Hacker News Reader

Comment by hndude | Hacker News Reader

I've spent lots of time studying neurotransmitters and their relationship with various mental illnesses and amino acids. It has been my understanding for a while now (from the book 'The Mood Cure' by Julia Ross) that too much of a neurotransmitter can have the same symptoms as too little. That book also seemed to indicate that dopamine and serotonin have an antagonistic relationship with each other, so too little (or too much?) serotonin can cause an excess of dopamine, which can lead to all kinds of anxiety, including potentially social phobia.

I've been considering buying books on endocrinology/neurobiology to further study these phenomena, if anyone with more knowledge/experience could enlighten me on this I'd really appreciate it.

View on HN

One thing that has become increasingly clear is that the simplistic "too much x" or "too little y" theory of Mental illness as a "neurotransmitter imbalance" is flawed to the point of uselessness. Neurotransmitters certainly do mediate synapse growth and activity, but the brain is a complex adaptive organ, and it will adapt to modifications to neurotransmitter levels. This is why antidepressnts become less effective and require stronger doses, and why their sudden withdrawal leads to the massive exacerbation of symptoms. The problem isn't simply that patients "go off their meds". The problem is that meds stop working, and withdrawing them leaves the poor patient with a brain that was adapted to their presence suddenly unable to cope. The meds make the organic problem worse, but it dorsn't show until you withdraw them. We're still basically at the witch-doctor stage of "try it and see" with most if these drugs, with nothing like a proper pathology model or functional description of how the meds work to even do proper long-term studies.

Full disclosure: there is pretty good evidence that some of these drugs (like SNRIs) are effective for short-term mitigation of symptoms, although not a great deal above active placebo. Some other therapies are very promising, particularly Cognitive Therapy and a guided Mindfulness program (although study quality on the latter is suspect. DO NOT MODIFY YOUR MEDICATION WITHOUT THE ADVICE AND MONITORING OF A MEDICAL PROFESSIONAL FAMILIAR WITH YOUR CASE.

>the witch-doctor stage of "try it and see"

Welcome to differential diagnosis? If that's with-doctor stage then witch-doctor shouldn't be an insult.

Understanding mechanism is very useful but not critical. If I had to choose I'd rather have a reliable way to measure mental health in a patient.

I have often wondered if the adaptive nature of the brain is what's confusing things. In other words, if someone is suffering the systems of major depression or bipolar disorder, and you "shock" that system with a change in brain chemistry, you're going to get change, and that often the change is enough to snap people out of whatever depressive/manic rut they're in. Problem is, that's not a cure.

Reply on news.ycombinator.com