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The only time I've seen something like this is when my doctor really wanted me to try an anti-depressant, so he gave me a perpetual supply of free samples.
Don't antidepressants take weeks to start working?
A doctor said this and it was such a good metaphor: imagine that you have a 3000 year old machine (which no one understands anymore) with a bunch of cogs and gears, and you're looking down at it from above. You're trying to fix a gear that is slightly out of alignment further down in the machine, you can't really tell which one it is but you know roughly which area, and to fix it you drop a rock into the machine and watch it fall down.
That's what we're doing with SSRIs. We're dropping a rock that manipulates our serotonin, which gives a bunch of effects but not the one we're after. The one we're after is somewhere down the line. It's affected by processes that are affected by the serotonin somehow. We're not exactly sure which one it is, but we know that if we drop the rock in there it will make the gears align sooner or later.
Which is why it takes time, and why it has some odd effects on people sometimes.
edit: added a detail I missed, to make it clearer.
This is a great metaphor for why psychiatry is pseudoscience
SSRIs definitely work for some people. It’s just that everyone’s brain chemistry is extremely different and complex. Doesn’t make it less scientific. Making the best guess is math and science.
I would say it even works for many people. We're aware of the fact that it works, and we're aware of the fact that it effects serotonin. We also know that serotonin isn't what does the work. There's something down the line that is affected by the processes of the body that just happens to react in the chain from the serotonin manipulation.
But all the other things that are affected in that chain can also do weird stuff to you if you're unlucky. That's why it's important to have good communication with your physician during the process.
This is one thing where so many people I talk to got unlucky. For me, SSRIs were super lucky in that they helped alleviate depression caused by my anxiety which then helped me find other roots of the anxiety. Turns out undiagnosed ADHD is terrible for your anxiety - got diagnosed though!
Side effects for me have included stomach issues and weight not coming off even as my physical condition improves as I've started running again. I'll take it for now until I start weaning off in the future. I wouldn't say they were a lifesaver but they helped immensely.
I always recommend trying it if the doctor recommends it (and if you want it) even though I was unlucky and turned paranoid three pills in. I stopped taking them and it was over in a couple of days. So many people get helped by them and never say a word. People you and I wouldn't ever assume were on them.
You hit the nail on the head.
SSRIs are terrific at clearing some of the noise and making you more receptive to other therapy (namely talk therapy) and striking at the root of what’s causing the issue. I wouldn’t have even thought about talking to a therapist a year ago and it’s been revolutionary understanding my behaviors (especially those that I learned in childhood) and how I’m inadvertently passing them down to my kids.
Consequentially I’ve also been more aware of my wife’s behaviors and how she’s passing them down to the kids and she’s not quite as receptive to the criticism as I’ve been.
It really is eye opening to have a good long conversation about what’s troubling you with someone who understands the intricacies of how the mind works and how it pieces things together.