The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
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Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
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Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
Jump in the discussion.
No email address required.
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Update since @FtttG already thanked me for my previous depression post, (read my blog already Ft!), but I am doing much better!
The primary issue in my case was playing too many video games, especially of the addictive, competitive kind. After I set that down I naturally went back to spending more time reading, in prayer/meditation, and generally just taking care of responsibilities at work and in the household, which has been great for my mood. Ultimately I find that in retrospect it's often quite obvious why my mood has dipped, but when I'm in the middle of a depressive episode it's frustratingly hard to understand or take action on it. Oh well.
I also want to do a quick shoutout here to anti-depressant drugs. For over a decade I dealt with depression and refused to take any prescriptions for it. While I do think it's good to resist treatment for a while, ultimately I caved and I'm glad I did. I'm on an SNRI and it has been a tremendous help to me. So if anyone is on the fence about it and has struggled with depression or anxiety for a while, I'd recommend at least trying some.
Has there been a new generation of antidepressant since 2012 or so? I have known four people who started antidepressants and then blew their brains out within a year. As somebody who's struggled with depression in the past, that scares the shit out of me.
If you're talking about pills you can pop? No. Probably not. Which I'm happy about, because it means my textbooks don't change regularly; and which I'm sad about because, well, I've been depressed. The worst part is that the workload and my upcoming exam is threatening to send me into a relapse.
The good news is that IV or nasal ketamine is much better established in terms of safety and efficacy now. There's rTMS, which isn't as effective as ECT but is a solid option.
Antidepressants do not meaningfully increase the risk of suicide for those 25+, the profile is best described as mixed but in a positive direction. For children and adolescents, there's enough elevation to warrants extra caution and more monitoring. In the UK, we'd follow up an adult on a new antidepressant 2 weeks after initiation, those younger a week or so earlier. This is usually explained as the drugs sometimes giving you the energy to act on existing suicidal thoughts before they reduce the suicidal ideation or impulse. In other words they're fixing you, but in the wrong order. In the elderly, the evidence is even more robustly in favor of a net improvement on all fronts.
Current best practice for adults here is to monitor a followup review 2 weeks after starting someone on one, to check this hasn't happened.
There's Auvelity, which is two old drugs in a new trench coat. But if you want something novel, the last one was probably vortioexetine, agomelatine or zuranolone, depending on how annoying or pedantic you went to get about things.
And of course, the emerging evidence for psychedelic therapy.
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As the saying goes, the plural of "anecdote" is not "data". Astral Codex Ten:
The probability that your four people were all in the unlucky 50 percent who get no benefit from SSRIs is 6 percent—low, but well within the realm of possibility. If you broaden your net of anecdotes to encompass the denizens of this website, you probably get something closer to the expected 50 percent.
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SSRIs are trash. They lead to a death drive in some people. And are hardly better than placebo in most others, while giving side effects.
I thought this for a long time, until I started them and they immediately helped me out of years and years of depression.
I am on an SNRI and have chronic pain though, so it might be different than most.
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Rebuttal from Astral Codex Ten
There's no reason to think that people who developed the death drive or worse depression will just stop taking the pills. They'll likely be told to give it a few months in order to let it build up in the system and take effect or some such.
It's not through random chance that most spree killers are on these things.
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I think SSRIs and that class are still the cutting edge. Scott Alexander has a good article about them but I can't find it at the moment, I think @self_made_human linked it to me a while back.
Link
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