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Fiora Esoterica @fioraesoterica
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one of my favorite science "lies to children" is the pop culture story of how antidepressants work

the truth of the matter is it's not only deeply wrong, but that they didn't have a damn clue when they invented them and have been bouncing around all kinds of theories ever since
you know the lie: "depression is about serotonin, and SSRIs increase serotonin, which helps fix depression".

of course, these are all lies
the lie falls apart when you compare SSRIs and similar antidepressants to other brain drugs, like bupropion or methylphenidate.

SSRIs take weeks to take effect, and have a long (weeks-long) withdrawal, even though their duration of action is far shorter than that.
neither bupropion or methylphenidate affect serotonin much, but they're still reuptake inhibitors like an SSRI. yet they take effect in a few hours, have a duration of action, then fall off. like you would expect from most drugs!

they don't take weeks.
in other words, whatever SSRIs do *must* be something far longer-term and subtle than "gives you serotonin".

in fact, there are drugs that "give you serotonin" or otherwise agonize serotonin receptors! you probably know a few! LSD is one.
this is the part of some theories of their action, which is already a fairly significant modification from the "lie".

but it's yet more complex than that.

one major current theory, elaborated on a fair bit here:…

is that depression appears to involve *actual physical brain changes*, and treating it involves *actual physical brain changes*, and relates to BDNF (brain-derived neurotrophic factor)
this explains why it appears possible to treat someone with antidepressants for some period of time and then they go into remission, at least in some cases; you can get the brain to reverse the shrinkage associated with depression!

and that's also why it takes months, not days.
yes, your brain can change up and down in volume massive amounts throughout your life. it's not a constant! you can lose lots of brain volume and then GET IT BACK
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