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Comment by kolinko | Hacker News Reader

If you have a neurotypical person, therapy, or psychedelics can bring a lasting result.

But for a certain subset of population, with messed up serotonin pathways, antidepressants are the cure. Just like for a diabetic an insulin shot is.

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Messed up serotonin pathways. What does that even mean? The chemical imbalance theory of depression has zero proof behind it and is just something told to patients to alleviate their concerns and sell them on these drugs that many will eventually become dependent on (1). No one knows what the mechanism of depression is or how to treat it. It's just a guess as to why and how these chemicals work or don't. Cure my ass. They don't even know how it works or what is wrong with the patient and you're taking about cures.

1: http://www.afterpsychotherapy.com/chemical-imbalance-in-your...

>messed up serotonin pathways, antidepressants are the cure. Just like for a diabetic an insulin shot is.

We should be careful when saying psychiatry is "just like" biological science, it's not.

"psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests"

https://en.m.wikipedia.org/wiki/Allen_Frances

While it's true many people have experienced positive results with antidepressants (many have with placebos as well), "messed up serotonin pathways" and "chemical imbalances" are marketing slogans, not scientific facts.

I read "Lost Connections" by Johann Hari[1] a couple weeks ago. He spends much of the first section on the research and history of antidepressants. One particularly interesting thing is that drugs that decrease serotonin levels are just as effective as those that increase serotonin. The same goes for drugs that alter levels of dopamine. It seems that a great majority of the effectiveness of antidepressants comes from the placebo effect, and the remainder is somewhat of a mystery. Also, doesn't cure imply something that is permanent and not just a temporary measure?

[1] https://www.theguardian.com/books/2018/jan/17/lost-connectio...

I don't know much about human biology, but if the relationship between dopamine/seratonin and depression/anxiety is more non-linear than linear, then the fact that both increasing and decreasing dopamine/seratonin is effective can make perfect sense. This sort of relationship - where small changes shift an equllibrium and result in a qualitative change - are common in nature and a forteriori human physiology.

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