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169 points flaxxen | 1 comments | | HN request time: 0.208s | source
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Aurornis ◴[] No.43209537[source]
Important to note that the serotonin theory of depression doesn't have to be strictly true for SSRIs to be effective. People who having passing familiarity with neuroscience often assume that psychiatric medications work by correcting deficiencies, but this isn't true. It's also not accurate to say that SSRIs "give you more serotonin" or any of the other variations on that theme.

Neurotransmitters aren't simple levels in the brain that go up and down, despite how much podcasters and fitness influencers talk about them like that. Neurotransmitter dynamics are complex and the long-term adaptations after taking medications like an SSRI can't be simply described in terms of "levels" going up and down. There are changes in frequency, duration, and movement of Serotonin across synapses that are much more complex. There are also adaptations to the receptors, including auto-receptors which modulate release of neurotransmitters (side note: some newer antidepressants also directly target those autoreceptors with possibly slight improvements in side effect profile).

So keep that in mind when reading anything about the serotonin theory of depression. This is often brought up as a strawman argument to attack SSRIs, but we've known for decades that the serotonin theory of depression never fully explained the situation. We've also known that some conditions like anxiety disorders are associated with increased serotonin activity in parts of the brain, which SSRIs can normalize.

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1. Lerc ◴[] No.43212406[source]
I think if it like a snow globe, occasionally the snow falls into patterns you don't like, there is an abundant body of science that covers principles of physics that dictate how the snow moves. You might be able to come up with some broad patterns that show what lead to outcomes that you don't want.

Nevertheless the best option for fixing the undesirable pattern of snow is to give the globe a quick shake. Solutions do not necessarily require a complete understanding of the problem, or even directly target the problem.

Now if you only wanted to move a few problematic flakes without shifting any others, that's a different, much harder problem.