Most active commenters
  • robertakarobin(6)
  • pizzafeelsright(5)

←back to thread

Prozac 'no better than placebo' for treating children with depression, experts

(www.theguardian.com)
206 points pseudolus | 24 comments | 21 Nov 25 00:02 UTC | HN request time: 0.001s | source | bottom
Show context
robertakarobin ◴[21 Nov 25 20:43 UTC] No.46008748[source]▶
I was very young when my mom started Prozac but do remember how angry and sad she was before compared to after.

Years later there was a time when me and my sister noticed our mom was acting a bit strange -- more snappish and irritable than usual, and she even started dressing differently. Then at dinner she announced proudly that she had been off Prozac for a month. My sister and I looked at each other and at the same time went, "Ohhhh!" Mom was shocked that we'd noticed such a difference in her behavior and started taking the medication again.

I've been on the exact same dose as her for 15 years, and my 7-year-old son just started half that dose.

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.

What I tell my kids is that getting depressed, feeling sad, feeling hopeless -- those are all normal feelings that everyone has from time to time. Pills can't or shouldn't keep you from feeling depressed if you have something to be depressed about. 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 -- and that's called Depression, which is different from "being depressed."

replies(7): >>46008842 #>>46008941 #>>46009047 #>>46009643 #>>46010222 #>>46011117 #>>46011264 #
techietim ◴[21 Nov 25 21:00 UTC] No.46008941[source]▶
> my 7-year-old son just started half that dose

This is horrifying.

replies(7): >>46008980 #>>46008992 #>>46009112 #>>46009132 #>>46009406 #>>46010017 #>>46010816 #
robertakarobin ◴[21 Nov 25 21:19 UTC] No.46009112[source]▶
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.

replies(7): >>46009133 #>>46009144 #>>46009595 #>>46010064 #>>46010306 #>>46010535 #>>46010800 #
jacobgkau ◴[21 Nov 25 21:22 UTC] No.46009133[source]▶
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."
replies(7): >>46009157 #>>46009313 #>>46009487 #>>46010591 #>>46010716 #>>46011003 #>>46011152 #
robertakarobin ◴[21 Nov 25 21:25 UTC] No.46009157[source]▶
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.
replies(2): >>46009203 #>>46010115 #
1. pizzafeelsright ◴[21 Nov 25 23:03 UTC] No.46010115[source]▶
Children are intelligent and creative and this is normal.

Children speak like this and then I correct them. I explain it isn't helpful, explain why they are blessed, how their life could be worse, and provide them alternative phrases while they explain their emotional state.

Depression is caused by laziness and anxiety by hopelessness. My kids know that they aren't permitted to be lazy or say they are bored. They don't have anxiety because they have hope despite circumstances.

replies(6): >>46010316 #>>46010343 #>>46010404 #>>46010602 #>>46011205 #>>46011493 #
2. konmok ◴[21 Nov 25 23:27 UTC] No.46010316[source]▶
> Depression is caused by laziness and anxiety by hopelessness.

I wish this were true, but its not even close. I wonder how your kids will react when they move away, and you're not around to police their emotional expression. If they're like me, they will promptly collapse into paralysis and self-destruction.

I strongly suggest that you frequently give your kids long stretches of time (months) to practice regulating themselves, without your interference.

And if they have anxiety or depression, please let them see a professional. If my parents had noticed the signs earlier, they would have saved me decades of pain.

replies(1): >>46010438 #
3. poly2it ◴[21 Nov 25 23:29 UTC] No.46010343[source]▶
> Depression is caused by laziness [...]. My kids know that they aren't permitted to be lazy.

Do you really believe this, or do you believe your children aren't depressed? Your comment is not in accordance with science. Depression is a complex topic. I'm having trouble imagining a way to be more wrong. Is this satire?

replies(1): >>46010405 #
4. ◴[21 Nov 25 23:37 UTC] No.46010404[source]▶
5. pizzafeelsright ◴[21 Nov 25 23:37 UTC] No.46010405[source]▶
No, not satire. How does science measure depression? There isn't a blood test and brain scans are inconclusive.

That said, I have not met a depressed person who exercises each day and lives in a clean house.

replies(8): >>46010425 #>>46010440 #>>46010611 #>>46010760 #>>46010875 #>>46011134 #>>46011159 #>>46011280 #
6. piperswe ◴[21 Nov 25 23:39 UTC] No.46010425{3}[source]▶
It's almost as if depression reduces your executive function, making it more difficult to exercise each day or consistently clean your house.

And then you feel worthless for not being able to do those things, reinforcing the depression.

replies(1): >>46010473 #
7. pizzafeelsright ◴[21 Nov 25 23:41 UTC] No.46010438[source]▶
At this age I am teaching emotional regulation on a daily basis.

As for when they grow up, adults who cannot manage their emotions get fired or are sent to jail. It is critical to be slow to anger, quick to forgive, and work at building strong friendships.

replies(1): >>46010926 #
8. konmok ◴[21 Nov 25 23:41 UTC] No.46010440{3}[source]▶
I know several depressed people that exercise every day and live in a clean house.
replies(1): >>46010480 #
9. pizzafeelsright ◴[21 Nov 25 23:44 UTC] No.46010473{4}[source]▶
I agree 100% and it is an uphill battle requiring significant effort. That is where discipline is required. Exercising that discipline will bring positive results. There is nothing other than self stopping someone from cleaning instead of crying under a blanket.
replies(1): >>46010889 #
10. pizzafeelsright ◴[21 Nov 25 23:46 UTC] No.46010480{4}[source]▶
That's unfortunate. Ask they why they are depressed and see if there is any way to fix it.
replies(1): >>46010771 #
11. skywhopper ◴[22 Nov 25 00:02 UTC] No.46010602[source]▶
You have no clue of which you speak.
12. skywhopper ◴[22 Nov 25 00:03 UTC] No.46010611{3}[source]▶
You should shut your mouth and stop talking about things you know nothing about.
13. robertakarobin ◴[22 Nov 25 00:23 UTC] No.46010760{3}[source]▶
You can use me as an example! When I got diagnosed I was very physically active and also quite clean.

One of the hardest things for me with depression is the incredible guilt I have. What right do I have to be depressed when my life is objectively fine? Why should I get therapy when that might mean one less space for someone who is dealing with trauma or poverty or something else that gives them a "right" to be depressed? This causes a feedback loop of guilt leading to more depression and vice-versa.

Like I tell my kids, it's normal to sometimes feel depressed or hopeless. If you're dealing with a difficult circumstance then it's reasonable to have those feelings, and the only way to address those feelings is to deal with the circumstance. What's not normal is feeling depressed and hopeless for no logical reason at all.

replies(1): >>46010981 #
14. robertakarobin ◴[22 Nov 25 00:24 UTC] No.46010771{5}[source]▶
You think they don't ask themselves that question all day, every day?

reddit.com/r/thanksimcured

15. V__ ◴[22 Nov 25 00:40 UTC] No.46010875{3}[source]▶
Black swans do not exist. I have never seen one.
16. V__ ◴[22 Nov 25 00:43 UTC] No.46010889{5}[source]▶
"If you have executive dysfunction, just discipline through it" is definitely a take.
17. robertakarobin ◴[22 Nov 25 00:49 UTC] No.46010926{3}[source]▶
You imply we aren't teaching emotional regulation on a daily basis? We have always placed a great deal of emphasis on talking about feelings and developing "tools for our toolboxes" to deal with them. Unfortunately those tools are largely inadequate when there isn't a rational cause for a debilitating emotional state.
replies(1): >>46011520 #
18. arjie ◴[22 Nov 25 00:55 UTC] No.46010981{4}[source]▶
I appreciate your sharing your experience. I think it's very valuable that human beings describe to each other their decision making, actions, and outcomes. Often, people attempt to dissuade the sharing of information, and I think that leads to us, as humans, being less able to form an accurate model of the world. I appreciate your pushing through that form of opposition.
19. nick__m ◴[22 Nov 25 01:16 UTC] No.46011134{3}[source]▶
you have the causality reversed....
20. peepee1982 ◴[22 Nov 25 01:19 UTC] No.46011159{3}[source]▶
It’s pretty tough to exercise or clean your house when getting out of bed feels like an insurmountable task.

Depression isn’t like an infection or cancer—it’s a diagnosis based on established criteria, as are most mental disorders. Experts may disagree on diagnosis or treatment, but that doesn’t make it useless.

By that logic, you might as well say autism is caused by avoiding eye contact—since there’s no blood test for it either.

21. JadeNB ◴[22 Nov 25 01:29 UTC] No.46011205[source]▶
> Depression is caused by laziness and anxiety by hopelessness. My kids know that they aren't permitted to be lazy or say they are bored. They don't have anxiety because they have hope despite circumstances.

This sounds horrible. If I weren't depressed or anxious, being told that I wasn't ever permitted to be lazy or say that I was bored would make me so; and, if I were, then being told that I was lazy and hopeless would make it worse.

22. collingreen ◴[22 Nov 25 01:43 UTC] No.46011280{3}[source]▶
This is a pretty nasty line to double down on.

I hope you can take your personal anecdotes and add them to a larger body of research and other people's experience to refine your understanding. If you're right that everyone who has Depression is actually just lazy, you'll see lots of support for that. If, instead, you find a lot of different experiences you might conclude that Depression is a pretty nuanced and complicated topic, which might both expand your understanding and help you bring more empathy to the suffering people around you.

23. ◴[22 Nov 25 02:24 UTC] No.46011493[source]▶
24. rfrey ◴[22 Nov 25 02:28 UTC] No.46011520{4}[source]▶
People who have never experienced a particular challenge are quick to assume credit for its absence and assign moral failings to others who experience it. It's insufferable but common.

Imagine a millionaire who had millionaire parents lecturing his children on how they're not allowed to be poor. Lo! They're not! The lectures worked.