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posted by martyb on Sunday February 18 2018, @01:27PM   Printer-friendly
from the improved-outlook-on-improving-outlooks dept.

New studies zero in on roots of depression and why ketamine reverses it

[There's] been significant progress in unravelling the confusion over ketamine, with researchers identifying a ketamine derivative that tackles depression with far fewer side effects. And this week, a team of researchers at China's Zhejiang University announced that they've figured out where in the brain ketamine acts when it blocks depression, a finding that gives us significant insights into the biology of the disorder.

The new studies rely on the work of a number of other labs, which have identified a specific structure deep in the brain that's associated with depression. Called the lateral habenula, it's been associated with a variety of activities, the most relevant of which seems to be the processing of unpleasant outcomes and punishment. Electrodes implanted there have been used to relieve depression in at least one instance.

To test whether this might be the site of ketamine's activity, one team of researchers infused the drug directly into the lateral habenula of rats with depression-like symptoms; it blocked them. So did a separate chemical that inhibits the same proteins that ketamine acts on. Tracking the activity in the area, the researchers were able to show that there are bursts of activity in rats with symptoms of depression that are absent in healthy rats. The drugs that blocked depression suppressed these bursts.

Ketamine blocks bursting in the lateral habenula to rapidly relieve depression (DOI: 10.1038/nature25509) (DX)

Astroglial Kir4.1 in the lateral habenula drives neuronal bursts in depression (DOI: 10.1038/nature25752) (DX)

Related: FDA Designates MDMA as a "Breakthrough Therapy" for PTSD; Approves Phase 3 Trials
Study Suggests Psilocybin "Resets" the Brains of Depressed People
Ketamine Reduces Suicidal Thoughts in Depressed Patients

Original Submission

Related Stories

FDA Designates MDMA as a "Breakthrough Therapy" for PTSD; Approves Phase 3 Trials 28 comments

The U.S. Food and Drug Administration has given its approval for Phase 3 trials to treat participants with PTSD using MDMA ("ecstacy"):

The non-profit Multidisciplinary Association for Psychedelic Studies (MAPS) today announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy Designation to MDMA for the treatment of posttraumatic stress disorder (PTSD). MAPS and the FDA have also reached agreement under the Special Protocol Assessment Process (SPA) for the design of two upcoming Phase 3 trials (MAPP1 and MAPP2) of MDMA-assisted psychotherapy for patients with severe PTSD.

MDMA-assisted psychotherapy is a novel treatment package that combines psychotherapeutic techniques with three administrations of MDMA as a pharmacological adjunct. By granting Breakthrough Therapy Designation, the FDA has agreed that this treatment may have a meaningful advantage and greater compliance over available medications for PTSD.

The first Phase 3 trial (MAPP1), "A Randomized, Double-Blind, Placebo-Controlled, Multi-Site Phase 3 Study of the Efficacy and Safety of Manualized MDMA-Assisted Psychotherapy for the Treatment of Severe Posttraumatic Stress Disorder," will begin enrolling subjects in Spring 2018, after the completion of an open-label lead-in training study at Phase 3 sites starting this fall.

[...] The Phase 3 trials will assess the efficacy and safety of MDMA-assisted psychotherapy in 200-300 participants with PTSD, aged 18 and older, at sites in the U.S., Canada, and Israel. Participants will be randomized to receive three day-long sessions of either MDMA or placebo in conjunction with psychotherapy over a 12-week treatment period, along with 12 associated 90-minute non-drug preparatory and integration sessions. The primary endpoint will be the Clinician Administered PTSD Scale (CAPS-5), as assessed by a blinded pool of independent raters.

In MAPS' completed Phase 2 trials with 107 participants, 61% no longer qualified for PTSD after three sessions of MDMA-assisted psychotherapy two months following treatment. At the 12-month follow-up, 68% no longer had PTSD. All Phase 2 participants had chronic, treatment-resistant PTSD, and had suffered from PTSD for an average of 17.8 years.

Also at ScienceAlert, the Washington Post, and Science Magazine:

Since 2012, FDA has designated close to 200 drugs as breakthrough therapies, a status that indicates there's preliminary evidence that an intervention offers a substantial improvement over other options for a serious health condition. The agency aims to help develop and review these treatments faster than other candidate drugs.

Original Submission

Study Suggests Psilocybin "Resets" the Brains of Depressed People 58 comments

An fMRI study has found evidence of a reduction in depressive symptoms after treatment with psilocybin:

A hallucinogen found in magic mushrooms can "reset" the brains of people with untreatable depression, raising hopes of a future treatment, scans suggest.

The small study gave 19 patients a single dose of the psychedelic ingredient psilocybin. Half of patients ceased to be depressed and experienced changes in their brain activity that lasted about five weeks.

However, the team at Imperial College London says people should not self-medicate.

There has been a series of small studies suggesting psilocybin could have a role in depression by acting as a "lubricant for the mind" that allows people to escape a cycle of depressive symptoms. But the precise impact it might be having on brain activity was not known.

Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms (open, DOI: 10.1038/s41598-017-13282-7) (DX)

Original Submission

Ketamine Reduces Suicidal Thoughts in Depressed Patients 34 comments

Study: Suicidal Thoughts Rapidly Reduced with Ketamine

Ketamine was significantly more effective than a commonly used sedative in reducing suicidal thoughts in depressed patients, according to researchers at Columbia University Medical Center (CUMC). They also found that ketamine's anti-suicidal effects occurred within hours after its administration.

The findings were published online last week in the American Journal of Psychiatry.

Ketamine for Rapid Reduction of Suicidal Thoughts in Major Depression: A Midazolam-Controlled Randomized Clinical Trial (DOI: 10.1176/appi.ajp.2017.17060647) (DX)

The reduction in SSI score at day 1 was 4.96 points greater for the ketamine group compared with the midazolam group (95% CI=2.33, 7.59; Cohen's d=0.75). The proportion of responders (defined as having a reduction ≥50% in SSI score) at day 1 was 55% for the ketamine group and 30% for the midazolam group (odds ratio=2.85, 95% CI=1.14, 7.15; number needed to treat=4.0). Improvement in the Profile of Mood States depression subscale was greater at day 1 for the ketamine group compared with the midazolam group (estimate=7.65, 95% CI=1.36, 13.94), and this effect mediated 33.6% of ketamine's effect on SSI score. Side effects were short-lived, and clinical improvement was maintained for up to 6 weeks with additional optimized standard pharmacotherapy in an uncontrolled follow-up.

Wikipedia's entry on midazolam notes:

Midazolam, marketed under the trade name Versed, among others, is a medication used for anesthesia, procedural sedation, trouble sleeping, and severe agitation. It works by inducing sleepiness, decreasing anxiety, and causing a loss of ability to create new memories. It is also useful for the treatment of seizures

Related: 4/20: The Third Time's Not the Charm
Study Suggests Psilocybin "Resets" the Brains of Depressed People

Original Submission

Ketamine Shows Promise as a Fast-Acting Treatment for Depression 14 comments

Ketamine could become an approved treatment for depression in the UK soon:

Ketamine has 'fast-acting benefits' for depression

Ketamine has "shown promise" in the rapid treatment of major depression and suicidal thoughts, a US study says. Ketamine has a reputation as a party drug but is licensed as an anaesthetic. The study found use of the drug via a nasal spray led to "significant" improvements in depressive symptoms in the first 24 hours. The Royal College of Psychiatrists said it was a "significant" study that brought the drug "a step closer to being prescribed on the NHS".

The report by researchers from Janssen Research and Development, a Johnson and Johnson company, and Yale School of Medicine, is the first study into ketamine as a treatment for depression that has been done by a drug company.

[...] The study found those using esketamine had a much greater improvement in depression symptoms at all points over the first four weeks of treatment. However, at 25 days the effects had levelled out. The study's authors suggest it could offer an effective rapid treatment for people severely depressed and at imminent risk of suicide and could help in the initial stages of treatment, as most anti-depressants take four to six weeks to become fully effective.

Also at Medical Daily.

Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study (DOI: 10.1176/appi.ajp.2018.17060720) (DX)

Can a Framework Be Established for the Safe Use of Ketamine? (DOI: 10.1176/appi.ajp.2018.18030290) (DX)

Related: FDA Designates MDMA as a "Breakthrough Therapy" for PTSD; Approves Phase 3 Trials
Study Suggests Psilocybin "Resets" the Brains of Depressed People
Ketamine Reduces Suicidal Thoughts in Depressed Patients
Studies Identify How Ketamine Can Reverse Symptoms of Depression
Over Years, Depression Changes the Brain, new Study Shows

Original Submission

Groundbreaking Ketamine-Derived Treatment for Depression Approved by the U.S. FDA 24 comments

Fast-Acting Depression Drug, Newly Approved, Could Help Millions

Of the 16 million American adults who live with depression, as many as one-quarter gain little or no benefit from available treatments, whether drugs or talk therapy. They represent perhaps the greatest unmet need in psychiatry. On Tuesday, the Food and Drug Administration approved a prescription treatment intended to help them, a fast-acting drug derived from an old and widely used anesthetic, ketamine.

The move heralds a shift from the Prozac era of antidepressant drugs. The newly approved treatment, called esketamine, is a nasal spray developed by Janssen Pharmaceuticals Inc., a branch of Johnson & Johnson, that will be marketed under the name Spravato. It contains an active portion of the ketamine molecule, whose antidepressant properties are not well understood yet. "Thank goodness we now have something with a different mechanism of action than previous antidepressants," said Dr. Erick Turner, a former F.D.A. reviewer and an associate professor of psychiatry at Oregon Health & Science University. "But I'm skeptical of the hype, because in this world it's like Lucy holding the football for Charlie Brown: Each time we get our hopes up, the football gets pulled away."

[...] Esketamine, like ketamine, has the potential for abuse, and both drugs can induce psychotic episodes in people who are at high risk for them. The safety monitoring will require doctors to find space for treated patients, which could present a logistical challenge, some psychiatrists said.

The wholesale cost for a course of treatment will be between $2,360 and $3,540, said Janssen, and experts said it will give the company a foothold in the $12 billion global antidepressant market, where most drugs now are generic.

[...] One question that will need to be answered is how well esketamine performs in comparison to intravenous ketamine.

Also at STAT News, Reuters, and NPR.

Previously: Ketamine Reduces Suicidal Thoughts in Depressed Patients
Studies Identify How Ketamine Can Reverse Symptoms of Depression
Ketamine Shows Promise as a Fast-Acting Treatment for Depression


Original Submission

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  • (Score: 3, Funny) by JoeMerchant on Sunday February 18 2018, @02:07PM

    by JoeMerchant (3937) on Sunday February 18 2018, @02:07PM (#639696)

    I think I'd be depressed if my lateral habenula were bursting...

    🌻🌻 []
  • (Score: 4, Funny) by Anonymous Coward on Sunday February 18 2018, @02:10PM

    by Anonymous Coward on Sunday February 18 2018, @02:10PM (#639697)

    How can we ban this? It's encouraging the kids to take illegal drugs and destroy their lives and others. Because of Freedom and Religious Liberty I have the right to not let anyone put some things in their body - including drugs and penises in the butthole - otherwise (...fill in later...). Illegal drugs are illegal!

    Now it's time for my oxys and a glass of wine.

  • (Score: 1) by Sulla on Sunday February 18 2018, @03:14PM (18 children)

    by Sulla (5173) on Sunday February 18 2018, @03:14PM (#639724) Journal

    After doing a bunch of reading over the past few days on school shootings I am really seeing the importance of a depression drug that doesn't cause suicidal/violent outbursts. In many cases antidepressents were involved around (specifically quitting) when school shootings happened. A drug that works in reducing depression without having withdrawls would be very useful.

    Ceterum censeo Sinae esse delendam
    • (Score: 1, Interesting) by Anonymous Coward on Sunday February 18 2018, @03:30PM (6 children)

      by Anonymous Coward on Sunday February 18 2018, @03:30PM (#639726)

      Big pharma has been trying to re-invent in an afternoon what the planetary Goddess perfected through evolution on time scales that make all of human history the blink of an eye. The humans have a civilization-wide case of NIH syndrome.

      • (Score: 3, Informative) by Azuma Hazuki on Sunday February 18 2018, @05:56PM (5 children)

        by Azuma Hazuki (5086) on Sunday February 18 2018, @05:56PM (#639759) Journal

        Show me where mean mother Gaia invented air conditioning, indoor plumbing, sanitary surgery, etc. She and her abusive pimp boyfriend Malthus can fuck off and die. And when the resident stereotypical granola dyke with the gallon bottle of Dr. Bronner's soap is telling you your Mother Nature narrative is bullshit, you KNOW it's bullshit.

        I am "that girl" your mother warned you about...
        • (Score: 1, Funny) by Anonymous Coward on Sunday February 18 2018, @10:09PM (4 children)

          by Anonymous Coward on Sunday February 18 2018, @10:09PM (#639828)

          1st: If I’m not for me, who am I? Nobody! 2nd: Yet, if I’m only for me, what am I? Nothing! 3rd: If not now, when???!!! Once more, unless constructive-selfish I work hard perfecting first me, absolute nothing can help perfect me! 4th: Only
          hard work-God’s Law can save us, but if we teach only our clan, we’re all hated then! So, Hillel taught Jesus, we must teach friend & enemy, the whole Human race, the full-truth, hard-work, press-& profitsharing Moral ABC’s All-One-God-Faith, uniting the whole Human Race! For we’re All-One or None! As teach for 6,000 years the astronomers Abraham & Israel, since the year One! “LISTEN CHILDREN ETERNAL FATHER ETERNALLY ONE!!!” Exceptions Eternally? Absolute None!!!

          5th: Whatever unites mankind is better than whatever divides us! Yet, if absolute-unselfish I am not for me, I’m not but classless, raceless, starving masses, never free nor brave! Only if constructive-selfish I work hard perfecting first me, like arctic owls–penguin–pilot–cat–swallow–beaver–bee, can I teach The Moral ABC that the real Rabbi Hillel taught Jesus to unite all mankind free. 6th: Absolute cleanliness is Godliness! Balanced food for body-mind-soul-spirit is our medicine! Full truth our God, half-truth our enemy, hard work our salvation, unity our goal, Free Speech our weapon, All-One our soul, self-discipline the key to freedom, unity, love unites All-One above! For we’re All-One! As teach for 6,000 years astronomers Abraham & Israel: “LISTEN CHILDREN ETERNAL FATHER ETERNALLY ONE!” Exceptions Eternally? Absolute None!!! So, when your fellow man you measure, take him at his best: with that lever, lift him higher, overlook the rest! 7th: Each swallow works hard to be a perfect pilot-provider-builder-trainer-teacher-lover-mate, no half-true hate! Have courage & smile, my friend. Think & act 10 years ahead! Find the man without fault? He’s dead! Do one thing at a time, work hard! Get done! Then teach friend & enemy how to work-love-unite all mankind free! Uniting One! All-One! Face the world with a smile, life is always worthwhile! To the fearless are given jewels, keep out of the past, disappointments won’t last! Help unite mankind, or we’re wandering fools! Repetition is the key to knowledge! 8th: More good is caused by evil than by good, do what’s right! Enlarge the positive! Replace the negative with The Moral ABC’s eternally tremendous AII-One-God-Faith that unites the Human race! For we’re All-One or None! As teach all astronomers, for 6,000 years since the year One. “LISTEN CHILDREN ETERNAL FATHER ETERNALLY ONE!” Exceptions Eternally? Absolute None!

          9th: Free Speech is man’s only weapon against half-truth, that denies free speech to smear–slay–slander–tax–enslave. Full-truth, our only God, unites all mankind, if 10 men guard free speech, brave! “If ever one religion unites all mankind, it will be by omitting all irrelevancies & redundancies, added unto the Faith in One-Almighty, all-embracing, ever-loving, ever-evolving, ever-recreating Eternal God, and by ABSOLUTE NOTHING ELSE.” America’s founding father, Thomas Paine, 8 books suppressed since 1799! 10th: Thank God we don’t descend down from perfect Adam & Eve to sinful sinner, brother’s keeper, divided slave! United armed, loving, hard-working trained brave, from dust we ascend up! Thank God for that! Our brother’s teacher of The Moral ABC, mason, tent- & sandalmaker Hillel, taught carpenter Jesus to unite all mankind free! With it, every human being created on God’s Spaceship Earth can evolve united, inspired-raised-trained-skilled-disciplined, guided lighting-like by a new birth! Without it, we destroy God’s Spaceship Earth! Aknathan-Bahá’u’lláh-Buddha-Confucius-Moses-Hillel-Jesus-Mohammed, inspired every 76 years by the messenger of God’s Law, Halley’s Comet, teach: A fire, a mist, a planet, a crystal, a cell, a jellyfish, a dinosaur, caves where cavemen dwell! Then a sense for work-love-song-art-play-law-beauty, a face turned up from the sod!

          • (Score: 3, Funny) by Azuma Hazuki on Monday February 19 2018, @03:44AM (3 children)

            by Azuma Hazuki (5086) on Monday February 19 2018, @03:44AM (#639948) Journal

            I don't know who Spam-modded you for that, but that right there is better religion than you will find in any holy book, anywhere, with the possible exception of some Buddhist scriptures :)

            I am "that girl" your mother warned you about...
            • (Score: 2) by aristarchus on Monday February 19 2018, @05:40AM

              by aristarchus (2645) on Monday February 19 2018, @05:40AM (#639982) Journal

              Not MikeeUsA, since there is no mention of pedophilia, or Hebrew Law, or perversion in general. Hmm, a new sentient form of like on SoylentNews? God-Damn!

            • (Score: 1) by gtomorrow on Monday February 19 2018, @07:08AM (1 child)

              by gtomorrow (2230) on Monday February 19 2018, @07:08AM (#640007)
              It's from the label [] of the aforementioned Dr. Bronner's soap []. Or maybe you knew that already.
              • (Score: 2) by Azuma Hazuki on Monday February 19 2018, @09:26PM

                by Azuma Hazuki (5086) on Monday February 19 2018, @09:26PM (#640279) Journal

                Yup, I just brought the refill of the citrus-scented soap a couple of days ago :) The writings look insane if you're only paying attention to the surface details, but the meaning underlying them is crystal clear and universally true.

                I am "that girl" your mother warned you about...
    • (Score: 0) by Anonymous Coward on Sunday February 18 2018, @05:51PM (9 children)

      by Anonymous Coward on Sunday February 18 2018, @05:51PM (#639756)

      The sad thing is people will see this as an excuse to abuse a drug and self medicate. Instead of good scientific study (like the one here). It will get vilified and end up like all the other drugs out there that could help people in particular cases.

      To do a proper study we need control groups. Long term and short term effects. What sort of dosage are we talking here? Milligrams or grams?

      I think I may have some sort of mild depression (long term well over 20+ years). But most of the drugs I look into have seriously nasty side effects that are basically worse than what I am going through. Then on top of that most of the drugs seem to cover up the root causes. In some cases it is an imbalance. But it may be something else. But you have basically smoothed it over and still are not finding the root cause. In some cases it is psychological in others a genetic thing in others an environmental thing. Then just to add icing to the cake 'Obamacare' has basically put me personally getting help out of reach due to stupid high deductibles. Looking down the barrel of several thousand dollars of costs with a 'maybe we can help, or maybe not' then a high cost ongoing cost. I miss the 90s this shit would have cost maybe a few hundred bucks, tops.

      • (Score: 0) by Anonymous Coward on Sunday February 18 2018, @06:04PM (7 children)

        by Anonymous Coward on Sunday February 18 2018, @06:04PM (#639761)

        You can grow lots of shrooms for under $200. Spores can be legally bought by mail order.

        If you did turn to non-prescription ketamine, it's only Schedule 3.

        • (Score: 0) by Anonymous Coward on Sunday February 18 2018, @10:35PM (3 children)

          by Anonymous Coward on Sunday February 18 2018, @10:35PM (#639833)

          I am not touching that shit. Again self medicating is just shooting in the dark. I do not like psychedelic effects. It makes me extremely sick. Sure I may not feel depressed but I feel like total hell. I am not looking to feel geeked out or floaty. I just do not want to be depressed.

          I am also not going to 'give ketamine a try'. That sort of thinking is little more than drink a can of 7up and take an aspirin to feel better when you have the flu. It may sooth the side effects a bit but does not fix the root cause.

          Dealing with the 'drug scene' is like dealing with extremely inexperienced programmers. They 'try' things with little regard for the science and rigor of doing it correctly. "just try X" well thats nice but it did jack diddly to fix the issue at hand. What is worse there are many out there who have master level experience but never graduated to actually doing things correctly. Just because you have done something for 10k hours does not make you an expert. It just gives you the opportunity to do so.

          • (Score: 2, Insightful) by Ethanol-fueled on Sunday February 18 2018, @11:58PM

            by Ethanol-fueled (2792) on Sunday February 18 2018, @11:58PM (#639869) Homepage

            Where is your version of this "drug scene" of which you speak?

            My version was seeing junkies literally begging to suck dick for heroin, or to try and sucker me into cold-calling their dealers at 3 a.m. and score drugs for them because even their dealers would no longer sell to them. Or how about the tweekers who rent and illegally sublet a Mexicali-slum studio apartment with nothing but a shit-stained mattress in it fire up the glass dick and take turns sitting on their asses on the floor and pacing around like some kind of urban powow gone bad. Or the single mother of two OD'ing and dying after a round of booze and pain medication. Or the other numerous cases of Hep-C and jail time, driving their own girlfriends up to Johns' houses and pimping them out multiple times a night before kissing the mouth that just sucked 5-10 dicks.

            Booze is a destructive drug but there is more dignity in being the village drunkard than there is the last paragraph above.

          • (Score: 0) by Anonymous Coward on Monday February 19 2018, @12:04AM (1 child)

            by Anonymous Coward on Monday February 19 2018, @12:04AM (#639874)

            You keep on saying it but it's not true. Nobody should take your pessimism about this to heart.

            You can self-medicate safely with shrooms. You can take small amounts and adjust the dose up each time. Doses under about a gram will have few or no psychedelic effects. Microdosers take as little as 0.25 grams.

            • (Score: 1, Informative) by Anonymous Coward on Monday February 19 2018, @02:03AM

              by Anonymous Coward on Monday February 19 2018, @02:03AM (#639916)

              IME, it takes about 2-3 grams to get any visual effect, and those usually light until I get into 1/8 oz or above. Shrooms are non-addictive, very safe, and extremely useful both recreationally and for dealing with depression. Pure MDMA has a similar efficacy, but it also has side effects and isn't quite as safe.

        • (Score: 1) by Ethanol-fueled on Sunday February 18 2018, @11:46PM (2 children)

          by Ethanol-fueled (2792) on Sunday February 18 2018, @11:46PM (#639862) Homepage

          You can legally buy the spores, but you get on the FBI watch-list for legally buying the pressure-cookers needed to grow. And, as we all have recently discovered if not known for years, the FBI is an organization with its priorities straight.

          • (Score: 0) by Anonymous Coward on Sunday February 18 2018, @11:57PM (1 child)

            by Anonymous Coward on Sunday February 18 2018, @11:57PM (#639868)

            You're already on multiple watchlists. But you can buy the pressure cooker with cash at some Bed, Bath & Beyond place or a local hardware store.

            If you want to be ghetto or avoid a watchlist you can use boiling water only for the BRF method.

            • (Score: 2) by SanityCheck on Monday February 19 2018, @09:04AM

              by SanityCheck (5190) on Monday February 19 2018, @09:04AM (#640031)

              Would you by chance know whether the watchlist is single or double ply?

      • (Score: 0) by Anonymous Coward on Sunday February 18 2018, @06:43PM

        by Anonymous Coward on Sunday February 18 2018, @06:43PM (#639770)

        There's a number of things that need to be studied before something like this can be prescribed ethically. Then there's the legal consideration.

        I cringe when I hear people boosting things like kratom, marijuana and ketamine without having appropriate research as to the efficacy, side effects and protocol that would be relevant to prescribing them. Sure, they may have unapproved uses that work, but so did morphine and heroine and they've caused all sorts of trouble due to the way they were used.

        Drug policy should be based on the best available science.

    • (Score: 1, Insightful) by Anonymous Coward on Sunday February 18 2018, @06:39PM

      by Anonymous Coward on Sunday February 18 2018, @06:39PM (#639769)

      One problem is that these medications don't necessarily impact everybody the same way. Most of the time, the difference is that what works for one person doesn't do much for somebody else, but it can provide the break on depression necessary to do the things that they were too depressed to do. Usually, this is a good thing, but it can also cause somebody to commit suicide or mass murder when they were previously too depressed to do it.

      This is one of the reasons why medication is prescribed by trained professionals rather than handed out over the counter.

      The bigger issue though is that psychiatric medications are based on unproven science. The belief is that there's a chemical imbalance that causes the illness. But, there's not a whole lot of evidence that the causal relationship is pointed in that direction and popping pills is really just a temporary fix while other treatments that have a much more solid foundation are allowed to work. Therapy tends to work quite well over the long term for most people and the basis for it is relatively well understood when compared with the pills.

      To make matters worse, the placebo effect is growing stronger and it's getting increasingly challenging to come up with medications that are effective enough to be approved. The result is that if one of the current medications isn't helping, there's less and less hope that in the future some medication will come along that will work.

  • (Score: 5, Informative) by Anonymous Coward on Sunday February 18 2018, @06:07PM (3 children)

    by Anonymous Coward on Sunday February 18 2018, @06:07PM (#639763)

    Clinical Major Depression is not just a bad case of 'feeling down'.

    I know anecdote is not the singular of data, but for those who have never experienced it, it can be hard to get your head around the concept.

    I have no delusions that I can clearly articulate what so many other, more talented writers have attempted, but maybe my sharing some of my story may help someone else.

    Having been sufficiently depressed that suicide seemed like a viable option, I'd like to share some of my personal experience in the hopes that it helps at least one person dispense with some common misconceptions.

    Saying something like "Look on the bright side" or "just cheer up... thing's can't be that bad" is about as effective as telling a starving person to ignore their feeling of hunger.

    What it was like:

    In the midst of a major depressive episode, everything feels like an insurmountable burden... one that that promises no hope of success. Any thought of attempting something is immediately met with thoughts of how it could go wrong. And should it go wrong, well, I'm already holding on with everything I've got! There's no way I could deal with that, too.

    Imagine waking up in the morning after a night out on the town. You're still in your clothes, you're not sure where you are, you ache all over, and your brain feels like it is full of mush. You're exhausted as if you had just run a marathon. And the clothes you are wearing? While you were sleeping, someone replaced them with a wet suit that is made of lead. (Think of getting a dental x-ray and that lead bib they put on you for protection, only moreso.) Every effort is excruciatingly exhausting.

    Now, go through your whole day, from awakening through day's end, feeling laden down like that. Oppressive. Debilitating. Draining.

    Food lacks taste. Activity is increasingly burdensome. Friends and family feel distant. Melancholy and dark clouds permeate every waking moment. Nothing is enjoyable or even barely satisfying.

    Any pleasures are immediately damped down to nothingness, like a candle tossed in a lake. All is dark.

    Endure that for a whole week.

    Now for a month.

    When that starts to stretch past a year... what can you do?

    How long can one persist in keeping one's wits about oneself in the face of such overwhelming feelings?

    I was fortunate to have an intervention which got me clinical help. In-patient therapy. (Colloquially: staying in the nut house.) Medications and sessions with a psychologist and with therapists slowly helped turn the tide. I found great help from CBT - Cognitive Behavioral Therapy and DBT Dialectical Behavior Therapy. I'd estimate it took me over two years time before I was back to something approaching 'normal'.

    If this medication is even 10% as effective as these studies suggest, it could be a literal life saver.

    That was many years ago and I am incredibly grateful that I have not reverted to that depth of despair, since. There have been times when things start trending downhill, but I have been to recognize the symptoms, now, and take steps to keep it from spiraling back out of control.

    I have a whole host of friends, now. Most days, easily a dozen people see me and greet me by name, and with a smile. I know I could ask any one of them for help and they would be more than willing to lend a hand in whatever way they could. And, as this research suggests, there are more tools becoming available all the time.

    tl;dr There is help available. If you know someone who is struggling, lend a hand. If YOU are struggling, reach out for help. There are countless resources available, if only one is willing to ask.

    • (Score: 3, Insightful) by Anonymous Coward on Sunday February 18 2018, @06:43PM

      by Anonymous Coward on Sunday February 18 2018, @06:43PM (#639771)

      For me, the worst part was always the inability to enjoy anything.

      How many times have you had to perform some unpleasant task that you really don't want to do, and to motivate yourself you make a deal? Something like, "I'll clean the toilets, and afterwards I'll play a video game for a while." Well, when you're depressed, everything is an unpleasant task that you really don't want to do. So you make yourself lots of deals. Except your "reward" doesn't feel good. It doesn't make you happy. You know it should make you happy, but you feel nothing. And that, itself, makes you feel even worse.

      Of course, this all feeds into self-loathing. I hate myself, because I'm basically defective. Because I hate myself, I want myself to suffer. I deserve to feel miserable; it's only right that I can't enjoy anything.

    • (Score: 2) by sbgen on Monday February 19 2018, @02:04AM

      by sbgen (1302) on Monday February 19 2018, @02:04AM (#639917)

      Looks like you have turned around a bend and backed away from the abyss. Hope you will keep moving positively to a better state of mind. As for Ketamine, it is a new tool and very fast acting effective one at that. Efforts are on to understand the mechanisms of function of various forms of the compound. This is not a medical opinion but that of a research scientist. There is hope indeed; how long before it is worked out is a different matter.

      Warning: Not a computer expert, but got to use it. Yes, my kind does exist.
    • (Score: 1) by DBeemer on Wednesday February 21 2018, @10:08AM

      by DBeemer (6398) on Wednesday February 21 2018, @10:08AM (#641100)

      Fortunately I don't suffer from depression, but my girlfriend does have times of serious depressions, where she openly talks about suicide being a viable solution.

      All I can say is that when you have person close to you with such depression, do not ever give up on them. Stay with them and try to provide support.
      This can be very hard and mentally wrecking for you as a support, but it will slowly help the person to get out of it.
      From this I learned with my girlfriend, and please don't assume this will work for you, that I have to sort of break her to get her out of that mental state.

      Fortunately we found out that her depressions mostly stem from a lack of exposure to the sun and we have it under control with a combination af vitamine b12, D and a daylight lamp.
      She now tells me whenever she begins to feel down, so that we can take action to prevent the occurence of a new depression wave.

  • (Score: 2) by MichaelDavidCrawford on Sunday February 18 2018, @09:43PM

    by MichaelDavidCrawford (2339) Subscriber Badge <> on Sunday February 18 2018, @09:43PM (#639823) Homepage Journal

    My witch doctor at ucsc didn't ask whether I was bipolar before she prescribed Elavil

    Hilarity quite literally ensued

    I spent some time in the slammer. The prosecutor agreed to drop the charges if I agreed to spend 72 hours in a nuthatch

    "But I'm not crazy!"

    "I know that but stay cool for three days and you're a free man!"

    I didn't stay cool. I was in for a month. I should have been in longer but my insurance ran out

    Yes I Have No Bananas. []