this post was submitted on 14 Nov 2023
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When I first got officially diagnosed with depression the doc prescribed me an antidepressant and when I asked about sideffects he said "noone ever gets any sideffects from this med". It literally had a black box warning and a CVS recipt of known sideeffects. Also yes there were definitely sideffects. Luckily the pharmacist wasn't a moron like the doc and actually told me what to expect.
My psychiatrists told me for well over a decade that they reason it takes antidepressants a couple weeks to start working is they need to build up in the blood.
Later research showed that antidepressants work through neurogenesis, same way as exercise. The thing that takes two weeks is the proliferation of new and differentiated cells eventually leading to new emotional states.
This whole “build up in the blood” thing never made any sense. If you ingest MDMA or alcohol it doesn’t need time to build up in the blood. The timeframe for an ingested chemical to reach peak volumes in the blood is about 30-60 minutes.
This story never made sense, yet it was accepted and parroted by doctors everywhere.
This depends on the antidepressant. Most modern antidepressants have a relatively short half-life in the body. For example the one I'm on now has a half-life of about 10 hours. However one of the first SSRIs and the still most frequently prescribed one, Fluoxetine, has a half life of 4 days for the medication itself and its metabolite has a half-life of up to 10 days. So that one does literally take weeks to fully build up in the blood and that's probably why doctors use that line.
Regardless, even with the shorter half-life drugs it does take a couple of weeks for your brain to adjust to the altered neurotransmitter levels. So even if it's not technically "waiting for it to build up in the blood", the result is the same and it's an easily understandable explanation for doctors to use even if it's not technically correct.
Doctors will absolutely gaslight your symptoms with anything that affects your brain. They don't care that you can't sleep or eat or have sex or experience emotions, it's all about throwing pills at the problem until one seems to work a little bit and doesn't make your life shit. I've never met a psychiatrist capable of basic human empathy.
There are a lot of really shitty doctors out there that do shit like that but there are still decent ones too. Luckily the one in my initial post wasn't my primary care doc. I couldn't get in to see my normal doc at the time so I just got Dr. Dumbass instead.
My primary care doc is actually great with dealing with my depression despite it not being his area of expertise. I'd love to get in to see a psych and therapist but they're all so booked up my doctor can't even get me on a waiting list so he just does the best he can on his own. He literally called up that department while I was in the office with him and they basically gave him a flat no and then hung up on him. Durring one of my initial appointments he just straight up told me that mental health isn't an area he knows much about but as time went on it became clear that he was putting in a ton of effort to actually educate himself. Now whenever I'm having an issue related to my depression or medications sideeffects he can quickly come up with multiple potential solutions discuss the pros and cons of each one with me and ask which one I want to try. Needless to say I will be keeping this doctor even if it means I need to lock him in my basement.
amazing!