[HN Gopher] Post-SSRI sexual dysfunction
___________________________________________________________________
Post-SSRI sexual dysfunction
Author : taxyovio
Score : 169 points
Date : 2021-10-28 11:33 UTC (11 hours ago)
(HTM) web link (rxisk.org)
(TXT) w3m dump (rxisk.org)
| mmastrac wrote:
| Interesting flip-side: the anti-depressant Tradazone can cause
| Priapism.
|
| I don't think we understand nearly enough about these systems,
| though I'd argue that anti-depressants are still a big net
| positive.
| brunoTbear wrote:
| Anecdata: an ex experienced this on SSRIs. Was brutal on her and
| tough for me. A friend had the same issue.
|
| Antidepressants are an awfully tough thing to get right. Whenever
| my friends talk to me about them I recommend therapy and all the
| other things before starting ssris or the other families of brain
| drugs.
| cwwc wrote:
| Hmm.. a bum side effect especially since it looks like that SSRI
| antidepressant might be a treatment for covid.
| [deleted]
| kortex wrote:
| PSSD seems to be in part mediated by desensitization of 5HTP1A
| receptors. Psychedelics are known to modulate 5HTP1A and increase
| plasticity of serotonin neurons. This would logically be another
| research avenue for psychedelics.
|
| I could not find anything substantial on this specific avenue in
| a brief literature search, but the mechanism is there, and
| anecdotally people have reported success.
|
| We need to de-schedule these drugs. At the absolute minimum, we
| need to get rid of the vile Schd 1 "no medical uses" to allow
| their research to be more politically/financially palatable.
| symlinkk wrote:
| Has anyone taken SSRIs and actually thought it was worth it? I
| have severe social anxiety and I'm trying to decide if I should
| try medication or not.
| slowmotiony wrote:
| Yes, 100% worth it for me.
| maxehmookau wrote:
| Yes. I have been taking sertraline for over a decade and it has
| literally saved my life. I was able to become the person I
| always wanted to be without social anxiety overtaking my life
| at every corner.
|
| Please don't take any advice from anyone on HN, including me.
| This community often attracts armchair anecdoctors. Go and
| speak to a doctor.
|
| Good luck.
| ivraatiems wrote:
| Anecdotally, yeah. It's worth it. To be frank (I'll comment
| more on this elsewhere) I think the risk of _permanent_ sexual
| dysfunction or any other permanent effect is dramatically
| overblown by articles like this one. The short-term and while-
| you 're-taking-it side effects are real, but for me and many
| others well worth it.
|
| Everyone in my family has some sort of anxiety issue.
| Citalopram (with the help of therapy and lifestyle changes)
| helped me overcome severe anxiety, helped my brother stop
| throwing up whenever he got in a too-high-pressure situation,
| and gave my sister the willpower to move out of my parents'
| house and get a job.
|
| They're good drugs with frustrating downsides. That's life. I'd
| still recommend them.
| txsoftwaredev wrote:
| Yes. I've been on/off (mostly on) them for around 20 years. It
| started when I was young and a girl broke my heart. I just
| couldn't get out of my "funk". I started taking Zoloft and it
| gave me a life again. I probably have social anxiety and I am
| def. more comfortable in public and around people I don't know
| when I'm on an SSRI. I am not as negative and cynical and have
| hope for the future. I don't want to take them, wish I didn't
| have too but even with consistent exercise, therapy etc. it
| just wasn't enough without the medical help.
| prionassembly wrote:
| Many many summers and a thousand years ago, I went to a pdoc to
| complain of anxiety issues. I left (after a good hour+ of
| talking) with a bipolar 2 diagnosis. The diagnosis was correct:
| at low doses, lamotrigine/Lamictal behaves like an
| antidepressant (and you have to taper in slowly to prevent bad
| reactions) and I flipped the fuck out in euphoric mania. I
| shortly after went on lithium and never regretted it. I started
| having dreams that seemed to resolve my deeper
| "psychoanalytical" issues. It really fixed me up.
|
| This has been like 15 years ago. The more I learn, the more it
| seems I was the textbook case doctors never expect to meet.
| People are not generally aware that dysphoric mania is a thing.
| A good diagnosis can change your life.
| superflit2 wrote:
| I am not saying it is not for you.
|
| But please consider alternatives as CBD or a healthier routine.
| symlinkk wrote:
| What makes CBD healthier necessarily? Curious of your
| viewpoint
| n8cpdx wrote:
| It doesn't cause permanent long term sexual dysfunction,
| and all the 2nd order effects that entails.
| superflit2 wrote:
| From the people I know personally.
|
| Situation 1. Interview next day.
|
| They can't sleep, can't focus. Like they are rolling on
| their bed all the time but no real sleep.
|
| Then on the next day when they have the interview their
| cognition is exhausted and tired. Solution: CBD helped them
| sleep better like in 40 min.
|
| Situation 2. Meeting or having a situation that they will
| be anxious. (meeting, new job,etc).
|
| CBD before makes the "negative voices" stop.
|
| I talking CBD only.
|
| You will not feel high or anything.
|
| Indeed you will forgot that you use it but then you will
| not be anxious. Meaning -> it does not give a "kick" that
| you feel. suddenly you are relaxed and "forgot" about being
| anxious.
|
| I was a person that thought the medicinal effects were
| "exagerated" so the ""hipppies"" could use it. But then
| once I saw it working I changed my prejudice.
| bduerst wrote:
| My experience with CBD is that it will knock you out and
| give you a deep sleep on day 1, but the more you use it
| the harder it is to sleep without it. Almost like the
| payday loans of falling asleep.
| R0b0t1 wrote:
| It's not just libido. It's lethargy, weight gain, lack of
| mental motivation, brain fog. There's a lot of SSRI side
| effects.
| blockmarker wrote:
| Yes, but it is not an aspirin. Before trying medication try
| therapy with a psychologist.
| sterlind wrote:
| Anecdote: I had severe OCD from childhood through my first year
| in college, triggered by separation from my parents (who never
| got me therapy despite extremely obvious signs.) I had multiple
| panic attacks per day resulting in
| depersonalization/derealization, I was failing my classes etc.
|
| Logically I knew that my mom wouldn't die if I didn't stop my
| room fan at its maximum rotation or if I didn't make the sign of
| the cross 2^n times. But mental illness is illogical. What "good
| coping skills" would fix that?
|
| Psych put me on Prozac, which numbed every feeling but panic,
| which it didn't touch. I got relief from a bad trip on 2C-E, in
| which I had such a severe panic attack that it permanently
| destroyed that identity and left me with depersonalization. The
| old me was dead, so over the following months I built a new one.
| OCD apparently got erased with the rest of me. I successfully
| went off Prozac by quitting it cold turkey and stayed off SSRIs
| for a decade.
|
| I guess the takeaway is: serious mental illness exists,
| platitudes about life wouldn't help, SSRIs didn't help either but
| didn't make me dependent, and psychedelics are a crapshoot.
| ljm wrote:
| This was one of the factors that made me think twice about going
| back on anti-depressants, until I made peace with the fact that
| my ability to orgasm wasn't going to pull me out of the hole I
| was in. It's a shitty choice but the desire to not be suicidal
| forces your hand.
|
| It's literally like flipping a switch. One day, the plumbing
| works. The next day, it doesn't. Many times I'd just give up, out
| of boredom.
|
| The side-effects are clearly stated but to use myself as an
| example, I vastly underestimated just how strong they would be.
|
| That said, if you're dealing with the big black dog as it were,
| don't use it as a reason to avoid anti-depressants if you really
| need them. Keep your doctor up to date about the side-effects so
| they can adjust your prescription. And don't be shy just because
| you're talking about your private parts.
|
| And make sure you have a therapist too.
| lost-found wrote:
| You ever look into ketamine for treating depression?
|
| Self medicated this past weekend and had some major
| breakthroughs with my long time depression/suicidal intrusive
| thoughts. Nice thing is you don't have to stay on it unlike
| other antidepressants--I would never do a medication that you
| have to constantly take.
| thanatos519 wrote:
| Try 2F-DCK. Many benefits but no K-hole.
| ghostbrainalpha wrote:
| I just lost a friend to Ketamine, and there is another thread
| on the front page about someone famous who destroyed their
| life with it.
|
| Ketamine seems like a miracle but a ton of people cant
| control their usage of it at all. Even if you think you know
| how addiction works, Ketamine sneaks up on you in a way
| cocaine, heroin, and oxytocin do not.
|
| Please be careful.
| lost-found wrote:
| Of course, I am very responsible with my illicit drug use.
| Probably did < 50mg across several night and am not
| planning on doing it again for 6+ months. Good advice
| though for everyone!
| standardUser wrote:
| "I would never do a medication that you have to constantly
| take."
|
| Tell that to your heart doctor when you're 70.
| lost-found wrote:
| Probably will.
| ljm wrote:
| I appreciate the concern but, honestly, it's exhausting to
| keep fielding 'have you tried...', 'have you looked into...',
| 'have you explored...' questions.
|
| I get that it comes from a good place, but I'm sharing my
| experience, not asking for advice.
|
| The best help you and others can offer is to just listen,
| instead of offering another solution.
|
| There are two replies to me in the 'have you tried' vein. I'm
| not aiming it at you specifically, just trying to stop a
| pattern.
| lost-found wrote:
| I get what you're saying. The only reason I suggested
| looking into it is because they are seeing hugely promising
| results (70%+ reported improving symptoms) but you only
| have to do a few sessions. It's not another pill you have
| to take each morning.
| neverendingsigh wrote:
| For what it's worth, from at least one person's perspective
| it's exhausting to just _read_ these replies, as if you or
| other OPs are eternally naive neophytes with no experience
| or understanding, or that providing a personal anecdote is
| automatically, implicitly, and irrevocably requesting
| advice. This tends to be the case with a lot of medical
| discussions online, but especially with mental health.
|
| (It would be somewhat better if these questions were asking
| for advice themselves--"Have you tried $medication? It's
| been recommended to me and I'm interested in others'
| experiences"--but it's almost always "Surely you haven't
| tried ($medication || $lifestyle_change || $religion ||
| just_grow_up()) because I have and it's a panacea.")
| ljm wrote:
| Thanks. I just want to share and be heard, and maybe
| someone can relate.
|
| Good intentions all around, but people need to understand
| that you're not always someone to be helped or saved. It
| can feel quite disempowering at times.
| cwkoss wrote:
| Ketamine can be pretty rough on the bladder and kidneys.
| Please read up on the risks. It is definitely dangerous to
| take recreational doses several times per week - it seems
| that low/moderate doses every week or two avoids most of the
| problems while still providing therapeutic effects, but
| definitely keep an eye on the health of those systems,
| ideally with letting your doctor know so they can help.
|
| Many of users on /r/researchchemicals using either ket or
| novel analogs at recreational doses regularly for both fun
| and depression relief end up with bladder issues after over-
| consuming for a period - so while it's a promising depression
| treatment, I'd recommend caution around dosage and frequency
| and titrating to find your minimum effective dose.
| [deleted]
| lowercase1 wrote:
| Recreational doses are 10x-30x that of medical doses and
| those effects are quite a bit less at medical doses
|
| https://astralcodexten.substack.com/p/drug-users-use-a-
| lot-o...
| lost-found wrote:
| Of course, anything taken in excess has risks.
| ivraatiems wrote:
| Have you considered augmenting with something like Wellbutrin?
| Some people find it helps with the side effects. I've tried it
| myself and while I found it was too anxiety-inducing (I felt
| too keyed up) there's truth to that at least.
| ljm wrote:
| No, not personally. I eventually was able to come off the
| medication. Took a couple of weeks to get back to some
| semblance of normal but I'm sure there's permanent damage
| still.
|
| That said, it's not easy to walk away from suicidal
| depression (and attempts to commit suicide) without a decent
| helping of trauma, and potentially even PTSD. So, of course,
| there isn't really a 'normal' to go back to once you've got
| the awareness of that and how far down the rabbit hole you
| fell. Normal becomes something else.
| ivraatiems wrote:
| Wellbutrin has no sexual side effects (the opposite, in
| fact) and is very effective for depression (but not
| anxiety). You might want to give it a try if you are still
| struggling. Of course, it comes with its own tapestry of
| possible issues.
|
| Either way, hope you are doing OK/OK enough.
| wayoutthere wrote:
| Ugh. Yes. Not meaning to be crude here and I'm incredibly
| sympathetic to the men I date, but as a woman in her late 30s
| it's hard to find a man my age who _doesn't_ have problems
| getting / keeping it up. Most of them link back to
| antidepressant use.
|
| What about modern society drives the need for such widespread use
| of antidepressants? Is that something we should be willing to
| give up? It hasn't _always_ been this way, has it?
| n4r9 wrote:
| > What about modern society drives the need for such widespread
| use of antidepressants?
|
| There's little space for compassion and sociability. Most
| people in the West spend 8 hours a day working through an
| endlessly growing backlog of demands, all the while justifying
| each hour to clients and managers, then go home to drink and
| watch TV or scroll through news feeds. Our brains are not
| suited to constantly worrying over the demands of others while
| being so disengaged from social face to face contact.
| Broken_Hippo wrote:
| "There's little space for compassion and sociability"
|
| I would argue there is more space now than there used to be.
|
| I mean, women were basically property at one point, with
| changing degrees of freedom. You might not get out of the
| house much, depending.
|
| Folks working as servants around 1900 basically had to do
| what their employers said, even if that meant you simply
| weren't allowed to have a romantic partner.
|
| We kept _slaves_ , and unfortunately, some folks still do.
|
| We are probably lucky to spend only 8 hours a day on things,
| and I'm really happy that housework doesn't take up a lot of
| time now. Doing housework or working long hours doesn't grant
| you much space for compassion nor sociability.
|
| The television and feeds are hobbies and entertainment. The
| folks in the past did similar stuff, and they had their own
| outcries - books, bicycles, women's ankles, and so on.
|
| Drinking has been with us for literally Millenia. The amount
| of drunkards has varied alongside whatever it is we feel is
| "too much" - in other words, drinking daily wouldn't be
| strange if that is in the culture, but it is possible that
| same culture would frown on daily drunkenness.
| iammisc wrote:
| > I mean, women were basically property at one point, with
| changing degrees of freedom. You might not get out of the
| house much, depending.
|
| Can we please stop just repeating cliches that are not even
| obviously true? While certain countries certainly had these
| notions, this is not a universal.
|
| And even in cultures with strong 'female ownership', the
| picture you're painting is incredibly wrong. While women
| may be considered 'basically' property, they would
| constantly be socializing with one another. They would be
| out of their house often with other women and their
| children. The appearance of 'ownership' would only be from
| the vantage point of men.
|
| For example, looking at Middle Eastern society, it's
| completely false to say women don't get out of the house.
| Women have entire portions of the house to themselves,
| where they and their female friends can get together, talk,
| interact, and gossip without any interference from men,
| including their own husband.
|
| Today we are way more atomized. Many people work, watch TV,
| and sleep. That's sad. We used to spend most of our day
| with friends and family. Even the slaves would.
| yjftsjthsd-h wrote:
| > What about modern society drives the need for such widespread
| use of antidepressants? Is that something we should be willing
| to give up? It hasn't always been this way, has it?
|
| It's completely possible that there's something messed up in
| modern society that causes depression, or in medicine that
| diagnoses depression and/or prescribes antidepressants, but the
| null hypothesis would be that before modern times, people
| were... just depressed. And then more recently that they'd try
| treating it with cocaine/meth/etc. Or that they'd fail to treat
| it, and some percentage of those people would commit suicide,
| and the remainder would never admit that there was anything
| wrong, both of which mean the outcome you observe wouldn't
| happen.
|
| Again, this isn't to say there isn't a more interesting answer,
| just that you have to at least consider the _possibility_ that
| it 's _not_ something about modern society.
| iammisc wrote:
| Depression is relative. Today on social media, people come
| away with the false conclusion that they are meant to feel
| euphoric most of the time.
|
| I don't believe in 'feeling happy', yet every magazine
| promises me i'll be happy if I just do X. Instagram says if I
| just follow <blah>, my life will become infinitely better.
| It's all a joke. I never feel happy, but I am not depressed.
| And more importantly, I have no interest in constant
| happiness... how boring. Most days I just feel meh. Sometimes
| I feel hungry.
| nradov wrote:
| We know that exercise is an effective antidepressant for some
| people. In pre-modern times people were generally more
| physically active so I suspect that prevented a lot of
| depression symptoms.
|
| https://www.health.harvard.edu/mind-and-mood/exercise-is-
| an-...
| iammisc wrote:
| I am a straight man, so have no experience with other men
| obviously, but this is fascinating. How can it be that so many
| of us are on antidepressants? Something is surely wrong as
| you've said right?
|
| There may also be selection effects as men in their late 30s
| may not have 'paired up' so to speak due to depression. But
| still, I'm curious if anyone has stats on how many people are
| on these drugs.
| wayoutthere wrote:
| About 15-20%. But that's _just_ the antidepressants; sexual
| dysfunction can also be caused by blood pressure medication,
| epilepsy meds, etc. Anecdotally I would say regular sexual
| dysfunction among men over 35 is probably closer to 50%.
|
| I don't know how this compares to past eras though.
| [deleted]
| [deleted]
| ralusek wrote:
| Trouble in that department is also heavily impacted by men just
| generally being more sedentary, having poorer diets, and due to
| those reasons and more, having lower testosterone. Also,
| consuming pornography in much greater amounts than previously
| available to people is known to cause serious problems here.
| 1_player wrote:
| Yes, changing diets, better sleep and giving up porn works
| wonder in my case. I'm in my mid 30s and never had any sexual
| dysfunction, but relatively small changes cause major changes
| in my perceived feelings of "potency", if you will.
|
| Fatty meats, cholesterol heavy foods (butter, eggs), vitamin
| D have the biggest effect on me, still less than just simply
| giving up porn.
| prionassembly wrote:
| I tied the knot in my early 30s, but friends who chose to
| remain free agents (even having had opportunities to marry
| someone great) report that the market thins out more and more
| as time goes by. And these are men, with easier access to a
| younger pool.
| wayoutthere wrote:
| I wouldn't say women have it much different -- I end up
| dating a lot of significantly younger men. It is harder to
| have much in common outside of physical attraction with
| someone too far from your age group though.
| prionassembly wrote:
| My wife is actually five years older than me. But we met on
| a night club and made out before talking too much and it
| stuck. I think we developed a crush on each other in the
| ensuing daytime dates, came to admire each other and
| recognize common values. But we had kissed first and tested
| the chemistry.
|
| People overthink dating and mating. We'd all probably be
| reasonably happy on arranged marriages. With apologies for
| the non-inclusive language of an old song, "woman needs man
| and man must have his mate, on that you can rely as time
| goes by".
| wayoutthere wrote:
| 5 years isn't that much difference and you still share
| some cultural overlap. I've dated people who are closer
| to 15 years younger and it was hard to have more than a
| physical relationship because our personalities were
| formed in such different contexts.
| Broken_Hippo wrote:
| _What about modern society drives the need for such widespread
| use of antidepressants?_
|
| Honestly, the "about" is that we've developed medicines that
| aren't nearly as horrible as the medicines of yesteryear.
| Prozac wasn't marketed until the 80's, and a lot of other
| things have been marketed since then. Marketing is key too - it
| is really hard to take this stuff if you don't know something
| is available. And misery has been with us for quite some time.
|
| _Is that something we should be willing to give up?_ Well, no.
| Giving up antidepressants means that people suffer more. We
| could work on reducing the general population 's suffering and
| anxiety. We aren't 100% sure on how to do this, it seems, but
| we know things like easily affordable health care and a safety
| net helps out lots.
|
| _It hasn't always been this way, has it?_ Actually, yes. And
| no. I 'm not convinced that housewives that used to take
| vallium in the 70's were taking it because they were happy, for
| example. We didn't always think to write about this stuff -
| doubly so when going on about it could get you in a non-modern
| mental hospital. The 'no' is simply because we can do something
| about it now. I like to think we are more compassionate overall
| now, but I have no real reason to think this.
| nradov wrote:
| Exercise is as effective as antidepressants for some
| patients.
|
| https://www.health.harvard.edu/mind-and-mood/exercise-is-
| an-...
| Broken_Hippo wrote:
| I don't see how that is relevant here. I'm guessing
| relieving financial stress is really effective in some too.
|
| So what?
|
| It doesn't help all patients, which means that we just
| can't cure everyone with exercise. Hence, we'd be worse off
| without them as some folks would suffer more.
| nradov wrote:
| It's relevant because there are a variety of therapies
| available. No single treatment will work for all
| patients. Medication is sometimes appropriate but it
| isn't always the best option.
| m00x wrote:
| It's not about society, it's about having the option now.
|
| I have severe anxiety and I always just accepted it. After
| taking 75mg/day of Effexor, I don't have that anxiety anymore
| and I can function like a normal human. I'm in my mid-30s and I
| can have sex 3-4x/day easily and it still functions like when I
| was 15.
|
| I wouldn't blame it all on anti-depressants, since sexual
| issues for 35+ year old men are common even without them.
| Blaming anti-depressants is convenient though since no one
| wants to blame it on genetics/health.
| lewispollard wrote:
| > What about modern society drives the need for such widespread
| use of antidepressants? Is that something we should be willing
| to give up? It hasn't always been this way, has it?
|
| GPs have very limited amounts of time for individual patients.
| Therapists, counsellors and psychiatrists are expensive and
| have mixed results, and require a significant time investment
| from the patient and the professional. It may be a long time
| before any kind of talk therapy has results. For many people
| who go into a doctor's office complaining of depression
| symptoms, it will go away within a reasonable timeframe. In
| many countries, there are waiting lists for any kind of further
| treatment.
|
| The whole situation adds up to handing out SSRIs as a first
| line treatment when anyone comes to a GP reporting depressive
| symptoms; it's cheap, it buys time, it gives the patient a
| feeling that they're doing something to work on their issue,
| and gives them time to sign up for further support and get
| through their waiting list. As far as the GP knows, in most
| cases, side effects are rare. For many people coming in with
| mild depressive symptoms, there is some temporary life factor
| that will go away within the first course of treatment, and
| with it the symptoms, and that is a "success" for the SSRI
| stats.
|
| Of course, anyone who's been on SSRIs of various types for any
| longer length of time knows that's bullshit, and they're quite
| serious substances with prolonged side effects and withdrawals.
| I really hope the situation changes.
| Tade0 wrote:
| > It hasn't always been this way, has it?
|
| As a man in his 30s growing up I witnessed a shift in attitudes
| from "just man up" to "seek help", so there's that.
|
| If anything I would suggest humanity to give up dating apps.
| They're essentially making people feel inadequate and pay for
| the dubious privilege.
| wayoutthere wrote:
| Dating apps are awful, but were a lot better once I
| challenged my standards (and lowered them a bit; I'm not the
| young hottie I used to be and that was a hard realization).
| prionassembly wrote:
| Feeling inadequate is integral to the cherchez-la-femme
| experience. But it's probably better to be humiliated in
| night clubs (where eg. women sometimes will pretend not to
| even see you) than in apps; ego defense mechanisms have less
| of a chance there. Also: actually kissing tells you _a lot_
| that detailed self-reported profiles will never do -- the
| "chemistry" thing is real, sometimes two people find someone
| cute and stylish but the kissing doesn't work.
| [deleted]
| mzs wrote:
| I've experienced the sexual side effects. For me they lessened
| over time (going from mostly not being able to achieve climax to
| that rarely happening) and taking a lower dose helps. For those
| that are not at risk of seizures they can take bupropion as well
| to decrease the dose of the other SSRI further.
|
| But honestly sex is mostly in the brain and not finishing every
| time is only a drag if you think that it is. Personally I find it
| liberating, sex becomes a fun intimate pass time without an end
| goal. And certainly the benefits to my depression and anxiety out
| weigh the negatives for me.
| agumonkey wrote:
| Anybody knows about the neurology of libido ? not the
| biomechanical sequence (attractive person -> nerve impulse ->
| blood flow etc)
|
| Talking about the higher representations of the other person's
| body, why proximity / touch causes all these mental discharges.
| michaelgrafl wrote:
| On the flipside, if you have problems with premature ejaculation,
| taking one of those might mitigate the issue.
|
| Not a doctor, by the way.
| jac241 wrote:
| Yes they are indicated for that.
| sigotirandolas wrote:
| Probably. Clomipramine, a TCA, is sometimes used for premature
| ejaculation.
| selexin wrote:
| I don't usually post here, especially on such personal topics,
| but feel I should. I've been on SSRIs and SNRIs for some time now
| (Pristiq, and now Zolof), and can definitely attest to the some
| of the changes described in the article. I clearly remember
| reading the documentation in full that came with both drugs
| before starting each, and the mentioned side effects were only
| mentioned in passing, along with possibly every other side effect
| imaginable, so it was very easy to dismiss - especially when you
| are in a place you know you need help out of. There was also no
| real warning of long term side effects from both doctors that
| have prescribed me. I guess I don't have any real point, other
| than if you are considering anti-depressants do more research
| than I did before taking what you've been prescribed - and if in
| doubt get answers from your doctor, and failing that find a
| better doctor (if you can).
| xattt wrote:
| Sertraline (Zoloft) often causes more sexual side effects in
| males than it does in females. I have seen this used at the max
| dose to control hypersexual behaviour in a patient with
| dementia.
| matheusmoreira wrote:
| It's also used to treat premature ejaculation. Side effects
| can be really useful in the right context.
| FilMo wrote:
| First of all, I need to say I always pay attention to all
| side effects indicated. I really treat with caution every
| prescription I get. As for Sertraline, I noticed that the
| generic one I got from https://www.canadapharmacy.com/ has
| less sides than the branded one. Don't know why there is the
| difference, but it still calms me down a bit.
| ljm wrote:
| I spent about 18 months on sertraline. Even on the
| 'therapeutic' dose that I started off with, it basically
| nuked my ability to perform. Could still get an erection
| easily enough, the frustration was being unable to do
| anything with it.
|
| It wasn't that much better with fluoxetine, but with that I
| found that I could at least wait a few days to sort of build
| up the energy.
|
| As with another poster here, I'm happy being open about this
| stuff too. The first hurdle is opening up about mental
| health, I think that already puts you on a good track to take
| the shame away from the sexual aspect.
| 300bps wrote:
| When I was in my mid-20s my doctor wanted me to take blood
| pressure medication because when I went to her office in the
| morning I had blood pressure of 150/110. I told her I wanted to
| see what I could do on my own first.
|
| I cut out salt and caffeine, increased potassium and exercised
| every day. I went back in two months and my blood pressure was
| 120/80. She took it four times because she didn't believe it. I
| think the primary thing was the caffeine - it just gives me a
| temporary but strong spike in blood pressure.
|
| Years later, a doctor prescribed me Lexapro. I actually picked
| up the prescription. But I never took it. I started exercising
| every day, started mindful meditation, removed sugar from my
| diet, read the book Learned Optimism and did the CBT-like work
| in there. Ended up never taking the SSRI but haven't had
| anxiety in 7 years. (btw Learned Optimism was recommended to me
| on HN).
|
| Some people definitely need medication - I worked with a guy in
| his early 20s that had cholesterol of 400+. I saw him eat
| oatmeal every day for breakfast and lunch and then saw his
| cholesterol go up to 420. I'm sure there are people that need
| SSRIs. But it does seem like doctors at least prescribed it to
| me when I didn't need it.
| matheusmoreira wrote:
| Lifestyle changes are the best treatment there is. Shame they
| can't make a pill out of it. Statistically most people fail
| to maintain lifestyle changes over the long term. Especially
| dietary changes.
|
| Pharmacological treatments allow doctors to help those
| people.
| silexia wrote:
| I have never had a doctor recommend lifestyle treatments to
| me. They don't make any money on those. I have
| osteoarthritis in my hip and multiple doctors recommended
| an immediate hip replacement. I did a ton of research and
| ended up on the anti-inflammatory index diet in combination
| with changing exercises from running and golf that put high
| impacts on my hip to cycling which does not. All of my pain
| was gone in three months and has stayed gone for the last
| two years.
| wara23arish wrote:
| I got back from the doctor last week due to some chest pains.
| He was more worried about my high blood pressure 130/90.
|
| Every time i measure it at home its 110s/70.
| cwkoss wrote:
| Have you heard of white coat syndrome?
| https://www.healthline.com/health/white-coat-syndrome
|
| Recently learned about it, and based on my own measurements,
| seems I have it to some extent.
| speeder wrote:
| Probably eating the oatmeal that made his cholesterol get
| higher.
|
| There are now tons of research coming out about how cereals
| (wheat and corn specially) are basically the culprit of a lot
| of diseases that in the past were blamed on "fat", and also
| that this past blame was partially due to corruption (for
| example coca-cola literally gave six digits money to Harvard
| scientists so they would lie and say sugar was safe and the
| culprit for people problems was meat).
| voldacar wrote:
| dietary cholesterol has a negligible effect on blood
| cholesterol levels. Almost all cholesterol in the body is
| endogenously created
| rhinoceraptor wrote:
| There's a U-shaped curve for all cause mortality with
| cholesterol levels, just like anything else. Cholesterol
| is not bad, it's literally the building block of steroid
| hormones, vitamin D, etc.
|
| Similarly, there's a good argument to be made that most
| people actually eat too little salt. If you compare most
| sodium guidelines to data of sodium intake versus all
| cause mortality, you're more at risk of death following
| the guidelines.
| shlant wrote:
| > Probably eating the oatmeal that made his cholesterol get
| higher.
|
| I... don't think so
|
| https://www.health.harvard.edu/heart-health/research-were-
| wa...
|
| https://www.sciencedaily.com/releases/2016/10/161007085247.
| h...
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885279/
|
| https://www.sciencedaily.com/releases/2008/01/080108102225.
| h...
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394769/
|
| > There are now tons of research coming out about how
| cereals (wheat and corn specially) are basically the
| culprit of a lot of diseases
|
| Care to share more on what you are referring to?
| aserdf wrote:
| (not op) for reference, 39g of oats contains 28g of
| carbohydrates.
|
| https://www.hsph.harvard.edu/nutritionsource/what-should-
| you... - The biggest influence on blood
| cholesterol level is the mix of fats and carbohydrates in
| your diet--not the amount of cholesterol you eat from
| food. - Although it remains important to limit the
| amount of cholesterol you eat, especially if you have
| diabetes, for most people dietary cholesterol is not as
| problematic as once believed.
| sizzle wrote:
| What's up with the conflicting info on carbohydrates?
| Should I skip the bowl of oatmeal every morning?
| bruce343434 wrote:
| This seems to be a thing for pretty much every
| food/nutritional category. I've decided for myself to
| just "ignore" the science since the definition of
| "healthy" seems to change so often. Instead I try to use
| common sense for picking my meals.
| haolez wrote:
| In my case (Pristiq), it was a net positive. My libido
| decreased (but never desapeared) and I've never had erectile
| disfuncion so far. Totally worth it for me, with my specific
| metabolism.
| BoiledCabbage wrote:
| As a herbal observation, it seems like such a scam that medical
| pamphlets will list possible side-effects, but not frequencies.
|
| Knowing that one person in one thousand saw some issue is very
| different from 20% of people. Especially as almost every
| medication I've ever seen advertised has a list two pages long
| of possible side effects.
|
| How is a person supposed to make an informed judgment?
| sofixa wrote:
| I don't know if it's the law here in France or just nice
| manufacturers, but I've seen side effects broken down by
| occurence rate ( 1 in 100,000: X, Y, Z; 1 in 1,000,000: A, B,
| C, etc.) multiple times.
| cwkoss wrote:
| > herbal observation
|
| What does this mean?
| foxyv wrote:
| Autocorrected from honest or personal I believe.
| BoiledCabbage wrote:
| Yup, and I didn't catch it in time.
| s1artibartfast wrote:
| All US drugs have to include the rate of side effects in
| their clinical trials.
|
| Google " _Product name_ prescribing information "
| watwut wrote:
| The frequencies are there, they were in all pamphlets I read.
| It is a law.
| jamal-kumar wrote:
| SSRIs need to be obsolesced already. Screw the sexual
| dysfunction, how about increaased risk of suicidal ideation? How
| about them taking two entire weeks to work?
|
| The thing is the rest of the world doesn't seem to feel the
| burning desire to get as many people on them as possible and even
| have alternatives which aren't as limited. Reversible MAOI drugs
| like moclobemide have been around since the 90s and while they
| have a higher interaction profile (Can't mix it with anything
| serotonergic basically, so no amphetamines or cocaine or other
| antidepressants, which is fine), the reduced side effect profile
| is considered a bonus and the biggest reason for lack of adoption
| of this along with other treatments (It's astonishing how long we
| have known about the ketamine thing without using it) happens to
| just come down to marketing and doctors scared off by the early
| MAOIs where you need to strongly consider diet. The new stuff
| even reportedly improves sexual function. And you can't get it in
| the USA.
| diskzero wrote:
| I am in the US and I have never heard of the treatments you
| mentioned. I guess this is your point! This makes me very sad.
| I am glad a SSRI worked for me, but I know that a percentage of
| people will also be at great risk for self-harm.
| ironmagma wrote:
| Not to mention the sometimes lifelong brain zaps which are
| truly disturbing and make trying to go to sleep a terrifying
| experience.
| bruce343434 wrote:
| > lifelong brain zaps
|
| Could you expand on this? Is this the "exploding head
| syndrome" where you have an incredibly "loud" hallucinatory
| experience just as you fall asleep?
| ironmagma wrote:
| I am not a doctor and do not know the difference between
| brain zaps and EHS (or whether there is one), but this
| article[1] summarizes it well.
|
| For me, it is a loud sound but sort of within the head,
| accompanied by the sensation you get when you receive an
| electrical shock, which of course startles you awake. This
| unfortunately occurs just at the boundary between
| consciousness and sleep, which after it happens a few times
| in a row can put you off the idea of even trying to sleep.
| Occasionally I did awaken thinking there had been a literal
| explosion in the building.
|
| I haven't taken SSRIs for 3 years and still get them,
| albeit less than when I was weaning off of them.
|
| [1] https://www.medicalnewstoday.com/articles/brain-
| zaps#how-the...
| pyronik19 wrote:
| SSRIs took me from being unable to function and leave my home
| due to social anxiety to knocking out the bulk of my symptoms
| and having a solid 15 years of being socially and professional
| productive. I'd prefer we keep them.
| ironmagma wrote:
| There are probably a number of other drugs that could have
| done that, though.
| R0b0t1 wrote:
| Heroin, interestingly enough. IIRC they screened pain
| medicine recipients for depressive symptoms and in this way
| determined opiates relieve major depression more
| efficaciously than SSRIs.
| ironmagma wrote:
| Yes, and a close relative (oxycodone) is something I've
| had experience with and can confirm it's quite good at
| curing the depression. The problem is the permanent brain
| damage and/or death it will cause when taken long-term.
| Link < https://www.drugabuse.gov/publications/research-
| reports/hero...>
| romwell wrote:
| I've had a very positive experience with SSRIs as well
| (Sertraline).
| bduerst wrote:
| MAOIs have potentially serious dietary interactions and side
| effects. They can cause serotonin sickness just by taking it
| with OTC tryptophan supplements.
|
| SSRIs are not perfect but have a safer track record of being a
| first-attack against depression and anxiety, before having to
| resort to bigger guns like MAOIs.
| [deleted]
| foobarian wrote:
| Selective Serotonin Reuptake Inhibitor (SSRI)
|
| https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i...
| efields wrote:
| I was prescribed cognitive behavioral therapy (CBT) and Prozac.
| The CBT did far more for me. I dumped the Prozac after a few
| months. I have bad days and good days, but I know how to get
| through the bad ones now. I know what prompts them and even when
| its hard to think positively I still know that I won't think
| things are as bad tomorrow.
|
| YMMV! A lot!
|
| As I get older I feel healthier when I move, touch people, give
| love and get love.
|
| In the US, we _do not prioritize health_, physical nor mental.
| We're surrounded by shit food. We're "insured" basic baseline
| function, and improvement often has to come out of our own time,
| energy, and money. If you're in a relaxed white collar
| environment, its easy to duck out for an hour of therapy. If
| you're on the clock, it's almost impossible. This is the bigger
| issue.
|
| Again, some ppl DO need SSRIs or they will harm themselves or
| others. But always pair with some form of talk therapy and get
| some daily exercise.
| stefanwlb wrote:
| From another post about COVID treatment. Welcome to world wide
| sterilization.
|
| "If WHO recommends this, you will see it widely taken up," said
| study co-author Dr. Edward Mills of McMaster University in
| Hamilton, Ontario, adding that many poor nations have the drug
| readily available. "We hope it will lead to a lot of lives
| saved."
|
| The pill, called fluvoxamine, would cost $4 for a course of
| COVID-19 treatment. By comparison, antibody IV treatments cost
| about $2,000 and Merck's experimental antiviral pill for COVID-19
| is about $700 per course. Some experts predict various treatments
| eventually will be used in combination to fight the coronavirus.
| vimy wrote:
| Wellbutrin has the opposite effect. It makes you feel 15 years
| old again.
| tonyarkles wrote:
| One thing I find super interesting is how that side effect is
| pretty inconsistent even in the same person. I'm currently on
| Wellbutrin/Zyban/Bupropion as a smoking cessation aid and am
| not having that side effect this time. But last time I was on
| it for the same reason... oooooohhhhh boy, yeah, it's a good
| thing that I had a partner who was good with that!
| antiterra wrote:
| It's possible some of the variation is from the specific
| manufacturer or manufacturing process. In the case of
| Wellbutrin XL, generic brands have even been recalled due to
| not being bioequivalent (https://www.medicinenet.com/script/m
| ain/art.asp?articlekey=1...)
|
| I have been told by a doctor that effects appear inconsistent
| across brands or places of manufacture, even with non-
| recalled generics. You should always consult with your own
| medical professionals about your medication, but you can
| often ask for a different generic at the pharmacy.
| kayodelycaon wrote:
| That's because Wellbrutin is an NDRI (norepinephrine-dopamine
| reuptake inhibitor). It's a stimulant.
|
| It's actually a third-line medication for ADHD and is sometimes
| used with other medications to counteract the sexual side-
| effects of other medications.
| hellojesus wrote:
| I want to kill myself every second of every day, and it's been
| that way for 15ish years now.
|
| The only thing, fleeting as it may be, that I find worthy of
| doing in life is sex, and these ed side effects have kept me from
| exploring the potential for a world in which I don't to cease to
| exist or murder in the sake of nihilism.
|
| I'd rather destroy the lives of those around me or others'
| randomly than live without sex. It's just a function of my
| utility curve.
|
| Unfortunately and as counter intuitive as it may seem, I'm very
| cautious of skin to skin diseases such as hsv and hpv, which has
| kept me from hiring prostitutes, even though the only thing in
| life I want is exactly that.
| sillysaurusx wrote:
| I was in a similar position to you (minus the murder part). The
| only thing that pulled me out of it was Prozac. I wrote up my
| experiences here:
| https://twitter.com/theshawwn/status/1392213804684038150
|
| I have sex on a regular basis, and it's not nearly as bad as
| these side effects make it sound. It's different, sure, but you
| can definitely have enjoyable sex.
|
| You need to take antidepressants every single day for at least
| 30 days before you'll notice any effect whatsoever. _Every_
| day, without fail. If you haven 't tried that yet, I urge you
| to; it was nothing short of miraculous, and there was no reason
| for me to live so many years in misery.
| R0b0t1 wrote:
| That last part isn't true. People report credible effects of
| positive mood immediately. The issue is you can't necessarily
| trust these self-reports and it takes roughly 1-2 weeks for
| someone with a clipboard to start writing down results that
| correlate with a perceived increase in mood.
|
| Some adverse reactions to SSRIs are so bad people will kill
| themselves if they go a month. If it doesn't feel right you
| should just stop taking them.
| sillysaurusx wrote:
| That last part is my own experience. It was so true for my
| case that I nearly didn't discover Prozac at all, because I
| gave up after the first week. It wasn't until many years
| later that I knuckled down with the consistency, since I
| had nothing to lose.
|
| As it turned out, I had everything to gain.
|
| All of this should be done with the supervision of a
| doctor.
| hellojesus wrote:
| Thank you for taking the time to post this. I'll take a look
| at your experiences and consider taking action.
| R0b0t1 wrote:
| If you try anything, ask for Wellbutrin first if it is not
| the first thing prescribed. There are usually not any
| libido or lethargy issues.
|
| You may have ADHD and may want to get tested for it. I'm
| looking for a doctor to go to again, but being an adult the
| ones I've seen so far think I just want drugs.
| Complications from ADHD look a lot like depression.
| hellojesus wrote:
| This is really interesting. May I ask why you came to the
| ADHD conclusion in the first place? Was it solely the
| correlation between depression/anxiety and adhd?
|
| I did a quick search and came across a few articles such
| as the following one: https://totallyadd.com/23-signs-
| you-do-not-have-adhd/
|
| I was surprised to find I exhibit many of these symptoms.
| Most prominently having stacks of things throughout the
| office/house which contain various half-worked projects
| or hobbies or just general information. My shieldmadien
| constantly complains about the "disaster" and is always
| shocked when she asks where something is, and I'm able to
| go straight to the pile of junk which contains exactly
| what she's looking for.
|
| Other things like time being an elusive concept or going
| to another room to get something and then getting there
| and having no idea what I am supposed to be doing are
| also frequent occurrences. I know where my car keys are,
| but that's only because I have a very specific plastic
| tray on the kitchen counter that is supposed to contain
| them and my wallet. If they disappear from there because
| I get distracted between walking into the house and
| emptying my pockets then it's usually a hunt for them.
|
| I tend to bounce between new projects but get obsessively
| engrossed with them at the start... and then just never
| complete them.
|
| Not sure if I actually have it, but it is an interesting
| thought.
| sillysaurusx wrote:
| I don't think libido or lethargy is the most important
| consideration. The consideration is whether it eliminates
| suicidal thoughts. For me, Prozac was the only thing that
| worked, and this advice would've led me astray.
| R0b0t1 wrote:
| If you want to discount libido that is at least halfway
| excusable, but that depends on the individual. Lethargy,
| which almost always comes with libido issues, is more
| problematic, as it causes weight gain and a corresponding
| decrease in life expectancy.
|
| It an be hard or impossible to combat. I've had people
| tell me they discontinued their medication due to weight
| gain (or libido issues, as in this thread).
| hansor wrote:
| Don't worry too much, you are not alone mate, and it's
| perfectly normal to ADORE sex!
|
| That why it is at the same level as breathing, eating and
| shitting in:
|
| - https://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs
|
| ps. Having sex in rubber with prostitute is safer in terms of
| HPV/HSF infection then with average female in UK without any
| protection (especially with Y gen) :) So I would not worry
| about it THAT much.
| elwell wrote:
| Sorry to hear that. Do you think it's a function of your
| philosophical beliefs?
| hellojesus wrote:
| Which part?
| yosito wrote:
| I'm sorry you feel that way. It sounds difficult. I believe
| there are many things that could help you find more pleasure in
| life and also find more fulfilling sex. I recommend searching
| for those things, and looking for people who can help you. But
| I'm actually commenting to point out that sex with a prostitute
| doesn't have to be risky, despite stereotypes. Most prostitutes
| are frequently tested for infectious diseases, and most will
| have no objection if you ask to see a recent clean test. Very
| very few prostitutes will have unprotected sex. And you could
| even find a less active prostitute who doesn't have sex with
| many people. The biggest risk is probably legality, depending
| on where you're based. But, assuming you have legal access to
| it, I would recommend seriously considering it. It's a fair
| exchange of something you have, for something you need that
| could really help you get what you want out of life. As long as
| it's between consenting adults, there is no problem with safely
| exploring this option. One note that I would recommend if you
| do pursue it is to also pursue personal growth at the same
| time, because few people find that sex with a prostitute was
| what they really wanted, and you may find that what you really
| want in life will take a lot of work to achieve.
| hellojesus wrote:
| Thank you for your response. I appreciate it.
|
| The problem I have concerning diseases and prostitutes is
| that, although many get tested often, almost all testing
| excludes hsv and hpv unless specifically requested. And since
| ~12% of the population carry hsv-2, which can shed
| asymptomatically and be contracted from skin-to-skin groinal
| contact, it seems that it's an eventuality if I pick up
| prostitution long term, and then it's for life.
|
| Condoms help, but they're not perfect. I asked on a forums
| once if prostitutes would be okay if I wore condom shorts
| such as the following link, and I was told that (1) the hobby
| was not for me, (2) the probability of contraction given the
| use of condoms is low enough not to be a consideration, and
| (3) the item probably wasn't tested under the same standards
| as condoms so probably isn't as safe (I figure latex material
| such as this would be a find physical barrier).
|
| https://m.aliexpress.com/item/1005001595057592.html?spm=a2g0.
| ..
|
| I'm still contemplating it but am having trouble digesting
| the sti risk. The legal risk doesn't bother me.
|
| Edit: auto-correct
| ghostbrainalpha wrote:
| I was where you are for about 10 years. Don't give up hope,
| it can end.
|
| Also have you tried websites for "sugar babies" instead of
| an actual prostitute. Someone who is willing to get tested,
| and sleep with you regularly but doesn't have the same risk
| profile as a prostitute?
| hellojesus wrote:
| I've considered it but haven't had much luck.
|
| For a period of time in the past I ran a small porn
| production shop wherein I would hire and then get recent
| test results from models. But TTS, the industry standard,
| doesn't test for hsv or hpv so I gave up while I was
| ahead.
| voldacar wrote:
| For someone who wants to die constantly, you seem very
| concerned about taking good care of your body and health.
|
| Not insulting you, I know how weird and contradictory
| humans can be. It's just interesting.
| hellojesus wrote:
| I know. It's ridiculous, and I hate it, but that's my
| mental state. I think I wrote it was counter intuitive in
| my initial post because, as you point out, it's as
| rational as pi.
| slowmotiony wrote:
| A different anecdotal experience from my own use (10mg Lexapro) -
| I've always had a problem with premature ejaculation. Was trying
| all kinds of tricks like doing math problems in my head during
| sex or trying different breathing techniques - all of that was
| useless, once I started taking Lexapro it's like it flipped some
| switch in my head and I can basically go as long as I like now,
| and finish almost on command. Absolute game changer, it's a
| fantastic improvement to my quality of life. I also take 5mg of
| Cialis daily, which definitely helps with erections.
| sizzle wrote:
| Ummm I'm pretty sure the cialis is keeping the blood engorged
| where it needs to be. Why not try an experiment, lose the
| cialis and see if you can "keep it up" so to speak. (This is
| not medical advice, I'm speaking hypothetically fyi)
| exdsq wrote:
| A big thanks to everyone commenting for helping normalise mens
| mental health <3
| robbie-c wrote:
| This is interesting. I'm a founder of an app[1] that deals with
| this ballpark of issue, by providing (among other things) couples
| with sensate focus therapy, which is a form of sex therapy that
| has an extremely strong evidence base, and is a pretty standard
| go-to for libido issues.
|
| We definitely have users that have experienced PSSD and have
| found our app helpful, and the underlying therapy techniques
| _are_ proven.
|
| [1] https://www.blueheart.io
| chilmers wrote:
| I took SSRIs for a year in my late twenties. They had no effect
| on my depression, but resulted in permanent sexual dysfunction.
| My own fault for not properly researching the potential long-term
| side effects, I suppose, but it certainly wasn't raised as an
| issue by the prescribing doctor either. I hope someday there will
| be cure of some kind.
| michieldotv wrote:
| I feel you. I was on escitalopram in my twenties too for a
| depressive episode. It wrecked my libido and 10 years down the
| line there is hardly any sign of improvement in sight.
|
| I have a very understanding spouse, luckily, but I'm honestly
| devastated in not being able to accommodate this dimension of
| our relationship anymore.
|
| Recently, my GP offered to prescribe me antidepressants again
| for an episode of burnout, but I'm absolutely not keen to go
| down that road again. I get that it's cheaper and more
| available than therapy, but I've been burned before.
| revolvingocelot wrote:
| A close friend took an SSRI, citalopram, for a year in his
| early twenties and he got that too. It wasn't permanent, though
| ("full") recovery took almost a decade! Keeping in mind
| varying-milage and a sample size of one, he's vaguely suggested
| that his recovery was speeded by working out muscles in his
| hips. Perhaps a combination of our Western sedentary lifestyle,
| our proclivity to sit in computer chairs all day, and the
| effect of the SSRI? Far be it from me to dispense medical
| advice, but working to open one's hips and doing some squats
| probably can't hurt, even if it doesn't actively help.
| slowmotiony wrote:
| Have you tested your hormone profile (blood test)?
| Testosterone, Free T, Estradiol, Prolactin, Progesterone, SHBG
| - you could check if all of those are in range because that
| might be the root cause of your issue. There were studies done
| where use of SSRIs was causing elevated levels of serum
| prolactin.
| chilmers wrote:
| Interesting, thanks. I did do a basic consumer blood test
| which reported my testosterone as "normal" (whatever that
| means), but I should probably do a more in-depth one and
| check these things.
| slowmotiony wrote:
| Yup, I strongly recommend you do at least the ones I
| mentioned above, it's possible that your issues could be
| very simple to fix.
| iammisc wrote:
| https://www.artofmanliness.com/health-fitness/health/how-
| to-...
|
| ^ has information on why 'normal' isn't a good range for
| everyone.
| [deleted]
| stimpson_j_cat wrote:
| > I'm not a doctor or a medical expert
|
| > The Art of Manliness participates in affiliate
| marketing programs
|
| Seems like a terrible resource. Much better would be
| blood work at your PCP (and a possible referral to an
| endocrinologist).
| iammisc wrote:
| Endocrinologists are terrible at knowing what hormone
| ranges are good for your age and sex. As a man with
| thyroid problems, I am thoroughly disabused of the idea
| that most endocrinologists have any clue what they're
| talking about. Certainly, for a middle aged women, must
| can put it together, but barring that, you're better off
| on facebook groups.
| LurkingPenguin wrote:
| When did the sexual dysfunction begin? During treatment,
| immediately after or was there a delay between the time you
| stopped taking the medication and when it began?
| robbiex88 wrote:
| In my early 20s (male) I was prescribed (read: pushed) citalopram
| by my family doctor. I took it for about a year. I'm in my early
| 30s now and sometimes STILL suffer from the inability to reach
| orgasm. I stopped taking the medication and when I realized it
| was in fact the medication interfering with my love life, and
| unfortunately realized too late. I've read alot about this after
| the fact and am surprised this reached HN. Nothing really to add
| to this conversation but its reassuring to know I'm not alone.
| Igelau wrote:
| Takes me a little longer on Zoloft. My psychiatrist and I agreed
| this is more of a good thing than a bad thing. The crippling
| anxiety I had without it was much worse for my libido.
|
| That being said, I wish we understood these drugs better, because
| I know the side effects and efficacy vary in the extreme. I know
| for some people it's like trying to put out a fire with gasoline.
|
| Continued anecdata: when I forget to get my refill, the
| withdrawal is terrible. Dizziness, malaise, and "brain zaps". One
| of these days I'm going to have to wean off of it carefully
| before I try psychedelics.
| mehphp wrote:
| I'm not a doctor, but I'd caution against trying psychedelics
| at all if you had crippling anxiety before.
|
| I didn't realize just how bad my anxiety could get until after
| I did Psilocybin. It wasn't the root cause of my anxiety, of
| course, but it sure as hell exacerbated it to the point of
| being pretty debilitating.
|
| I'm now on 25mg of Sertraline, which has all but wiped out my
| anxiety.
| lkjfklajsdfpsdf wrote:
| I'm diagnosed with MDD. I was prescribed an SSRI and was not made
| aware or informed of the sexual side effects. Thankfully after
| quitting them my libido has restored but to the other extreme
| where I'm constantly horny.
| kayodelycaon wrote:
| I've had significant problems with my anti-psychotic before my
| psychiatrist and I found a proper mix. Given I frequently deal
| with hypersexuality, there was no way I'd stay on medication long
| term if that wasn't fixed.
|
| For the curious, Wellbrutin is the medication we added. It helps
| me with depression, ADHD, sexual issues, and some anxiety.
| bostik wrote:
| I must be a weird outlier. While I can agree with the article's
| opening ("Close to 100% of people who take antidepressants
| experience some form of sexual side effects") I can't, at least
| from personal experience, subscribe to the main message.
|
| As my wife can attest, when I was on SSRIs, I was hornier than
| usual.
| ivraatiems wrote:
| I think this article is a little alarmist. Warnings like these
| scared me away from SSRIs for a long time despite their likely
| efficacy in helping treat my symptoms.
|
| I sent a number of articles like this one (and several of the
| medical publications it cites) to my psychiatrist. To her credit,
| she read them, and her response was that she agreed this kind of
| permanent change is possible, but it is extremely unlikely.
| (Anecdotally, she told me, she's treated thousands of people with
| SSRIs and had never had a report of something like this; she
| hadn't heard of it happening until I showed her case studies.)
|
| I don't think that means my doctor is ignorant - I think that
| means permanent damage is indeed likely very uncommon.
|
| Here is a write up from Lorien Psych (the day job of Scott
| Alexander at Slate Star Codex) that I think is evenhanded:
| https://lorienpsych.com/2020/10/25/ssris/
|
| Alexander has his issues, but this is an area where he's actually
| an expert and his approach to the topic helped me a lot.
|
| As for me, the benefits of a relatively low dose of an SSRI have
| really outweighed the risks so far.
| staticman2 wrote:
| Your psychiatrist may have had patients suffering from this
| that never told her.
|
| They would have discontinued the medication, terminated the
| doctor patient realationship, then waited for things to "go
| back to normal" when they were off the drug but found it never
| did.
|
| In fact they may have voiced concerns to her and she may have
| said "it will go back to normal if you discontinue the drug".
| But they never went off the drugs until they fired her as their
| doctor, so she would never know about the subsequent problems.
| ivraatiems wrote:
| That's possible but it's an awful lot of speculation. She
| also might have had lots of patients who did so well on SSRIs
| they stopped seeing her and just had their GP prescribe the
| medication from then on. Or all her patients might have
| overdosed on an unrelated drug and died. You can come up with
| lots of scenarios other than the most likely one.
|
| But this:
|
| > They would have discontinued the medication, terminated the
| doctor patient relationship, then waited for things to "go
| back to normal" when they were off the drug but found it
| never did.
|
| is not the way a good psychiatry practice (like the one I
| frequent, IMO) is designed to work. You try a lot of
| different things and you see what works. You're told upfront
| that this is part of the process and that if you don't like a
| medication, you don't have to keep taking it, and you should
| tell the doctor why and what you're open to trying next.
|
| I tried buspirone (which I still take), duloxetine
| (intolerable GI side effects; didn't take for long enough to
| experience anything sexual), and bupropion (too stimulating,
| not right for my condition) before I settled on citalopram. I
| had been specifically avoiding citalopram because I was
| scared of it, and I feel a little foolish for that now.
|
| So I think your scenario is unlikely in my case. I can't
| speak for other doctors.
| staticman2 wrote:
| You don't have to keep taking the drug, I agree. But the
| doctor will give you another instead, and if the
| dysfunction continues it will be assumed to be a
| "temporary" symptom of the subsequent drug like it was with
| the old drug.
|
| You won't go "cold turkey" to see if things go back to
| normal unless you fire the psychiatrist because frankly, in
| America at least, psychiatrists are pill pushers and,
| unless you are wealthy and will pay out of pocket, you will
| only get insurance covered talk therapy with a cheaper
| psychologist or social worker.
|
| Psychiatrist are often only there for quick discussions
| about medication. The time intensive talk therapy is done
| by someone less expensive. In my area psychiatrist will
| often partner with therapy practices and only handle the
| drug side of things. If someone stops taking drugs, there
| would be no reason to see the psychiatrist.
| ivraatiems wrote:
| > You won't go "cold turkey" to see if things go back to
| normal unless you fire the psychiatrist because frankly,
| in America at least, psychiatrists are pill pushers and,
| unless you are wealthy and will pay out of pocket, you
| will only get insurance covered therapy with a cheaper
| psychologist or social worker.
|
| This is just not my experience, sorry. Perhaps this is
| true of the majority and I got lucky, or perhaps you have
| had some very negative experiences worth sharing, but I
| have never felt pressured to do anything I didn't want to
| do. After I tried duloxetine, I waited several months
| before trying anything again (except the buspirone which,
| as I mentioned, I'd been on the whole time). I met with
| my psychiatrist regularly during that time. It was all
| covered by insurance.
|
| In fact, going directly from one SSRI to another without
| cross-tapering is not standard practice and can be quite
| debilitating. If your physician did this to you, they
| were not doing their job correctly.
|
| > Psychiatrist are only there for quick discussions about
| medication. The time intensive talk therapy is done by
| someone less expensive.
|
| True, but not really relevant, I think. If medication is
| what you want, a psychiatrist is who you should have.
| Choosing the right one can be a challenge, I agree, but
| that doesn't make their profession not valuable.
| staticman2 wrote:
| I meant cold turkey as a synonym for no longer on drugs,
| I should have phrased it differently.
|
| I never said psychiatrists pressure patients. I said they
| only treat patients on drugs. If the patient decides to
| go off drugs that's the natural end of the relationship.
|
| You replied and said you saw a psychiatrist when you were
| still on a anxiety drug and the insurance paid for it.
| Well, of course they did, you were taking a drug.
|
| You are correct that some patients could stop taking an
| SSRI and still see a psychiatrist.
|
| I'm also correct that many patients who have gone off the
| drug to see if the sexual dysfunction stops will probably
| no longer be making appointments with the psychiatrist.
| What would be the point? If they want to talk to someone
| that's what therapists are for.
| ivraatiems wrote:
| > You replied and said you saw a psychiatrist when you
| were still on a anxiety drug and the insurance paid for
| it. Well, of course they did, you were taking a drug.
|
| The insurance company doesn't know what you are
| discussing in your sessions and isn't going to let you
| see or not see a specialist just based on whether they
| prescribe you meds. That's not how it works - or not how
| it should be working if your insurer is acting
| appropriately. I also saw this psychiatrist a couple of
| times before taking anything. I didn't walk out of my
| first session with a prescription for buspirone.
|
| > I never said psychiatrists pressure patients. I said
| they only treat patients on drugs. If the patient decides
| to go off drugs that's the natural end of the
| relationship.
|
| It is, but that doesn't mean you just immediately stop
| seeing them and never communicate again. That's not how
| it works - with a good psychiatrist at a good practice.
| You taper off, verify the taper worked and you have no
| further issues, and _then_ stop seeing them if you want.
|
| > I'm also correct that many patients who have gone off
| the drug to see if the sexual dysfunction stops will
| probably no longer be making appointments with the
| psychiatrist. What would be the point? If they want to
| talk to someone that's what therapists are for.
|
| You need to provide some data for this assertion if you
| are going to keep making it. The point is that the
| psychiatrist, as the person overseeing your care, is the
| person you would naturally tell about a problem you were
| having. I don't think "go off the drug and just stop
| talking to the doctor" is the normal behavior, I think
| it's more like "tell the doctor you're going off the
| drug, confirm you went off the drug, the doctor asks if
| you want to try another drug, you say no, and then you
| stop talking to the doctor."
|
| I'm sure some people do just stop taking whatever they're
| taking and never speak to their doctor's office again -
| but most practices are set up to prevent that, because
| you'd have to actually cancel an appointment and ignore
| phone calls in order to get to that point. Doctors hate
| risk by and large, and letting patients randomly
| discontinue drugs with no supervision is not something
| they generally want to incentivize.
| staticman2 wrote:
| "tell the doctor you're going off the drug, confirm you
| went off the drug, the doctor asks if you want to try
| another drug, you say no, and then you stop talking to
| the doctor."
|
| This is completely consistent with the patient never
| telling the doctor that, to their surprise, after waiting
| months the SSRI side effects never go away.
|
| I feel like you are arguing against my choice of phrase
| but not the substance of what I had to say.
|
| When a patient terminates treatment doctors do not tell
| their patients "be sure to make a followup with me in 6
| months after going off the drugs in the event you are
| permenently injured by the drug side effects in a
| condition that has no cure. I won't be able to help you
| but please pay me to chat about it."
|
| The article this thread links to indicates there is no
| cure, so any patient who has done research would know
| discussing it with a psychiatrist would be useless.
|
| And of course I have no data, you told an anecdote and I
| responded with a comment along the same lines.
|
| I made a pretty small claim, that your psychiatrist may
| (not did have, may have) had patients with a condition
| they didn't discuss with her, that only became known to
| the patient after treatment had concluded. If you think a
| minor claim like that requires "surveys" or data, believe
| what you want, I don't know what to tell you.
| ivraatiems wrote:
| > This is completely consistent with the patient never
| telling the doctor that, to their surprise, after waiting
| months the SSRI side effects never go away.
|
| That's true, that could certainly happen. I'm more
| skeptical about the rate at which it happens -- but also,
| if it is happening, presumably a patient will eventually
| go back to someone in the medical system and mention it.
| Whether they connect the dots is a question, but one
| which can be studied.
|
| > I made a pretty small claim, that your psychiatrist may
| (not did have, may have) had patients with a condition
| they didn't discuss with her, that only became known to
| the patient after treatment had concluded. If you think a
| minor claim like that requires "surveys" or data, believe
| what you want, I don't know what to tell you.
|
| The claim that my psychiatrist might have done something
| or not isn't the claim I want data for. The claim I want
| data for is "I'm also correct that many patients who have
| gone off the drug to see if the sexual dysfunction stops
| will probably no longer be making appointments with the
| psychiatrist. What would be the point? If they want to
| talk to someone that's what therapists are for."
|
| That's not an anecdote, that's a pretty bold claim.
|
| > The article this thread links to indicates there is no
| cure, so any patient who has done research would know
| discussing it with a psychiatrist would be useless.
|
| I don't think people think about things that way
| necessarily. I wouldn't read an article and conclude I
| _shouldn 't_ talk to my doctor because the article
| suggests the doctor can't help, because I don't
| necessarily put that much faith in a single article. And
| doctors will frequently _ask_ these sorts of questions,
| so even if I had read the article, I don 't think I'd lie
| about it to them.
|
| In general, I think you are making a number of
| assumptions about how people - doctors, insurers, pharma
| companies, and patients - behave that aren't necessarily
| borne out in reality. If your assumptions are all
| correct, your conclusions are reasonable, but I am not
| sure they're correct.
| batrachos wrote:
| > The insurance company doesn't know what you are
| discussing in your sessions
|
| That's not true. From what I understand, sessions are
| coded e.g. "Intake" or "Meds check" when billed to
| insurance. They know roughly what you're talking about.
|
| > and isn't going to let you see or not see a specialist
| just based on whether they prescribe you meds.
|
| You can't bill a meds check with no meds.
|
| > That's not how it works - or not how it should be
| working if your insurer is acting appropriately. I also
| saw this psychiatrist a couple of times before taking
| anything. I didn't walk out of my first session with a
| prescription for buspirone.
|
| And those sessions were probably billed as "intake",
| "evaluation" or the like. A psychiatrist cannot keep
| billing intakes and evaluations forever. Talk therapy is
| coded in its own way, and generally paid at a lower rate.
| ivraatiems wrote:
| > That's not true. From what I understand, sessions are
| coded e.g. "Intake" or "Meds check" when billed to
| insurance. They know roughly what you're talking about.
|
| You are correct that CPT codes give some insight into
| what was provided, but you are wrong about what codes
| providers use in this case.
|
| To check myself, I pulled my insurance provider's EOBs
| for my last two visit to a psychiatrist and my last visit
| to a psychotherapist. The codes were as follows:
|
| Psychiatrist - CPT 99214 and 90833. Those are "office or
| other outpatient visit for the evaluation and management
| of an established patient, which requires at least two of
| these three key components: a detailed history, a
| detailed examination and medical decision making of
| moderate complexity", and "Individual psychotherapy,
| insight oriented, behavior modifying and/or supportive,
| 30 minutes" respectively.
|
| So I don't think from these you can assume "this person
| was prescribed meds", necessarily. These are very similar
| to a standard doctor's visit billing code, or a therapy
| billing code (as below).
|
| Psychologist - CPT 90837, which is "60 Minute Individual
| Therapy"
|
| Both of these EOBs indicate the insurance paid the
| provider for the codes as billed. This is one example,
| but I'd be surprised to find it wasn't representative
| (that is, that my providers are not billing in generally
| accepted ways).
|
| > You can't bill a meds check with no meds.
|
| As you can see above, there isn't necessarily such a
| thing as a "meds check" CPT code. The codes don't give
| the kind of information you're imagining.
|
| > And those sessions were probably billed as "intake",
| "evaluation" or the like. A psychiatrist cannot keep
| billing intakes and evaluations forever. Talk therapy is
| coded in its own way, and generally paid at a lower rate.
|
| It is true talk therapy is a separate CPT code; it isn't
| true that it's always paid at a lower rate. The
| negotiated rate depends on the insurance company and
| provider's agreement.
| superflit2 wrote:
| I will provide some AnecData.
|
| I am from a generation that when SSRI became available, it was a
| marvelous drug.
|
| Prescribed to teenagers freely and plentiful.
|
| Now on my peers of friends, we have many people who don't have
| any libido.
|
| The hardest-hit group was Women as they go to therapy more[1].
|
| It is so huge we have Forums like "dead bedroom."
|
| Once a friend that took SSRI told me how she felt about sex:
|
| "I am looking forward to when my husband reaches his 40s, so he
| does not bother me about sex anymore."
|
| "Brushing my teeth is more useful and fun than sex."
|
| I am not talking about sex partners that are not "competent" or
| good. It is like you never felt hungry or willing to eat. But
| then you *have* to eat, and when you are tasting the food, it is
| like cardboard * every time*
|
| The concerning part is that our PharmaCo does this every ten
| years. (Thalidomide, SSRIs, etc.) So can we believe the mRNA
| vacuum is really safe?
|
| [1] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937254/#R27
| iammisc wrote:
| With women, birth control is the other obvious problem.
|
| My wife took birth control for a day or two in her twenties
| before we married, had the symptom, and threw the pills away.
|
| It's very sad. Women's sex drives are as strong as men's, and
| much stronger when ovulating.
| taxyovio wrote:
| I posted this here in hope more people would be aware of the long
| term risks involved with SSRI, which are often not discussed from
| the doctors. These symptoms might only appear after the
| withdrawal.
|
| Some manufacturers and healthcare organisations are being to
| label this as a potential side effect. You can find a one line
| warning on NHS website now.
|
| People take the drug are usually desperate and at their most
| vulnerable periods in life. It's very risky to make life-changing
| decisions, more so without complete knowledge.
|
| Doctors usually won't even listen to cases of PSSD by simply
| attributing the SD as remission of depression. But there're some
| recent studies on how SSRI could change neutral receptors in a
| non-reversible way, which could be the potential mechanism.
| GoHydra wrote:
| Glad to see this finally getting attention. This is not what
| teenagers have in mind when they ask for "help".
| jonotime wrote:
| I did not realize even the short term affects where that
| prevalent. Terrified of the long term ones now. It definitely
| happened to me on citalopram. And now on escitalipram. I have
| been experimenting with adding DHEA and ginseng from my doc and I
| think its helping a bit.
| a0-prw wrote:
| You shouldn't take _any_ form of medication unless it 's
| necessary to save your life. Period. Doctors are still mostly
| quacks, except in some exceptional circumstances
| Madmallard wrote:
| I wonder when we're going to find out better ways to alter the
| body without causing deleterious entropy. Surely pills and shots
| are not a solution for everything and are only present because of
| their easy testability. We need better methods and aggressive
| creative problem solving and the funding to incentive it.
| theawesomekhan wrote:
| Seems I'm geo-blocked. My Location is Turkey.
| chinathrow wrote:
| https://archive.md/wip/rG5st
| ainar-g wrote:
| Same in Russia. Archive:
|
| https://web.archive.org/web/20210911150504/https://rxisk.org...
| mattowen_uk wrote:
| My personal anecdote: I'm on Venlafaxine which is an SNRI (also
| cited in the article), and I definitely suffer some of those
| side-effects. It sucks. At times it makes me want to shy away
| from sex completely. Other times I think I'm doing OK, only to
| find out I can't finish, or I finish weakly with no adrenalin
| rush.
|
| So my choices are, come off the pills, and emotionally go down a
| dark well I may not come out of, or keep taking the pills and
| live with sexual dysfunction. So not a choice at all really.
|
| Thankfully I have an understanding partner, who has seen me at my
| emotional worst and has no desire for that to happen again, so we
| work around the issues and find new ways to enjoy each other. I
| think it also helps that I'm staring down the barrel of my 50th
| birthday, so it's not like I'm a youngster who would have
| uncontrollable desires anyway ;)
|
| As you probably worked out, I'm fairly open about this, and will
| tell anyone who asks, as I believe it's an important issue that
| people should be aware of.
| thrownaway561 wrote:
| this... when it comes to sex, we all need to have an
| understanding partner. you are very lucky to have such a person
| in your life.
| coolreader18 wrote:
| Hey I'm also on venlafaxine! It's worked very well for me as
| well, though I don't think I can really speak to the topic of
| the OP since I started taking it when I was relatively young. I
| haven't noticed.. much? I guess?
| hvs wrote:
| I had the same problem with Venlafaxine (Effexor XR). My
| psychiatrist had me switch to Duloxetine (Cymbalta) and my
| problems went away (but it worked as well as Venlafaxine for
| GAD and depression). FWIW I'm in my mid-40's but I had this
| problem about 10 years ago (when I switched).
| mattowen_uk wrote:
| I'm taking Venlafaxine also for GAD and depression. I think I
| will talk to my doctor & psychiatrist about Duloxetine at my
| next check-in. Thanks for the heads-up!
| tata71 wrote:
| Is this the only drug/treatment you've attempted to combat the
| dark well with?
|
| This is not medical advice, only anecdotal interest, but, have
| known many to leave SSRI for well-timed CBD oil.
|
| Wonder if issues requiring an SNRI are "similar" enough?
|
| Wishing you well!
| diskzero wrote:
| Not the poster, but exercise and diet really helps with my
| side effects. Sometimes I think about tapering off or trying
| some other drug, but then I get scared. I don't want to go
| back into the tunnel of depression.
| ddorian43 wrote:
| Are you overweight & do you exercise ? What are your test &
| free-test levels ? Did you try any other meds ? Maybe you don't
| hit the side effects bingo on other similar meds.
| diskzero wrote:
| I am in a similar situation to mattowen_uk. Venlafaxine has
| been the best for me and I was eventually able to work through
| the side effects. Communication with your partner is key and if
| I find I can't reach orgasm, I can pay more attention to her.
| In some ways, it has been a very good thing, allowing me to be
| open and honest in the bedroom and out.
|
| I too am older, so I totally understand how sexual side effects
| could be brutal for someone younger and in the active dating
| scene. If this is you, please know you are not alone.
| Depression is a literal killer. With a bit of work tuning the
| amount and type of medication, things will get better.
| mattowen_uk wrote:
| Well said, that man. :)
| bradydjohnson wrote:
| Vortioxetine is associated with fewer sexual side effects, and
| it works for me!
| n8cpdx wrote:
| As someone dating in their 20s, it is getting hard to find people
| who aren't having SSRI-related dysfunction. Recently met an older
| (early 30s guy) and it was seriously cool having a sexual
| experience that didn't end with "don't bother I'm just not going
| to finish no matter how long we go." They really seem to be
| handing out these serious, almost-impossible-to-withdraw
| medications like candy on Halloween.
|
| They don't actually solve the problem long term, you can't really
| come off them ever (I know a lot of people who have tried; only
| one who succeeded and they were on an exceedingly low dose to
| begin with - it took six months before the frightening
| neurological symptoms subsided), and they permanently damage
| ability to have human connection (I don't understand how that
| doesn't worsen depression and anxiety long term).
|
| I get that I'm the asshole for suggesting that people take a
| second look at the side effect profile and consider whether these
| might be overprescribed. I get that they do make life better
| overall for some people. I've also seen my friends become
| psychotic and ruin their lives when they try to get off them
| (because the sexual side effects and weight gain were
| unbearable). So IDK, it feels urgent enough to raise as a
| concern. Especially when so many people are taking them.
|
| I see a lot of people given SSRIs for anxiety that could probably
| be better treated by e.g. not smoking so much weed. It is hard to
| manage the underlying factors that drive people to alcohol and
| drug use, but I think probably easier than being rendered
| impotent by SSRIs.
|
| I get that seemingly everyone is depressed these days, but I
| really question giving SSRIs, which have poor efficacy and
| devastating side effects, before demanding lifestyle change.
| Walking 10k steps and CBT are useful interventions that can be
| easily monitored by physicians with modern technology.
|
| I guess good for half the 20-something cohort for not being able
| to orgasm really ever, but it's not great for building the
| physical aspect of human connection, which I maintain is
| important. IDK what society looks like when half the prime age
| population isn't able to have a fulfilling or enjoyable sex life.
| FFRefresh wrote:
| I do wonder if there's a culture-wide bug/meme with regards to
| mental health (and beyond) that makes it hard to push for
| lifestyle changes at scale.
|
| I think one such meme is around agency, with the underlying
| meme being that humans have no control over their circumstances
| or mental state. They _have_ anxiety or they _have_ depression.
| It 's part of their identity, and these seem to be thought of
| as immutable diseases.
|
| And it's a social faux pas to suggest to someone with anxiety
| (particularly someone you are not super close with) that if
| _they_ altered their behavior and consciously tried to work on
| their thought patterns, that they could get better. In our
| culture now, that gets translated as 'blaming the victim',
| because with a victim mindset, such a suggestion implies that
| it's the fault of the person.
|
| It's an unfortunate state of affairs. It feels like we are
| increasingly leaning into concepts such as an 'external locus
| of control' and 'learned helplessness' as a society. I don't
| know how we can push back on these ideas at scale, but if we
| don't, it's hard not seeing mental health issues and the
| externalities of the easy pharmacological solutions expand.
| iammisc wrote:
| You're absolutely right. This is an unpopular opinion, but I
| don't think anxiety or depression are mental illness. They
| are just feelings. Your feelings do not make you ill...
| People attribute it to a 'chemical' imbalance, but your brain
| being run by chemical fluctuations, everything is a
| 'chemical' balance, including this comment I'm typing right
| now. What we've done is taken these brain fluctuations, and
| labeled them bad, without addressing why one's brain is
| thinking this.
|
| I am an anxious person. I have had several terrible things
| happen to me that have led to prolonged periods of
| depression. Ultimately, these things are a choice, and people
| need to be taught good skills for coping with the sad
| realities of life. Life is ultimately a long series of
| sufferings, ending in death, which one can either choose to
| embrace or to worry about. Unfortunately, as a society we
| have stopped teaching all the traditional tools one would use
| to get oneself out of such funks.
| vettedvat wrote:
| You're describing situational depression. Very different
| than major depressive disorder or dysthymia for which these
| drugs are often prescribed. Common mistake.
| iammisc wrote:
| 'Major depressive disorder' is just situational
| depression applied to every situation. Common mistake.
| Many psychiatrists and psychologists make the same
| mistake. Many psychiatrists, by virtue of their
| education, are part of a class of people who are
| themselves more prone to depression and anxiety, so we
| probably shouldn't be looking to them for great advice.
| vettedvat wrote:
| Wrong again, a psychologist would not make that mistake.
| They know what those words mean; you just googled them.
| Luckily you didn't even try explain away dysthymia from
| your armchair because, well, you have nothing to stand
| on.
|
| > Many psychiatrists, by virtue of their education, are
| part of a class of people who are themselves more prone
| to depression and anxiety
|
| Yikes, now we're just on to blind speculation.
| iammisc wrote:
| > Yikes, now we're just on to blind speculation.
|
| Not at all. More educated people tend to be more anxious
| and more depressed.
|
| https://www.originsrecovery.com/wp-
| content/uploads/2020/10/H...
|
| The fact that we trust those more prone to depression to
| solve depression should not be discounted.
|
| When it comes to 'dysthymia'. The only reason we find it
| to be a disease is that we expect people to be happy all
| the time. We've labeled anything other than that as
| diseased. As I stated elsewhere, I do not believe in
| happiness. Most of my day is spent neither sad nor happy.
| Were I to be sad all the time, I don't think that's
| particularly interesting either. Our society is not set
| up with space for people to not be happy. Society is ill,
| not the people.
| vettedvat wrote:
| Your study says that some of 3715 mensa members were
| depressed. Not that "many psychiatrists, by virtue of
| their education, are part of a class of people who are
| themselves more prone to depression and anxiety." So
| yeah, blind speculation.
|
| > When it comes to 'dysthymia'. The only reason we find
| it to be a disease is that we expect people to be happy
| all the time.
|
| Completely wrong, again. You can experience situational
| depression without having dysthymia. You just don't know
| what these words mean.
| ghostbrainalpha wrote:
| What are the traditional tools we can use to get ourselves
| out of depression? Exercise probably?
| iammisc wrote:
| Community, shared culture, shared religion. Exercise
| happens when you do those three things.
| vettedvat wrote:
| All 3 are in abundance in Ethiopia. So why are depressive
| disorders so prevalent there? Folksy phrases aren't a
| great guide to mental health.
| iammisc wrote:
| > So why are depressive disorders so prevalent there
|
| Because there's no such thing as 'depressive disorder'.
| We expect people to be happy, and when they're not, we
| call them diseased. Nothing is wrong with them.
|
| Also, Ethiopia is in the midst of a civil war isn't it?
| vettedvat wrote:
| False, we expect people to be depressed when depressing
| things happen, this is normal and called "situational
| depression," you've confused it with a disorder.
|
| Depression has been a problem in Ethiopia for much longer
| than the conflict in Tigray, despite the abundance of
| "community, shared culture, shared religion." Looks like
| it takes more than that...
| mtalantikite wrote:
| Buddhism has been working on this for a couple thousand
| or so years. There are many different practices and
| traditions that have evolved in it, but many of them at
| the beginning will teach you to sit and observe all sorts
| of phenomena, or may even ask you to bring up
| uncomfortable, strong emotions to learn how to work with
| them.
|
| And yeah, for sure exercise. Just remember the practice
| of training your body is a marathon, not a sprint.
| Consistent effort over years is what you're going for
| rather than trying to go hard at the beginning. It's a
| lifestyle change.
| retrac wrote:
| > And it's a social faux pas to suggest to someone with
| anxiety (particularly someone you are not super close with)
| that if they altered their behavior and consciously tried to
| work on their thought patterns, that they could get better.
|
| We seem more attuned to emotional distress. And illnesses
| like anxiety present as acute distress, usually. We naturally
| want to assuage the person. And a person with anxiety
| naturally learns all sorts of avoidant coping mechanisms.
|
| We seem to have entered some sort of negative feedback cycle
| there. Medications do help some, but it goes best with
| therapy, and the mainstay is basically exposure therapy. Face
| your fears, and struggle through something uncomfortable,
| until you learn to tolerate it. People should be gently
| nudged in that direction, not encouraged to lean into their
| withdrawal from the negative triggers.
| kodah wrote:
| I was on SSRIs for a time until my thoughts became so
| irreversibly cloudy that I weened off and stopped. After that
| I coincidentally stopped drinking, my weight dropped, and now
| I've stopped using weed for the most part. My anxiety doesn't
| go away, even if I go ride my bike for hours.
|
| The things that give me anxiety are largely social. How
| people think of me at work, my appearance, what women think
| of me, and how they perceive how I act. The only thing that
| helps is shutting these thoughts down with CBT. I've dubbed
| this my, "Nobody cares Mother Fucker(tm)" routine.
|
| I've noticed relying on my friends to vent just sours
| relationships. As much as people gloat about support systems,
| it's mainly a farce. People will only tolerate hearing so
| much of your internal dissonance, concerns, and stressors.
| People want to enjoy you, for the most part. Maybe a partner
| will be there for you, but not likely in my experience
| (though, I'm unmarried, so take what I say with a grain of
| salt.)
| gbjw wrote:
| Cf. 'The Myth of Mental Illness' by Thomas Szasz (1961):
| https://en.wikipedia.org/wiki/The_Myth_of_Mental_Illness
| LorenPechtel wrote:
| The doctors don't seem to care about the side effects. All the
| psych drugs have horrendous side effects which get basically
| ignored. I've even seen multiple suggestions that mass
| shootings might be a rare side effect from them.
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