
Thanks for the response. I meant equilibrium as a more normal perception and behavioral response than chemically. Just trying to keep things ELI5. Again, thanks for the explanation though.
Ahh, yeah, focusing on behavior as the target rather than neurochemicals is much more accurate and reflects actual practice. The problem is that people sometimes don't expect side effects or alternatively, completely demonize drugs when they think they're just supposed to make you "normal".
I also forgot what sub I was in, so point well taken there :-D
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I'd need to pour through the research, but essentially it's just doing the same sort of thing through a different mechanism. Increasing serotonin broadly is a fairly sloppy, highly indirect and side effect ridden approach to enhancing neurogenesis and happens way, way downstream.
The activity of tianeptine could be related to a reflexive increase in serotonin receptor density (receptor upregulation) or possibly just another receptor target.
Its anxiolytic properties, though, are probably a direct product of reducing serotonin. Activity at certain serotonin receptor subtypes can be significantly anxiolytic.
I don't want to derail things here, but as someone with what feels like a GABA deficiency (it honestly seems a GABA agonist solves all of my issues) I would love to pick your brain for more info.. as in whatever sources or web-based resources you might suggest on the subject, I've studied pharmacology to a degree in my opiate-addict days (thank god, that's no longer an issue) I have some background, but you seem to have a steadier head on the subject than most, and I want to learn more from you..
What kind of GABA agonist, I'm guessing benzos? I'll answer any specific question to the best of my knowledge however you want to send it, GABA systems aren't my strongest suit but I know a fair amount.
I mostly read straight research (so Google Scholar and pubmed) and reported research these days. Rxlist for basic drug info, Wikipedia for quick review (needs to be taken with a grain of salt but people often note recent findings) , Essential Psychopharmacology by Stephen Stahl is my favorite general text and the one I recommend to people studying psychopharm. It's far from comprehensive, but can give you a solid background.
I like reading clinical pearls. It's not something you can probably find online, but the Audio Digest: Psychiatry CME series is great for this.
On reddit, there's /r/drugnerds and /r/Nootropics for questions and discussion, I'm sure other subs as well.
Most straight GABAergics are pretty blunt tools. How does whatever you take work for you? Have you tried GABA-B agonists like baclofen or nootropics like picamilon? Phenibut? Tigabine or gabapentin/pregabalin? These are much more "nuanced" GABAergics that can reduce excitatory tone without all the deleterious and potential long-term side effects of something like benzos.
Picamilon is fairly benign, phenibut is nasty and tolerance builds rapidly, I don't know much about tigabine but I think it's alright, pregabalin is great but not that potent, gabapentin is a bit dirtier but alright for some.
gabapentin has never been helpful, apart from a really fast way to multiply the effects of alcohol.. I've been considering trying out something along the phenilbut line, but am unsure of how well it crosses the BBB.. something along the lines of a straight GABA-a like phenilbut + etizolam sounds ideal, but it's usually a messy alprazolam + alcohol mix that turns me into a regular human able to deal with people.. normally, it would be fine, but I have dosing issues, your tolerance is soooo hard to figure out when the time comes, it's a fine line between doing OK and overdoing it on that mix.. I don't like it...
I go through roughly 120mg of alprazolam per mo, all legit, + too much alcohol that starts out ok, but my tolerance climbs too fast for it to be more than a productive few days and a bunch of nasty withdrawal time.. it's no solution..
That's a pretty solid bombardment on those GABA receptors, and as you suggest, it's not a great long term strategy. You can really go down a rabbit hole with GABAergics since they desensitize so robustly.
Honestly, I'm unimpressed with phenibut except as an occasional sleep aid. Tolerance builds rapidly and it's a pain to deal with. Dosing issues are worse than anything.
Ultimately, weaning yourself off benzos with the support of some of those other options I mentioned would probably be a good strategy, but you know that, I'm sure, and it's way easier said than done. You might want to chat with some of the people in /r/drugnerds - I think there was a recent discussion on a similar topic. Something like theanine, taurine or possibly picamilon or tigabine could be dosed regularly without screwing over your future self like your current regimen tends to do ;-)
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Wow, that's incredibly rapid, I'd have thought you were talking on the scale of weeks rather than days. Maybe you can try seeking out a different doctor so you can try to explore your options without taking that risk? Or maybe try some combination of the OTC supplements I mentioned to get a sort of inhibition baseline?
Using magnesium, theanine and/or a few grams of taurine per day is about as benign as you can get. Kava is pretty much blunt too, but probably less so than alprazolam.
Tianeptine might be worth looking into too, though I don't know much about it.
I think you should really consider posting your whole situation to /r/drugnerds or a similar sub - I have lots of ideas for what you could try to get onto a more functional and sustainable regimen, but I haven't been there myself. I hope you keep trying alternative approaches either way.
Isn't proper nutrition a key in re-balancing these deficiencies? What do you think about psychedelics? I feel like the gateway that it opens is extremely helpful. I think in order to change your thought process you need to have an extremely open mind. I think having that open mind, you explore other avenues to your approach in whatever. I am aware of my feelings, thoughts and such, I check them with what I do on a daily basis. If there is conflict I dissect it and see what is wrong and what needs to be changed. Being psychologically aware of your own self is a huge hurdle to overcome when it comes to making yourself a better you.
However, if you were raised in a "proper" setting you won't have such issues, and you will be ahead of most people. So my ideas and thoughts apply to those that are less fortunate. People that grew up in a mentally abused setting, or whatever, something that wasn't the norm. So it all comes down to who raised you and how well they did. I find it really scary that we have so much influence on a life, especially those that are not educated properly.
I think that further speaks to the functional rather than purely biochemical nature of these so-called deficiencies. Chronic blood sugar imbalance, increased stress hormones, higher inflammatory tone, chronic allergic responses, depletion of methyl donating capacity, omega III insufficiency - all of these can be affected by diet and exercise and none of them involve directly just jacking up levels of a certain neurochemical.
I think that psychedelics represent an interesting approach, but are probably best coupled with either formal cognitive-behavioral therapy or just learning the appropriate strategies. The same positive effects you describe can also lead to rumination, existential suffering and detachment, depersonalization or disengagement with the outside world. This makes them a very risky tool for someone who "wasn't raised in a proper setting" or who has mental health issues of any etiology.
If you come into it well-prepared and ready to take a hard look at yourself and the world then respond in a positive way, psychedelic experiences can be great, and research bears this out as well. There is something called depressive realism, where depressed patients are actually better at assessing their abilities than healthy patients since they don't wear the same rose colored glasses, so for many depressed patients, poor self-awareness isn't quite the issue.
You could honestly make the same sort of arguments when it comes to thinking in general. If you spend all day mired in negative self-talk and repeating harmful messages, you're gonna have a bad time.
There are so many factors isn't there? I come to this conclusion and it is very overwhelming. I just wish there were more professionals that have the answers. The people that don't have the time to research this stuff just listen to whatever they are told.
Depressive realism blows my mind, I feel like that fits me. But if you can't get over the negative self talk you are not going any place. I love your response, thank your for the information.
The people in the worst shape usually have the hardest time doing their research too. And whatever the authorities they're listening to describe as the most important or effective approach is what they'll think.
Going back to how this thread started, if you have a doctor that oversimplifies and tells you "depression (or whatever) is a disease caused by a serotonin deficiency and this SSRI will treat it", you're much less likely to look towards other interventions.
Moderate intensity exercise - not even all that much of it - is an essentially zero side effect intervention with antidepressant effects comparable to drug therapy, with added anxiolytic and anti-asthenic effects and of course, generally positive effects on physical health, self-efficacy, self-image, attention, cognitive performance, etc. I don't think I know anyone whose psychiatrist vibrantly endorsed exercise, much less did what they should and recommend/discuss compliance with a specific exercise plan during every visit.
I honestly think that some basic cognitive-behavioral interventions should be taught in school. Teach people from the youngest age how to deal with destructive thoughts, how to break bad habits, how to respond to stress, etc. We weirdly assume that people will just figure it out.
The education system in America is terrible. The key is to getting the education community to instill that idea. You can tour the country teaching people.
But for drugs like SSRIs isn't the end result that the levels of serotonin being used by your brain are changed to be closer to normal?
Nope, at therapeutic doses, levels of serotonin in the synapse are well above normal. That's what causes all those side effects, but also what causes the ultimate therapeutic effects. You bombard the postsynaptic neuron with serotonin and downregulate receptors, which sets off a cascade of signaling events that ultimately affects gene transcription and leads to neurogenesis in the hippocampus.
Hormone replacements (insulin, testosterone, thyroid hormone) do work this way, but very few psychoactive drugs do.
Oh, ok, thank you for clearing that up.
Can you please elaborate on "trigger[ing] the growth of new neurons"
[I posted this link above] (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181899/) - a fairly exhaustive review of neuroplasticity, including hippocampal neurogenesis, in the therapeutic effects of antidepressants. It's a rather involved signaling pathway.
Great paper, but I don't see anything about re growth of neurons. It is know that neurons can show slight-moderate regrowth the hippocampus, but something such a depression involves more than just that brain region. The CNS stops itself from repairing and regrowing neurons in every other brain region.
Oh a great reply. If you have time, could you elaborate on the changing of gene expression? Something like amphetamine affects the neuron at the synapse, do SSRIs not work in that sense?
There's a little covered way down there under the 'neurogenesis' section (not a huge amount in this paper), but absolutely! That's why I posted the paper, it covers other forms of neuroplasticity linked to antidepressant use.
I do think that hippocampal growth through both neurogenesis and other forms of neuroplasticity (dendritic branching, "filling in" by glial cells) is important, but far from the whole issue. I do think that almost the entire effect of SSRIs and SNRIs is mediated by gene induction though, given that research shows no reliable symptomatic improvement before the 3-4 weeks I cited.
I'm starting to hit my limit of what I can comfortably cite offhand if you're asking for the full pathway, but essentially you bombard the synapse with serotonin and get receptor downregulation at the postsynaptic neuron (and also some autoreceptors on the presynaptic neuron, but let's not go there ;-).
Basically you have the cascade going downhill from there, maybe you have reduced levels of activated g-proteins from 5-HT1a receptor downregulation, which hits a second messenger system and affects an adenyl cyclase, altered levels of cAMP activates certain transcription factors, which are brought to the nucleus and affect gene transcription, which results in a wide variety of outcomes (e.g. increase in BDNF and other neurohormones). I'd say bust out a cartoon on this one if you want to see a good path overview.
Just a small correction, amphetamines do not make "anyone" a better student. They did nothing for me, even at high doses.
Yeah, that was obviously a generalization, I should have been more specific. More speaking against the idea that they're amazing medicine for people with ADHD and criminal poison for people without.
I'd go one step further and point out that amphetamines don't make everyone with ADHD a better student either, in fact, and I knew several people growing up who were great cases in point.
Ed: also, high doses don't tend to be better. There's a sweet spot that maximizes benefits and minimizes side effects but people often end up overdosed, unfortunately.
This is really interesting to me. I have refused to brave it through the first few weeks of antidepressants multiple times because I had no understanding of how that window of time made the medicine begin to take effect. I figured it was a neuronal restructuring thing. So you're saying it changes the epigenetic switches in your cells to somehow promote new growth? Sorry for my layman language.
Terminology is off but upshot is correct if I'm reading you right. I read a big meta-analysis at some point demonstrating that no typical (SSRIs, SNRIs, tricyclics) antidepressants show any reliable efficacy before three to four weeks, although side effects and placebo/active placebo response kicks in right away.
[Simplified depiction.] (http://www.psychiatrist.com/pcc/brainstorm/images/br6103f1.gif) The Wikipedia article on neurogenesis isn't bad either, it's a good jumping off point.
Thank you for the info. Maybe I will give them one more go around :)
If you're put off by the side effects, you should try something like Wellbutrin (bupropion) - not free from side effects, but a completely different and IMO "better" side effect profile. Also does have some acute mood boosting activity for many. There's also options like SAMe and selegiline which act faster and with fewer adverse effects.
I don't love SSRIs - they're just fine if you can tolerate them well, but a pain in the ass and pretty underwhelming if you can't.
can confirm. my roomate does amphetamines regularely and is actually more concentrated when learning.
You don't create new neurons. It takes a while for SSRIs because they block the reuptake of serotonin. You are just waiting for more serotonin to accumulate.
[Sure you do.] (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121947/) You're actually waiting for the downregulation of post-synaptic serotonin receptors to activate the signaling pathways that lead to hippocampal neurogenesis. Otherwise you could just dose up on 5-HTP and buspirone and have a rapid response. This isn't quite ELI5 material though ;-)
That's making more receptors. Still not actually forming more neurons.
No, you're definitely making more neurons. And making fewer receptors, actually. Leading to hippocampal neurogenesis, the growth of new neurons in the hippocampus via mitosis, the same way other cells reproduce.
There are, however, a bunch of other forms of non-mitotic neuroplasticity I didn't go into (synaptic plasticity, dendritic branching, receptor up and downregulation, DNA methylation and other forms of genetic regulation).
Interesting, do you have any other sources for something like this happening? I've never heard of such great plasticity just from SSRIs. Also, only the abstract is available for that publication nothing else. I'm pretty skeptical.
An increase in receptor number is still what I'll stick to for now but you found an interesting effect that may happen in addition.
[Wikipedia is chock full of citations in their article discussing adult neurogenesis.] (http://en.m.wikipedia.org/wiki/Neurogenesis#Occurrence_in_adults)
And [here] (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181899/) is a fairly exhaustive review of neuroplasticity, including hippocampal neurogenesis, in the therapeutic effects of antidepressants.
I don't doubt that neurogenesis happens. I'm not sure if it's a large portion of the effect in SSRI's. If you stop taking SSRIs, you will lose their effects. Is the increase of 5HT necessary to be constantly there to keep the neurons alive even after they've been created?
Nope, it's not necessary but that question isn't really posed well since all of this occurs far downstream (and time-delayed). Read through (selected parts of?) that second article!
Then they end up out of equilibrium again and get horrible side effects.
Not really. Think adderall, or any other ADHD medication, It brings me closer to the equilibrium and with very little side effects.
I've been battling depression without medication since the late nineties. I'd experimented with drugs, but most of the types my psychiatrists prescribed made me gain huge amounts of weight and made my emotions basically flatline. I became a fat robot. So I took myself off of them and decided to muddle through without.
When my son was born, having a depressive episode suddenly had a huge impact on someone else. I was a little slower to answer his cries. I was a little less motivated to go out and do stuff. I was a little less keen on doing things that needed doing, like household chores or personal hygiene routines. And those little bits really add up when you have a kid. They snowball in a huge way. So I got a prescription for Buproprion (Wellbutrin). I can honestly say that I've never felt better, and it's made me a better father. There were some side effects while my body adjusted to the new normal, but now I'm past them and feeling great.
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They really are. It can be so shitty finding the right one and right dosage for your body. But once you find it, I feel like it's so worth it.
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Aww :( mental illnesses are so tough. I have depression and anxiety and I was very fortunate to find something that worked for me relatively quickly. I hope one day you find something that works even better for you! Have you tried therapy along with the treatment and medication?
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Oh man. Keep on trooping buddy!
When you said I have to double up on my meds not to act like a lunatic, how do you realize you're acting like a lunatic?
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I'm not judging you. I'm curious. When you have these episodes, like laughter into rage, can you see the response you're having to the emotion, or can you not recognize it until after it passes? Thanks for replying.
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Sounds hard.
My wife just got diagnosed with bipolar a few months ago. She went into full blown, thought she was in God mode, mania. Now she's getting kicked out the military, is being investigated for drug use and adultery, and we're pretty much getting a divorce, she just doesn't know it yet. Right now she's in the depressive, wants to die daily and is sleeping 16 hours a day phase.
Im so sorry to hear that. I wish I had words that could offer some consolation but Bipolar is just absolutely destructive when not treated properly. I dont blame you for wanting a divorce even though I know that much of her actions were out of her control almost entirely. When someone is fully blown manic they have essentially lost their mind and are basically incapable of rational thoughts or actions. I once lit a large portion of my yard on fire in high school while doing a science project and was laughing the entire time. But regardless of whether she was in control or not any action has repurcussions and sometimes it's just too hard for the ones we love to handle. Good luck man, and hang in there.
Out of her control? She said she was in complete control.
Then i'd say you are probably right in seeking a divorce.
There are a lot of reasons why someone might say they were in complete control during a manic phase. The manic phase might lead to what's called "magical thinking" which leads the sufferer to believe they have control over everything (not even just themselves), they might have a really ingrained shame/fear reaction that leads them to take inappropriate responsibility.
Fact is, though, if she was genuinely in a manic phase, regardless of what she thinks/thought, she was NOT in complete control of herself. That's kind of a diagnostic criteria.
This is true. She may have other, self-worth and fear-related reasons for wanting to be seen as in control. If others feel she is out of control, her rights might be removed, she may or may not see this as a good thing, i.e., recognize she needs help.
If there are children involved, she may not want to be seen as an out-of-control mom. She may not want you to think of her that way. She may not want to admit it to herself.
The proof is in the behavior. Is it harmful? Is it irrational (to most people)? Is there any other medical or social reason?
In any case, it's terribly stressful. Try to take care of yourself /u/jova33, as if you yourself had the illness. You'll need your strength.
Either way, what she did is inexcusable. If you scroll through /r/bipolar and /r/divorce, I go a bit into detail about her spiraling out of control and me going suicidal.
(Huge hugs.)
There is a myth that by going to 'x' psychiatrists and trying 'y' drugs with any kind of mental illness, there will always be either a partial or total alleviation of the symptoms.
Not true. Many times, there is no solution.
I didn't intend to suggest that therapy+meds = guaranteed treatment. And as a matter of fact, I have never heard in psychology that any form of treatment is guaranteed to treat an illness. There is a lot of trial and error involved, and that is the general consensus that I was taught.
The only reason I asked about therapy is because there is a higher potential for improvement when you combine medication and therapy, as opposed to either on their own. Not to imply that the combination was a miracle cure, sorry if I came off that way!
I know. I was not directing that comment at you, at all.
I was speaking to what the general public thinks. Many people seem to be under the misconception that there is some magic meds that can fix anything - not including you. ;)
Well, the thing with brain chemistry is that we understand a bunch of it, but there's so much we don't know yet. Trying to find something that will work with your personal chemistry isn't like throwing darts at a dartboard. It's more like throwing baby squid at a hyperactive kitten in a dark room. Sometimes you hit right on the thing you're aiming for (squidkitten! fifteen points!) sometimes you end up with a giant mess of squid and a pissed off cat.
I'm depressed and fat, so you're telling me I should definitely start taking Wellbutrin?
You need some phentermine more likely
Wow. The psychiatrist I go to(and hopefully a lot more) doesn't stick to the "known side effect" list, any change from before to after the medication is usually assumed as a side effect, listed or not.
oh man I just started taking wellbutrin and have the same side effect. Glad to hear it's the medicine and not something else.
Yeah definitely talk to your psychiatrist about it. It really fucked with my health. I used to do what my family called "the passion of the christ", where id slightly suck in my stomach and all of my ribs were visible.
Well I gained a shit ton of weight due to being almost completely sedentary and an alcoholic as a result of severe depression. So, not being able to eat much for now is not really a bad thing for me.
Try Tianeptine
I had a lot of issues with depression/anxiety medicine fucking with me in high school, but thats when you're going through a lot of changes physically and its really hard to find something that works without horrible side effects. I've abstained from any sort of psychiatric medicine for a few years now, but I'm going back on it now that I need something more than my own willpower to keep my issues under control, and I'm hoping that it will effect me in a more positive way, now that I'm physically and mentally more matured.
High school really is the worst time to experiment with medication when you have mental health issues. Most people's really bad experiences with these drugs seem to be during that period of time.
Except if this vomiting after meals had started after changing to a new medication, any medical professional would have factored it in as a potential cause. So either your lying, your doctor is incompetent or there was a lack of information flow between the two of you.
Well, im certainly not lying. Because it wasnt a known side effect it didnt send any red flags off with my psychiatrist (who at the time wasnt very good, not quite incompetent, but im no longer seeing them). I saw a ton of specialists who for a time diagnosed me with cyclical vomitting syndrome. It wasnt until after I came off the wellbutrin, for other reasons, that the vomitting stopped and they came to the conclusion that that was the most likely cause.
Most of the drugs you'd used then were really garbage, with massive, intolerable side effect profiles like you describe. Until the era of SSRIs and other next-gens (I'm a big fan of bupropion for people who can tolerate it, so I'm glad you're doing well on it!), we had to deal with nasty things like tricyclics and MAOIs.
Now we have OTCs like SAMe that compete well on effectiveness and we're on the cusp of moving past even the next gens to ketamine analogues and other more highly targeted therapies. It's looking good!
Some people can't tolerate bupropion? How so? What does it do to them?
I can't speak for everyone, and I don't know if my results are typical, but it gave me more swingy moods making my depression closer to bipolar disorder. Normally I would be the typical fat robot as described, just flat affect. There was no "up" as with bipolar disorder, but any down was harder to handle than an unmedicated depression "down". I was put on lithium, which is normally used with bipolar disorder, in an attempt to manage the suicidal tendencies. Eventually going off the medication and returning to unmedicated depression was a relative improvement. (Preemptive "go fuck yourself" to the armchair psychiatrists who chime in and say it sounds like I'm actually bipolar and not depressed. You're wrong because you're not qualified to assess that.)
Yeah, neither are most psychiatrists.
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Thanks for that information that isn't relevant to my case. I gave you a paragraph, my doctors who knew a lot more didn't see it as anything other than major depression. And having a friend who knows what they're talking about isn't the same as you knowing what you're talking about. Kindly move along.
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Well, it has double the seizure risk of SSRIs. Some people feel anxious, become irritable or get headaches. Insomnia occasionally. I know at least one person who found the boost in sex drive intolerable (harmed their focus, were spending a lot of time masturbating).
You can check Rxlist or elsewhere for the full list of side effects, but those are the ones that stand out in my mind. It's extensively metabolized and has a bunch of active metabolites, so I think it can elevate liver enzymes (sign of liver damage) in some, but I don't know how common this is.
As you suggest though, its side effect profile is quite different from any other antidepressant and it's generally pretty well tolerated. I'm a fan.
Increased sex drive? I think I like this already.
It's an extremely useful effect for some people, especially considering that SSRIs are notorious for decreasing both sex drive and sexual enjoyment. On the other hand, man can it be distracting to feel like you're going through puberty again ;-) your mileage may vary.
It's worth mentioning that I also know at least two people who have taken it exclusively for the slight mood boost and increase in sex drive. One even asked for it from her doctor explicitly to increase her sex drive.
It made me really aggressive. Bad enough that I had to stop taking it.
A coworker of mine once tried Bupropion to try and quit smoking and broke out in a pretty severe case of hives. I use it myself and was having dizziness issues until the dose was lowered a bit, now it is fine.
from what i can remember of my time on bupropion. it really fucked me up. made me even more suicidal, made me gain weight, and made me horrible to be around.
In my case, as with every antidepressant I've ever taken, it made me more depressed. It works for my father though.
It hasn't been a dream, but Lexapro doesn't deserve all of the hate it gets IME, botched clinical trials aside. Very few side effects, and for years it has significantly helped my self confidence.
For SSRIs, for the people they work well for, I actually like Lexapro and Zoloft - pretty fair side effect profile on the former and possibly a bit more efficacy for the latter.
My dick would go limp during sex. I'd have to stop, make a girl suck it til it got hard again, then continue.
That made me more depressed.
This was the first drug I tried that didn't help me, but didn't make me worse either.
Unfortunately, SSRI's still aren't as efficacious as most trycyclics and MAOI's.
I'm not the biggest fan of SSRIs in general. They don't work remarkably well and aren't as benign as advertised. Comparing them to TCAs and MAOIs, sure, but that's a pretty extreme comparison. Interestingly, MAOIs are, or at least should be, first line therapy for psychotic depression.
For this gen I'm more into the atypicals like mirtazapine (Remeron), bupropion, SAMe and even the MAO-B inhibitor selegiline. They work well for some, but there are some doctors that will try five different SSRIs before even considering these other options, and this is pretty irresponsible, IMO.
What is SAMe?
Edit:Never mind google answered my question. Thank you for bringing this up I have never heard of it before.
Do share. Fuck it, I'll look it up, too, and won't relay the information.
Sorry! I felt silly for asking something I could google and got embarrassed and forgot to share the link.
http://www.mayoclinic.org/drugs-supplements/same/background/hrb-20059935 http://www.nlm.nih.gov/medlineplus/druginfo/natural/786.html
Thanks. I actually did the same. LOL
If I'm not gonna quite ELI5, SAMe is an amino acid/DNA base pair derivative (S-adenosylmethionine naturally found in the body that's involved in methyl group donation. There is very good evidence supporting high dose SAMe (400-800 mg/day) in the treatment of depression. It takes effect somewhat more rapidly than most antidepressant drugs. It's also remarkably expensive, especially at those effective doses. It's also used sometimes to treat arthritis.
Some practitioners use it as an adjuvant treatment to traditional antidepressants or in milder cases. I'd read up on it if you're interested, it's very well tolerated but isn't free from risk. Hurts your wallet more than anything else at effective doses, though.
Very much appreciated.
Ah well if you're interested in that, check out inositol, PEA/selegiline, sulbutiamine and low dose lithium. Even mifepristone if you really want to go out there! All very interesting potential treatments for depression that don't get much play because they're unpatentable.
Fuck that stack piracetam with choline; the former is made by Albert Hoffman.
Easy, its not the same as the other
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Same thing
What you want is Tianeptine, it's an SSRE. Best antidepressant currently on the market (granted not the US market, but you can get under the FDA PIP)
Ahh, good mention. I'm impressed by the side effect profile but I think it's been a bit overhyped. Admittedly I don't know as much as I should about how well the hype has played out for the reason you point out though.
The one person I know who's tried it thought it was alright but not worth the cost and hassle to get again - you have any experience with it?
Yeah, I've used it a bit. I'd say it's worth the hype.
You can get bulk powder on the RC market pretty cheap: https://newmind.com/tianeptine.html
Very interesting. That'd be a similar general mechanism as ketamine, though not necessarily hitting the same upstream pathway. That price per dose for powder would be dramatically cheaper than what I saw when I last looked like 5+ years ago.
Do you vouch for that source? I'll definitely pick some up if so; I know more than one other person who'd appreciate it, particularly the bonus anxiolytic effects, even if I don't.
Can as of earlier this year.
I'm all about it then. Thanks!
How has taking it affected your sleep? Quality, subjective experience, dreams, restfulness, energy and alertness the day after, etc?
Energy and alertness are definitely increased. Haven't noticed much else with my sleep, but I usually take it with modafinil which decreases my sleep needs.
There are also some amazing new treatments like Transcranial Magnetic Stimulation that could again revolutionize how we treat depression. The program at my hospital is seeing an 80% significant response rate. It certainly changed my life when I had been on every medication and then some with little response.
MAOi's, sure, but tricyclics remain among the least side-effect addled options.
? Which tricyclics are you talking about? They're not first line anymore for anything but migraine prophylaxis and neuropathic pain.
All that alpha and anticholinergic activity makes them very hard to tolerate relative to almost any of the next gens with the possible exception of mirtazapine (which works much better than they do). Lots of weight gain, sedation, sympathomimetic side effects, etc.
They have a higher risk for suicidal thoughts, iirc.
Man, in my experience, all of that shit is toxic. I was on a cocktail of them from 10 to 20/21. The last few meds my doctor gave me made me extremely homicidal/suicidal and I had really vivid hallucinations, like to the point where I've got a mild case of PTSD because of them. Any kind of mind altering drugs freak me the fuck out. The best thing I ever did for my depression was quit taking my medication and wait out the month long withdrawal. As soon as it was out of my system, I was like a new person. Haven't looked back since.
A lot of people are critical of the idea that polypharmacy can ever really be "rational". Your doctor obviously wasn't monitoring you well, asking the right questions and looking to see whether you were actually doing better overall, which is a shame and particularly awful when it happens to kids.
Unless it's an emergency, a good doctor should have looked at each med critically with an eye toward discontinuing them. It's pure hubris to think that you can just keep adding meds to "tweak someone into normalcy" without risking serious, even catastrophic side effects.
I don't know fully understand the science behind the medicine. All I can tell you is this. I had/have depression. It wasn't some teenage phase. I could literally be in a room full of people who loved me, having a good time, and want to kill myself for no reason other than I was inexplicably extremely upset/sad. I didn't know why I was upset. I'd make shit up to explain it to people, even my parents. I made up a lie that an online friend I had a crush on committed suicide on a webcam in front of me, and that's why I was upset. That was about the level of upset/angry/depressed. I didn't know how to tell people, I feel like this and I don't know why. So my depression was real. I had a serious problem in my mind. Add that to a long list of abuse, verbal, mental, physical, and sexual, and I was a serious nut case. The meds only ever helped a little. I'd keep quiet and not talk about how upset I was, I wouldn't last out at all, but every day, putting a bullet in my brain was seriously considered. Finally one day I told my doctor I wasn't happy, he switched up my meds, shit got worse. My girlfriend was cheating on me, I knew it, she knew I knew it, I stayed because I was scared and didn't want to be alone. She just wanted to fuck as many guys as she could get away with. Finally the new med they put me on, Effexxor or something like that, made me hallucinate. Like that shit you see in horror movies, where the lights flicker and something bad gets closer and closer to happening. It took over my vision. One was that the girl who was cheating on me, who I somehow still loved so much, was in my arms, and suddenly she's looking at me in shock, gasping for air, then I pull my hands back, they're bloody and I'm holding a knife. Another, my dad's S&W floating up to my temple, then a loud bang and my vision went red. The last was me walking into the local courthouse with an AR-15 and dumping mags into everything that moved. All with that same god damn flicker effect. Like a god damn sick twisted movie that I can't leave. For three days I was wide awake, hallucinating. Couldn't sleep. It was my own personal hell. I was hurting people, and I didn't want to. Finally on the forth day the medication was out of my system. Doc moved me to Wellbutrin (sic?), and I just really wanted to kill myself. It was all I could think about for a week. Then I quit. Cold turkey. The ensuing month was awful. The cocktail of medication had caused addiction, my system was freaking out because I didn't have any in me, I was an emotional wreck and would lash out at anyone for any reason. After that month, it was gone, and for the first time in a long time, I felt clean, sober, and I could think straight. It was the best move I ever made. I feel thousands of times better than I ever did on medication. I've since, to a degree conquered my depression, it only every comes back for a day or two and I get over it. I can't say staying away from these medications is for everybody, some people may REALLY need them, but for me personally, they were absolute poison turning me into a suicidal/homicidal maniac.
I'm the same. Wellbutrin was a godsend. My brother and another friend, both of whom suffer from depression and anxiety, reacted badly to it (near catatonia in the one, panic attacks in the other), but for me it's emotionally the difference between the sun rising or not. I even stopped drinking caffeine after it was in my system a few months. My energy is up, my moods are balanced, and I'm able to enjoy company and recreation and just life in general for the first time in long dark years. Amazing stuff.
Edit: It also made cigarettes taste like dirt and killed their buzz.
Who cares? Alone it's like a cigarette which lasts all day and doesn't stink!
Buproprion! Yes!
I've been through a couple different medication regimens with various results (Prozac made me feel like a zombie, ugh), but so far Buproprion has been awesome.
Thats so awesome that you got help for your depression and its working for you! I am on Wellbutrin and a couple others and they have worked well for me too. Congrats man, im happy for you!
Wellbutrin imo is a wonder drug. Helped me out a lot. One thing to watch out for is liver damage, make sure every once in awhile you get liver values checked by your PCP. This happened to me so I have to monitor and adjust things regularly.
I didn't react well to SSRIs and so my doctor just switched me as a potshot and hoped for the best. She said since I also have OCD and ADD the fact that it affects dopamine or something like that would probably help me best. Best decision I ever made, I love my buproprion except I can't say it.
Anytime I meet someone who's completely not helped by SSRIs I always suggest they ask their doctor. I'm like a commercial.
Pretty similar story for me. I'd been avoiding medication as an option for treating my depression and anxiety my whole life, mostly because of the negative stigma attached to it. When it got to its absolute worst point, where I was contemplating suicide daily, couldn't handle the stress of a normal job, and was making my wife absolutely fucking miserable, I finally gave in and talked to my doctor about SSRIs. She prescribed me a very, very low dosage of Setraline, and it pretty much saved my life. Side effects were minimal, and I'm a functional adult with a happy marriage and an awesome job. I don't think I'd be here right now if I hadn't given medication a shot.
Sorry for hijacking, but - Do you find the Buproprion caused any excess weight gain? I tried it briefly but felt like it was almost too effective in the dose I was given so I dropped it (without Dr permission, I admit).
I'm on Venlafaxine now and have been for about a year but I have gained a ton of weight, way too much given my diet and exercise level. I would love to see if this is the reason why but am trepidatious if it's just going to be more of the same...
I'm actually losing weight, and the Bupropion is helping. Almost all anti-depressants make you gain weight, but Bupropion is sometimes prescribed as a weight loss aid. It was the deciding factor on this trial run for which meds I'd be trying.
I gained forty pounds over a year while on the drugs they gave me in the early 2000s, and that weight hasn't gone away. I'm down something like fifteen pounds right now, after two months of dieting, increasing my activity level, and Bupropion (I think the article I read could point to a two pound per year loss for people on Bupropion, all other things equal).
I think I've probably gained close to that as well in the past year that I've been on Effexor, even though I eat fairly clean and try to be active. It feels like I just keep gaining. Clothes I bought last summer no longer come close to fitting, it honestly makes me more depressed.
This has helped me put two and two together! Even if it's just a minor change, having something that's not so drastically affecting my life will be refreshing. I'll have to have a talk with my Dr about it of course, but maybe it's worth looking into again. Thanks, and congrats on the weight loss :) I'm glad it's working out for you!
move to another country (australia to the canadian rockies) and try 3 medium magic mushroom doses over a period of 6 months, cured my depression!
Oh no! I already live in Canada!
then come to australia! i promise it will help, the cliche tumblr quote applies, before you diagnose yourself with depression, make sure you aren't surrounded by arseholes, change your situation!
I didn't diagnose myself with anything. I let professionals do that with all my free healthcare.
I would TOTALLY come to Australia, though. My stay-at-home dad salary isn't exactly conducive to travel, but I'll see what I can work out.
Buproprion really helped me out also. Other drugs always gave me side effects.
I had some side effects when I first started. I got some insomnia and some dizziness, rocked a headache for about a week. Eventually my body just got used to the difference in brain chemicals and things got much better for me. As with any long-term meds, it can be important to just weather through the bad for a while (which can be admittedly very difficult if you're already depressed).
Adderall has lots of side effects. Taking it long-term can cause severe issues with cognition and recall and physical side effects such as high blood pressure tachycardia and even heart attacks.
Source?
Should be taken with Modafinil and Guanfacine as adjuvants to prevent that, but it's a rare combo to see prescribed.
My father has very bad ADHD, can't function well without meds. The amphetamine salts actually lower his blood pressure to a safe level. Maybe its different for everybody or has vice versa effects to people that actually have ADHD. Also hes been taking it for years, since i can remember really.
Those are just the physical side effects
Suicidal thoughts and depression are also known side effects
And, if you stop the medication there is a approximately six week time for your body to recover from the imbalance it causes in the endocrine and adrenal systems. The drug leaves your body within 48 hours however long term use causes physical dependency within the adrenal glands. The result is alternating sleeplessness with narcolepsy and lethargy for several weeks.
That's why my doctor recommended I take it only when I needed it.
Yes it makes you feel closer to equilibrium. But the simple truth is that people with ADHD are not simply deficient of amphetamines or Adderall or whatever, it doesn't magically un-ADHD people.
Now can most people take amphetamines with little side effects, yes, but they do exist.
dependence is an adverse side effect.
I dated a girl with a horrible adderall addiction. She developed a massive tolerance and was up to 120 mg a day. Obviously no doctor is going to prescribe that much she would do anything to get it. Doctor shop, sex favors for pills, steal, etc.
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If you actually have ADD, then it's really not possible to find that balance. The whole point is that I'm physically incapable of ignoring distractions on my own. I can mitigate that (and did from ~16-28) but it's not the same as overcoming it entirely.
Came here to say how beautiful adderall is.
Adderall has a very similar effect on neurotypical individuals as it does on people with ADHD. Don't kid yourself.
source: medicated for ADHD since early childhood
My friends who take adderalls and vyvanses clearly have side effects.
you'll still end up out of equilibrium eventually, which is why you'll have to up your dose
I think he was talking about real mental illness like schizophrenia or extreme depression
medically Ecstasy is fine as well but you don't see people taking medical doses
Good case in point. You can take Adderall for a long time if all you do is take it to reach normal productivity levels. But if you start taking it for recreation then it's pretty much meth.
Yeah I use it regularly and I don't have any negative side effects, unless I take it too late in the day then I have trouble going to sleep. However, I only use the prescribed amount, or more commonly, less. I know a couple people who have ruined their lives by abusing adderall. Like, staying up for three days then getting the FBI involved in a delusion they have of a plot to murder them. It works great for me, but if you start to abuse it, it can go terribly wrong. Which is probably true for most everything though.
Altho not directly adhd medicine is know to cause depression high alertness and suicidal thoughts
This is information enclosed with them ( alteast in Holland)
And shamefully I can confirm this indeed are real side effects
thats because you're not using enough of them to get a euphoric effect. if you took enought to get that typical amphetemine high then it has the same as just that: an amphetemine high
Adderall has a ton of side effects. If I take it without weed,I vomit. It makes me shakey and never hungry. I have adhd and narcolepsy and take 60mg a day and have been for three years. It was great for the first year but I built a tolerance really fast. I mean, yes, it's highly effective, but it has TONS of side effects. For men, it makes ejaculating more difficult, it makes everyone less hungry, it causes heart palpitations. Too much can even cause methamphetamine psychosis.
HAHAHA! Then you were not taking adderall.
I do take adderall, have for well over a year now, and I really don't experience side effects from it. I didn't say you can't have them, I was only saying in my case, I don't.
how much you take in a day and when IR or ER?
I take 30mg ER twice a day, one before work, then another after about 6 hours to hold me over through the rest of my shift and school/homework.
Ahhhh got ya, I had the IR. I might try ER someday... Have you had to change the dosage to keep it working for you?
Only time I've had to change the dosage was my first few months on it while I figured out a good balance
Addies can actually have some horrible side effects depending on the person
Kinda but I feel like it has made things so much worse when I don't take it. I mean I just feel normal and productive when on it, not really a high anymore. But I am worse than worthless when I don't take it.
Yeah because all mental illnesses are as benign as ADHD...
He was just using it as one example out of many possible cases
Sorry just got a little miffed with someone actually calling ADHD a "mental disorder"
Properly diagnosed ADHD can be a seriously life affecting mental disorder. However 90% of those diagnosed are perfectly functioning individuals with parents that don't see any other solution than to sedate their children.
Out of curiosity, why do you not consider ADHD to be a mental disorder?
It's pretty famously over diagnosed and kids are given drugs to numb them when really they just needed decent parenting. Now some people have gone the other way thinking that it doesn't actually even exist and it's all some big pharma ploy to push pills on children.
I agree that it is over diagnosed, but I don't think that that means the disorder doesn't exist at all.
I'm right there with you, I fully believe it exists but some people are crazy and think it's made up because of the fact that it's over diagnosed. I should have made it more clear that I don't share that opinion.
Oh I gotcha
ADHD is BS... much like fibromyalgia...most doctors will admit this if you ask them.
edit: downvoting may help you feel better but it doesn't make what I said any less true...(thats why no one can say anything disputing the claim)
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Thanks for the heads up man. I don't give a fuck about up votes or down votes...I care about the truth. Suck on this truth reddit....
There's a school of thought among scientists that doesn't like the use of the worth equilibrium because it makes it sound like your body reaches some singular stable state. Some people prefer dynamic equilibrium or dynamic disequilibrium to describe biological systems. Basically, you're only alive because you're never at equilibrium. Life functions by having concentration and temperature gradients across different membranes and areas in the body.
So you're always 'in equilibrium' in the colloquial sense, but when people are talking about getting back to an equilibrium, they're either A) referring to returning to some ideal cycle or B) you're actually in some horrifying state of disarray and dying/dead. The problem with drugs isn't that they take you out of equilibrium, it's that they change the equilibrium you're in. If you notice a patient's current equilibrium is far from ideal, you can use drugs to change it to a different one that is closer to the ideal, or what we consider normal/healthy.
It depends on the drug, the dosage, and the individual. Certain antidepressants will work better for one person while others will help another, for example.
SSRI works for me and millions of others. Stop with the ignorance.
Don't think there's anything ignorant about pointing out that there's side effects. Very relevant to this debate methinks. Yes the drugs work for millions, and I'm glad they've worked for you. But there's also millions who can't tolerate the side effects and end up feeling like a failure because of the medicalisation of their normal human experience.
My little brother was told he was "slightly autistic" and had "learning disabilities" and then he was "overly aggressive"...
Every time the medicines kept piling on, and with every medicine, there was the risk he'd miss one...
If his "aggressive behavior" before he started medicine to control it was 7 of a scale of 10, then the days he forgets to take it or something else, he's usually a 568983 out of 10.
Why are so many "corrective medicines" that he takes creating these horrible rubber band effects? None of his symptoms prior to taking medicine were as severe as when he doesn't take it after having taken it for a long time. Is it like a mental addiction?
He probably creates mental and physical dependencies on the drugs he takes so that when he forgets them his body has to relearn how to cope without them.
I don't want to insinuate that the doctors are completely assfucked wrong about how to deal with your brother, but... They are completely assfucked wrong. (*In my opinion/experience)
Piling on pills left and right to compensate for an unknown variable (The actual emotional state of someone who has trouble processing said emotions) is as close to throwing darts in the dark while skimming your wallet as you can get.
Now the only question I ever really ask here: Did they ever, once, perform an overall hormone level test?
If the answer is No, get the hormone test. Hormone imbalances are being found to be somewhat common in the autistic-spectrum community and at least for me accounted for 90% of what I would have been on hard medication for, like your brother.
If this doesn't apply feel free to disregard, and I sincerely hope your brother finds that stable peace of mind.
Edit: Here is an article that specifically deals with the problem of doctors going straight to medication: http://autismdigest.com/hidden-medical-problems-can-cause-behavior-problems/
Re:edit I know no one will see this 25 days later but this is a perfect example of people overtrusting doctors. Everything I've said was on topic, with a source and aiming to be helpful but oh no, he doesn't think doctors are Gods, he can't be right!
But it might not help because the drug doesn't match up to complete their equilibrium.
An then there are always that side effect where it could actually make it worse...
Of course, that's the -theory-, but the only way to tell for sure would be to take out someone's brain, cut it into little cubes, and run those cubes through a centrifuge. Clinical Psychiatry is only concerned with clinical observation of behavior and statistics about what kinds of therapies are likely to produce the desired effect. This is why giving prescribers feedback and being in a position to communicate and advocate for yourself is so important.
The truth is, doctors don't know the "chemical balance" in a patient's brain. When they prescribe an SSRI, for example, they're really just guessing based on symptoms and hoping for the best. As a result, a lot of people end up in a worse state from the prescribed medications (e.g. someone with bipolar disorder who's prescribed just an antidepressant might end have a severe manic episodes).
Correct me if I'm wrong but I believe OP was referring to recreational drugs, not prescribed therapeutic drugs.
I believe that is what ELI5 is for!
People are forgetting they're in ELI5 and are thinking I'm trying to write some scientific paper here or something.
This also goes for almost every ELI5 question. Top answer is always something that most adults wouldn't understand.
How can there be an "oversimplification" of an explanation that is supposed to be simplified down to the understanding of a 5 year old?
Sorry my wording was redundant. Good on you for catching it and pointing it out.
No need to apologize, friend. I do admire how you learn from the advice of others rather than get annoyed or angry that someone would point it out.
Can confirm: Have depression, took meds for awhile, ended up fucked up.
Now pot works ust fine for me, and gives me back my mojo.
No by the definition of psychological disorders, they are taking drugs to behave in culturally accepted ways and to regain functionality in their society.
They are physiologically in equilibrium, as in, unless their body simply cannot produce certain neurotransmitters, their body is technically fine. But their mind, by society's common standard, is not fine.
I meant equilibrium as a more normal perception and behavioral response than chemically.
NO BY THE DEFINITION THAT I WONT PUT HERE
A psychological disorders must be 1. reduce the ability of the individual to function in the society 2. cause mental or behavioural patterns that's against society's common standards
According to...you.
I googled your 'definition' and nothing came up. Was this in a book? Please photograph or scan the entry. Or maybe its from a site that doesn't come up on google, please link or screenshot.
I want to thank you. For a few moments I was going to assume that all people with mental illnesses need to take drugs to get back to an equilibrium. I didn't even think twice. But then I saw it: the EDIT. Thank god for edits! I read through your edit and then I realized something - you weren't sure - you didn't know! The actual answer IS A LOT MORE COMPLICATED! Thanks for sending me on to more thorough research in this arena - I was about to go back to my couch and have another beer while binge watching television.
Then they shoot up a movie theater or shopping mall
The first problem is that frequently, we don't know what the exact, root cause is. We see the symptoms, and guess at the cause. Or we treat the symptoms because we don't have a clue. This is especially true with mental illnesses.
The second problem is isolating the desired effect. Biochemistry is incredibly complex, and we've got nothing that does only one thing. Blood pressure high? Take this hypertension pill, it will reduce your blood pressure. Except it also causes you to piss alot, so here's another pill that will fix that. Except this pill has another side-effect, but it's mostly pretty minor (dry mouth) so we don't need to prescribe yet another pill. But do call us if you have any of this long list of symptoms....
That's for non-neurological issues, mind you. When it comes to head problems, things are even worse -- they're much more interconnected, and a lot of the time we don't even know why certain drugs work for certain conditions, only that they do. Sometimes.
This is why any time you start a new medication your doctor needs a lot of feedback. He's experimenting to get the right chemical balance and can only do that effectively if his patient is very specific and concise with feedback. The better you describe the effects to your doctor, the better job he can do of helping you get where you want to be. It takes a little team work. Though I doubt most doctors explain that very well.
Depressed? Take this pill, it makes you more stable. Now you're tired and dissociated? Take this pill, it will make your more alert. Oh shit, now you're having delusions and hallucinations that demons are trying to kill you? Oops.
Using current drugs for mental illnesses is like driving a screw in with a hammer.
That's because a lot of these drugs were not actually designed to treat the conditions for which we are currently using them. I read an article about this a while back, and apparently a lot of the drugs currently on the market were discovered in the 60's (there was a lot of research in this field at that time, probably looking for the ultimate high with no adverse side-effects). This lead to the discovery of a lot of different chemical compounds, with varying physiological effects. The patents for these drugs were obtained/held by pharmaceutical companies and in an effort to turn these patents into cash, they started looking into finding ways to market these drugs to the public. So to make a long story short; these drugs were not designed to treat these conditions, instead they tried to make the condition fit the drugs they had available.
Can you recall what the article was called? I'm trying to search for it (or something related) and am coming up with nothing.
There's also the fact that they are untargeted, acting on multiple systems in the brain...
E.g. Viagra
How is weed far from completely harmless?
... I didn't make any claims about weed. But anecdotally (my experience of using, my observation of others using, and others telling me of their experience of using), weed messes with your memory and your motivation.
Physically it is harmless, but everyone has different neurochemistry. I don't think it is foreign to anyone that weed can exacerbate underlying psychoses for instance.
define 'psychoses'
a severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality.
Yeah you Dictionary.com that sucka!
Right. He asked for a definition and I provided it. Not too sure why he couldn't look it up himself...
He asked for it and had it coming to him.
Here is an askscience thread that explains the flaws in the out-dated "chemical imbalance" model of mental illness
Aside from what has been said, most psychotropic medications are intended for short term use (usually a few months to a year). This is to get the brain back to an equilibrium, because continual use has similar potential for damage as illicit drugs. Think of psych meds as restarting the computer.
There's no biological free lunch.
For example people with bipolar type 2 who become hypomanic? That's the closest thing I can think of to a non-chemically (external) induced high.
If you check out two fairly common diseases you can see this in action and it's neat. If you look at schizophrenia and Parkinson's disease they both revolve around dopamine. Too much and you get the effects of schizophrenia and too little causes Parkinson's.
They're in equilibrium it's just a bad equilibrium. Equilibrium is probably the wrong word to use here.
Use of narcotics is taboo in our society - we're not really sure who uses and who doesn't for the most part. Those that reveal themselves usually do so only to other users they use with and dealers, are found by police, or voluntarily submit themselves for rehab and treatment.
The vast majority are uncaught, do not volunteer, use for a while, stop, or use intermittently without revealing themselves.
I say all of that because I suspect that a considerable amount of congenital disorders and mental illnesses are caused by use of narcotics and go undocumented.
My only reason for suspecting that is that I have know three people who ended up manic/depressive - all have killed themselves - and after the fact, all were revealed privately as users at some point.
I have a suspicion that we'd have far fewer mental health issues if you could make the narcotics vanish.
People who are bi-polar (manic depressive) are considered predisposed to abuse drugs. I'm not sure if their drug use caused their bi-polarity.
I imagine that bipolar people are predisposed to all sorts of mischief in their manic phases. They get everything done, are running 100 mph in their minds, and then still have tons of energy to unload with boundless confidence of their success. They are over optimistic about the outcome of anything. Should they encounter drugs, booze, or sexual opportunities, I imagine that they would partake of them with full confidence that it would lead them to eventual conquest of the planet earth.
But I wonder if bipolar is something that "just happens" or if their isn't a cause and effect there.
I presume you mean adhd/add/schizophrenia in wich case the drugs supply a certain chemical wich brings back the balance
As somebody who is schizophrenic I'll tell ya weed for instance is a way different experience for me compared to my peers.
Elaborate?
All growing up I had a horrid time dealing with people. At 4 got my lead levels tested cause my parents couldnt figure out why I was so destructive. Multiple times during elementary, jr. high and highschool I had personality tests, a.d.d. tests, interviews with church leaders, and meetings with psychiatrists. Looking back on the first 18 years of my life its a strange blur. After I graduated I got a job as a liftie at the canyons ski resort... Lo and behold, Marijuana. I smoked buches with them and it was amazing, but kinda different. Most smokers will tell you that it is the 'icing on the cake' not 'the CAKE'. For instance, if you're feeling depressed and smoke a big fatty yet keep thinking about your depression. In my experience you just get more depressed. When I smoked it was like a cloud of sporadic, racing, scary and confusing thoughts were aligned in my brain and only then could I focus on the real world. Fast forward 12 years and I'm a daily user. The other day my boss of 2 and a half years came to me and asked "Tyler, I'm wondering if you could help me out? I'm not exactly sure what potheads act like." I didnt want to tell her she had never worked with me when I wasnt stoned but did tell her that there's usually no outward symptom of a pothead. Multiple times in the last 12 years I've quit for 3-4 months for various reasons. Each time I can feel my mind slowly slip into mush in the first few weeks of sobriety. After about a month I'm pretty stable-crazy and after that the sober experience is real scary. The best example of what I experience is this cool video i saw a couple years ago. https://www.youtube.com/watch?v=dkB2CGL769o Especially the scary darkness in the corners for me. I'm starting to ramble a bit but yeah, the only time I feel sane and in control of my racing mind is when I've smoked that week.
It's really interesting that it would have that effect. Man, the human mind is amazing
I asked this same question with two drugs; a gaba antagonist and a partial dopamine agonist. The effect as my professor put it "will result in the crazy of sitting in the middle of the street naked talking to yourself.... permanently" because of the hit the dopamanergic system would take from over activation. One of the drugs in question is a high therapeutic dose of an adhd med
Then drugs make ya goods
Then they take drugs to compensate. But it is always give and take. Go look up anti psychotics and check on some of those side effects.When taking a drug for these reasons the only question is, do the pros out weigh the cons.
Right... I used to ask people if it was possible for glasses to give you better than 20/20 vision. They'd give me a dumb look and say that was ridiculous (obviously, it wasn't).
I don't see why the same couldn't be true of other aspects of the human body.
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Many drugs are used for the purpose of balancing these imbalances, that said however there is more to consider than the imbalance or hormones and brain chemicals, but also the metabolism and excretion of the drug can cause increased load on the liver, kidneys and even heart, and in this regard can cause permanent damage to one or all three.
Honestly they should stay away from drugs even more than an "stable" person. The chemical imbalances in the brain that are (could be) causing their mental illness are not very well understood. Even the changes in the brain caused by drugs psychiatrists prescribe aren't really that well understood.
The latter part of your comment isn't false, but the upshot certainly is. We use these drugs not to treat a "chemical imbalance" like we would treat a type I diabetic, but to achieve a functional outcome.
We absolutely know that antipsychotics are far from perfect and have terrible side effects, but we also know that psychosis is an awful state to be in (and for that matter, is damaging in and of itself). You balance the risks of taking a drug, including speculative risks, versus quality of life and the impact of an illness.
Never said they shouldn't be taking prescribed medication under the proper medical care. I said that even the medical drugs are not very well understood. My position is that they should stay away from recreational drugs.
Ahh thanks for the clarification, I don't think that's too controversial :-)
There is a big gray area there - for example, downthread I'm talking with someone about tianeptine,which is a powerful therapeutic that can't be prescribed in the US or Canada - but of course this is generally damn good advice.
So you're saying people with mental illnesses shouldn't take any drugs? That would be disastrous, millions of people with mental illnesses rely on drugs to be stable and productive people. And remember that many of the drugs prescribed for mental illness are also popular recreational drugs, such as benzodiazepines for anxiety and amphetamines or other stimulants for ADHD.
No. I'm saying they shouldn't take recreational drugs. How could you extrapolate that to include medications that are prescribed?