Thread by @fioraesoterica

the “chemical imbalance/serotonin theory of depression” is a lie pushed by astrazenica marketing... but you don’t need that lie to justify antidepressants. if they work for you, that’s valid and that’s all that matters

https://twitter.com/javeigh/status/1105516196139597824

2. for any drug or drug combo: just because your psych prescribes it doesn’t mean it makes sense. do your own research, for your own sake.

just because you’re prescribed dumb shit doesn’t mean you are required to take it

3. many psych drugs are bad as shit for you long term and were never intended for such use (benzos for example). I won’t judge you if you choose to — but please for your own sake ensure you’ve tried all alternatives you can and understand exactly what trade offs you’re making

4. trauma is defined symptomatically. it’s not uncommon for a person whose experiences seem mild to have worse trauma than someone who underwent awful experiences. trauma is a complex interplay of factors. “but they had it worse and are doing fine” is not a valid argument.

5. CPTSD is probably what we should have called borderline personality disorder all along, but that would mean the previous generation admitting that they fucked up the kids

6. diet is probably dramatically underrated as a treatment for many mental problems but there's really not enough evidence to conclude what, if anything, is the "right" diet for any given person, so don't act like you know

7. stop prescribing people neuroleptics you lazy fucks

8. "atypical antipsychotics" are a misnomer because that's all they ever prescribe anymore, so they're not exactly atypical in any meaningful way

https://twitter.com/Lorelei_is_love/status/1105979916741423106

9. drugs are scheduled based primarily on the whims of the DEA, drug company lobbying, and perhaps a slight bit of how liable they are for abuse.

... not how safe they are under typical use.

for example:

benzos (schedule IV) are widely believed to be harmful under long term use (> a few weeks).

amphetamine (schedule II) is not, beyond potential extremely long term neurodegeneration risks (e.g. parkinson's likelihood increase on a timescale of multiple decades)

or how neuroleptics can sometimes be harmful on a timescale of months to years despite not being scheduled drugs at all.

10. it's tempting to react to dumbasses telling depressed people to stop being depressed by saying that depression is a disease that you can't will your way out of, that needs medicine, etc, etc.

i dislike this a lot

why i dislike this: all depression is different

it's possible your depression can be treated without meds. it's also possible it can't be!

so if you manage it on your own? you're valid. but you also can't generalize your experience to every other depressed person

the idea that "if you're depressed, you will always need meds, and if you somehow treat your depression without meds, it wasn't real depression" is Bad (TM)

11. ive ranted about this before but methylphenidate sucks for a lot of people for a lot of reasons and is not representative of adhd meds and i hate that so many people get casually thrown on it without good reason despite its awful tolerability

12. there is no evidence that methylphenidate is any safer than amphetamine on any axis

also, the only reason it's """"less abusable""" is because it's harder to abuse things that make you feel like shit :>

13. going back to number 2), psychs make errors (often from lack of knowledge or familiarity) more commonly than you'd think. two examples i'm familiar with include:

a. prescribing antidepressants to people before ruling out bipolar [thus destabilizing bipolar patients]

b. prescribing bupropion without being fully cognizant of its effects on seizure threshold

c. prescribing medicines with sedative side effects (valproate, lithium, many antidepressants, etc) to people with pre-existing fatigue issues

also yes i know that's more than two,.,,