The correct use case of medication to treat depression and ADHD is not to “drag the non-conformers into line” but to help alleviate chronic, clinically measurable deficiencies in brain chemistry. A clinically depressed person will be consistently depressed irrespective of outside conditions. A person with severe ADHD will struggle to find motivation to focus on anything that doesn’t capture their interest immediately, even if they genuinely want to do that thing.
I used to suffer from severe clinical depression, and it made it difficult to eke any enjoyment from anything, even things I once enjoyed. Those who are depressed but less self aware tend to blame whatever is going on around them as the root cause (“I feel awful and society sucks. I must feel awful because of society’s problems”), but for cases of clinical depression it is a proven imbalance of neurotransmitters that are at least partially responsible.
I still struggle with some aspects of ADHD, but for both of them medication has changed my life. I can find motivation to accomplish things, curiosity to learn and joy from simple experiences.
Without modern medicine I can confidently say that I would be a shadow of who I am now, because in my depressed and distracted state I never would have found the motivation and resilience to succeed at any of the hobbies and career choices that have taught me and brought me enjoyment. For that matter, I would likely never have discovered this site.
I have ADHD myself, and I used to have “uncurable” depression.
Kids are diagnosed with ADHD for showing completely natural traits like boredom. There’s nothing wrong with them, the modern society requires too much tedius and sedentary activity, which is unnatural. This causes everyone at the far-end of the distribution, say the top 10% to be labeled “sick”.
Many people are depressed because their needs aren’t being met. Again, it’s those with the stronger needs who become depressed first, those in the tail-end of the distribution. What need am I referring to here? The need for agency, control over ones own circumstances. That, without which, one feels powerless, trapped, insignificant, disillusioned, so that they come to the conclusion that life is meaningless.
Both ADHD medicine and anti-depressants have the side-effect of emotional blunting, making one into a robot or a zombie respectively. You technically aren’t bored when you’re running on autopilot, and you technically aren’t sad when you feel absolutely nothing at all, but I wouldn’t call either of them good solutions. Everyone reacts differently to medication, and the positives can outweight the negatives, but it’s still better to get away from bad environments than it is to help people cope with remaining in said environments.
A clinically depressed person will be consistently depressed irrespective of outside conditions
Such people exist, but they make up perhaps 5% of all cases of depression. Your brain will give you the neurotransmitters you need if you fulfill your own needs, but what if your need of agency is higher than what the modern world allows, or if you work too many hours to have a social life as well?
Both ADHD medicine and anti-depressants have the side-effect of emotional blunting, making one into a robot or a zombie respectively.
That seems far too broad of a stroke. The statement “making one into a robot or a zombie” seems like a largely rhetorical and hyperbolic comparison rather than a useful observation describing detrimental effect. Side effects are highly variable between individuals.
While I don’t doubt emotional blunting is among the potential side effects, do we have substantial evidence to indicate that it has high frequency in the population and high severity among those that do experience it? (I have not researched this particular issue so I don’t know what the data actually says.)
Anecdotally, I’ve found depression to dull my emotions far more than antidepressants. And I feel a lot more enthusiasm and curiosity in general when taking my ADHD medication.
It may be interesting to note that I was not diagnosed for ADHD until I was 18. If I had been diagnosed as a kid I probably would have done much better in school. I used to hate math until I got treatment, now I have the ability to enjoy it. That being said, I do agree that the United States school system in particular is dysfunctional and has far too much tedium and busywork.
> Everyone reacts differently to medication, and the positives can outweight the negatives, but it’s still better to get away from bad environments than it is to help people cope with remaining in said environments.
I agree to that.
Such people exist, but they make up perhaps 5% of all cases of depression. Your brain will give you the neurotransmitters you need if you fulfill your own needs, but what if your need of agency is higher than what the modern world allows, or if you work too many hours to have a social life as well?
Do you have a source for that number? It seems like it would be difficult to pin down in a clinical trial setting. The “perhaps” sounds like it was a ballpark estimate from memory or similar, which is fine but I would like to see the underlying data supporting it.
I would say “a healthy brain will produce the neurotransmitters needed if sufficient physical/social needs are met.”
I’m part of the population that was clinical and chronic. I felt depressed despite consciously acknowledging that things were going relatively well in my life and I could not pin down any good reason why I would feel so numb and empty.
I live quite close to a place for mentally ill people, and will have to walk around some of them on their long hallways, for otherwise they will just walk straight into you. There are no visibility problems, they just don’t register that other people might exist on their path to whatever destination. This is how the staff treat their suffering, by medicating them into a lower state of consciousness. Speaking of which, anti-psychotic medicine is mood-stabilizing, which is precisely my point. It’s all about restricting the range of emotion. It’s the same for stoicism, by the way.
The zombie effect is what I’ve personally experienced, it’s because I also have anxiety, which stimulants make worse. The body then either numbs you as a defensive mechanism (like the state of shock) or simply depletes the resources required for keeping you in a high-alert state.
Until I started ADHD medicine, I was used to feeling the entire range of emotions: https://www.reddit.com/media?url=https%3A%2F%2Fi.redd.it%2Fc0v1cv9crcc51.jpg On this scale, I’d swing between 1 and 10. Now all I experience is 5-7. Most professionals would consider this a win, but I feel like the full human experience has been robbed from me, it’s like going from a wild rollercoaster ride to a kiddy-version. My opinions are not simply born from this, though. I take full responsibility for everything I’ve done to my own body.
This article, which I randomly clicked, by the way, even makes the same observation as me: “Emotional blunting is a common side effect of SSRI antidepressants. In a way, this may be in part how they work – they take away some of the emotional pain that people who experience depression feel, but, unfortunately, it seems that they also take away some of the enjoyment” Amphetamine-like stimulants affect the amygdala. I found that non-stimulants had the same blunting effect for me though, and if you search on Reddit, many other people have experienced similar things. I found this study result for atomoxetine: “Atomoxetine led to a small (effect size 0.19) but significant (P=0.013) treatment effect for emotional control”. It wouldn’t surprise me if this “emotional effect”, which is of course described positively, is just a clamping of the range of emotions.
Of course, I wish you the best, and if medicine helps you, then I don’t want to discourage your use of it. I just think better approaches are possible, and that destructive tradeoffs are described more positively than they ought to be. A common piece of advice I see online is “Nothing matters” and “Nobody cares about you, they’re too busy thinking about themselves”. This is freeing to hear for some, but it’s ultimately a nihilistic kind of thinking, mere detachment.
> Do you have a source for that number?
No, it’s an estimate for the portion of people living good lives (psychologically healthy lives, not just socities impression of a good life) but finding themselves unexpectedly depressed despite that. And I think it’s quite telling that the rate of depression is almost negatively correlated with standards of living. Africa has some of the lowest rates! Our “improvements” are making us enjoy life less, not more, we are very poor judges of what is good for us.
I don’t think depression is an error at all, I think it’s an adaption to an environment (and that agency and control are fundemental needs). There’s a Wiki page called “Evolutionary approaches to depression” but it seems this view is still controversial and that it’s not receiving a lot of attention.
> I could not pin down any good reason why I would feel so numb and empty
This is just a guess, but did you perhaps think logically? “Logically”, a zoo animal should be happy because they have all the food and water they could ever want, as well as absolutely safety. But zoo animals are known to have high rates of depression and anxiety just like the general population in modern socities. Logic doesn’t help with psychological well-being, even Nikola Tesla died poor and alone. I’m 90% sure he’d have lived a better life if only he had socialized more (and met better people), but intelligent people do not introspect with the consideration that they’re animals with animal needs, they consider themselves above such things
And I think it’s quite telling that the rate of depression is almost negatively correlated with standards of living.
Lack of exercise is a large contributor to this trend, as demonstrated by the well-established data that exercise is one of the biggest factors benefiting mental health. (I suspect you already agree with this point considering you previously mentioned sedentary behavior as one of the problems with modern life, but I’m citing some sources for any who want to verify the claim.) And even knowing this, it’s still difficult for me to make myself exercise regularly. Stupid psychology.
>if you search on Reddit, many other people have experienced similar things.
I try to avoid using anecdotal data to update my map. Social media tends to be biased towards negativity, so I would guess that those who are happy with their results with medication are a lot less likely to post their experience than those who have issues they want to discuss. That is not to say their issues are not relevant problems to address, but it does raise questions as to how large the proportion of people with undesirable side effects is relative to the proportion of patients who are satisfied with their treatment.
>”Logically”, a zoo animal should be happy because they have all the food and water they could ever want, as well as absolutely safety. But zoo animals are known to have high rates of depression and anxiety just like the general population in modern socities.
It’s logical only if one assumes that food, water and safety are their only important needs. Perhaps we haven’t made the effort to understand what they need that the zoo isn’t set up to provide. (Like, say, a few more square kilometers of running space)
It’s interesting that this does not apply to all animals in captivity. For instance, the types of fish that do well in captivity have a significantly longer lifespan on average (assuming proper aquarium conditions) than the same species does in the wild. For example: Clownfish in the wild on average live between 4 and 10 years. Clownfish in a well-maintained aquarium have been known to live more than 20 years. (Note that while their lifespan in the wild has been scientifically studied, the lifespan in captivity is entirely based on anecdotal reports)
I do agree with exercise. And yeah, knowing what to do is insufficient. If exercise is part of ones lifestyle it doesn’t feel like a bother, but if you’re told to go to the gym you likely won’t be motivated whatsoever.
The Reddit data proves that some people have had an experience (so it’s a proof by contradiction of the claim that such an experience doesn’t happen), you’re correct that it doesn’t give us an idea of the real prevalence.
We do know more or less what zoo animals need, it’s just cheaper to give them less than that. What humanity does seem entirely ignorant about is human needs and mental health in general. Consider for instance the impact of telling children “Santa knows if you’ve been bad” or “god is watching you”. Do we even know? What about the modern panopticon that is society? I found some related papers on this but they’re scarse and about specific cases like being watched at work.
How human beings function is perhaps the most important branch of knowledge in the world, and yet it’s neglected like this. Even modern psychologists can learn something from Buddha. You can’t say the same about fields like mathematics or physics, as these actually advance.
I agree about fish by the way. Longevity and well-being aren’t exactly the same, but it’s a fair point nonetheless. I think small fish are more on the simple side as far as animals go, though. This might be why fish is the go-to if you want to get away with animal cruelty.
I agree about fish by the way. Longevity and well-being aren’t exactly the same, but it’s a fair point nonetheless. I think small fish are more on the simple side as far as animals go, though. This might be why fish is the go-to if you want to get away with animal cruelty.
My conjecture as to why certain small fish do well in captivity is that (for those I’ve taken the time to research) their lifestyle is something along the lines of “find a cozy home in a rock/hole/anemone/coral and stay there waiting for food to come to you”. If an aquarium provides access to that same lifestyle + the added benefit of no predators, why wouldn’t they be better off? Humans only feel like an aquarium is abusive because our own psychology would go stir-crazy if we were trapped in a box all the time. But for an animal that will voluntarily live it’s entire adult life within a single square meter of reef? Why should it mind?
On the other hand, I do think its cruel to keep certain other type of fish in aquaria (e.g. tangs and other types of surgeonfish) because their growth will be stunted in an aquarium setting and in the wild they are grazers that might swim many kilometers in a single day.
What I mean by cruelty is fishing, bonking them on the head, boiling lobsters alive, eating squids while they’re still moving, forgetting to feed your goldfish while on vacation and throwing its dead body into the toilet, etc. Even some people who call themselves vegetarians eat fish. They seem to be a level lower than cows and pigs, which are a level lower than cats and dogs, on some imaginary hierarchy.
Agreed again, we should only keep animals whose needs we can more or less satisfy
People who eat seafood, but not the flesh of other terrestrial animals are pescatarian. Ethical (as opposed to environmental) pescatarians say fish and other marine life aren’t complex enough for fear or pain. Perhaps they call themselves vegetarians just to avoid having to explain pescatarianism.
The correct use case of medication to treat depression and ADHD is not to “drag the non-conformers into line” but to help alleviate chronic, clinically measurable deficiencies in brain chemistry. A clinically depressed person will be consistently depressed irrespective of outside conditions. A person with severe ADHD will struggle to find motivation to focus on anything that doesn’t capture their interest immediately, even if they genuinely want to do that thing.
I used to suffer from severe clinical depression, and it made it difficult to eke any enjoyment from anything, even things I once enjoyed. Those who are depressed but less self aware tend to blame whatever is going on around them as the root cause (“I feel awful and society sucks. I must feel awful because of society’s problems”), but for cases of clinical depression it is a proven imbalance of neurotransmitters that are at least partially responsible.
I still struggle with some aspects of ADHD, but for both of them medication has changed my life. I can find motivation to accomplish things, curiosity to learn and joy from simple experiences.
Without modern medicine I can confidently say that I would be a shadow of who I am now, because in my depressed and distracted state I never would have found the motivation and resilience to succeed at any of the hobbies and career choices that have taught me and brought me enjoyment. For that matter, I would likely never have discovered this site.
I have ADHD myself, and I used to have “uncurable” depression.
Kids are diagnosed with ADHD for showing completely natural traits like boredom. There’s nothing wrong with them, the modern society requires too much tedius and sedentary activity, which is unnatural. This causes everyone at the far-end of the distribution, say the top 10% to be labeled “sick”.
Many people are depressed because their needs aren’t being met. Again, it’s those with the stronger needs who become depressed first, those in the tail-end of the distribution. What need am I referring to here? The need for agency, control over ones own circumstances. That, without which, one feels powerless, trapped, insignificant, disillusioned, so that they come to the conclusion that life is meaningless.
Both ADHD medicine and anti-depressants have the side-effect of emotional blunting, making one into a robot or a zombie respectively. You technically aren’t bored when you’re running on autopilot, and you technically aren’t sad when you feel absolutely nothing at all, but I wouldn’t call either of them good solutions.
Everyone reacts differently to medication, and the positives can outweight the negatives, but it’s still better to get away from bad environments than it is to help people cope with remaining in said environments.
Such people exist, but they make up perhaps 5% of all cases of depression. Your brain will give you the neurotransmitters you need if you fulfill your own needs, but what if your need of agency is higher than what the modern world allows, or if you work too many hours to have a social life as well?
That seems far too broad of a stroke. The statement “making one into a robot or a zombie” seems like a largely rhetorical and hyperbolic comparison rather than a useful observation describing detrimental effect. Side effects are highly variable between individuals.
While I don’t doubt emotional blunting is among the potential side effects, do we have substantial evidence to indicate that it has high frequency in the population and high severity among those that do experience it? (I have not researched this particular issue so I don’t know what the data actually says.)
Anecdotally, I’ve found depression to dull my emotions far more than antidepressants. And I feel a lot more enthusiasm and curiosity in general when taking my ADHD medication.
It may be interesting to note that I was not diagnosed for ADHD until I was 18. If I had been diagnosed as a kid I probably would have done much better in school. I used to hate math until I got treatment, now I have the ability to enjoy it.
That being said, I do agree that the United States school system in particular is dysfunctional and has far too much tedium and busywork.
> Everyone reacts differently to medication, and the positives can outweight the negatives, but it’s still better to get away from bad environments than it is to help people cope with remaining in said environments.
I agree to that.
Do you have a source for that number? It seems like it would be difficult to pin down in a clinical trial setting. The “perhaps” sounds like it was a ballpark estimate from memory or similar, which is fine but I would like to see the underlying data supporting it.
I would say “a healthy brain will produce the neurotransmitters needed if sufficient physical/social needs are met.”
I’m part of the population that was clinical and chronic. I felt depressed despite consciously acknowledging that things were going relatively well in my life and I could not pin down any good reason why I would feel so numb and empty.
Thanks for your reply!
I live quite close to a place for mentally ill people, and will have to walk around some of them on their long hallways, for otherwise they will just walk straight into you. There are no visibility problems, they just don’t register that other people might exist on their path to whatever destination. This is how the staff treat their suffering, by medicating them into a lower state of consciousness.
Speaking of which, anti-psychotic medicine is mood-stabilizing, which is precisely my point. It’s all about restricting the range of emotion. It’s the same for stoicism, by the way.
The zombie effect is what I’ve personally experienced, it’s because I also have anxiety, which stimulants make worse. The body then either numbs you as a defensive mechanism (like the state of shock) or simply depletes the resources required for keeping you in a high-alert state.
Until I started ADHD medicine, I was used to feeling the entire range of emotions: https://www.reddit.com/media?url=https%3A%2F%2Fi.redd.it%2Fc0v1cv9crcc51.jpg
On this scale, I’d swing between 1 and 10. Now all I experience is 5-7. Most professionals would consider this a win, but I feel like the full human experience has been robbed from me, it’s like going from a wild rollercoaster ride to a kiddy-version.
My opinions are not simply born from this, though. I take full responsibility for everything I’ve done to my own body.
According to a quick Google search, emotional blunting happens to 50% of users of anti-depressants: https://www.cam.ac.uk/research/news/scientists-explain-emotional-blunting-caused-by-common-antidepressants
This article, which I randomly clicked, by the way, even makes the same observation as me: “Emotional blunting is a common side effect of SSRI antidepressants. In a way, this may be in part how they work – they take away some of the emotional pain that people who experience depression feel, but, unfortunately, it seems that they also take away some of the enjoyment”
Amphetamine-like stimulants affect the amygdala. I found that non-stimulants had the same blunting effect for me though, and if you search on Reddit, many other people have experienced similar things.
I found this study result for atomoxetine: “Atomoxetine led to a small (effect size 0.19) but significant (P=0.013) treatment effect for emotional control”. It wouldn’t surprise me if this “emotional effect”, which is of course described positively, is just a clamping of the range of emotions.
Of course, I wish you the best, and if medicine helps you, then I don’t want to discourage your use of it. I just think better approaches are possible, and that destructive tradeoffs are described more positively than they ought to be.
A common piece of advice I see online is “Nothing matters” and “Nobody cares about you, they’re too busy thinking about themselves”. This is freeing to hear for some, but it’s ultimately a nihilistic kind of thinking, mere detachment.
> Do you have a source for that number?
No, it’s an estimate for the portion of people living good lives (psychologically healthy lives, not just socities impression of a good life) but finding themselves unexpectedly depressed despite that. And I think it’s quite telling that the rate of depression is almost negatively correlated with standards of living. Africa has some of the lowest rates! Our “improvements” are making us enjoy life less, not more, we are very poor judges of what is good for us.
I don’t think depression is an error at all, I think it’s an adaption to an environment (and that agency and control are fundemental needs). There’s a Wiki page called “Evolutionary approaches to depression” but it seems this view is still controversial and that it’s not receiving a lot of attention.
> I could not pin down any good reason why I would feel so numb and empty
This is just a guess, but did you perhaps think logically? “Logically”, a zoo animal should be happy because they have all the food and water they could ever want, as well as absolutely safety. But zoo animals are known to have high rates of depression and anxiety just like the general population in modern socities. Logic doesn’t help with psychological well-being, even Nikola Tesla died poor and alone. I’m 90% sure he’d have lived a better life if only he had socialized more (and met better people), but intelligent people do not introspect with the consideration that they’re animals with animal needs, they consider themselves above such things
Lack of exercise is a large contributor to this trend, as demonstrated by the well-established data that exercise is one of the biggest factors benefiting mental health. (I suspect you already agree with this point considering you previously mentioned sedentary behavior as one of the problems with modern life, but I’m citing some sources for any who want to verify the claim.)
And even knowing this, it’s still difficult for me to make myself exercise regularly. Stupid psychology.
>if you search on Reddit, many other people have experienced similar things.
I try to avoid using anecdotal data to update my map. Social media tends to be biased towards negativity, so I would guess that those who are happy with their results with medication are a lot less likely to post their experience than those who have issues they want to discuss. That is not to say their issues are not relevant problems to address, but it does raise questions as to how large the proportion of people with undesirable side effects is relative to the proportion of patients who are satisfied with their treatment.
>”Logically”, a zoo animal should be happy because they have all the food and water they could ever want, as well as absolutely safety. But zoo animals are known to have high rates of depression and anxiety just like the general population in modern socities.
It’s logical only if one assumes that food, water and safety are their only important needs. Perhaps we haven’t made the effort to understand what they need that the zoo isn’t set up to provide. (Like, say, a few more square kilometers of running space)
It’s interesting that this does not apply to all animals in captivity. For instance, the types of fish that do well in captivity have a significantly longer lifespan on average (assuming proper aquarium conditions) than the same species does in the wild. For example: Clownfish in the wild on average live between 4 and 10 years. Clownfish in a well-maintained aquarium have been known to live more than 20 years. (Note that while their lifespan in the wild has been scientifically studied, the lifespan in captivity is entirely based on anecdotal reports)
I do agree with exercise. And yeah, knowing what to do is insufficient. If exercise is part of ones lifestyle it doesn’t feel like a bother, but if you’re told to go to the gym you likely won’t be motivated whatsoever.
The Reddit data proves that some people have had an experience (so it’s a proof by contradiction of the claim that such an experience doesn’t happen), you’re correct that it doesn’t give us an idea of the real prevalence.
We do know more or less what zoo animals need, it’s just cheaper to give them less than that. What humanity does seem entirely ignorant about is human needs and mental health in general. Consider for instance the impact of telling children “Santa knows if you’ve been bad” or “god is watching you”. Do we even know? What about the modern panopticon that is society? I found some related papers on this but they’re scarse and about specific cases like being watched at work.
How human beings function is perhaps the most important branch of knowledge in the world, and yet it’s neglected like this. Even modern psychologists can learn something from Buddha. You can’t say the same about fields like mathematics or physics, as these actually advance.
I agree about fish by the way. Longevity and well-being aren’t exactly the same, but it’s a fair point nonetheless. I think small fish are more on the simple side as far as animals go, though. This might be why fish is the go-to if you want to get away with animal cruelty.
My conjecture as to why certain small fish do well in captivity is that (for those I’ve taken the time to research) their lifestyle is something along the lines of “find a cozy home in a rock/hole/anemone/coral and stay there waiting for food to come to you”. If an aquarium provides access to that same lifestyle + the added benefit of no predators, why wouldn’t they be better off? Humans only feel like an aquarium is abusive because our own psychology would go stir-crazy if we were trapped in a box all the time. But for an animal that will voluntarily live it’s entire adult life within a single square meter of reef? Why should it mind?
On the other hand, I do think its cruel to keep certain other type of fish in aquaria (e.g. tangs and other types of surgeonfish) because their growth will be stunted in an aquarium setting and in the wild they are grazers that might swim many kilometers in a single day.
That does sound reasonable.
What I mean by cruelty is fishing, bonking them on the head, boiling lobsters alive, eating squids while they’re still moving, forgetting to feed your goldfish while on vacation and throwing its dead body into the toilet, etc. Even some people who call themselves vegetarians eat fish. They seem to be a level lower than cows and pigs, which are a level lower than cats and dogs, on some imaginary hierarchy.
Agreed again, we should only keep animals whose needs we can more or less satisfy
People who eat seafood, but not the flesh of other terrestrial animals are pescatarian. Ethical (as opposed to environmental) pescatarians say fish and other marine life aren’t complex enough for fear or pain. Perhaps they call themselves vegetarians just to avoid having to explain pescatarianism.