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Comment by cedws | Hacker News Reader

If somebody is in an abusive relationship, in financial turmoil, and has a terrible job, it's probably not a serotonin imbalance causing them to feel depressed.

There's actually a name for the above, it's called "Shit life syndrome" [0]. I don't know why society sees it as acceptable to load someone up with SSRIs when it's environmental factors causing them to feel the way they do. If you're going to drug someone up to make them feel numb to their awful circumstances why not just go the whole way and give them literal happy pills?

Given the scary, common side effects of SSRIs such as suicidal ideation and sexual dysfunction, I don't know how doctors can prescribe these things. It breaks the Hippocratic oath in my opinion.

[0]: https://en.wikipedia.org/wiki/Shit_life_syndrome

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The interviewee touches on this:

> And so I would say, in response to what’s often asked, which is: If depression isn’t simply an abnormality in serotonin, why would you prescribe an SSRI? And I think the answer is that through serotonin and norepinephrine, we can promote the brain’s capacity for resilience against the adverse effects of stress and depression on the brain.

The people I know who have been in serious inpatient treatment for major depression have told me that in group every single person there shared some horrible shit in their past that directly contributed to their being there.

I found Johann Hari good on this with “Lost Connections” where he talks a lot about chemical imbalance vs life situation and their impacts on depression. Found it very enlightening.

[0] https://thelostconnections.com

Not everybody that is depressed is in a shitty life situation, quiet the opposite.

I have no idea how you come to that conclusion and devalue people, that have the medical need for medication.

That’s exactly the type of thinking that they’re opposed to.

The vast majority of people with depression have actual life circumstances that cause it. Whether or not they’re fixable is perhaps another issue. I’d argue that the way we live in modern life itself is often a cause. We’re “meant” to live in tight-knit tribes. How often do I get to see my friends? Once a month, if that? We have a newborn and a toddler. The help of parents living with us would be immense. Our sets of parents are all retired and relatively close, but it’s not the same.

Instead we all live in individual homes, not that that doesn’t have its own advantages like privacy and moderate prevention of infidelity.

Who is „they“? Depressed people?

Antidepressants are not the solution for all people and all problems, but your solution to just live in tight knight tribes and visit friends is a good start, but that will not help people with depression that is caused by many difference causes: childhood trauma, abuse, …

Therapy AND antidepressants can be a solution. Pills are not sweets, but „just be happy“ is not the solution. You can be severely depressed and have all the things, tight family …

„Whether or not they’re fixable is perhaps another issue.“

So, if the causing issue is not fixable, depressed people have to live with it and not take medication.

I mean, you’re agreeing with me. Mine was just one example, and in my mind probably the cause for most. Obviously there are plenty of other causes.

I didn’t say they shouldn’t take medication. I was just pointing out how unfortunate it is that so many people think they just have a “chemical imbalance” and that’s all there is to it.

The claim that a vast majority of people with depression have life circumstances causing it is extremely dubious and reeks of bias.

So you think that 17.7% of women in the US just naturally having a "chemical imbalance?" Evolution really screwed up there, eh?

That's not what he said.

“If somebody” … does not refer to all scenarios.

Many people are in horrible situations and don't get depressed though. For instance, being bombed in WW2 apparently made British people happier. Not that they are ever very happy, being British.

(Also, every person who ever lived before modernity kind of had a shitty life. Often very literally. Usually horses are involved.)

The British in WW2 had hope and collective purpose. Shared suffering for a noble goal feels meaningful and worthwhile, and you get to be a part of something bigger than yourself.

I'm less certain about peasant life, but I suppose if it's all you've ever known, and everyone you know is in the same boat, then it probably is manageable. I imagine you live for the stories around the fire at night, and the occasional fair / feast / dance. Gruel isn't so bad if it's all you've ever known.

Shit life syndrome is watching the rest of society seemingly have it easy, while you're constantly struggling to get by. It's using your one free hour of the day to watch TV about the super-rich and their yachts. It's having no hope that things will ever get better for yourself or your immediate community.

There's a difference between having a shit life together and a shit life alone.

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