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Full article: https://theconversation.com/depression-is-probably-not-caused-by-a-chemical-imbalance-in-the-brain-new-study-186672

I want to start this out by saying that I'm not suggesting that people should stop using anti-depressants or that they have no value in treating depression. For what it's worth, I think the article makes sweeping conclusions towards the end when caution and further research would be better advised. How anti-depressants work has always been something of a guess beyond it seeming that it does (which is why people often have to try different anti-depressants at different doses to find one that works for them), and even if depression isn't caused by a chemical imbalance in the brain, it could still have a positive effect through some other unknown mechanism.

But the part that stuck out to me was this: "Although a famous early study found a relationship between the serotonin transporter gene and stressful life events, larger, more comprehensive studies suggest no such relationship exists. Stressful life events in themselves, however, exerted a strong effect on people’s subsequent risk of developing depression."

I personally believe that the cause behind most cases of depression is the stress of modern living, which approaches traumatic. Even before there was a pandemic that's raged on for years and forced us into even further social isolation, just trying to make it in the world today has been a struggle...it's a struggle for most people to have their basic needs met. Jobs don't pay a living wage, and the price of food and shelter keeps going up. It's less likely that people will have a good support network, either to physically help them meet these needs or to be there for them emotionally. I recently saw something about how Americans of all age groups now spend most of their time alone (and it gets even worse as it gets older). And that doesn't factor in traumatic events and abuse, which seems to be more prevalent now than I ever knew before.

Most people are struggling to get through life by themselves. No wonder depression is raging in the modern world.

I think the greater solution is to end this way of living and replace it with something where people aren't struggling alone like this. I know that's a tall order, and I wish I had something to say to that...as I get older it's definitely something I'm becoming more focused on thinking about, which is partially why I put out semi-serious ideas like the Wintreath teamhouse. How on a least a small scale something like that would help for a few people. And I don't think the answer is one big solution that fits everybody, but a lot of little solutions that collectively cover everybody. Beyond those thoughts, I don't really know how you tackle such a vast problem, but I do feel that's the major source of depression (and a lot of other issues, if we're being honest) these days.

More broadly speaking, I think this speaks to how the medical system focuses on treating proximate causes of disease rather than root causes, ie social issues.

Back when my mom had cancer, I bought a book called Anti-Cancer, which was written by a neurologist who lived with brain cancer for 15 years...kinda amazing because most people don't survive a year from that after it's diagnosed.

One of the things that stood out to me was when he talked about the differences between the American and European medical systems...one of his examples was that if somebody went to the doctor complaining of pain in France, the doctor would suggest taking it easy and maybe having a glass of wine, while in America doctors are more likely to prescribe a painkiller. Part of it is the culture...Americans want a quick fix, and pills are a cheap way to do that, but part of it is the system itself too. Insurance is more likely to pay for pills than something more expensive like, say, physical therapy. According to him, doctors have long given-up on suggesting people diet and exercise, so a pill is just easier for everybody around.

But in the last five years or so I've read this book, a book on diabetes written by a pediatrist (who started his career amputating feet from diabetes patients), and a number of articles on mental health, and what amazes me is that all focus in on the same few things:

1) Eat a healthy diet, low in added sugar, saturated fat, and processed foods and high in fruits, nuts, seeds, fish, whole grains, etc. Most point the the Mediterranean diet as a good example to follow.
2) Exercise - most sources agree that 30-45 minutes of moderate exercise a few times a week is sufficient.
3) Reduce stress as much as possible - we seem to all be agreed that stress weakens the immune system and encourages chronic inflammation

Of course, we all know it's not as easy as that or everybody would be doing it, lol. I'm finding out that in order to really make those changes you have to tackle your psychology behind them, and that's unique to each individual person and thus isn't the cheap one-size-fits all solution the medical and insurance industries like. And it would involve social changes that would not be good for the people and groups that benefit from the way things are now.

So simple, yet so hard. v_v

Yeah I think a great number of today's problems really stem from social isolation and the loss of really strong ties and sense of community.

On the topic of health, the US health system is horrendous.  My girlfriend is actually in a Central American country now and literally walked in to a *rural*, got medical assistance, and left with antibiotics in hand and a diagnosis in 2 hours.  In the US for a similar issue last year, she had to schedule weeks in advance, and even then eventually had to go in a couple days later when the issue had gotten more serious, which she had tried to tell the secretary when she first tried to get an appointment, to no avail.  Meanwhile, a country that's widely considered an LDC has WAY better healthcare. 

The US over-perscribes pain killers and for some reason just refuses to encourage lifestyle changes to make people happier.  Walking daily and making sure to get outside probably has an effect as beneficial as many antidepressants, and that doesn't require the whole host of additional precautions.  Much of the blame can be placed on just the methods that professionals in medicine/health generally today in the US use.  They assume patients want the "easy" out, when it'd be better for the patient to have the slightly less convenient, but much safer long term solution. 

I've also considered communal living as a possible solution to both unaffordable rents and social isolation, but I'm not quite sure how that'd be operationalized.  Curious as to your thoughts about the Wintreath teamhouse, I've not actually seen any discussion there @Wintermoot .

This study is actually awful.

"Studies of depression associated with specific subtypes of depression (e.g. bipolar depression) were excluded."

Ah yes only certain types of depression matter in trying to figure out of the field of psychology is using faulty information.

And AFAIK I might have missed it they didn't even explain fully what they excluded from the study. Big yikes.

I can only really speak from my perspective, obviously, but with guys especially, we have a really strong and incredibly stupid cultural bias of men are not allowed to show emotions, they are never allowed to cry or be weak or show anything other than stoicism or anger... thats... about... it...

living like that, and ive done it, all that sadness and everything else builds up and it eats away at you.  we're not allowed to talk to people about it because thats not "manly" so most guys just let whatever it is consume them from the inside out. its no wonder i see so many guys that are clinically depressed.  we're also touch starved as a nation regardless of sex.  we have an absolutely absurd view on physical touch. just a simple hug or holding somebody's hand can do wonders for ur mood. but not in 'MERICA... because thats "gay". and we cant have that.

im at my worst when im alone. i despise being alone. having somebody that will hold on to me and talk to me and just be near me helps with my depression a ton.  and sure, anti depressants can work, for some people. but alot of it i think is maybe a person just needs to be able to talk to somebody, be able to cry without being ridiculed, or have somebody that will hold them

Yeah, that's a good perspective Mateo.  When you push one gender to be the "strong" one that isn't allowed to surface show any upset emotions, it can really do a number on folks.  It builds up, and can really as you said eat away at you and lead to worse problems as you get older...be it either leading to some really horrible depression to the point of potentially suicidal thoughts, or severe anger issues since it becomes the only way you're allowed to express negative feelings, or a combination of both.

Either way, it's ridiculous.

On the flipside, women are highly encouraged to cry, like almost to a manipulative degree.  Many that I've known were encouraged to cry for every little thing and to basically be fragile little dolls so that men that they get with would be their "prince charming" that would always hold them close and provide for them...rather than any notion of equal relationship contribution ever existing.  Some still get encouraged to follow that archaic mindset of literally doing nothing when they get older except finding a nice man and living off of him while being the good housewife.

Like men, I can see that on the flipside taking a huge toll on women who don't want to meet those expectations put on them, but who are also accused of faking it/attempting to manipulate the situation when they do choose to cry and aren't taken seriously.  Having someone respond negatively when you're upset can be just as devestating, if not moreso than when you're just told over and over that you're not allowed to because you have to be the "strong" one...and likewise can just lead to those emotions eating away and becoming worse because you're just so afraid to express them without fear of a negative response, but for different reasons.

I think there's definitely different things we need to work on to be better: finding ways to reduce stress in life (such as the horrendous setup we have in the US for how jobs are), improving healthcare to better help folks who are diagnosed depressed or bipolar or similar (since as BSR said, the healthcare in the US is fucking awful), and overall just figuring out how to improve the overall wellbeing of folks.

But I will say a monumental part of that starts where Mateo mentioned: improving the at-home upbringing where we're taught early on when it's okay to feel things and not, and how one gender is allowed to feel more than anyone else.  Yes it's good to be a strong presence that puts folks at ease, but not at the expense of your own wellbeing and emotional state.  Yes it's okay to express emotions when you feel things, but not at the extent of manipulation to where nobody takes you seriously.  As in all things, there has to be a balance.  Be a strong person that isn't afraid to cry in front of people when something upsets you, because just as it's okay to be a strong support for folks who want to cry on your shoulder, it's equally okay for you to want to cry on another's shoulder as well, and it doesnt make you any less of a person.

But I also agree that study is horrible.  I get wanting to make a point, but completely ignoring something like Bipolar disorder which in itself lends to depression (as well as so much more) is an absolutely idiotic way to do it.  It becomes a pretty flimsy study on depression if you automatically toss out one of the causers rather than even acknowledging that there's potential exceptions to your point (beyond saying they were excluded).

I actually think it makes sense that they exclude bipolar disorder/depression because that could be an entirely different beast. If it is, it could skew the results...the best thing to do would be to do another study specifically on that and see if the results match or not.

Also think Mateo brings up a good point...there's something quite unnatural about the gender roles we try to thrust on people. As people, we need to be able to express ourselves...excitement, joy, fear, hurt, anger...all of that. We do need to be able to do that in a healthy way, but we have to be able to do that. It reminds me that almost every school shooter is male, and many of them seem to have been unable to handle their feelings before it got to the point that it did.

@BraveSirRobin: A little of it has been on the Discord, and the rest in private areas. I'm sensitive to the image that this sort of thing would look kinda cultish, and to be honest even the most serious chats about it have been semi-serious. The gist of it is I think it would be cool to have maybe 3 or 4 people share a place and split the rent. That means at least 4 bedrooms, which drives up the price, but split more ways it works out...and I just think 4 is a good number. I think it'd be good to start out with just a few people, get the dynamics in order, something that isn't overwhelming. I think it'd just be cool for people to be around people they like, share lives with each other, and maybe work together...we've talked about having things like a streaming room, a place to do podcasts, etc.

Right now it's a lot more aspirational than operational, but I'm always interested in more input and seeing how we can get there.

So I brought this up to my therapist because I was interested in her take since she's naturally recognized for the books she's written on depression and anxiety both in academic and peer reviews.

Anyways she said that the relationship between serotonin and unipolar depression was debunked 20 years ago and that this paper largely notes things that are widely known about unipolar depression but are obviously and perhaps unsurprisingly not known and kept hidden from the public by pharmaceutical companies. 

(She also said that bipolar depression works differently and is why it was excluded and that makes sense though I still think it should be noted) 

Anyways. She hates drugs in general and wrote her dissertation on how they are used in the US lol. 

Funny because I am like 95% sure I'm on a serotonin based drug lol

Back when my mom had cancer, I bought a book called Anti-Cancer, which was written by a neurologist who lived with brain cancer for 15 years...kinda amazing because most people don't survive a year from that after it's diagnosed.

One of the things that stood out to me was when he talked about the differences between the American and European medical systems...one of his examples was that if somebody went to the doctor complaining of pain in France, the doctor would suggest taking it easy and maybe having a glass of wine, while in America doctors are more likely to prescribe a painkiller. Part of it is the culture...Americans want a quick fix, and pills are a cheap way to do that, but part of it is the system itself too. Insurance is more likely to pay for pills than something more expensive like, say, physical therapy. According to him, doctors have long given-up on suggesting people diet and exercise, so a pill is just easier for everybody around.

But in the last five years or so I've read this book, a book on diabetes written by a pediatrist (who started his career amputating feet from diabetes patients), and a number of articles on mental health, and what amazes me is that all focus in on the same few things:

1) Eat a healthy diet, low in added sugar, saturated fat, and processed foods and high in fruits, nuts, seeds, fish, whole grains, etc. Most point the the Mediterranean diet as a good example to follow.
2) Exercise - most sources agree that 30-45 minutes of moderate exercise a few times a week is sufficient.
3) Reduce stress as much as possible - we seem to all be agreed that stress weakens the immune system and encourages chronic inflammation

Of course, we all know it's not as easy as that or everybody would be doing it, lol. I'm finding out that in order to really make those changes you have to tackle your psychology behind them, and that's unique to each individual person and thus isn't the cheap one-size-fits all solution the medical and insurance industries like. And it would involve social changes that would not be good for the people and groups that benefit from the way things are now.

So simple, yet so hard. v_v

Perhaps prescribing rest in Europe is more likely to work because people are more likely to have workers' benefits and protections and work culture which allows them to take more rest.

@Wintermoot on one hand, perhaps it could be perceived negatively but... I also don't really think such a thing would be cultish unless it was run like some weird kpop house or whatever lol.  Rents are expensive and life is quite isolating in the modern world, I think some form of community living is as reasonable a solution as any.  Especially if you've established trust and are willing to live with others you trust, etc, like a sort of more communal roommate situation that's almost sort of like a dorm of sorts?  There are some interesting projects in Denmark that are sort of semi-communal housing that aren't totally like, communal, that are an interesting model.

https://journal.theaou.org/news-and-reviews/the-popularity-of-cohousing-in-demark/

https://cohabitas.com/a-visit-to-saettedammen-co-housing/

Here are some interesting articles.  Not quite sure how workable such a thing would be in the USA, mostly because of how religiously opposed most zoning is to sensible, community-oriented and efficient land usage.

I've been thinking of things like community zoning and changing the urban landscape to encourage more meaningful community connection a lot recently, I think that a lot of the fabric of society fraying really boils down to the profound feeling of isolation that had been building in society for so long, and then was exacerbated by covid to the point that pretty much everyone can acknowledge the issues now.  

I think a lot of modern issues can be boiled down to: American Urban Planning is literally the worst.

Full article: https://theconversation.com/depression-is-probably-not-caused-by-a-chemical-imbalance-in-the-brain-new-study-186672

I want to start this out by saying that I'm not suggesting that people should stop using anti-depressants or that they have no value in treating depression. For what it's worth, I think the article makes sweeping conclusions towards the end when caution and further research would be better advised. How anti-depressants work has always been something of a guess beyond it seeming that it does (which is why people often have to try different anti-depressants at different doses to find one that works for them), and even if depression isn't caused by a chemical imbalance in the brain, it could still have a positive effect through some other unknown mechanism.

But the part that stuck out to me was this: "Although a famous early study found a relationship between the serotonin transporter gene and stressful life events, larger, more comprehensive studies suggest no such relationship exists. Stressful life events in themselves, however, exerted a strong effect on people’s subsequent risk of developing depression."

I personally believe that the cause behind most cases of depression is the stress of modern living, which approaches traumatic. Even before there was a pandemic that's raged on for years and forced us into even further social isolation, just trying to make it in the world today has been a struggle...it's a struggle for most people to have their basic needs met. Jobs don't pay a living wage, and the price of food and shelter keeps going up. It's less likely that people will have a good support network, either to physically help them meet these needs or to be there for them emotionally. I recently saw something about how Americans of all age groups now spend most of their time alone (and it gets even worse as it gets older). And that doesn't factor in traumatic events and abuse, which seems to be more prevalent now than I ever knew before.

Most people are struggling to get through life by themselves. No wonder depression is raging in the modern world.

I think the greater solution is to end this way of living and replace it with something where people aren't struggling alone like this. I know that's a tall order, and I wish I had something to say to that...as I get older it's definitely something I'm becoming more focused on thinking about, which is partially why I put out semi-serious ideas like the Wintreath teamhouse. How on a least a small scale something like that would help for a few people. And I don't think the answer is one big solution that fits everybody, but a lot of little solutions that collectively cover everybody. Beyond those thoughts, I don't really know how you tackle such a vast problem, but I do feel that's the major source of depression (and a lot of other issues, if we're being honest) these days.

Honestly, I just cannot be convinced at this point that most drugs aren't just shoved down our throats because it is hella profitable for the drug companies. Exercise has always been a much better treatment for my depression than anything else. That, and a few friends and family members who refuse to let me withdraw, as I am prone to doing while depressed.