Our 11 year old daughter was seriously depressed recently. N=1, but fluoxetine was life changing (and potentially life saving) for her, at least.

▲ potsandpans 6 hours ago | parent | next [-]

Genuine question (which I accept may be too personal to answer): what does depression in someone that young look like?

How is it different from the expected hormonal changes that an adolescent is expected to go through?

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jdietrich 4 hours ago | parent | next [-]

As someone who has been seriously depressed from an early age, I can tell you that it looks exactly like the DSM/ICD criteria - a lack of energy, loss of appetite, loss of interest in all activities, insomnia, feelings of worthlessness, suicidal thoughts and pervasive sadness and hopelessness.

Some people would rather believe that pediatric depression isn't real, rather than confront the reality of a loved and cared-for child who is constantly tearful, severely underweight, sleeps for three or four hours a night, spends most of their time staring into space and frequently talks about wanting to die.

Depression is an utterly dreadful illness and should not be confused with normal sadness or unhappiness.

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0134340 5 hours ago | parent | prev | next [-]

Probably something like Boy Interrupted[0]. Sad story and something I can sympathize with having some of the same feelings very early on despite having a rather normal upbringing and siblings not showing signs of it.

0: https://en.wikipedia.org/wiki/Boy_Interrupted

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potsandpans 5 hours ago | parent | prev [-]

It's incredible that my last four comments are down voted to -1, for engaging in genuine dialog across topics.

@dang it's hard to believe that I'm not being brigaded.

	▲	amanaplanacanal 5 hours ago \| parent [-]
		My advice as a long time participant here: pay no attention to upvotes or downvotes. Sometimes they seem to be completely unrelated to whatever you said. Stay curious.

▲ thebigspacefuck a day ago | parent | prev | next [-]

Placebo can be life changing

	▲	abraxas 6 hours ago \| parent \| next [-]
		Absolutely. These random namedrops of drugs are irritating. People respond to different psychiatric medications in wilddly different ways. And actually, the majority do not respond at all. Throwing a random name of some random medication helps absolutely nobody. It will just make some desperate people seek "this one drug" that they heard about on the internet.
	▲	biff1 a day ago \| parent \| prev [-]
		Nocebo can too. Apropos the featured article, I wonder if we should worry about that when we report in the popular media that antidepressants trigger suicides.

▲ tcj_phx a day ago | parent | prev [-]

Do you have a plan to get her off, or is she on the maintenance drug for life?

Sometimes girls get depressed when their periods start. Girls often don't ovulate regularly, which can cause problems until their cycle stabilizes. Sometimes pediatricians don't allow girls' cycles to stabilize. The doctor says to the girl, "you're a woman now, so we're going to regulate your irregular period with birth control."

Women often get depressed due to the progestins used in all the birth control prescriptions.

SSRIs never help because of boosting serotonin. When someone benefits, it's from the drug's other physiological effects.

▲ lemming 21 hours ago | parent | next [-]

Do you have a plan to get her off, or is she on the maintenance drug for life?

It's too early to say. Obviously the idea is to get her off it if possible.

SSRIs never help because of boosting serotonin.

That's a hell of a claim, which could use some evidence.

▲ blast 7 hours ago | parent | next [-]

https://www.nature.com/articles/s41380-022-01661-0

▲ jacobgkau 6 hours ago | parent | prev | next [-]

> It's too early to say. Obviously the idea is to get her off it if possible.

You understand that the people who sold you that drug have a vested interest in making sure it's not possible and/or that you & she think it's not possible, right?

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amanaplanacanal 5 hours ago | parent [-]

You think the pediatrician is getting a kickback for prescribing it?

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mrguyorama 4 hours ago | parent [-]

I'm big on medications for brain stuff but uh yes, in the US, doctors get lots of kickbacks for prescribing drugs.

Usually this takes the form of "I'm prescribing you with <Brand> instead of generic" or "I'm prescribing you this specific drug from this class of drug"

https://openpaymentsdata.cms.gov/

	▲	dragonwriter an hour ago \| parent \| next [-]
		> doctors get lots of kickbacks for prescribing drugs. From your own source: "In 2024: $172 or more in general payments have been received by half of physicians." Even if all of those payments count as kickbacks, a median of $172 in a year (significantly less than 0.1% of the median physician's annual pay) is not "a lot of kickbacks".
	▲	ksenzee an hour ago \| parent \| prev [-]
		Okay, but nobody is paying doctors to prescribe medications like sertraline and fluoxetine that have been generic for years and are cheap as dirt.

▲ tcj_phx 11 hours ago | parent | prev [-]

> > SSRIs never help because of boosting serotonin.

> That's a hell of a claim, which could use some evidence.

My experience with the chatbots is that they start with the conventional marketing tropes, but if you ask pointed questions they'll dig into the actual research.

This thread started with a generic question about why ECT seemed to help some patients. It had a really good reasoning about why SSRIs are still the first-line treatment for depression, even though the MAOIs were much better drugs.

https://chatgpt.com/share/69207aa3-26a0-8005-8dda-8199da153f...

  The Big Picture

  SSRIs flood serotonin globally, which can suppress 
  dopamine/norepinephrine and blunt mood.
  
  Anti-serotonin strategies (receptor-specific antagonism, 
  reuptake enhancement, or targeted modulation) often 
  result in cleaner antidepressant effects with fewer 
  side effects.
  
  This supports the criticism you mentioned: SSRIs may 
  “work” only because the brain adapts to the serotonin 
  disruption, whereas directly reducing or modulating 
  serotonin is more therapeutic.

The whole 'conversation' is pretty good, and would provide plenty of search terms for helping you figure out what science has actually figured out about depression.

A simple pregnenolone supplement can sometimes be magical, because of the steroidogenesis cascade: https://en.wikipedia.org/wiki/Steroid#/media/File:Steroidoge...

There's a supplement seller that said his pregnenolone powder was made with a newer, cleaner process than is used by most of the pregnenolone supplement vendors, but I don't know if he's still using that supplier. The powders are a much better value than the capsules.

hth.

	▲	flatline 6 hours ago \| parent [-]
		The chatbot is great as a first-line of research for many things, but something like this needs to be backed up by actual research to make a concrete claim. It will absolutely fabricate falsehoods or misrepresent truths based on an unknown number of stochastic factors behind any response. Shame on your for propagating a bunch of mumbo-jumbo that every reader must go verify for themselves if they want to substantiate or refute your claim - in response to a request for substantiation!

▲ EasyMark a day ago | parent | prev [-]

Puberty in general can be rough. I (a dude) had all kinds of bad thoughts and moods going through puberty and then one year it was just gone, grades improved dramatically, started making friends again, etc