Your anecdote has nothing to do with whether it's better than a placebo or not.

A later comment notes that it works well for some patients and not others. The argument is that drugs probably don't fix things very well unless the cause is mostly just bad brain chemistry. Some people have bad brain chemistry, others have "real" (usually more external - financial, relationships, actual life issues) problems they need to fix, and hiding from them by just taking a pill to help ignore them might not work so well.

(OK bad brain chemistry is also a real problem, but one that's fixable with a pill).

Also yes that's all a bit simplified.

There's a stigma against pills for a number of reasons, some good and some bad, the fact that often they don't work being one reason.

There is a case in between: sometimes the issues are too overwhelming and you can’t start fixing them until the pills give you the space you need to address them and get to a position where you can quit the pills.

The study found the average effect was no different from placebo. It’s plausible, based on anecdotes like the one you’re responding to, that Prozac is harmful for some people, helpful for others, with the expected benefit close to zero. If so, it might be necessary to just try it and see if it’s obviously helping, keep taking if so, stop if not.

This is, in fact, pretty much the exact procedure: try one type of treatment or medication, see if it's obviously helping, and if it isn't try a different treatment or medication. It's imprecise but it's the best we have.

The problem is that taking certain psychotropic medications changes your brain chemistry. It’s not as simple as it sounds. It’s not like trying on shoes. The brain is dynamic and drugs alter it, as does life experience, talk therapy, disease, aging, etc…

That’s a statement of fact, but not intrinsically a problem. Being alive changes your brain chemistry.

His anecdote explicitly mentions the possibility of it being a placebo.

> If I have a good day it's impossible to day whether that's due to Prozac. But since starting Prozac I have been much more likely to have good days than bad. So, since Prozac is cheap and I don't seem to suffer any side effects, I plan to keep taking it in perpetuity.

I was acknowledging that the "good days" could be due to Prozac or could be a placebo effect, but since being on Prozac correlates with having significantly more good days, and I experience virtually no ill effects, I choose to continue with it.

Wow, a shockingly argumentative tone for someone who is just flat out wrong.

Beyond the response someone else commented explaining exactly where the comparison was mentioned, the anecdote itself is useful in offering an experience of someone who's life has been changed by the drug.

In any case, the study mentioned in the article is a meta-analysis about children, not adults, so there is no onus on OP to qualify anything about placebo or not.

To be fair, I didn't read that suggestion as being about a possible placebo effect, just that you can't attribute any one good day to the pill. It's like climate change- it undeniably exists, but you can't blame climate change for a single heat wave or freak storm.

You read it that way because that’s the sensible way to read it. Everyone suggesting you missed the plot is in turn making a rather large logical leap.

Some people just need to have stuff spelled out for them.

The comment never said otherwise. They shared a personal story about how it worked for an adult.

No, they shared a personal story about how they think it worked, ignoring the data saying it likely didn't.

I said "it worked for an adult" because it did. It works. In adults. The article says it doesn't work well in adolescents, not adults. I work in mental health, I assure you fluoxetine works very well, but most drugs are not tested on non-adult populations. So this is a study on a population not normally tested to enhance the dataset we have about fluoxetine. More studies will try to replicate this result, and we'll have even more data about where it works and where it doesn't.

A seven-year old child is being given a brain-altering drug? I am very happy such drugs did not exist when I was seven years old.

the alternative is depression. brain altering drugs seem preferrable

Exactly. And it's a combination usually. It's really hard to do constructive therapy when you are depressed. Stabilise with the meds and then tackle the root causes with therapy.

But some people just are very prone to depression and need the extra help.

You wouldn't say "don't give that kid ibuprofen, let them just deal with the pain"?

And SSRIs are not very strong. They do have some nasty side effects especially sexually but this is not relevant at that age so that makes it even more suitable for kids than adults.

I would be very cautious advising SSRIs for anyone, especially developing children, considering my own experience (on sertralin), which was complete disappearance of a libido, and massive weight gain, +40kg (70 -> 110) in ~10 months. 5 years later I still have not undone the damage from it.

Yeah but it's something that affects people differently. I took escitalopram and my libido was a bit reduced but mainly it became harder to orgasm. That was not all bad, it's nice to be able to last an hour and a half :) I was already heavy but didn't gain any more weight. I did lose some when I moved to other stuff though.

But these side-effects just need to be checked for (and the libido issue isn't relevant to under-teens anyway).

How you acknowledge serious side effects some people have, sweep them aside with "but some people don't," and act like getting children on lifelong medication won't result in them having adult-relevant side effects once they're adults is mind-blowing.

> You wouldn't say "don't give that kid ibuprofen, let them just deal with the pain"?

Of course you would say that after the Nth time. You are supposed to find out what causes the pain, not mask it.

I've had recurring headaches my entire life. Have been to many neurologists, none have any idea what causes them, they just give me different pills to prevent them instead. This isn't unusual for headaches, quite often the cause is basically unknown. (If you ask people they'll give you a series of common things, eg water consumption, eating enough, etc, but it's just all unprovable folk medicine) Expecting everyone to "find the cause" is unreasonable.

If you have a headache, it's totally fine to take a painkiller. (If it happens on a regular basis, eg at least once a week, it can be a good idea to get those different pills from a neurologist, because the two main painkillers have bad side effects in the long run, but those different pills are just "masking" it in a different way)

I am not trying to say that you are never supposed to take medications long-term. I take medications, too. Unfortunately the causes are known (or rather, there is a diagnosis), but there is no treatment or cure.

What I am trying to say is that after the Nth time you would take the kid to the doctor to find out what causes the pain, instead of just giving them painkillers. It could easily be something treatable, or rather, curable.

Have you tried sumatriptan by the way?

You're talking about an adult, though, not a seven-year old child..

The dichotomy of such mental illness is people with more constitutional resilience just say "power through?" and they are absolutely correct, it is something they can power through.

Mentally ill folk literally cant, not in em. There are right answers to help them, but that's not the right one. It's kind of like telling someone who is color blind to squint real hard, won't ever help.

Myself, I'm someone very much in the power through category. It's the simplest and most straightforward answer surely. But if it were the answer that works in practice we'd have no homeless people, no drug addicts.

There are many mentally ill people who "power through", though. Some call it high-functioning depression.

There are different severities - a small depressive episode, a multi-year dysthymia or mixed (manic + depressive) episode.

I've been managing OK without meds, but maybe simply depression wasn't as severe as that of other folk. It's still a mental illness.

However, the effectiveness of Mindfulness based stress reduction and acceptance & commitment therapy show that those who can distance themselves from their thoughts have developed "mental resilience"

Is that the only alternative?

Therapy is effective, but not always. sometimes, especially with children, there is no root cause in life to the depression beyond "genetics". Additional, therapy may simply be useless and unproductive without medication being used concurrently.

There's also simply death. I didn't feel like mentioning it, but I think its worth pointing out that without treatment, death is a very real possibility.

>sometimes, especially with children, there is no root cause in life to the depression beyond "genetics".

I find this hard to believe. People in the past weren't depressed nearly as much, so whatever is causing it has to be environmental.

Do we know that, though? Historically the lives of most people were bleak and miserable. You don't really have much time to feel depressed when you have to work for 14 hours in a factory 6 days a week or lose your home and eventually die in the streets due to malnutrition and disease. People who couldn't take care of themselves and didn't have a support network just didn't live that long and/or were entirely erased from history...

People in the past couldn't get a diagnosis, so they had to settle for cirrhosis.

For a 7 year old? It's about as absurd/dystopian as somebody claiming their 3 year old was diagnosed with ADHD.

I wish I could have taken something as a kid. I knew when I was 5 that something was wrong. I felt different from other kids (as least as they said they felt) and that continued through my late 20s when I started taking SSRIs. It was the best decision I've made. Ever.

But back to being a kid and thinking and feeling differently: It negatively impacted me. And the abuse only made it worse. If only I was put on drugs and/or sent to talk therapy.

Under-nourishment/malnutrition, traumatic incidents/events, genetics, societal conditions, bullying and abuse, and so many things are also all brain altering. Why do we not consider them so and turn a blind eye to all that?

I'm very sorry to hear your story, and I'm really glad the medication has worked well for you and your family. It's early days, but it seems to be working well for ours too.

I also really admire the way you're dealing patiently with everyone in this thread arguing in bad faith, you have a lot more tolerance than I do! Hopefully it's not getting to you. Best wishes.

> my 7-year-old son just started half that dose

This is horrifying.

We had/have a lot of reservations about it too, and discussed it at length with our pediatrician over months of observation. We decided what was more horrifying was hearing a 7-year-old — who has supportive family and friends, good health, no traumatic events, no major life changes going on, never worries where food/shelter is coming from — say he feels like "he shouldn't be on Earth anymore" and suddenly react with extreme physical anxiety to almost everything. It was bad enough that he couldn't really implement any of the coping skills he learned in therapy. His therapist hoped that medication would bring him to a baseline where he was able to benefit more from therapy. My family's historical success with Prozac also made the decision more palatable since depression appears to be hereditary.

There has been a phenomenal positive shift in his behavior since he started medication. All that said, another commenter pointed out that the study specifically says that Prozac is no better than placebo for depression, which is similar to but distinct from anxiety, which is what my son is being treated for. My mom and I were both diagnosed with depression, but anxiety may be more accurate -- I'm not sure.

You seem to be handling the naysayers pretty well. But, still wanted to compliment you for sharing and encourage you not to let them get to you.

It sounds like you made a wise decision given your personal and family history and your son is benefiting. Kudos.

I was one of those “medicating kids is a terrible idea” people, until I had kids with severe generalised anxiety. It took a lot to convince me to try it, but it made their lives better in such an obvious, immediate way. The whole experience made me a lot more humble about opinions I hold without relevant experience.

It's important to remember that not being a "medicating kids is a terrible idea" person doesn't mean one is a "every medication is a great idea" person. I'm probably like most people where in a perfect world I wouldn't medicate at all, and treat unfamiliar medications with some skepticism. But also I accept that I'm not (and am not interested in being) a medical expert, so if there is a medical need that I can't handle myself I'll take the advice of a clinician who has earned my trust with good reasoning.

> The whole experience made me a lot more humble about opinions I hold without relevant experience.

I wish there were a way to shortcut this process for society so that so many people didn't need to either go through a similar experience personally to have such an epiphany, or worse, never have it at all. (Speaking not only about medication for kids, but other polarizing issues as well.)

I'd be more interested in where your 7-year-old even learned phrases like "I feel like I shouldn't be on Earth anymore."

Yes, us too. Beats us. Sure wasn't around our house, and we can't imagine any family/friends/TV/whatever he may have learned it from.

It sounds to me how a someone would describe feeling suicidal when they don't know the word for it.

Ya, when I'm sad I can come up with pretty creative language to express it. It does feel really tough to know that a seven year old feels like that :(

7 year olds are second graders in school. They are exposed to plenty.

Many public schools have teachings about climate change, issues white people gave the world, native stolen land etc.

It could be easy for a kid to feel depressed when they're either the source or the victim of all the world's problems only being 7 years in

All this comment points out it’s you aren’t very familiar with second grades curriculums.

For me it shows he's trying to shoehorn in right wing talking points into this situation.

With both my kids in 2nd grade and my wife also a public 2nd grade teacher, I consider myself pretty aware of what kids are being taught these days. They certainly are being gradually introduced to some of the problems of the world, but I think childhood development experts would all agree that's healthy. As for them being told they're the source or victim that's hardly the case. I'm sure there are a few isolated incidents that right-wing media love to bang on about, but not the experience for most.

> but I think childhood development experts would all agree that's healthy.

Could it be that we think it's healthy because we can just give meds to the kids that it affects?

How would someone even have the ability to say "it's healthy" - I'm struggling to think how it comes about. I think it's healthy for my kids to cry about a worm dying in the garden, but anything less than "anxiety about a dying planet"...

Put it another way: climate change messaging IS totally about anxiety and putting human as the cause, so we can (as adults) change our habits and save the planet. Could it be too much for kids though?

I grew up in the 80s and 90s. In school environmentalism was a big deal. We did conservation trips to these ecology parks, we were taught to recycle, and often watched films about animals that might die off due to climate change.

I only felt motivated to annoy my parents to recycle more. Since the effects were not directly in front of me a strong emotional reaction didn't occur.

Perhaps there are children who already have anxiety and latch onto climate change and other problems.

At what age will you permit your kids to leave the walled garden you've created for them?

I don't give them a walled garden. I let them experience life how they do, and i protect them from predators until they can defend for themselves.

(so in this particular situation, maybe highschool / early adult)

From what I understand, some of these predators are knowledge?

Issues like what? Civilization? Ending slavery? Those aren't teachings, they are genocidal lies.

Not sure about you but I didn’t learn my native language phrase by phrase only. You learn the individual parts and concepts and construct sentences from that.

He learned it from being on Earth? And noticing that some people who used to be on Earth aren’t anymore? And it dawning on him that he doesn’t have to be either?

I’m with you on this. Granted my oldest is only 5, but anything profound my kids say can be traced back to something they heard

Teachers / schools / mandatory privilege education

You seem to have a pretty narrow view of the world, especially about “privilege education.” FWIW I’ve never once heard anything about “white people bad” from my kiddo, about 10.

It’s also impossible to to talk about idk Columbus, slavery, Great Britain, or the founding of America (and like ya know, the treatment of native Americans) without ascribing some blame to the people responsible…who were by and large “white”. We also talk about how any judgement based on skin, appearance, gender, ethnicity, or religion, is flat out wrong.

Come on, 7 year olds should have already learned to form phrases.

No, you see, this phrase must have appeared in his training set.

As someone with bad mental health since I was ~5 and parents who refused to acknowledge it - I think you're making the right decision.

There is however also benefit in updating your priors as new research comes out. I won't say this particular research discounts your experience. But maybe some day your son will prefer a different medication.

I appreciate your candor in this. A respectful and on-going discussion and dialogue about this subject is really the best way forward for us all.

The solution for suicidal thoughts is a drug known to induce suicidal thoughts?

You said elsewhere that there were "no known long-term side effects". Aside from that not being universally true for any drug I've ever personally researched, no side effect is more long-term than suicide.

It's also horrifying to hear your 7-year old child talk about committing suicide when you have a deep family history of depression, anxiety, and suicide.

Have some empathy.

Why? If a kid has diabetes, would it be horrifying to treat it? Why would it be different for a neurochemistry issue that makes the same kid tired and sad all the time?

Because the problem's not a "neurochemistry issue" (that theory's been debunked and the "chemicals" in play have never been known), and the solution is "no better than placebo."

Can you provide a source for that theory having been debunked? I agree that data has been found that is at odds with the various neurochemical theories but am not aware of the neurochemistry link as a whole having been definitely debunked.

Whenever I read a comment like this, I’m always curious if the commenter did some basic searching of their own. Just searching “chemical imbalance debunked” yields a wide array of sources. So why ask? It seems almost like a form of Socratic questioning. You want to debate the point, but for whatever reason, are not doing so directly.

I'll take this sincerely, and ask you, is this really something you've a continuing curiosity about? I have a suspicion you understand what is taking place, but for whatever reason, are not expressing so directly. Are you asserting there is nothing more to discuss after one parses the search results for “chemical imbalance debunked”. The parent is quite clearly, at the minimum, meeting their parent's level of input, which essentially amounted to "this thing is debunked". As an onlooker and after a quick skim of the search query you suggested, I am still not exactly clear on what "neurochemistry issue [theory]" entails. What would help, is a more clear underpinning for what is being discussed, which your parent is suggesting, through question, before attempting to respond. I appreciate this personally!

Ah, well-put! I think we may be reacting differently to the same articles. My understanding is that while various neurochemical theories have not been proven as the general public seems to think, they have also not necessarily been disproven or debunked. Certainly it has not been proven that neurochemistry has no role at all.

I wouldn't recommend searching for "chemical imbalance debunked" unless you intend to confirm an existing bias. The internet will show you whatever you want, and there are enough people who distrust medical professionals that any search for "debunking" will be a minefield of fringe theories and grifters. I'd recommend someone start generally, searching for information about clinical depression, and then build on that to look at root causes and how the medical understanding of those root causes has changed over time.

Look, I can tell you've got a chip on your shoulder about this and are probably a conspiracy theorist, so I'm not going to argue anymore.

Maybe chip on their shoulder, but the claim of conspiracy theorist is completely unwarranted. The impression you give off is that you decided upfront their sources are bad and you're going to knee-jerk reject their evidence no matter what.

Sad how people start frothing at the mouth during a relatively anodyne conversation. You don’t see it often on HN - more of a Reddit thing - but apparently it does happen.

I think their rhetorical approach to this subject is bad and I have no respect for someone who tries to lead someone to a conclusion while being circumspect about their own biases. This is the internet; one should assume negative intent in these cases.

This all started with someone asking for their sources, and the person hasn't given any except to say to Google... which means for all we know the person who then googled ended up in a situation with lots of conspiracy theories. Google famously gives personalized results to an extreme degree especially when you add in differences in search terms.

I will say if you search for "chemical imbalance debunked" as discussed, the first result for me is a paper that also says dyslexia cannot be proved to be a disorder. Which just from vibes feels really conspiratorial, even without making comments on the veracity of the academic paper.

[https://pmc.ncbi.nlm.nih.gov/articles/PMC1518691/]

The person who was asked for sources was a different person than the one who quipped that finding said sources yourself is trivial.

> Google... which means for all we know the person who then googled ended up in a situation with lots of conspiracy theories.

If people have low enough media literacy that they cannot distinguish between scientific research published in refereed journals and conspiracy theories, then I cannot help them and it is not my responsibility to pander to their lack of competence.

> just from vibes feels really conspiratorial

Just from vibes? Clearly you are a scientific luminary.

Yeah, the person making the claim never responded. But I was more responding to your comments, specifically:

"Just searching 'chemical imbalance debunked' yields a wide array of sources. So why ask?", and "One of the first search results for me was a paper published in Nature. Other top results were from respected institutions like the NIH and Harvard University. Hardly grifters or crazies."

Those both trivialize the process of finding sources and interpreting them. I picked my top result which was from nih.gov and gave an example of why it's hard for a lay-person to interpret journal entries because it uses field specific terms that come across as wrong or conspiratorial. Heck the paper itself references other papers on other journals that appear legitimate that argue for the chemical imbalance theory, eg an article from JAMA (Journal of the American Medical Association) from 1993. Just because the source has NIH in it or is in a journal does not guarantee correctness or reliability because time passes and new science is done. The link in question was of a paper from 2006, which we are now further from than the 2006 paper was from the 1993 paper.

I am not claiming to be a scientific luminary and even agree that the chemical imbalance theory that was espoused for years was probably incorrect for many issues. I was just arguing against thinking it's easy to investigate and source claims. It's much easier for the person who is making the claim to provide their sources, and preferably they have a large body of evidence behind them and are recent or even better a source that has done that leg work of reviewing it and distilling it down.

Argue? I considered it a conversation, before your very rude and unwarranted ad hominem.

It seems that you really have no clue what you’re talking about, and are merely lashing out due to your own immaturity and insecurity. Maybe you can find a doctor who will prescribe you a pill that will fix your personality defects. It would certainly be easier than acknowledging your (massive) intellectual and emotional deficits.

Probably because the commenter is not a medical professional and isn't qualified to judge the veracity of anything they find. "Do your own research" is a fucking plague on our modern world and is why the internet is like wall to wall grifters now.

By all means, Google whatever you like, but if you show up to a doctors office waving WebMD sheets in a medical professionals face, you are going to be mocked and you deserve it.

I witnessed a pair of doctors prescribe a family member an incredibly dangerous drug for an off label use. The company had been fined $500 million dollars for various illegal schemes to convince doctors to write such prescriptions, but I’m sure the doctors in question were unaware of this. When this family member began to exhibit textbook symptoms of an extremely dangerous (life threatening) condition which could only be caused by the drug in question, the doctors failed to notice, and in fact repeatedly increased the dosage, and added more drugs on top to treat the symptoms caused by the initial drug. It was not until I accompanied my relative to a doctor’s appointment and delivered a carefully designed incantation that they made the correct diagnosis and halted the prescriptions.

So should I not have done my own research?

Please share your qualifications for making a statement like this- do you work in biology? Are you knowledgeable about the underlying biology here, and the limitations of medical publications?

Not that I agree or disagree with the underlying claim but a call to "credentialism" to dismiss someone's opinion is not as strong in 2025 as you think it is.

The last few years have been a proof that even the "experts" are following strong political or personal ideology.

Also we don't live in the 18th century anymore. A lot of knowledge (especially around medicine) is open to the world. People can read papers, understand research etc.

In this area, having credentials makes a difference. Experts matter.

Few if any non-medical people can read medical papers and make sense of what they say. There is simply far too much context to evaluate such papers, especially in the cases of complex medical conditions.

Sorry but strong disagree here.

I have had a lot of Spinal and sleep issues. I have read almost all new literature on this niche subject and I have brought to my spine doctor some new therapy and treatments they had literally no idea about. Those treatments have changed my life.

As an engineer I read a lot of deep technical paper as my day job. Medical papers are comparatively relatively simple. The most complex part being usually the statistical data analysis.

We have pushed to a whole generation of people that only the "experts" can have opinion on some fields. I encourage everyone to read papers and have opinions on some of those subjects.

We are in 2025. That type of gatekeeping needs to go away. AI if anything, is going to really help with this as well.

I think it's good to read papers and be curious.

It's also good to work with your doctors (as you seem to have done), have a discussion, and mutually agree on a plan of treatment.

Experts don't know everything. But they probably know some things you don't, and can think of questions you might not to have even thought to ask. As the saying goes, "you don't know what you don't know". Experience matters.

There's also a lot of people out there without an academic background that don't know how to properly read journal papers. It's common to see folks do a quick search on PubMed, cherry-pick a single paper they agree with, and treat it as gospel - even if there's no evidence of repeatability. These skills are not something that many people outside STEM are exposed to.

Cherrypicking is bad, but worse is reading a paper and thinking you understand what it says, when you don't actually understand what it says. Or thinking that a paper and its data can be observed neutrally as a factual and accurate statement for what work was actually done.

My experience in journal club- basically, a group of grad students who all read a paper and then discuss it in person- taught me that most papers are just outright wrong for technical reasons. I'd say about 1 in 5 to 1 in 10 papers passes all the basic tests, and even the ones that do pass can have significant problems. For example, there is an increasing recognition that many papers in biology and medicine have fake data, or manipulated data, or corrupted data, or incorrectly labelled data. I know folks who've read papers and convinced themselvs the paper is good, when later the paper was retracted because the authors copied a few gels into the wrong columns...

By extending your statement you are essentially saying that the credentialed experts have a monopoly on knowledge in their fields? As anyone else reading a paper probably think he understands but actually doesn't? What a weird take.

The knowledge is out there. Yes there are a ton of bogus papers and a ton of bad research. Not everyone got the critical knowledge to figure this out but I also don't think this is only reserved to the "experts". They are also subject to groupthink and other political pressure to think a specific way.

At the end of the day, do your best own research and work with your "expert" to agree on a solution.

Pushing back on people reading paper is an anti-intellectual take (to use the same wording as another poster below).

But is that really what you are seeing in this HN comment thread? People who seem very well researched in the biochemicals and meta studies of Prozac? I don’t. :)

> We have pushed to a whole generation of people that only the "experts" can have opinion on some fields. I encourage everyone to read papers and have opinions on some of those subjects.

There's nothing wrong with having an opinion on something as a non-expert, as long as those opinions are not acted upon or relied upon as a source of reliable information. Read papers, watch YouTube, browse WebMD, satisfy your curiosity--knock yourself out. But don't undergo treatment without working with an actual expert! I'm not an expert on orbital mechanics, but I have played KSP and have formed various opinions about it. But nobody should be listening to me for advice on how to launch a rocket.

We need gatekeeping for a reason, especially in the medical field which is rife with miracle cures, snake oil, herbal remedies, detoxes, homeopathy, and other forms of quackery.

Believing my "research" is better than my specialist's education is a path back to the dark ages.

> Believing my "research" is better than my specialist's education is a path back to the dark ages.

Doing your research should not be in competition with your specialist's education. It should be complementary as yet another source of information.

I'm not saying experts are wrong but I also don't think they are particularly always right. They are human and they have strong groupthink. They will agree and disagree with some takes based on their personal or political beliefs.

> Believing my "research" is better than my specialist's education

If you get rid of the scare quotes, you can spend 10x or 100x as long as your doctor when researching something specific enough. That has many advantages, even without the training.

> is a path back to the dark ages.

This is quippy but doesn't actually make sense.

This just reads as Dunning Kruger-esque to me. You think that because you know how to read a technical paper in engineering, you're as or more competent than a doctor.

Yes, experts are wrong all the time, they have the disability of being human, but this seems like an extremely anti-intellectual take.

sorry but your take seems to be the anti-intellectual here.

You seem to think that the educated class got a monopoly on knowledge on that field, yet after that claim to know that experts are wrong all the time. The anti-intellectual take is to give up on trying to understand as much as you can in a field because you don't have the right credentials to do so. Yes, medical papers are not that complicated to read.

That doesn't make you more competent than your doctor. But it probably makes you a better advocate for yourself than your doctor is.

My point is: Don't discount yourself reading papers and doing your own research. Then work with your "credentialed experts" to come to an agreement. Don't ever think that the "experts" got your best interest at heart.

Nobody who seriously read and understood the literature in a given field would issue a blanket dismissal of all the experts in that field. My experience is that reading papers and research leads one to understand WHY the professionals get it wrong - because you start to understand the nuances.

I'm not saying you issued such a dismissal, but the comment that started this thread did so.

I don't have a problem with reading papers and doing research, and I never once claimed that the "educated class" has or should have a monopoly on a field. You wouldn't know this, but for the first ten years of my career as a software person I was as a college dropout; I certainly am not someone who is going to get all hot and bothered about people having letters after their names.

That said, I have a tough time believing that spending an hour on Sci-Hub makes you better at diagnosis, yourself or otherwise, than someone who spent a decade being educated with decades of practicing. Thinking that you know better than trained experts because you have an understanding of the very beginning of a field is overwhelmingly tempting but is generally not based in reality. Usually the people who have actually been trained in the field know more about the field than a random person who read a few papers that they thought were "comparatively relatively simple".

I read papers all the time, usually formal methods, but sometimes other fields like medicine, and I will sometimes leave the medical paper thinking that it's "easier" than what I study, but I think that's just Dunning Kruger. I know more about formal methods, so I know a lot more about what I don't know, and thus I feel like it's harder. I don't know a ton about medicine, and since I don't know what I don't know it can feel like I know everything, and I have to fight this urge.

By all means, read about research in whatever ailment you have, I'm not really trying to discourage that, but I feel like dismissing experts in the field is almost the definition of "anti-intellectualism". If you find a study that you think is promising, bring it to your doctor. Hell, bring it to a dozen doctors, multiple opinions isn't a bad thing.

I just don't like the general "don't trust experts" thing that seems to be flying around certain circles now.

Ya, well i was diagnosed with a serious genetic condition by my doctor. I found out i was misdiagnosed based on information from the support group for the condition. If I hadn't, I would have had unnecessary surgery.

The excuse from my doctor? "I didn't know!"

> People can read papers, understand research etc.

Then he should cite the papers, point out the research, etc. Rather than dismissing the entire discipline and all its practitioners with a wave of the "common-sense mental illness isn't real" wand.

I hope you do realize that this comment thread is linked to an article that includes the words "Prozac no better than placebo" in its headline?

Yes, I do. I don't consider articles in the regular press to be even remotely worth looking at due to their high rate of inaccuracy. Here's the paper that the article refers to: https://www.jclinepi.com/article/S0895-4356%2825%2900349-X/f...

These types of studies are published all the time and can easily be dismissed. Antidepressants are _only_ for major depression. Not mild or moderate. These studies that find no significance compared to a placebo are always tried in patients with all types of depression. Not just major.

It's so common it's a trope. "Antidepressants don't work" says the scientists testing antidepressants on things they're not supposed to work on.

Studies repeated with just major depression all conclude antidepressants are better than a placebo.

Click through the article to the study and you'll find they did not limit their study to must major

I don't think we know if it's a neurochemistry issue. From what I understand what was debunked was the idea that they worked by blocking the reuptake of serotonin specifically.

…so what?

There’s an interesting theory lately [0] that the antidepressant effect of SSRIs is actually unrelated to its effect on serotonin. Suppose, for the sake of argument, that this is completely true: serotonin has nothing to do with depression, increasing serotonin levels is useless for treating depression, and everything everyone has ever claimed about chemical imbalances causing depression is flat-out wrong.

If so, pharma companies should probably try to develop different drugs instead of new SSRIs. But it does not follow that a patient with depression ought not to take an SSRI. That would be like saying that taking aspirin for aches has been completely debunked because there is no connection between aches and aspirin’s anticoagulant effect.

[0] See, for example, https://www.science.org/content/blog-post/trkb-bdnf-and-depr...

> Moreover, every approved drug is tested 'double blind' exactly because the placebo effect has such a big biasing effect on subjectively appreciated outcomes. Only when ruling out pure placebo effect, a drug can be approved.

Pretty weird the article we're commenting on about Prozac being no better than placebo for children is just now coming out when it was already approved for use in children, then.

> Because the problem's not a "neurochemistry issue" (that theory's been debunked and the "chemicals" in play have never been known), and the solution is "no better than placebo."

It most certainly has not been debunked and mind altering chemicals most certainly do work.

SSRIs have _questionable_ efficacy but that's not the same as proven to have none, which is an exceptionally high bar.

This is close minded dogma no better a religion.

If you don't have a serious model for what you are treating, then you are experimenting on your patients and hoping it works for unknown reasons. Not too different from folk remedies. Even worse, patients are essentially never informed that the doctor is throwing things at the wall hoping something sticks.

You just described what psychiatrists do.

(I have many first-hand and second-hand experiences.)

> This is horrifying.

I agree with this.

I've learned a lot through life, one thing I've learned is about detrimental long term physical and even social effects of antidepressants, and other medications like adderal. Both I used to take.

At this point in my life, if I realized my parents gave me an antidepressant prescription when I was SEVEN years old because I said something stupid WHEN I WAS SEVEN I'd be very disturbed and disappointed in them, I'd definitely give both of them a solid scolding.

Before you respond to this remember I'm talking about me. Not your kid or your friends kid or your cousins kid.

EDIT: Quick edit to add when I was a kid I was a total outcast, I was weird, anxious, and definitely often depressed. A lot of kids in my religious schooling systems were.

My kids go to a ordinary public school. They are very bright, cautious, and thoughtful, and generally pretty happy and upbeat. There is a strong correlation between academic intelligence and mental illness. Being depressed to the point of being suicidal and having a sunny disposition are not mutually exclusive at all. I absolutely agree that it would be disturbing and disappointing for a child to be medicated because of something stupid they said when they were seven. I think medication may be appropriate if they show a consistent pattern over several months of physiological symptoms and reactions that are consistent with depression or anxiety, and cannot be explained by external factors like trauma or major life changes.

I'm a victim of depression too, and don't think it's fair that you say we "gave up." I would never give up on my child. You imply that we didn't talk to our son, listen to him, and do our best to give him advice before we discussed medication? Don't we all try to make the most well-informed decisions we can?

This decision was made collectively by me, my wife, our pediatrician, the child therapist, the psychiatrist, and for what it's worth also my son. We did extensive research. You may disagree with our decision, but please don't cast aspersions on how much we care.

No, it's not.

Medicine is advancing. We're increasingly able to understand and adjust dysfunctions that cause major, negative quality of life impacts. These dysfunctions have always existed, we're just getting better at finding ways to help people work through it.

That's your opinion, that is not the general opinion of the professionals in the field.

I trust a cohort of scientists significantly more than anonymous strangers online, and you should too.

The data is very clear that the rate of mental illnesses is increasing. Rates of severe mental illnesses like Schizophrenia are also increasing.

NONE of the current theories being experimented with on patients have a concrete, proven scientific basis with some such as the decades-long SSRI scam have actively harmed patients and created physical dependence/addiction and actively causing harm to patients and their families (eg, SSRI-induced suicides).

I trust science, but I don't trust scientists any more than I trust any other human with their money, career, and reputation on the line. I trust the FDA and pharmaceutical company ethics even less (eg, Bayer knowingly selling HIV-infested drugs to hemophiliacs, saying Oxycotin is non-addictive, or the revolving door that allows non-working SSRIs to be released and marketed as working despite all evidence to the contrary).

Our ability to diagnose mental illnesses are improving.

50 years ago many people with mental illness would go undiagnosed. They would instead self-medicate through alcohol, illicit drugs, or risky behavior and die far too young after leading miserable lives.

This is an assertion, but there’s no supporting evidence and many indicators you are incorrect.

50 years ago was 1975. It wasn’t the dark ages and the worst cases were already being moved to asylums for at least 150 years before that.

Suicide in particular is hard to hide any suicide rates are going up despite treatment. If mental illness rates are the same as 50 years ago and more people are getting effective treatment, we’d expect per capita rates to decrease.

Impoverished third world countries where people have nothing but problems almost universally have higher reported happiness and less suicide.

Severe mental health issues don’t just go away because you drink and if alcohol could suppress the problems, we’d never have made treatments to begin with.

In terms of “self medicating” with drugs, we’re hitting an all-time high (pun intended). Risky and self destructive behavior is also way up as evidence with our prison systems overflowing.

Nothing indicates to me that mental health is improving and everything seems to indicate it getting worse despite all the attempted interventions.

You don't understand what having extreme anxiety at that age feels like.

As someone who lived through that, I refuse to let him. All of memories of school are just feeling anxious about everything, just tight and suffocated, always in a panic. I started living when I started taking anxiety pills at 39 years old, and I can see my 2 year old having the exact same anxiety ticks and fits I have.

I don't know at what age I'll medicate him, but I'll do it as soon as I notice he isn't coping and happy anymore.

Horrifying is forcing him to experience that because you can't comprehend us.

I'm sorry that you're dealing with this - it was my greatest fear at that point. That my daughter seems to not have my disposition and seems happy go lucky is the greatest thing ever. There's no rhyme or reason to my depression and anxiety, it's completely maladaptive and I'm relieved, that knock on wood, she stays happy and light while not having to shield herself from the horrors of the world.

The main issue I see is that the anxiety pill is a way to treat the symptoms, not the cause.

Do you think that there is a way to treat the underlying cause and not the symptoms?

How do you know an anxiety pill is treating symptoms only? What if the cause is physiological, and the pill treats that? It is entirely possible to sit in your therapist's office and mutually shrug because neither of you can find an underlying reason for your anxiety. Sometimes anxiety just is.

I had severe anxiety/depression and majorly recovered from the anxiety component through a year of dilligent transcendental meditation. It changes the brain structure and neurochemistry.

I was on medication during that period and it complemented my practice, provided a stable base to apply meditation and other recovery protocols.

I had panic attacks every morning before school. God, I hated school. Mainly because of the other kids, and when I was older, because of both the kids and the teachers. I remember telling my IT teacher I am using Linux (I forgot why I told her) and she was very condescending. I have a lot of other stories but yeah, school was an anxiety-inducing nightmare.

Often the cause is things that most people can handle, without being able to easily wield the tools to handle them. Having a pill that dulls the symptoms gives space to learn and become adept at the tools

Beyond obvious tumors/lesions/clots/abnormalities, we are not even close to being able to identify the cause of organic anxiety or mood disorders even if we wanted to.

We can say certain behaviors, experiences, illnesses and some genetic identifiers can trigger the conditions, but not the underlying cause. We can say things like some therapy and medication can help with the illness, but not the cause.

Not to trivialize therapy, but for many illnesses, not just mental, a portion of it can be described as ways of learning to live with the illness, not necessarily treating the underlying cause.

> Not to trivialize therapy, but for many illnesses, not just mental, a portion of it can be described as ways of learning to live with the illness, not necessarily treating the underlying cause.

Yeah, I feel like it's fair to describe the cognitive behavioral model. We're not necessarily looking for the cause of these thoughts and beliefs, tho they may come up, we're simply going to challenge them at face value and reinterpret the situation.

What if there is no rational cause?

I had terrible anxiety as a child and what I experienced dramatically affected the core of who I am. It is engrained in me and I struggle with it daily, though after decades I have surpassed a good portion of it. If a small dose can help someone have a somewhat "normal" childhood, then its worth a try.

If you're horrified that we are in a world and society where a 7yo has been put in a position where antidepressants help them, yeah, that's understandable. If you're horrified that a kid is taking them, that the parents sought medical intervention for "just a kid", then, I'd say you're reacting to the concept of a kid on antidepressants than actually listening to the OP and their family's history and story.

Often, people react to the concept of a thing rather than the ground reality of life and its complexities of lived experience. Most people also extrapolate (in either direction) others' lived experiences based on their learnings, understandings, pasts and future ambitions. In this case especially, there's also added stigma around mental health, antidepressants and the locus of personal responsibility when it comes to mental health issues.

The _concept_ of a child on antidepressants suspends trust in parents, that's often assumed and unquestioned depending, depending on the child's age. Maybe close to 18yo? Supportive parents. 7yo? Horrible parents. I'd argue it also tends to suspend critical thinking and introduces an unshakeable bias, that a child of 7yo _never [ever]_ needs antidepressants. Why? What makes you say that? What's your evidence and reasoning?

If you feel so horrified by that, can you consider for a moment that the parents recognize the weight and gravity of this decision too? That they had to really think this through, pursue more thorough medical advice than usual, make a judgement call, and have to live through this decision throughout all their lives?

OP's response to multiple comments indicates that they did not make this decision lightly and without making sure that this was the better thing to do overall. I commend OP's openness and honesty in talking about it. It's certainly inspiring to see a parent care for their child's mental health, and not dismissing that to be "oh, the kid's just young and moody, they'll feel better tomorrow."

PS. We (as a society) are always learning more and newer things about mental health and treatments. It might look like we know a lot. Perhaps. But we also don't know so much!

Why?

Because 7 years old is borderline too young to even make a depression diagnosis, and that kid's going to have his brain chemistry altered and essentially be addicted to a drug that he'll have to pay for for the rest of his life.

According to our pediatrician there are no known long-term effects of juvenile Prozac use. The effects may exist, but if they do they are of sufficiently low significance as to not have been detected yet. Interestingly the one possible effect she's aware of is that there may be a correlation with not growing as tall physically as one might otherwise. The data is not conclusive, but it gives me something to blame for topping out at 5'10" and never hitting 6' like my dad. :)

I appreciate how open and honest you have been in this discussion. While it might be that taking Prozac is the best choice for your child, I have to admit I would never let a pediatrician prescribe Prozac (or any other SSRI) - this is enough outside their normal training, I would want to consult with a specialist. Can't you get a referral to a pediatric psychiatrist of some sort?

I thought we were talking about long-term effects, i.e. ones that persist to and through adulthood? The sources in that Wiki article appear not to address that.

The clinicians I've interacted with have always warned me of the possible side-effects of psychotropic medications, and said they should be notify immediately if the side-effects appear. I believe this is at least standard procedure, if not legally required?

I do have a low libido. Can't say whether or not that's due to Prozac, but regardless it hasn't negatively affected my life, probably because it was low before I met my wife. If someone enters a relationship while their libido is at one level and then during the relationship it changes considerably then I can certainly see how that could be a major challenge. That's an important thing to weigh when evaluating medication.

In addition to the increased rates of suicidal behavior and aggression in children (which we know lasts for at least 9 months, but don't know if it's longer because the study only ran for that long), the Wikipedia article talks about long term effects in adults, at least one of which you have. Why should it be less likely for children to end up with these same issues?

You are asking for evidence that does not exist because nobody has done good studies on it. That's too high of a bar. There are many drugs and life interventions that we don't have studies on regarding children, but that doesn't mean those things are safe for children. To use an example so ridiculous that we can both agree on it: There are no studies showing long term effects of fentanyl on children. Yet if some parent managed to get a fentanyl prescription for their kid, I think we would both be concerned.

Obviously I'm not implying that giving a child Prozac is as harmful as fentanyl. I'm saying that your line of reasoning proves too much. If someone did get their kid on a dangerous drug, and defended their decision by pointing out that there are no studies on children showing its long term harm, there is nothing you can say to that parent that others in this thread haven't already said to you. That should give you pause.

This is one of the most shocking things I have ever read. There is a black box warning for Prozac:

‘Warning: Suicidality and Antidepressant Drugs

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants for Major Depressive Disorder (MDD) and other psychiatric disorders’

Read the package insert: https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/01...

The fact that you were not informed about this should serve as proof that you cannot blindly trust what doctors tell you. They will absolutely kill you out of ignorance or incompetence, and never even realize their responsibility.

Note that the black box warning has nothing to do with long-term effects of the medication. It was added specifically because kids were killing themselves within weeks of starting the medication.

> This is one of the most shocking things I have ever read.

Good grief. I hope you're exaggerating for effect.

> Note that the black box warning has nothing to do with long-term effects of the medication

What are the long-term effects of suicide?

A 7-year-old kid doesn't understand what suicide really means. Putting them on something that encourages a behavior that they don't understand and has completely catastrophic results isn't a risk I would take with my children.

I respectfully submit you might feel differently about it if your child were suicidal. When someone has to be watching them 24/7 already for fear they'll hurt themselves, the black box warning is a lot less worrisome. SSRIs prevent more suicides by far than they cause. It's that first few weeks where they can have a paradoxical effect.

Death is a long term effect. And I am not exaggerating. I did not feel the need to list any of the myriad other potential long term effects because death seemed sufficiently serious.

Edit: in case the OP is reading, I should say also that the package insert won’t mention many other potential long term effects addressed in the literature, like extra pyramidal symptoms (akathisia, Parkinsonism, dystonia, tardive dyskinesia).

Another edit: ask GPT-5 ‘What are the long term side effects of Prozac use which aren’t addressed in the package insert?’ for a list.

It sounds to me like you're saying suicidality in children either doesn't exist, or shouldn't be treated, or should only be treated with talk therapy. If what you're saying instead is "this SSRI is especially dangerous" then ok, you and I just disagree about what information sources are reliable, and that's probably not a difference we can resolve. But if you're saying suicidality in children shouldn't be treated with medication, I'm curious whether you've ever met a six- or seven-year-old who wants to die. It is terrifying. It needs treatment. And talk therapy in children that age is honestly a joke. In the OP's place I would give my child an SSRI without any hesitation.

right which is why they are treating the depression (which leads to suicidal tendencies) which is a symptom of depression, with prozac. that's what the prozac is for. to prevent death

Prozac and other SSRIs are proven to cause MORE suicidal tendencies in children.

I'll raise my hand in agreement. This thread is definitely one of the most disturbing sub-threads I've ever read on HN.

The specific thing they were shocked by was the claim of no long-term effects.

Are you disturbed by that claim? That's what you're raising your hand to.

It’s disturbing that a seven-year-old was treated for suicidality? Or it’s disturbing that people are opposed to such treatment?

We were certainly informed of this. I didn't count it among the long-term health effects. I'm an educated and skeptical person but have never found any reason to distrust my physicians.

It remains legal to provide drugs off-label because physicians sometimes know better than federal regulators

It's horrible that A-Z would illegally market drugs for off-label uses -- I would not disagree for a minute with your reasoning! -- but we retain this "escape hatch" because it is important to patient health

without the off-label "escape hatch," we would not have, for example, the glp-1 class of anti-obesity drugs, or, buproprion for smoking cessation, the most effective drug ever found in its area.

We needed doctors working firsthand with patients, and building "anecdotal" (i.e. case-based) evidence to learn things that really matter on a population level

This is such a blatant misrepresentation of the parent post that it feels almost bad faith.

The subject was specifically about long term brain chemistry changes.

People committing suicide after taking it, while incredibly sad, is completely unrelated.

There is no effect which is more long term than death. It is incredible to me that this is not obvious. But if you want other potential long term effects:

Lower bone mineral density, increased risk of fractures, osteoporosis

Sexual dysfunction / PSSD (Post-SSRI Sexual Dysfunction)

extra pyramidal symptoms (akathisia, Parkinsonism, dystonia, tardive dyskinesia)

emotional blunting / apathy

slowed thinking, brain fog

increased risk of gastrointestinal bleeding

QT prolongation

I, like every other person who hasn't been living under a rock, am abundantly aware of corruption in Big Pharma and medicine. If my mother and I have both taken a given well-known medication for decades and found it effectively treated a condition that may be hereditary with no negative side effects, and my son is demonstrating symptoms similar to mine and my mother's, is it unreasonable to tolerate my son trying the same medication? That's a far cry from committing to forcing him to take the medication his whole life, or trying some mystery drug with which I have no familiarity.

My deepest views on this subject are personal, subjective, and more controversial. I have watched several family members take antidepressants for upwards of four decades, and I myself suffered terrible depression throughout my childhood and teenage years. Despite my depression, I always avoided antidepressants for some ineffable reason-- a hunch, a nebulous suspicion, I'm not sure what to call it. Somewhere in my mid twenties my depression lifted and never returned. I look back on my life, which has been filled with hardship, and I feel positively disposed to the suffering. The suffering made me who I am. I feel strongly that my character would be diminished had I not experienced it.

On the other hand, I watched family members take these drugs, and their lives seem somehow dulled-- filled with banal tragedy, like staying in a bad marriage, or not being particularly interested in their grandchildren. I have a theory that the drugs make palatable that which otherwise wouldn't be, hence they stay in the bad marriage, the bad job, and they watch their bad TV and eat their bad food and everything is fine. I've also seen one of them go off the drugs, and for a couple months they were a much more vibrant person. I saw them express joy. I feel a low grade rage toward the industry that I've been deprived of this version of them. I do entertain the possibility that I'm imagining it all. Maybe things really would have been worse without the drugs. But I am glad no one ever insisted, or even strongly advocated I take them myself.

To be clear, nobody ever insisted or strongly advocated that I take medication — suggested maybe, but it was entirely my decision. And I completely agree about the importance of hitting "rock bottom." That's something I struggle with as a parent: wanting to make sure my kids have plenty of opportunities to fail, yet fail in a way that isn't irreversibly damaging. If at rock bottom I had simply killed myself rather than starting Prozac I wouldn't be around to have benefited from it.

A large part of me dislikes being on any sort of medication long-term, and think most people have the same dislike. I have gone off of Prozac a few times and always found that I gradually became frustrated and depressed again, and as you said the reason for the dislike is ineffable, so I chose to go back on. I'm fortunate to have a life with no bad marriage, no bad job, and very little trauma at all, which is also unfortunate since it means despite years of therapy and introspection and travel and hobbies and other varied experiences I've never been able to find any cause for the depression and therefore no way to fix it, other than medication. It makes me think of Captain Picard: "It is possible to commit no mistakes and still lose. That is not a weakness; that is life."

> palatable that which otherwise wouldn't be

Medication does not remove the need for therapy. If they are stuck in a bad situation and do not have the tools to come out of it, then in therapy they can learn about the tools and techniques.

Medication avoids having that particular day where everything hits rock bottom and the only solution seems to be suicide.

For some people just therapy is not sufficient but need also medication.

Psychiatric illness is something where many people have misunderstandings. Since many people go through depressive episodes, they feel that their experience is the same as others who are facing chronic depression. And since it is not physically visible, it is also hard to empathize with.

No one says you can come out of heart disease or diabetes by just bearing it bravely. Somehow for psychiatric illness people assume that it is something that can be braved out.

> . Despite my depression, I always avoided antidepressants for some ineffable reason-- a hunch, a nebulous suspicion, I'm not sure what to call it.

Yeah, I did that too, then I took some and I was less goddamn depressed aftwards.

How can you believe it's both "no better than placebo" but also that it's "going to have his brain chemistry altered and essentially be addicted to a drug". SSRIs are not considered addictive, though people can develop a dependence if it provides them significant improvement.

The whole point of the linked article is that the drug is no better at placebo at treating depression but also carries a host of known side effects, besides unknowns when it comes to long term use. They're not saying it's inert.

That's fair, though I never implied that there were no side effects. The part I was trying to point out in the quote was the mention of it being addictive which is not really supported, nor is that mentioned in the article.

A drug can have real effects while being no better than a placebo for doing something specific (what they're supposed to do).

Okay, so what makes you believe that about prozac (or SSRIs) then?

Here’s a paper from last year: The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS) https://doi.org/10.1016/j.jadr.2024.100765

‘Highlights

• Antidepressant withdrawal can be severe and protracted.

• It produces characteristic physical and emotional symptoms.

• All symptoms were more severe after stopping than before starting antidepressants.

• We identified the 15 most discriminatory withdrawal symptoms in our sample.

• Withdrawal did not differ between people with physical or mental health diagnoses.’

O cool. Do you have any appointments I can book for my kid?

Mine too! Only 2 years old but I can already see the massive anxiety bursts in him.

If this guy has a non chemical cure, I'm all for it. In fact I'm actively researching children psychologists to stave off the meds as much as we can, the problem is that 99% of psychologists are quacks, so choosing them is tough.

There's only so many times a kid can get sent home from school for biting/kicking/punching before you realize you need some professional help and will do anything to help the poor kid. I wish you luck.

I’m thoroughly impressed with how you handled the comments in this subthread. As someone who was on and off antidepressants for years, I can say confidently that for every one person spewing vitriol and judgement at you for your parenting decision, there was someone else solemnly nodding and sending love to you and your family. People just don’t fucking get it unless they get it. Best of luck to you.

> My sister and I looked at each other and at the same time went, "Ohhhh!"

I suppose the next step would be to upgrade from single-blind to double-blind, so that your mom won't know which month is the placebo month...

Interestingly my son has an identical twin! I like to joke that one is the control and sleeps in the house and the other has to sleep in the storage shed out back, and when they're 18 we'll publish a paper comparing their emotional development. :)

I always thought DNA determined pretty much everything, and we raised them exactly the same, but they have distinct personalities and some different physical features, although of course they're much more similar than they are different. My other son shows some symptoms of anxiety but not as much, yet.

> like to joke that one is the control and sleeps in the house and the other has to sleep in the storage shed out back

Glad to see you have your priorities straight! :p

https://www.girlgeniusonline.com/comic.php?date=20090706

That's what freaks me out about these drugs. You-on-the-pill becomes you, and you can't ever stop.

Sorry, I don't mean to second-guess your choices. There's clearly some very interesting issues here, and my experience is as someone who never felt they had any serious issues with mental health. But I do think that we have this culture where everyone is expected to be OK all the time. Do you worry at all that your son cues in to his parents relationship with the drug? I mean, say it was me, and I knew my parents took a pill so that they could "have a good day" but they didn't give me the have-a-good-day pill. I would think (perhaps subconsciously) that if I was having a bad day the drug could have made it into a good one. Having a bad day would be medical now, a reason to feel like you're sick or broken.

Prozac doesn't define me. It's just something I take to address a health condition, like an iron supplement for low iron levels or amoxicillin for strep throat. My kids learned about it because they saw me taking a pill every day and asked what it was. No biggie.

To be clear, Prozac is not a "feel-good" pill, it's a "gradually feel more stable" pill. It makes my lows less debilitatingly low and more manageable -- my lows are now largely logical responses to difficult events, as opposed to randomly happening for no reason at all. The effect is very gradual and subtle: you can't really evaluate it until after several weeks, and then the "evaluation" is a conversation about whether your affect has seemed generally more stable recently. An average person taking Prozac would probably notice no effect at all, good or bad. By contrast, a stimulant like Adderrall will have a noticeable effect on anyone within minutes.

My son never asked for Prozac or for a "feel-good" pill. My kids have heard of addiction before so we've talked about pills that do make you feel good and why they're dangerous, and also "dopamine drips" like brainrot on YouTube.

That's fair. Thank you for your thoughtful reply.

IMO, that's a common misconception. The fact that it seems this way can be attributed misunderstanding, bias in data, and perhaps a poor treatment choice. Sometimes, it's also the best healthcare can do for now.

Medical interventions for mental health issues aren't a forever-crutch. Plenty of people do taper off/change something about their prescriptions after a certain point, but we rarely ever hear those stories. What we do hear is plenty of people getting on meds/being on meds for a long time, which can bias us and make us think that most people who get on meds are on it for life.

well when the you-off-the-pill wants to kill yourself, becoming you-on-the-pill is a pretty rad thing

Such a simple concept, and for some reason so difficult to grasp for certain people. Usually the ones not coming across as particularly empathetic or open-minded.

I suppose the "good" news is that is just how life goes. Conceptually similar comparison to someone who is hungry and someone who isn't - the tendency towards snapishness is definitely there. Who someone is becomes unstable of long stretches of time (unless they are very boring), it results more from the present conditions that involve them than anything else.

The main issue with drugs is they are more likely to have unexpected or socially harmful side effects than most things.

I am surprised by how many people seemingly independently come up with a completely indescriptive "bad day" label - for the lack of a better one.

Good that things are working out for you.

Recently found that, on top of meds (that started wearing off - after taking them for a couple years now following a challenging life situation), going to social latin dance classes for a couple hours almost every day after work helps quite a bit.

> Pills are for people who feel depressed but don't have something to be depressed about -- they have food, shelter, friends, opportunities to contribute and be productive, nothing traumatic has happened, but they feel hopeless anyway

This warrants a whole different discussion, and I'll be down voted for it, but one that's never addressed: quality over quantity.

Pills are the individuals response to a society that feeds empty food, bland sterile shelter, fake friends, and meaningless jobs.

The natural human response to a lack of meaning is hopelessness, and this comes from our society. Pills helps individuals cope with continuing the meat grinder just a little while longer.

I had depression, and I cured it by finding meaning and beauty in the world. I get told "if you can cure it without pills, you never really had it" yeah cool, self fullfilling prophecy in that case innit. Can't cure it, because it doesn't exist without meds. It just comes out of "nowhere" and is here to stay.

I agree with your perspective but these things are on a spectrum. For very severe cases medication can be highly helpful and supportive, as they move to find their meaning and purpose. Each person’s situation is unique and I think blanket judgements are unhelpful.

For what it's worth, I have dealt with pretty severe depression for most of my adult life. I am only starting to have periods of coming out when I realized that most of depressed feelings come from a place of ego. I have an identity of who I am and what I like, and I seek things in the external world which might provide meaning for me. For me, it's because I always sought value from the things around me, rather than believing that I am already enough. Every single day, I have to beat down my instincts that tell me that I am worthless and remind myself that there is more beauty in the world and it's actually absurd that I am letting society tear away from me my natural instincts to want to live and enjoy life. You have to really sit with these feelings though... like really really get to know your voice vs the internalized societal voice. I have developed "tests" that help me discern which voice is which, but it has helped a bit. Also working out and taking care of your body is a bonus, and just taking pride in like... doing things to lead a peaceful life is underrated. Hope you feel better.

I hope you can understand that this and other comments about needing to find meaning and needing to sit with inner feelings... It feels patronizing. I have spent tremendous amounts of time and energy analyzing my feelings and looking for meaningful experiences. I've sought relief in meditation, religion, therapy, yoga, travel, art, etc. Most people probably have in one way or another. It's not rocket science to know those activities may be beneficial. They undoubtedly do help some people overcome feeling depressed. But feeling depressed is different from having depression.

I'm sorry it came off that way, I really didn't intend it to be, it was actually a self call out because I actually never learned as a child to sit with my inner feelings. I attribute that to being more sensitive and probably more intelligent than my siblings and acting as a buffer for my parents and basically only ever wanting to make other people happy, I never developed an inner world like other kids do.

Also I noticed... yoga, travel, art, those are still external. Even meditation can be if you approach it from a standpoint of like... one that is about forming your ego around it rather than being present... not sure if this makes sense. Like you can approach anything from a negative or place of wanting to 'fix' yourself, which ruins the experience imo. For me I would ruin things that were supposed to be fun because I would tell myself I should do this because it's good for me.

That being said, there are really low days still when I will feel absolutely nothing, I will think to myself... if this psychological pain is so intense, why should I keep going? I don't have answers for that. I genuinely just have to make it through the day. I understand that with the pressures of a family and kids, it's not one of those things where you can easily tap out, medication makes sense for that. I was just trying to share how I feel because honestly for me there isn't anyone in my life who I can relate with on this deep of a level... of these feelings, and it's really alienating in itself.

> So my career has been in software engineering since that involves building and fixing and pays well, but it still doesn't fill the hole.

A brief thought on this - I’ve found working in large software companies to be fairly unfulfilling, but working at smaller shops focused on delivering something other than software, or for which there’s some tangible connection to the real world, to be much more fulfilling. At its best, software engineering is indeed a craft and something you can take pride in and something where you can have a real impact on people’s lives by building things. A lot of that gets lost somewhere between the third roadmap meeting and the weekly scrum session to figure out how to prioritize product’s requests alongside paying down tech debt so we can improve ad unit performance, but the craft of software itself is still a creative act.

That's exactly the problem, "meaning in life" has no static definition and there is no possible way to explain it in general terms, even for people who proclaim to have "found" it.

Pills, on the other hand, are easy to understand. This is not to say that they are a viable substitute in any way, but it does explain why so many prefer substance treatments.

That's a good consideration.

Meaning in life is hard and personal. Some might have no idea where to start.

But I'd argue (somewhat pointlessly as I'm not going to change anything) -- This is the role that society, traditions, family, etc. has: "to bring people up" swimming in the same stream, given a purpose and meaning, etc.