This AskMe is depressing me December 19, 2013 8:15 AM Subscribe

I'm concerned about the answers to this AskMe post. Although I feel personal experiences can certainly inform our answers, in this case they seem to have become a basis for a debate on the efficacy/evilness of anti-depressants, with some over-the-top rhetoric thrown in that makes me really uncomfortable.

In the interest of full disclosure, Depression and the treatment thereof is a huge part of my daily existence. My family is predisposed to the condition (although not bipolar tendencies), and I have been receiving treatment for depression off and on (mostly on) for the last, jeez, going on thirty years now. I have a regular psychiatrist and have started and stopped several SSRIs (under the supervision of my doctors), as well as Wellbutrin and other anti-depressants. I have not answered in the thread (yet? Not sure if I should wade in) but have been watching it closely. I have flagged some answers but also feel conflicted.

What concerns me is that I feel like there is a bit of an an abuse of the system going on in that thread. Specifically, people who previously responded are coming back into the thread, under the guise of restating their answers, and using that as a excuse to throw in inflammatory, provocative and just plain erroneous asides, which I feel adds to that contentiousness in the thread.

Some examples:
assuming that antidepressants always magically lift a haze and reveal the true person underneath is terrifically naive.
SSRIs are evil
Some people are instantly happy with their anti-depressants
It could be the case that he's never loved you and only now has the bravery and fortitude to admit it, but it sounds much more like he went on Lexapro and became a bit dead to the world and now wants to go seek his fortune in a variety of ways that will probably never be deeply satisfying, because the drug will prevent him from caring.

I am not calling for a ban of anything here or looking for the mods to do more than they have (they've already asked respondents to quit arguing with each other). I would like to know what the userbase feels we can do to curtail this kind contentiousness and, more importantly, the spread of misinformation, in this thread and going forward.

Yes, I know there is a contact form. I wanted to bring this to the userbase because I think it is something we can all address if others also feel it is a problem. Mods, I am sorry this comes so close to the holidays.

Thanks, everyone!

posted by misha to Etiquette/Policy at 8:15 AM (169 comments total) 6 users marked this as a favorite

That thread was a trainwreck and I really hope the woman who posted it has people in her life who can help her through what is a terrible time for her and a difficult time for her husband.

I have nothing to add, but that's been on the tip of my tongue ever since reading that thread.
posted by crush-onastick at 8:19 AM on December 19, 2013 [23 favorites]

Yeah, that was one of those threads that made me think "Jesus Christ, everyone, we're dealing with people's lives here". I know people (at least generally) mean well but that did not look like a phenomenal example of it.

Full disclosure: I did post in that thread, hopefully in a thoughtful and helpful way but everyone thinks they're being helpful or they wouldn't answer.
posted by Mrs. Pterodactyl at 8:24 AM on December 19, 2013 [3 favorites]

I should make clear that I haven't read that thread, but I'm asking because I don't see any misinformation in what you quoted. I see opinions that are comparable to "SSRIs are lifesavers."
posted by OmieWise at 8:30 AM on December 19, 2013

SSRIs are truly magical for people for whom they work, but they are not really all that effective for many people and their side-effects (including the effects of stopping them) make them a complete non-starter for many folks.

The 'misinformation' in the thread was not from people suggesting SSRIs might not work all the time. Quite the reverse. In that thread, a lot of people were saying "oh, your husband's behavior has changed radically right after he went on mood-altering drugs and he is now demanding a divorce? It's probably because you're a hectoring shrew and the antidepressants made him grow a spine!" Even after multiple people chimed in to say HEY ACTUALLY I WENT ON SSRIS AND HAD MASSIVE PERSONALITY ISSUES JUST LIKE IN THIS QUESTION!
posted by showbiz_liz at 8:38 AM on December 19, 2013 [42 favorites]

While I feel for the OP, I think that question was basically unanswerable.

I mean the answer is basically, maybe, everyone responds to medication differently, go to couples counseling, husband needs to talk to his doctor.
posted by inertia at 8:40 AM on December 19, 2013 [32 favorites]

I mean the answer is basically, maybe, everyone responds to medication differently, go to couples counseling, husband needs to talk to his doctor.

I think that is a great answer! If more people had said stuff like that, I don't think we would be having this MeTa!
posted by Mrs. Pterodactyl at 8:42 AM on December 19, 2013 [30 favorites]

I've actually thought about this a great deal in the past, especially any medical-related question.

OP, trust me I have similar thoughts and have a background in a very related field and I know people for whom SSRIs and other classes of antidepressants have saved their lives.

But I have come to believe that there is another side of askmeta. The questioners are not necessarily asking for "can you help me find a meta-analysis" or what do the findings from the clinical trials suggest, but it is probing for anecdotal evidence. At the end of the day, it is what they are looking for and many come from a very painful perspective. I think that the question falls into the second bucket.

So I don't read them,and it includes the post that is being highlighted. Once in a great while, I will memail an OP and give a different perspective.

At the end of the day, I believe that most askmeta posts have answers with inaccurate, erroneous info.But they are trying and often time give an OP what they want.

On the topic of the same people answering the same question multiple times in the same thread, I wish something would be done about that. Once or twice the point is made,but multiple times is often arguing IMO, or at least in the things that I have seen.
posted by Wolfster at 8:43 AM on December 19, 2013 [3 favorites]

That question reminds me of this debacle, thought it isn't exactly the same situation. "My fiancee, who has never done anything of the sort before, kicked our dog while on new mood-altering medication. What should I do?" "He kicked a dog? Punch him in the face and call off the wedding!"
posted by showbiz_liz at 8:44 AM on December 19, 2013 [2 favorites]

It's probably because you're a hectoring shrew and the antidepressants made him grow a spine!

I understand that everyone translates what they read into a voice that makes sense to them, but it's actually unhelpful to paraphrase stuff and then include the words that reflect the tone you hear in your own head. You can link to things and people can read them. I think this is part of the problem, people are applying their personal experience-filter to this and then are replying as if someone is talking about them, and as if they were not in AskMe. I personally took the "he's been eager to yell back" line to mean that the OP has been yelling AT him, but I did not know and decided I didn't want to wade into that mess of a question.

I did not and do not like that thread (I think there is a lot of between the lines stuff that people are deciding to interpret in various less than charitable ways) and we've been keeping a pretty close eye on it.
posted by jessamyn (staff) at 8:44 AM on December 19, 2013 [31 favorites]

I think the Asker is trying to ask a very metaphysical question about love, and maybe even identity, but she's wrapping it in this very practical problem of SSRI dosages. So everybody is trying to find a balance between the metaphysical and the practical in their answers, and lots of them are coming down too hard on one side or another.
posted by rue72 at 8:44 AM on December 19, 2013 [3 favorites]

In that thread, a lot of people were saying "oh, your husband's behavior has changed radically right after he went on mood-altering drugs and he is now demanding a divorce? It's probably because you're a hectoring shrew and the antidepressants made him grow a spine!" Even after multiple people chimed in to say HEY ACTUALLY I WENT ON SSRIS AND HAD MASSIVE PERSONALITY ISSUES JUST LIKE IN THIS QUESTION!

But lots of people are saying that in the thread. The OP can read all the answers, notice that there are differences of opinion, and make up her own mind.
posted by John Cohen at 8:45 AM on December 19, 2013 [2 favorites]

This is probably spitting into the wind, since the issue has been brought up before and it still comes up frequently, people who are guilty of this don't necessarily read Metatalk, etc., but boy would AskMe be a better resource if there were fewer answers of the, "Let me share my tough love advice based on my deep insight into your marriage which I am now an expert on after having read one perhaps imperfectly articulated paragraph" variety.
posted by The Gooch at 8:47 AM on December 19, 2013 [51 favorites]

I thought she was looking for stories to support her desire to believe that it was the drugs that caused her husband not to love her any more. Framing the issue that way was guaranteed to draw a poor response. Though it is hard not to see why she'd want an alternate answer. I think the real issue is the very understandable pain she is feeling.

It would have helped if the first folks responding didn't jump all over her for being a yeller in relationship arguments. That was neither the question she was asking nor productive for her given that her relationship appears to be over.
posted by bearwife at 8:48 AM on December 19, 2013 [10 favorites]

I am frustrated that people in that thread who have negative experiences with Wellbutrin are posting them. SSRIs and Wellbutrin are different classes of drugs, Lexapro is in the same class as Celexa, Zoloft, etc - but not Wellbutrin.

If someone were to post a question about a bad reaction to ibuprofen, it would be relevant to talk about other NSAIDs, but it would not be relevant to post about reactions to acetominophen.
posted by insectosaurus at 8:52 AM on December 19, 2013 [16 favorites]

I occasionally feel that many AskMes (especially in the Human Relations department) would be better answered if we were forced to answer via question.
"Have you considered that he's sick of your shit?"
"Would you be interested to know that I had similar problems when I started taking SSRIs?"

A lot of those types of AskMes are really the start of conversations (if not between the Asker and other MeFites) rather than an actually answerable question. Which I know is against the idea of AskMe, but that's still how I feel on occasion.
posted by Etrigan at 8:54 AM on December 19, 2013 [1 favorite]

The 'misinformation' in the thread was not from people suggesting SSRIs might not work all the time. Quite the reverse.

That's not how I read the post here, but I could be reading it wrong. That's why I asked. I read misha's post here to be a variation on, "anti-depressants helped me immensely and it is misinformation for people to call them evil."
posted by OmieWise at 8:54 AM on December 19, 2013

I thought she was looking for stories to support her desire to believe that it was the drugs that caused her husband not to love her any more. Framing the issue that way was guaranteed to draw a poor response. Though it is hard not to see why she'd want an alternate answer. I think the real issue is the very understandable pain she is feeling.

I agree, completely. This was what made the question so sad to me.
posted by inertia at 8:56 AM on December 19, 2013 [6 favorites]

I've read that thread. It's a mess, but I still don't see it as a mess around SSRIs specifically.
posted by OmieWise at 9:06 AM on December 19, 2013

Well, since I'm one of those people this MeTa is calling out, let me retort: When I say SSRIs are evil, it's my opinion, I'm entitled to it, deal with it.

Furthermore, let me add this AskMe depresses me because a bunch of people immediately thought they knew all the circumstances and aspects of this relationship after reading a few paragraphs and felt it was okay to basically attack the OP (who is no doubt hurting something fierce right now without the mob piling on her). It also depresses me that so many people think marriage is a disposable thing that you shouldn't have to work at.

But you know what? I didn't feel the need to make a MeTa thread about it.
posted by entropicamericana at 9:06 AM on December 19, 2013 [3 favorites]

I see a tendency in a lot of AskMe answers to try and find the "real question" - unstated - lurking behind the stated question. This can be good when peoples' questions reveal a situation they don't know is dangerous / unhealthy / abusive, but in complicated things like peoples' lives it can get judgmental, quickly. I think that should be discouraged.

Also, I think it's clear by now that Metafilter does not do antidepressants well.
posted by graymouser at 9:07 AM on December 19, 2013 [19 favorites]

I really hope that poster and her husband get help of the therapy variety, either individually or as a couple.

For what it's worth, like the OP I was the one who suggested my husband go on medication for his depression and anxiety. I've suggested it since, actually, and he's always quick to remind me why it's a bad idea ("You like sex and cuddles and when I'm on them I hate both those things and the intimate bonds of our relationship start to unravel because you feel unloved and I don't notice" is pretty much why). I'm super pro medication for those for whom it works but it really, really doesn't work for every person or every situation.
posted by PhoBWanKenobi at 9:18 AM on December 19, 2013 [5 favorites]

I answered early in the thread based largely on my experiences with SSRIs. I had no idea the thread would end up like it has. I actually regret saying anything. The question was really short on detail and it left a lot of room for people to make assumptions, including myself.

Should have just passed over. Alas.
posted by Lutoslawski at 9:34 AM on December 19, 2013

Oh and yeah, the Wellbutrin derail was really odd. Totally different neurotransmitters, and if anything it's norepinephrine and dopamine that'll make you rage, not serotonin. That was weird too. I think part of why metafilter doesn't do antidepressants well is because we tend to treat them like some monolith, when it's a huge class of wildly different drugs.
posted by Lutoslawski at 9:38 AM on December 19, 2013 [10 favorites]

"oh, your husband's behavior has changed radically right after he went on mood-altering drugs and he is now demanding a divorce? It's probably because you're a hectoring shrew and the antidepressants made him grow a spine!"

First of all, the OP said it's been seven months, so it's not really "right after" he started taking medication.

Second, the phenomenon of a depressed person realizing they're not happy in a relationship or job or other situation that's been making them miserable and finding motivation to get out of the situation only after the depression starts lifting is a thing that happens. A lot. It's an extremely common way of measuring progress in treating depression -- is the person able to listen to their own emotions and value themselves enough to get out of soul-sucking situations?
posted by jaguar at 9:41 AM on December 19, 2013 [17 favorites]

What kind of misinformation are you seeing, specifically?

SSRIs are truly magical for people for whom they work, but they are not really all that effective for many people and their side-effects (including the effects of stopping them) make them a complete non-starter for many folks.

I agree with you that the effects of SSRIs are widely disparate, which is why words like "magical" and "evil" both bother me.

I am allergic to penicillin. Taking it would make my throat close up and I could potentially die. However, penicillin may well cure your ear infection. My allergic reaction does not mean penicillin is "evil", nor does yours make it "magical".

I also feel it is pretty common knowledge that SSRIs do not work immediately for the majority of people, which is why I am bothered by the "always instantly" phrasing.

Also, references were made to fits of rage being a frequent side effect with SSRIs, which isn't true and in fact is counter-indicated. SSRIs can be used to treat rage, even.

And, yeah, SSRIs and wellbutrin are not at all the same.

Which is not to say everything in the thread was wrong. Excellent information came from, among others, Mrs. Pterodactyl (thank you!) who pointed out that rage can be a side effect with bipolar individuals and certain anti-depressants.

It's just that there's a lot of emotional and psychological baggage that comes along with treating mental illness. People making blanket statements on medical treatments with no other basis than their own baggage bothers me, especially when they keep coming back into an AskMe thread to debate that issue rather than, you know, actually answering the question.
posted by misha at 9:41 AM on December 19, 2013 [14 favorites]

"I obviously have an opinion about this, but there is a for real controversy here."

Yes, and you have a vested interest in this which you might want to disclose.

"When I say SSRIs are evil, it's my opinion, I'm entitled to it, deal with it."

Sure, and I deal with climate change deniers and anti-vaxers and creationists, too. I think your opinion about SSRIs is evil, I'm entitled to that opinion, deal with it.

All things being equal, that some people think that antidepressants do more harm than good would be a perfectly valid and acceptable position to have about health policy.

But things aren't equal, there is a prejudice against seeing depression as a medical condition that rightly should be treated pharmaceutically that isn't similarly strong with other conditions such as schizophrenia or even anxiety, and because the previous is true there is a consequent moralizing subtext (or overt text) that blame depression sufferers for their depression and their "lazy" desire to falsely "solve" their problems with "happy pills".

Seriously depressed people, and especially chronically depressed people, have already lived within a social context that tends to see their depression as a behavioral failure of personal virtue, that they are weak or lazy or self-indulgent or just plain unpleasant, and a message to them that antidepressants are a lazy and false solution that just distorts their true personality compounds and intensified that message.

Like people with addictions, chronically depressed people internalize their own experience of self as their identity, as do the people around understand them as the addict or as the depressed person. When an addict begins recovery, it can be extremely uncomfortable for them to find themselves to be people they don't really know, people unfamiliar to themselves, and this is just as true for the people closest to them. A chief cause for people to go out of recovery is that they're not comfortable with their sober selves and so, also, are not their lovers and their family and their friends. To everyone, the sober person is the unfamiliar interloper, not the addict. This is exactly what often happens to people who struggle with depression, including when they become less depressed via only therapy. They're uncomfortable with this strange person they find themselves being, and more to the point, the people around them don't know how to relate to them, most especially when those people have been in a codependent relationship with them. Those people often have a vested interest in their loved one being depressed, so they can be taken care of.

The message that antidepressants are quick-fixes that cause false, distorted personalities is exactly how these people and the people close to them often perceive recovery from depression themselves. When there's something as unambiguous and undeniable as a pill that's being taken every day to point to, then it's easy for everyone involved to decide that this discomfort they feel is the dastardly result of a drug that turns you into someone else. And they stop. They go back to being that depressed person, whom everyone is much more familiar and comfortable with, especially the depressed person themselves.

And those people continue to suffer and no small number of them kill themselves.

There is a cost to promulgating that message, it's not merely an abstract discussion about health policy. Please note that a whole lot of people believe that AA is a cult and that it causes people to become creepy, unnatural, distorted people. It's easy for them to believe this, it's easy for them to think they're doing other people a favor by promulgating this view, and it's easy for other people to listen and drop out of recovery.
posted by Ivan Fyodorovich at 9:43 AM on December 19, 2013 [93 favorites]

It also depresses me that so many people think marriage is a disposable thing that you shouldn't have to work at.

This seems like exactly the mean natured mischaracterization of other people's comments that Jessamyn critiqued earlier in the thread.

Not only is it kind of mean, it's also sloppy. Marriage legally is disposable in almost every country. If you live somewhere where it's not, you're an exception.

Implying that thinking that marriages can and even sometimes should be disposed of is the same thing as saying someone shouldn't have to "work at" a marriage ever (where "work at" can cover an inestimably large area of ground) seems very disrespectful to people in the tread who told stories about harmful, damaging, even abusive marriages. If you personally think that no marriage should ever be disposed of, no matter how heinous, you're entitled to your opinion, but it is a little rich to accuse other people of black and white thinking.
posted by Salamandrous at 9:45 AM on December 19, 2013 [7 favorites]

I'm sorry that in my comment above I implied that the anon OP's marriage was soul-sucking; I was trying to speak more generally and I should have made that more clear. Sorry.
posted by jaguar at 9:47 AM on December 19, 2013 [1 favorite]

Oh christ, here I am, arguing on MeTa again. I'm out, have fun feeling virtuous and enlightened at other people's expense.
posted by entropicamericana at 9:48 AM on December 19, 2013 [1 favorite]

I plan to have fun without doing that.
posted by Ice Cream Socialist at 9:55 AM on December 19, 2013 [32 favorites]

Yes, and you have a vested interest in this which you might want to disclose.

what

My vested interest is in people having a broad array of proven treatments for mental health issues, as my comment makes clear. SSRIs are one of those treatment options. I assume you're referring to the fact that I'm a clinical social worker, and that I somehow have a "vested" interest in not feeling like SSRIs are the only treatment for mental disorders as a result. I'm not sure you have a clear grasp of the economics at work if that counts for you as a vested interest needing to be disclosed in comments like mine above.

People making blanket statements on medical treatments with no other basis than their own baggage bothers me

This happens all the time on AskMe, we've had people leave the site over it. It isn't just with anti-depressants that it happens. That doesn't make it right or good, but we see the opposite plenty on the site as well, and it's just as anecdotally based.
posted by OmieWise at 9:56 AM on December 19, 2013 [7 favorites]

Hi, misha. Cheers, and good luck!
posted by Nomyte at 10:11 AM on December 19, 2013 [1 favorite]

That thread is scaring me. After being at near suicidal levels of depression my wife got me to schedule a visit to the doctor (the shrink he referred to me to wasn't available until March and I'm afraid I'd be dead by then). Since he's just an internalist he'll probably just prescribe something. After reading that AskMe I'm suddenly afraid of how things will turn out - I've been unhappy about my marriage but I've assumed that is coming from a place of depression.
posted by charred husk at 10:15 AM on December 19, 2013 [1 favorite]

"After reading that AskMe I'm suddenly afraid of how things will turn out - I've been unhappy about my marriage but I've assumed that is coming from a place of depression."

Don't assume anything. As everyone always says, meds + therapy is far better than meds alone and therapy will help you figure out where that unhappiness is coming from and what you want to do about it. The depression could be causing you to obsess on something that isn't so big of a problem, or the depression could involve that something as a big problem. It could be either, right?

So don't make yourself upset by imagining future problems, take it a day at a time.
posted by Ivan Fyodorovich at 10:20 AM on December 19, 2013 [19 favorites]

I read that thread and I felt that it is useful for the OP to see both sides - it's possible that the anti-depressants are causing personality changes, it's possible that the lifting of depression was causing the husband to come to terms with the fact that their relationship had been rocky for some time. We can't know based on our limited information, so it seems fair that all perspectives should get aired.

*That said*, the judgmental tone of a lot of the answers was disheartening. People come to AskMe for advice at difficult times, I'd like to give them the benefit of the doubt and answer as graciously as I can.

As for whether anti-depressants are something that Metafilter doesn't do well, I agree that these conversations are often over-charged and circular. But I do get more useful perspective here than almost anywhere else.
posted by mai at 10:23 AM on December 19, 2013 [8 favorites]

When an addict begins recovery, it can be extremely uncomfortable for them to find themselves to be people they don't really know, people unfamiliar to themselves, and this is just as true for the people closest to them.

To me, this is a very insightful take on what the OP and her husband in the AskMe are going through, and I think it's too bad that the question isn't open-ended enough to have room for an answer like this. I think that actually, the OP *is* asking about how to handle the huge change in her marriage's dynamic and huge change in her husband. So, to me, the SSRI issue is almost a derail. Who knows how the Asker sees it, though.

I see a tendency in a lot of AskMe answers to try and find the "real question" - unstated - lurking behind the stated question. This can be good when peoples' questions reveal a situation they don't know is dangerous / unhealthy / abusive, but in complicated things like peoples' lives it can get judgmental, quickly. I think that should be discouraged.

I do think it's better to err on the side of being gentle and/or purely practical in these questions, because the Asker is probably feeling vulnerable and exposed already, and there's no reason to put a person on blast for asking about something painful.

I don't think that people answering the question should feel that they *have* to work within the Asker's framework or *only* answer the exact question asked, though. The person asking the question probably can't or won't see the situation well, and that's probably why she's asking the question in the first place. So if someone sees a way to answer one aspect of the question or reframe the question, I do think that can still be valuable to the Asker and worth posting -- a lot of the time, that might even be more valuable than a slavish regard for how the Asker put the question in the first place.

Then again, I also think personal anecdotes and baggage are perfectly acceptable and even useful on AskMe, so YMMV.

I've been unhappy about my marriage but I've assumed that is coming from a place of depression.

For what it's worth, I personally have seen a lot more relationships helped by medication than hurt by it. Treatment carries risks, and even in the best case scenario it carries costs, and adjusting to new dynamics/abilities/desires can be hell on everybody. But the rewards might still result in (a huge) net gain.

And, also for what it's worth, I've seen a whole lot of relationships hurt by a person's refusal to get treatment or medication. It's not as if carrying on without doesn't have risks and costs and difficult adjustments of its own.
posted by rue72 at 10:48 AM on December 19, 2013 [11 favorites]

It also depresses me that so many people think marriage is a disposable thing that you shouldn't have to work at.

Yeah, this. Commenters on Askme definitely fall into the all-or-nothing-thinking trap all the time, and I wish that they'd take the time to realize that real life isn't like books or TV: peoples' lives are MESSY. Messier than my hoarding great aunt's living room. Oh, he looked at another woman once in the hallway a year ago? DTMFA, and you're a bad person if you don't because you have no self respect or worth.

Sometimes people have situations that are outside Mefites' neat-and-tidy little experiences, and we shouldn't be so quick to dismiss people that don't fit our Ideal Of A Good Relationship.
posted by Melismata at 10:49 AM on December 19, 2013 [17 favorites]

I understand that everyone translates what they read into a voice that makes sense to them, but it's actually unhelpful to paraphrase stuff and then include the words that reflect the tone you hear in your own head.

Can we get a flag marked "Stupid paraphrase"?
posted by the man of twists and turns at 10:53 AM on December 19, 2013 [16 favorites]

Anyone who has participated on AskMe for any length of time could have predicted exactly what would happen in this question the moment it got posted. So many hot buttons! Constantly yelling at your husband! Antidepressants! Leaving your wife! All they needed was a cat being declawed.

I'm not sure what kind of answers OP was looking for (I tend to agree she was probably looking for "yes, antidepressants are making your husband act like this!") but the answers she did get were a foregone conclusion.
posted by Justinian at 10:58 AM on December 19, 2013 [5 favorites]

I see this as a continuation of the Iowa thing. People with ZERO FIRST HAND KNOWLEDGE/EXPERIENCE of a specific drug (or class of drug) felt compelled to answer, just like the people who had no experience with Simpson College felt the need to post replies. As I have no knowledge/experience with either subject, I stayed out of both questions.

Also, it should be okay to ask a very specific question without responders trying to open up the entire situation (be it a failing marriage or criteria for selecting a college) into a free-form discussion.
posted by 99percentfake at 11:08 AM on December 19, 2013 [3 favorites]

I read the question as asking for personal anecdotes about the effect of SSRIs on one's marriage and that is exactly how I responded to it. I made sure to include a couple of caveats even though I think it was probably clear from the way my response was written that I wasn't telling her what her husband was doing, only telling her my own experience. To the extent that I described how bad my relationship was, it was largely to illustrate that this wasn't a matter of taking a pill and changing my mind about my relationship.

What I didn't say was that my experience as related in that thread is what I tell people when they say, "I don't want to take a drug that will mask my real feelings and make me happy with whatever's going on."

I also didn't mention that my ex-husband had started on Prozac a year or two before I started taking Lexapro, and he didn't think it was helping him so he stopped taking it, even though I asked him to please continue with it. I made that request because he was so much easier to live with when he was on the anti-depressant. Ugh, I thought about giving an example just now but I don't like to remember all that business.

Anyway, I hope that the variety of responses in the thread will help show the OP that there are many results from the drug and there's no "one size fits all" answer. I have mentioned before that I at one time asked an anonymous question and got DTMFA responses almost universally, which was not a direct answer to my question but which I took seriously enough to discuss with my best friend to see whether his take was the same, considering that he has far more context for me than do mefites, even if I asked the question non-anonymously. I don't think that it's necessarily a bad thing to get the full gamut of possibilities in response to one's question.
posted by janey47 at 11:15 AM on December 19, 2013 [3 favorites]

There was a lot of perhaps good answers but dog awful horrible tone there (along with a liberal share of ignorant derails). I wish people where kinder in their approach, I wish I was kinder too at times.
posted by edgeways at 11:18 AM on December 19, 2013 [9 favorites]

A post about depression is depressing?

The problem with posts about depression and medication is each situation is unique. People's responses to SSRI's do vary from miracle to utter disaster.

Years ago I had a short lived period of anxiety (not attacks, just overwhelming unrelenting anxiety). My doctor gave me a pill. I'd take one when things were at their worst. He gave me 8. I started panicking about what I would do when I ran out, so he gave me a refill, so now I had 10! He told me he'd fill it if I needed more. Suddenly I didn't need them. Just knowing they were available was enough. I wrote a poem about it. I make fun of the medications, but I've experience with all of them.

I have a hard time discussing depression in others. I can only tell people how it is for me.
posted by cjorgensen at 11:26 AM on December 19, 2013 [1 favorite]

It also depresses me that so many people think marriage is a disposable thing that you shouldn't have to work at.

Like many other things in AskMe, this is a problem with the world that AskMe only paints in stark relief where people have to look at it. And by "this" I don't mean the idea of disposable marriage I mean the fact that marriage can mean different things to different people and that those ideas can be fundamentally at odds with each other and there is no objectively right answer and nerds love objectively right answers.

The lack of an objectively right answer is why people sometimes either console themselves that their answer is secretly right and that everyone else is an idiot (a little tough in AskMe where people you might otherwise respect are espousing positions diametrically opposed to ones you hold - this happens to me a lot) or just get judgey about other people's "bad" decisions and ideas about things. I try really hard when I see someone making a comment that seems unusually "I know THE answer" about a thing that doesn't have a right answer (there are a few things I know, but knowing what I don't know can be useful) that my response to them is qualified to my area of actual knowledge.

So, my folks treated marriage as non-disposable for a very long time and that was ultimately a bad idea for them and a bad idea for me and my sister. I think there are a lot of right ways to be married and to treat marriage, but realistically speaking it is true that marriages end and in some cases this is not a terrible thing. What someone decides to do about their personal relationships is really mostly between them (though people feel more strongly about intervening when there are kids involved) and I'm often surprised at how much people project their own experiences on to the experiences of others as if just saying "Hey this is how things worked out for me, this might be helpful for you to know as you are making your own decisions based on your own situation" isn't somehow going to be enough. I wish my parents marriage had been more disposable, but that's an issue for me and my therapist and not really a passion play that I should be acting out on the pages of AskMe.
posted by jessamyn (staff) at 11:29 AM on December 19, 2013 [38 favorites]

On the contrary, misha, I consider that a golden thread full of detailed, credible, and very illuminating personal accounts the like of which are very difficult to come by anywhere else (I spent an hour looking around on patient forums and such but found nothing comparable) which absolutely did answer the OP's question: "Have you or your spouse experienced a decline in attachment/romantic love after starting an SSRI?"
posted by jamjam at 11:33 AM on December 19, 2013 [4 favorites]

I wish I had stayed away from the thread entirely. It made me feel awful for various reasons.

OTOH the types of derailments and whatnot in that thread are rather par for the course on the Green and I can't say I was surprised, at all.
posted by sm1tten at 11:57 AM on December 19, 2013 [1 favorite]

The thread, and this one, make me feel sad for various reasons.

I have nothing I want to publicly add to either thread. Apart from wishing and hoping that the OP, and her husband, find their way to happiness and contentment in the future, whether together or apart.
posted by Wordshore at 12:11 PM on December 19, 2013 [4 favorites]

Here's few guidelines for answering questions in AskMe. Take'em with a grain of salt, if you prefer.

Be kind, even if you're disagreeing. Especially if you're disagreeing.
Remember, you're not getting the full story and if the question involves other people, you're definitely not getting their side. Be kind to the OP and others involved in the question, even if they're being assholes. You don't know the full story.
Be helpful. That's no need to berate or disparage the OP or anyone else.
It's not about you. Yes, your life experiences inform your world view and may cause you to be alarmed by question. That's ok, but it's not about you and few of our experiences are completely objective, so try and refrain from giving the impression that you are 100% right. Because you don't know the full story.
You don't have to answer.
It's good to participate in situations that bring you joy or at least minimal discomfort. If an AskMe is bothering to such an extent that you're violating some guidelines, then just walk away, go do something else.

posted by Brandon Blatcher at 12:41 PM on December 19, 2013 [49 favorites]

A lot of it made me sad, too. I think the OP needs to take care of herself.

The speculation that she's a harpy, her husband has taken the red pill, that SSRIs are like eyeglass cleaner for the soul... So unnecessary for a question where the asker is being so vulnerable and is obviously so devastated.

I also hate the game of find the real question - particularly when it relies on spotting the passive voice. FFS.
posted by sweltering at 12:46 PM on December 19, 2013 [6 favorites]

Isn't it only unnecessary if it's untrue?
posted by Justinian at 12:49 PM on December 19, 2013

"You guys need to go to couple's counseling" is not an appropriate answer for someone whose spouse has announced they're leaving. It's giving a level of hope in the outcome that is not, honestly, warranted. Counseling is for before you've gotten dumped. When you've been dumped, you've been dumped. She can believe that marriage should be for life, but her husband is leaving her. I think that in the end she'll probably be able to find options for her life that make her a lot happier, so it's not like we need to save her from a lifetime of despair or something. I certainly didn't mean to imply any deep wrongs about her behavior. Just that it seems like it's entirely reasonable that he wasn't thrillingly happy and would want a change from that.

I think if this were gender-switched, people would probably be a lot more respectful of the other party's agency. He wants to end the relationship. The fact that there's a legal contract involved does not take away the fact that he is an adult who has made this decision and he's not obligated to get her permission first. Not even if he's on medication. He's not the one asking for advice; she is. That's the part that makes me uncomfortable about a lot of responses. If your question is "how can I make my partner stay after they've said they're breaking up with me", is the answer ever anything other than "you can't"?
posted by Sequence at 1:02 PM on December 19, 2013 [4 favorites]

I think that thread suffers from the fact that the very first answer is pretty hostile to the asker ("Way to bury the lede there anon."). And by selectively quoting from the question and wrapping up the issue in a pithy epithet ("doormat"), it kind of sets up a tl;dr for subsequent posters to pile on to. After a few have piled on, others come in to defend the OP and chaos ensues. Plus, antidepressants.

I remember a MeTa about comment deletions on the blue (IIRC it was a music post and the deleted comment was about the I/P conflict) and several mods said that a major influence behind the deletion was that it was the first post and as such would set the tone and direction of the entire discussion. I am wondering if this reasoning ever applies to the green as well.
posted by payoto at 1:08 PM on December 19, 2013 [16 favorites]

Yeah that first post was completely out of line and should have been removed immediately.
posted by MisantropicPainforest at 1:09 PM on December 19, 2013 [8 favorites]

Yes, that was pretty hostile and ugly in its assumptions about the OP.
posted by Brandon Blatcher at 1:12 PM on December 19, 2013 [1 favorite]

Can we make Brandon's comment an interstitial screen whenever someone posts a comment to an Ask thread? Like, "You look like you're commenting in Ask Metafilter. Please follow these guidelines to help us keep the community wonderful", and then you have to click a checkbox or something?

Or maybe it should just be the result when someone clicks post. And then it discards their comment.

(this comment may or may not have hamburger in the second graf)
posted by scrump at 1:31 PM on December 19, 2013 [3 favorites]

*That said*, the judgmental tone of a lot of the answers was disheartening.

Yes, that - plus a false, 100% certainty about what, *exactly* the problem is, and what *exactly* the solution is can be one of the most off-putting things about askme, and it was very strong in that thread.

I was disgusted by the needlessly cruel and judgmental early comment - it never should have stood in a million years, regardless of if it technically was within the guidelines - and it subsequently derailed half the discussion I felt. I would love to see mods deleting ask me answers with the reason "Unhelpful tone. Try harder." You really don't need to try that hard.
posted by smoke at 1:52 PM on December 19, 2013 [5 favorites]

"You guys need to go to couple's counseling" is not an appropriate answer for someone whose spouse has announced they're leaving. It's giving a level of hope in the outcome that is not, honestly, warranted.

It's not at all clear how long ago this declaration came or at what stage of discussions the couple is in about the break-up. But her husband's attitude, along with the attitude of some of those commenting--that she needs just to step back and let him go without discussion, reflection, or any processing beyond, "Well, that's what he wants" seems really weird to me and not at all reflective of the reality of either divorce or marriage.

Is her husband obligated to say "yes" to counseling? No, of course not. But it seems worth a shot here, if she still loves him and believes in her marriage. At the very least, it may help her negotiate a better and safer outcome for herself.

In my experience, the hardest part of dealing with a similar situation was my partner's belief that his irrationally detached attitudes were normal. The first time he was on mood altering drugs during our relationship (they were mood stabilizers, as he'd been misdiagnosed as bipolar), he declared that he was too old to like sex anymore. At 26. These thoughts were actually not at all rational, and regardless of the outcome of our relationship, I find it hard to believe he would have been living his best life if he'd continued on those medications.

That thread is scaring me. After being at near suicidal levels of depression my wife got me to schedule a visit to the doctor (the shrink he referred to me to wasn't available until March and I'm afraid I'd be dead by then). Since he's just an internalist he'll probably just prescribe something. After reading that AskMe I'm suddenly afraid of how things will turn out - I've been unhappy about my marriage but I've assumed that is coming from a place of depression.

Just be aware that personality changes can occur; talk openly with your wife about it, and about the potential impact on your relationship. And seriously, talk to a therapist. It's the most effective thing you can do, whether or not you also pursue medication.
posted by PhoBWanKenobi at 1:54 PM on December 19, 2013 [10 favorites]

overall I think the pendulum has already swung too far towards "delete" in AskM

Not snark: I am genuinely interested in hearing more about why you think this. Can you give some examples of deletions that should have stayed up (obviously, you can't get the specific comments, but the gist)? When you say 'too far', who do you feel the deletions are hurting, how do you think it's affecting the utility of the site?
posted by smoke at 2:28 PM on December 19, 2013 [1 favorite]

"Yes, that was pretty hostile and ugly in its assumptions about the OP."

Although in general I'd be inclined to agree with this criticism, because I think it's a general problem on AskMe, in this case I agree with lalex in that it wasn't "that terrible". It wasn't great, but it was a valid point.

It's also something that I'd not think usually, and I'm usually critical of those who argue this, but I think that there is some gendered stuff involved in people criticizing that answer. I have trouble believing that had the poster been male and the spouse female, that things like "now she yells back and she sometimes starts fights" wouldn't have resulted in much stronger responses like that first one, and I also doubt that people would be arguing that "he" should try to stop "her" from leaving because maybe it's the drug and "she" doesn't actually know what "she" wants.

I know, as I always argue, that such reversals are invalid because they don't reflect the whole structure of society that makes something true one way, but not equally true the other.

Even so, I think that the general principle of "starting fights" and "yelling" are bad things to do, are bad signs in a relationship, is valid; as is the principle that you can't make someone love you and you can't make them stay and even if you're right that the problems can be worked out and that the falling-out-of-love is temporary, it does more harm than good to try to stop someone else from leaving a relationship when they want to leave it. Even in that individual relationship when it's true that it could be salvaged, trying to interfere with their own agency in choosing to cooperate in a relationship (which requires two assents to continue and only one veto to end) is hurtful to them and, not coincidentally, damaging to the relationship that you're trying to salvage. And that's assuming that it really can be salvaged.

I pretty strongly believe that people should try to answer the question that was asked and that "correcting" the questioner's assumptions is generally not the best thing. And especially that answerers should be kind and recognize that they know very little about the situation, as Brandon so clearly articulated. But a little of this is acceptable, and even though I don't like accusatory responses to a questioner, we can't really deny that there's a long tradition of this when answerers feel that the questioner has been behaving badly. Some answerers felt that this was the case in that thread, they responded accordingly.

The thread wasn't nearly as bad as I expected from reading this post and the comments here. There weren't as many "antidepressants are evil" answers as I'd feared, and I don't think that the pushback against the poster about her assumptions and conclusions concerning their conflict dynamic was so terrible. It was harsher than it should have been, but it wasn't cruel. It included loaded language with lots of implicit value judgments, but what else is new on AskMe?
posted by Ivan Fyodorovich at 2:30 PM on December 19, 2013 [8 favorites]

"While I feel for the OP, I think that question was basically unanswerable.

I mean the answer is basically, maybe, everyone responds to medication differently, go to couples counseling, husband needs to talk to his doctor."

Copypasta this a million times.
posted by klangklangston at 2:46 PM on December 19, 2013 [3 favorites]

Ivan: I think that such reversals are often but not always invalid, and I think this is one of the cases where it may be valid. I know that were I in the OP's husbands shoes the question shouldn't be "why did OP's husband leave someone who yells at them a lot?" but rather "why didn't OP's husband leave someone who yells at them a lot much sooner?". But maybe I have much less tolerance for being yelled at on a regular basis than some people.

Well, really, OP's husband should probably have tried to work on communication before jumping ship but since he didn't ask the question we can't really tell him that.
posted by Justinian at 2:48 PM on December 19, 2013 [2 favorites]

But, yeah, we can't answer the question (as I agreed in the thread itself). We don't have any idea if the medication worked and thus made the husband no longer so depressed he put up with being yelled at horribly or if the medication precipitated an abrupt and unwanted personality change which resulted in abandonment of a decent marriage. Either may be possible.
posted by Justinian at 2:49 PM on December 19, 2013 [2 favorites]

It's not at all clear how long ago this declaration came or at what stage of discussions the couple is in about the break-up. But her husband's attitude, along with the attitude of some of those commenting--that she needs just to step back and let him go without discussion, reflection, or any processing beyond, "Well, that's what he wants" seems really weird to me and not at all reflective of the reality of either divorce or marriage.

Reflection, processing, absolutely. On her part. Discussion seems to already be happening, in terms of talking about how to sort things out from here, and she describes nothing in the tone that implies it's an open question. The reality of the dissolution of long-term relationships, married or otherwise, is that it is indeed incredibly difficult to get blindsided by it, but you don't get to decide that it's not true just because you don't want it to be true. Going on the face of her assertions about what's happening, there's no equivocation. If there was any sign of equivocation, I would totally agree that it's worth a try, that it's worth some effort. But if the person with the most incentive to believe it was a maybe isn't describing it as a maybe, then I don't see any reason to read it like a maybe just because it will make her feel better in this moment. It's just delaying the inevitable. Sure, it sounds better to say there's hope, but if that hope is based entirely on data not given in the question, it's not a good answer.

Hedged in the right language it's not necessarily a bad suggestion, but a lot of the answers read the question as "we are struggling because he's angry a lot and want to patch things up", and that's not what she said was happening. As described, the anger has passed, he's being cordial and rational, and he's said he's leaving. Appropriate advice for that point in the problem is not the same as what would have been terrific advice before it got that far, you know? That's my problem. "If he's open to this, X" is fine, but a lot of responses seem to phrase it like counseling should just be the ordinary, healthy next step, and it's more like it would have been the ordinary, healthy next step five or six steps ago.
posted by Sequence at 3:18 PM on December 19, 2013 [2 favorites]

I was a little surprised at some of the comments which were not deleted in this AskMe. Not just the ones that were a bit accusatory toward the OP, but some of the more off-the-cuff comments (e.g. SSRIs are EVIL ACROSS THE BOARD) as well.

I flagged a couple and moved on, as I wasn't really in the mood to email the mods or post a MeTa at the time.
posted by Juffo-Wup at 3:25 PM on December 19, 2013 [3 favorites]

I remember a MeTa about comment deletions on the blue (IIRC it was a music post and the deleted comment was about the I/P conflict) and several mods said that a major influence behind the deletion was that it was the first post and as such would set the tone and direction of the entire discussion. I am wondering if this reasoning ever applies to the green as well.

Yes, it does.
posted by Busy Old Fool at 3:27 PM on December 19, 2013 [2 favorites]

but off the top of my head, these two threads discuss some of my issues with recent AskMe moderation.

It's funny that you pick those two.

The first was made by someone complaining that an answer which failed the cardinal rule of AskMe, that is, answer the question, got deleted. The second was made by someone with a history of making deliberately misleading statements.

Not great examples of a flaw in policy.
posted by the man of twists and turns at 3:27 PM on December 19, 2013 [4 favorites]

Reflection, processing, absolutely. On her part. Discussion seems to already be happening, in terms of talking about how to sort things out from here, and she describes nothing in the tone that implies it's an open question. The reality of the dissolution of long-term relationships, married or otherwise, is that it is indeed incredibly difficult to get blindsided by it, but you don't get to decide that it's not true just because you don't want it to be true. Going on the face of her assertions about what's happening, there's no equivocation.

I don't think that was at all clear from the information given, and I think the reality of dissolving a marriage is far, far different from, say, respecting a boyfriend who has told you he wants to break up and go non-contact, in the very least in that there could be legal ramifications in her simply stepping back and letting him go.

We don't have any idea if the medication worked and thus made the husband no longer so depressed he put up with being yelled at horribly or if the medication precipitated an abrupt and unwanted personality change which resulted in abandonment of a decent marriage. Either may be possible.

Honestly, the hardest thing about my undergoing similar experiences was my husband's belief, in the moment, that what was happening was rational and normal and his complete lack of perspective as to whether it was. There's a good chance that the husband in this case has no more idea than we do what's "really" going on. Which is unbelievably scary to watch, as a partner, regardless of one's normal communication style and whether OP should work on that or not.
posted by PhoBWanKenobi at 3:30 PM on December 19, 2013 [7 favorites]

"I think the reality of dissolving a marriage is far, far different from, say, respecting a boyfriend who has told you he wants to break up and go non-contact, in the very least in that there could be legal ramifications in her simply stepping back and letting him go."

I understand that because of your personal experience the idea that someone might not be in their right mind when they want to end a relationship, especially a marriage, is very frightening to you. It's frightening to me. But even in a marriage, you don't have a right to "stop" them from leaving.

I'm aware that in some jurisdictions it doesn't work that way, but, seriously, that's barbaric.

And, again, the poster herself uses words like "yell" and "starting fights" to describe her own present and past actions, as well as characterizing his changed behavior as "defending himself", which implies that she's verbally attacking him, and that he describes his feelings to her as not being romantic with her for months, that they've both long been "unhappy", and he wants to separate (and implicitly divorce, because he talks about both of them finding happiness with other people).

A partner denying those feelings and decisions as being, essentially, crazy and wanting the partner to stay, in the context of how she herself describes their past interactions, really sets off alarm bells in my mind. It's not only men in relationships who can be emotionally abusive and controlling, women can be this way, too; and that she's described some their past relationship in terms that make it clear that she was dominating and aggressive and he was submissive and passive, at least with regard to disagreement, combined with any hint of "he's not in his right mind, I don't want to let him leave" really creeps me out.

It's entirely possible that their situation is the same as yours. But it's entirely possible that it's not. I have trouble believing that the incidence of antidepressant-incited false "falling out of love and leaving" is even remotely close to the the incidence of antidepressant-incited "I'm not miserably depressed anymore and so I realize I don't want to be in this relationship". Because asserting to one's partner the former is such an insult to their autonomy (even when it's true), and the latter is so often the case, the assumption should be that the latter is true because that will do the lesser amount of total harm.
posted by Ivan Fyodorovich at 4:07 PM on December 19, 2013 [7 favorites]

That there are legal ramifications should involve contacting a lawyer, not just suggesting marital counseling. But the legal sorting-through required to attend to such things doesn't change the fact that when someone says they're leaving you, they've already made a decision about this and you don't get to make them take it back.

I get that you did go through something similar, PhoBWanKenobi, but that doesn't mean that what she's going through is identical to your experiences, you know? I'm sure that in either case it's terrifying. I've had long-term relationships wrecked by mental illness before. (I do not live in a state where marriage is an option for me, but dealing with joint bank accounts and jointly-owned vehicles is still a nightmare.) But the perfect advice for you at that point is not necessarily perfect without some big qualifications for someone whose situation is not the same. She does say he had anger issues, but she also says they passed--over the summer, so months ago, not last week. She says he wants her to leave, he wants to separate, he doesn't love her, he wants to see other people. Where do you read equivocation into this? This is where I mean that, like, I think your advice would have been great if she'd asked the question in June, but... hindsight.

Not to really pick on you specifically because it was a thing that came up a number of times. I just don't see where anybody can pull from this a hint that he's interested in reconciling., except that it would be nicer (and I certainly agree) if that were true.
posted by Sequence at 4:14 PM on December 19, 2013 [2 favorites]

But even in a marriage, you don't have a right to "stop" them from leaving.

Of course not, but it doesn't mean that one partner has a right to unilaterally decide that a marriage should be dissolved without negotiation or discussion--particularly that the wife should just "leave and move on with [her] life." (Which, honestly, merits at the very least a discussion with a lawyer before she leaves her marital home) The suggestions to simply step aside and set him free strike me as really, really bad advice in light of the way their relationship has apparently unraveled.

Where do you read equivocation into this?

It's not clear at all that she's discussed his personality changes with him; it's not clear whether or not she loves him or is happy in her marriage. It's not clear if she agrees with him that she needs to leave, and it's hazy, at best whether his "yelling back" implies a marriage in which there is verbal abuse or indicates a simply mismatch in communication styles. We can read these things into the question, based on our experiences, but I certainly don't feel confident asserting that any interpretation is absolutely true. The suggestion to get counseling, incidentally, isn't one I raised to suggest fixing their marriage but to facilitate communication about his personality changes and discuss the way their marriage has changed with an impartial third party. Reconciliation isn't the only end goal to counseling.

I have trouble believing that the incidence of antidepressant-incited false "falling out of love and leaving" is even remotely close to the the incidence of antidepressant-incited "I'm not miserably depressed anymore and so I realize I don't want to be in this relationship".

For what it's worth, and I'm really not comfortable talking more about this or having my experiences further interrogated, my experiences correlated with our only discussions of divorce in my relationship--unilaterally, from my husband's side. We didn't. We're still happily married--much more so today than we were then. Other individuals who have commented in the post have also recounted experiences of marital strife and disharmony precipitated by SSRI use. You may not believe it's common, but it clearly happens and it does neither the OP (who was explicitly asking for anecdotes of this kind) or those who are sharing painful experiences any favors to second guess them.

For what it's worth, the article the OP linked to is actually pretty informative on the topic.
posted by PhoBWanKenobi at 4:26 PM on December 19, 2013 [9 favorites]

there is a prejudice against seeing depression as a medical condition that rightly should be treated pharmaceutically that isn't similarly strong with other conditions such as schizophrenia or even anxiety, and because the previous is true there is a consequent moralizing subtext (or overt text) that blame depression sufferers for their depression and their "lazy" desire to falsely "solve" their problems with "happy pills".

This is really worth repeating.

I actually had to walk away from the computer when I read that bit about how a medication (that has helped several people who I know live better) is evil. Precisely because of all the times I had to sit through well meaning family and acquaintances drilling my wife about if she had tried X or Y, and if she REALLY was more happy or if it was just the drug making her think she was happy, or well you get the point. It's important to remember that people react differently to SSRIs; brain chemistry is complex, and people are different. Good or bad experiences doesn't negate other, differing experiences. The other important thing to remember is that the way that people relate those experiences can reinforce messages that actively harm other people.

As to that thread, there are good answers from people telling their personal experiences, even if those experiences are vastly different. The real problems in that thread are the answers that try and diagnose the askers situation based on their own experiences. There are ways to say "yes, that happened to me" and "that didn't happen to me, you may want to consider that there are other problems with your marriage" that don't do this, and people HAVE done that. I think the thread actually seems worse than it is, because the lived experiences are so varied and the topic is so very personal and sensitive that when people don't walk with care it's very easy for others to get hurt or worked up.
posted by Gygesringtone at 4:47 PM on December 19, 2013 [16 favorites]

I think the thread actually seems worse than it is, because the lived experiences are so varied and the topic is so very personal and sensitive that when people don't walk with care it's very easy for others to get hurt or worked up.

Yeah, I'm sure I'm not the only person who feels choked up over the whole thing. Painful stuff. It's what makes the responses so passionate and what makes the whole thread so hard to read.
posted by PhoBWanKenobi at 4:56 PM on December 19, 2013 [4 favorites]

Being ambivalent, or even anti-, SSRI is not like being a climate change denialist or an anti-vaxer

If you're saying things like "SSRIs are evil" then that is 100% precisely what it is like.
posted by drjimmy11 at 5:01 PM on December 19, 2013 [19 favorites]

Of course not, but it doesn't mean that one partner has a right to unilaterally decide that a marriage should be dissolved without negotiation or discussion

For better or worse, that's not true in most places. The terms of the separation are of course subject to negotiation and discussion, but either person can unilaterally announce a decision to pursue an end to the marriage itself.

I find discussions of depression and of marital issues distressing enough to read that I try to stay out. And people so often fully project their own experiences onto the situation at hand that the nuances and particularities can easily get lost.
posted by Dip Flash at 5:01 PM on December 19, 2013 [5 favorites]

For better or worse, that's not true in most places. The terms of the separation are of course subject to negotiation and discussion, but either person can unilaterally announce a decision to pursue an end to the marriage itself.

Legally, sure, though I don't think the OP's husband would have a legal right to tell her to leave their home and move on with her life and I think suggestions that she should are . . . bad advice.

Morally, ethically, and realistically--in the way that marriages and relationships often unravel--it just doesn't jive with my experiences or what I've seen. Humans and their relationships are messier than that.
posted by PhoBWanKenobi at 5:06 PM on December 19, 2013 [1 favorite]

"...a legal right to tell her to leave their home..."

I agree with that. He can unilaterally leave, but he can't order her to leave. And I feel the same way with the genders reversed.

"Morally, ethically, and realistically--in the way that marriages and relationships often unravel--it just doesn't jive with my experiences or what I've seen. Humans and their relationships are messier than that."

Realistically, it jives with my experience and what I've seen about many divorces.

Is it ethically right? Well, I think that you're conflating two different things. It's not ethically right for him to leave without discussion/negotiation; that's something you really owe your partner. But it's also not right for her to insist upon or try to prevent him from leaving without discussion/negotiation.

I got less from my ex-wife in the way of discussion, negotiation, or even explanation than the asker describes she got from her husband. I was told that she'd fallen out of love with me the previous summer. A few weeks later, she moved out and then divorced me.

This really messed me up for many, many years because she denied me the single most important thing to me given my own history and issues: the need to understand. For years I actually had dreams where I'd see her and I'd ask her just to explain it to me, what she was thinking and feeling, what had happened, just so that I'd understand.

I think she hurt me in a way that she shouldn't have.

But there's nothing I could have done about it and, more to the point, there's not anything I should have been able to do about it. One reason is that even if she was hurting me and choosing to do so, it's entirely possible that she was preventing herself from being hurt even worse. Or maybe explaining herself was just something that she couldn't do, period. I knew her well enough to have some pretty good guesses about what was going on in her head, as well as (eventually) having enough self-awareness to realize that maybe with someone else she'd have been able to do things differently.

What I do know, mostly after-the-fact, is that she felt deeply unhappy and trapped and, given that, I tend to favor her own right to do what she needed to do for herself over my need for her to explain herself to me or, even more so, stick around and go through counseling or something when she clearly knew her own mind.

Even in a marriage, you can't stop people from leaving. If they change their minds and you work things out, that's wonderful! But the phrase "set him free" shouldn't even be part of the conversation because it implies something that shouldn't be the case in the first place. You can't choose or not choose to set someone free because you don't (or shouldn't have) them locked up. Not "setting them free" is basically yanking on chains you shouldn't be holding, that shouldn't exist. Or if they exist, they should always be voluntary.
posted by Ivan Fyodorovich at 5:28 PM on December 19, 2013 [14 favorites]

I just don't see where anybody can pull from this a hint that he's interested in reconciling., except that it would be nicer (and I certainly agree) if that were true.

People go to couple's counseling all the time to figure out how to leave marriages more gracefully than simply walking out the door. It's perfectly appropriate to suggest it.

If you're saying things like "SSRIs are evil" then that is 100% precisely what it is like.

Bullshit. The data on SSRI effectiveness is completely equivocal. That is quite clear to anyone who has paid any attention to the development of the data, and the reporting on the massaging of the data. Saying that SSRIs are "evil," a position with which I do not agree, is obviously an opinion, but not one that is proved by the data we have to be wacky, any more than the "SSRIs are a miracle" position is.

This strawman that people who haven't had good experiences with SSRIs, or who point out that the data suggest they are not all that efficacious and come with costs that some people don't want to pay, are actually unwittingly promoting the suffering of people with depression, is wrongheaded and unintelligent. It's telling that almost every impassioned argument to this affect is essentially an anecdotal one, that in the process of building its own anecdote, strenuously puts down any anecdote that does not agree with it.
posted by OmieWise at 5:57 PM on December 19, 2013 [10 favorites]

It's possible it was intended as such, but I'm willing to give enough benefit of the doubt that the person could have intended "SSRIs are evil" much the same way that I would say that Strattera is evil because the side effects I had on it were horrific. Not that anybody else absolutely shouldn't take it, it's more an expression of how bad the experience was.
posted by Sequence at 6:11 PM on December 19, 2013 [2 favorites]

People go to couple's counseling all the time to figure out how to leave marriages more gracefully than simply walking out the door

+1 to that. My ex-wife and I did counseling and while in theory it started as a "can we save this?" , we knew the answer before we went. But it really, really helped the actual separation/divorce process to have someone to help us through it.
posted by wildcrdj at 6:14 PM on December 19, 2013

"This strawman that people who haven't had good experiences with SSRIs, or who point out that the data suggest they are not all that efficacious and come with costs that some people don't want to pay, are actually unwittingly promoting the suffering of people with depression, is wrongheaded and unintelligent."

Wait, which part was the strawman? Was it the part about [people] claiming that everyone who describes their bad experiences with SSRIs, or explaining that SSRIs have costs that some people don't want to pay, are unwittingly promoting the suffering of people with depression? Is that the strawman you had in mind?
posted by Ivan Fyodorovich at 6:20 PM on December 19, 2013

what
posted by OmieWise at 6:24 PM on December 19, 2013

The thing you're claiming is a strawman is a strawman itself. No one has argued that someone pointing out that SSRIs have costs that some people don't want to pay is "unwittingly promoting the suffering of people with depression".

I think it's kind of amazing that you would set up a strawman of other people setting up strawmen.
posted by Ivan Fyodorovich at 6:53 PM on December 19, 2013

> But even in a marriage, you don't have a right to "stop" them from leaving.

You don't. But if you are not actively abusing them and they unilaterally get up and walk out of the marriage they are sleazebags, without respect for the committment their spouse made and has continued, nor for themselves and the promises they also once made. Heh, that was then, this is now, that's all it takes.

> I know, as I always argue, that such reversals are invalid because they don't reflect
> the whole structure of society that makes something true one way, but not equally true
> the other.

In these cases factual correctness and logical validity are not appropriate criteria. We aren't examining a proposition or weighing the truth value of a theorum, we're responding to an ethical imperative--namely "Do unto others as you would have them do unto you." To refuse even to consider how you would feel if the pinching shoe were on your foot, as such reversals ask, requires more than just a failure to live up to "Do unto others", it requires active rejection of it. When people who have truly gone down that road are nearby you may be sure I'll be watching my back. Who knows what they might do?

> I got less from my ex-wife in the way of discussion, negotiation, or even explanation
> than the asker describes she got from her husband. I was told that she'd fallen out of
> love with me the previous summer. A few weeks later, she moved out and then divorced me.

Sleazebag. I'm sorry, Ivan.
posted by jfuller at 7:05 PM on December 19, 2013 [4 favorites]

misha has a problem with something I said and is bringing it up in as squirrelly and passive-aggressively as possible. I am shocked.

Saying "I have a problem with the ~general tone~ of the answers in that thread and then selectively quoting just me is really fucking dopey, just fyi misha.

Anyway, I found the early answers in that thread absolutely awful, and that's why I posted several times. It is a known risk of antidepressants to have massive personality swings if one isn't being monitored in therapy or otherwise-- SSRIs and Wellbutrin alike, which btw, I actually did post in that thread that Wellbutrin was not an SSRI, but people were more interested in creating warfare in a marriage than reading, I guess.

Seven months is not that long after going on a new antidepressant-- they generally tell you to stay on for six months to a year to see how it will effect you. Her husband is right there in that spot.

I think a lot of people who have had bad experiences with drugs know how profoundly and surprisingly the wrong drug can affect a person. It's a legitimately scary issue, and as much as misha doesn't like it antidepressants aren't magic and don't just magically cure each person that they touch. They are a serious drug and a person should work closely with a doctor to find the right one for them. A lot of people have serious side effects and value the drug anyway-- often weight gain and anorgasmia are not great fun, but are preferrable to being depressed. However, if one's mood disorder is more low-level, I think that shopping around for the right drug is a good idea, and I think prescribing someone an antidepressant and leaving them without regular therapy or follow-up appointments is a profoundly bad idea, for the exact reason in the Ask and which many people in the comments also reported.
posted by stoneandstar at 7:06 PM on December 19, 2013 [2 favorites]

It isn't a strawman. It's implied in many many of these types of conversations. Can you really not see that? That surprises me.

I quote a post that suggests that not treating depression "pharmaceutically" is part of a moralizing subtext blaming depression sufferers and claiming that they want to take "happy pills." This is not only an assertion that does exactly what I claim occurs in these conversations, it's wrong and actually restricts the efficacious treatment options available to people who suffer from depression. In other words, it's not only a strawman (the very one you claim I'm inventing), it's a strawman that accomplishes precisely the opposite of what the author claims to want. It is just one example, but we could find it in any of these conversations about anti-depressants, or ADHD meds, or whatever. People are very convinced that the thing that helped them will help everyone, and that saying so is a denial that it helped them at all.

I get that you disagree with me (although I'm not clear about the nature of that disagreement), but I'm not sure why you would claim my contention is without basis when I quoted a comment that does exactly what I claim is a problem.
posted by OmieWise at 7:10 PM on December 19, 2013 [3 favorites]

OmieWise, thank you.

This strawman that people who haven't had good experiences with SSRIs, or who point out that the data suggest they are not all that efficacious and come with costs that some people don't want to pay, are actually unwittingly promoting the suffering of people with depression, is wrongheaded and unintelligent.

Thank you thank you. Also, I absolutely do not think SSRIs are evil. That would be a ridiculous conclusion to draw from my comments. I think that they have powerful affects on a person's outlook and personality and thus should be taken with care and combined with therapy (though that is not foolproof either). They change people's lives-- sometimes for the better, sometimes for the worse. They are a tool, not a cure-all. A very very important tool for some, but that doesn't somehow mean they work perfectly for everyone.

I mean Christ, I'm not even trying to say that taking them is unethical or somehow wrong-- having the wrong prescription still helped me deal with depression, even while it was kind of changing me in a bad way. I'm just saying that they are serious business and a person should be alert about the risks and benefits. If they can afford to find the best fit, they should. They can absolutely save a person from a serious illness and are important to the practice of mental health, but I don't see what's controversial about noting that some people have bad reactions to some prescriptions.

I mean, sulfa antibiotics make me break out in hives and yell at people, so if I had to be on them long-term I'd try to be aware of that and maybe look for alternatives. Same with certain antidepressants for me.
posted by stoneandstar at 7:13 PM on December 19, 2013 [3 favorites]

This Meta is depressing me.

I'm concerned about the answers to this Meta post. Although I feel personal experiences can certainly inform our answers, in this case they seem to have become a basis for a debate on the efficacy/evilness of anti-depressants, with some over-the-top rhetoric thrown in that makes me really uncomfortable.
posted by cjorgensen at 7:13 PM on December 19, 2013 [2 favorites]

stoneandstar, I agree with you pretty strongly that it's just as valid to say, in that ask thread, that "SSRIs don't help everybody" as it to say "SSRIs help a lot of people". I hope you'll take that on board when I say that, even when you are 100% correct, and even if (as wasn't the case here, IMHO) everyone else in the conversation is wrong, it does your case no good whatsoever to comment more than a half dozen times in a single thread on the green. I actually think that that many comments, of a strongly argumentative nature, from a single poster would be a bit over the top even in the blue, let alone on ask metafilter.
posted by Ipsifendus at 7:20 PM on December 19, 2013 [6 favorites]

I don't think it does my case good or bad to post as many comments as I did. Idk, people say this from time to time to me about "posting too many comments," but don't seem to have an equal problem with people who post monstrously huge comments regularly. I could just consolidate everything into one gigantic fucking comment I guess, but it doesn't really matter to me. If the mods would prefer that I will try to do that from now on, but I am kind of tired of being concern trolled about how I post by non-mods. (Especially by misha, actually. Please stop misha.)

Lots of people have distinctive posting/thinking styles. I don't rag on other people for how they format their comments.
posted by stoneandstar at 7:27 PM on December 19, 2013 [5 favorites]

"I quote a post that suggests that not treating depression 'pharmaceutically' is part of a moralizing subtext blaming depression sufferers and claiming that they want to take 'happy pills.' This is not only an assertion that does exactly what I claim occurs in these conversations..."

I wrote that, but here is what I actually wrote:

"...there is a prejudice against seeing depression as a medical condition that rightly should be treated pharmaceutically that isn't similarly strong with other conditions such as schizophrenia or even anxiety, and because the previous is true there is a consequent moralizing subtext (or overt text) that blame depression sufferers for their depression and their 'lazy' desire to falsely 'solve' their problems with 'happy pills'."

Saying that a prejudice exists which refuses to see depression as a medical condition that should be treated pharmaceutically is not the same thing as saying that not treating depression pharmaceutically is part of a moralizing subject blaming depression sufferers.

It's the same difference as saying that "there's a social prejudice against teens taking birth control and it's harmful to teens" from saying that "a parent refusing their teen birth control is harming their teen". There's various valid reasons why a parent might refuse their particular teen birth control (I can't think of any at the moment, but for the sake of the argument, I'm fine with assuming that there must be) and saying so is not incompatible with saying that the general prejudice against teen birth control is generally harmful.

So it doesn't do "exactly" what you claim occurs in these conversations; it's unambiguously not the same thing.

Furthermore, when you write that something is "implied in many many of these types of conversations" as proof that something exists and isn't a strawman, you've gone off the rails. Saying that something is implied, and saying that this implied thing exists in unspecified many cases, is pretty much exactly the straw out of which these men are built.

I have no problem with someone discussing their own negative experience with an antidepressant. I also have no problem with someone asserting, correctly, that antidepressants have various costs associated with them that many people reasonably conclude aren't worth the benefit. I've never claimed that either of those kinds of people saying those things are hurting depressed people.

What my comment did say, and what I do argue, is that a blanket prejudice against anyone taking antidepressants, or the assertion that overall they do more harm than good, or the general claim that they are shortcut solutions that don't actually solve anything, all are harmful to depressed people because they reinforce the common cultural idea that depression is not a medical condition, but rather a moral failing. That depression is a kind of punishment for people who aren't willing to do some work to make themselves happier. That's not a strawman, I can find you quite unambiguous, explicit examples of this in pretty much any discussion of antidepressants.

It's illuminating to contrast this against anxiolytics or antipsychotics, where there's widely agreed side-effects and negatives associated with these medications but where people aren't otherwise widely expected to first attempt to become not-anxious or not-schizophrenic by willpower and therapy alone and that using a medication for these ailments is a "shortcut" that creates an artificial, false personality. Experiencing crippling anxiety or schizophrenia is (now) widely accepted as being a medical condition, not a character flaw while, in contrast, being depressed still widely is. Therefore, the discourse surrounding the treatment of depression, and particularly with medications, is heavily loaded with value judgments that are frequently harmful to depressed people and it's very important to try to avoid that.

None of what I just wrote is a claim that any discussion of the negatives associated with antidepressants is necessarily and in itself harmful to depressed people. None of what I just wrote is a claim that people discussing their own negative experiences with antidepressants is necessarily and in itself harmful to depressed people.

Rather, it's a claim that general condemnations of antidepressants, particularly those which describe them as being quick-fix non-cures, and especially those which reinforce the idea that the depressed person is the authentic person and the undepressed (medicated) person is the inauthentic person, are harmful to depressed people.
posted by Ivan Fyodorovich at 7:53 PM on December 19, 2013 [14 favorites]

"I am frustrated that people in that thread who have negative experiences with Wellbutrin are posting them."

I think anecdotes about how other psychiatric medications can radically alter one's personality, behavior, beliefs, feelings, etc. are relevant because most people do not realize just how drastically medications can change a person. The assumption that all an antidepressant does is give you the fortitude and self esteem to address a pre-existing problem is false and the stories about other medications helped demonstrate that sometimes antidepressants create new problems by changing you into someone you would have never chosen to become if you'd known in advance how they would affect you. If the husband is not in his right mind because of the medications he is taking, that warrants a very different response than if the medications are just helping him figure out what he really wants/needs.
posted by Jacqueline at 8:07 PM on December 19, 2013 [4 favorites]

But if you are not actively abusing them and they unilaterally get up and walk out of the marriage they are sleazebags, without respect for the committment their spouse made and has continued, nor for themselves and the promises they also once made. Heh, that was then, this is now, that's all it takes.

How active must the abuse be before one may leave? Is a persistent pattern of contempt enough, or must one be daily beaten with a stick thicker than one's spouse's thumb before the condemnation of the community may be avoided?

Speaking as (I suppose) a sleazebag, I'm genuinely curious.
posted by winna at 8:11 PM on December 19, 2013 [15 favorites]

Marriage is a complicated thing that means different things to different people. I place too much value in it personally so have ever done it. I'm not willing to risk a divorce, so I avoid marriage. I know my perspective is abnormal, but there you go. So instead I have long term relationships I hope won't end. Most have, but I have hopes for the one I am in now. Regardless ex-girlfriends I can deal with, ex-wives? So glad that a no! Because I fear failure I won't even try. Pretty much how I feel about a lot of things.
posted by cjorgensen at 8:36 PM on December 19, 2013

I totally felt where answerers were coming from with their reading that maybe he'd been unhappy in the relationship for a long time and was only starting to act on those feelings now that the antidepressants were giving him the perspective, mental energy, and sense of self-worth to allow him to do so. That was my impression too. But then I realized that there really wasn't enough information in the question to be able to say anything really firm about that, and that it was a pretty big leap to make based on just a hunch, and that I was probably doing some projecting since I've been the "husband" in a really similar situation myself before. So I just sort of sighed and decided to take a pass on the whole thread.

It's one of those threads where it's really impossible to give good information. There are so many variables – the way that SSRIs affect people, the way that the husband feels about the relationship, the dynamics of the relationship, the underlying implicit concerns of the asker – that it's really impossible to say anything solid. It's obviously a mess, and the only thing that can really be said is that they need to get some therapy and figure out where they each really and truly stand on the issue, and that the husband needs to talk to his doctor about it too and try to figure out whether it makes sense in the grand scheme of his life to adjust his medication. But there's so much else going on, it's such a messy and complex situation, that that's just a hopelessly inadequate answer.

So it's a mess, is what I'm saying. It's too complex to untangle in the context of an AskMe. That happens sometimes, but it's too bad that more people couldn't just walk away instead of jumping to one conclusion or another.
posted by Scientist at 8:49 PM on December 19, 2013 [8 favorites]

Jacqueline, the comment you're responding to is expressing frustration that people posted about Wellbutrin when the question referenced an SSRI. The question asked for experiences around SSRIs. Wellbutrin is not an SSRI.
posted by sweetkid at 8:52 PM on December 19, 2013 [2 favorites]

And you know, what I always say in SSRI threads – and what I probably would've said in this thread, if I'd had the energy to give a level-headed response, which I didn't – is that they help a lot of people, including me and several people I know, but that they don't help everyone. Antidepressants in general, SSRIs included, are kind of a crapshoot and the name of the game is to find a drug and a dosage where the therapeutic benefits outweigh the adverse effects. Not every depressed person finds that with every, or any, antidepressant.

They're still worth trying if you're someone who has depression that isn't adequately controlled by other means, but one has to be prepared for a long process of searching for the right drug/dosage – a process that may be inconvenient, unpleasant, and potentially fruitless. For a few lucky people they are pretty miraculous. For most people with depression, there is probably a drug out there (if they can find it) that will at least be more good than bad. For some, there is only bad.

They're neither "evil" nor "magic". No drug is either of those things. Drugs are just chemicals that alter the way your body and/or brain functions. They can have good effects or bad effects, or both. They can be used appropriately or inappropriately. They are tools. Antidepressants in particular (including SSRIs) are complex, poorly-understood, potentially dangerous tools that can nevertheless be of great help to some people where no other satisfactory help exists.

Antidepressants should be used with caution and care, under the supervision of a cautious, caring, competent expert who can guide the user through the process. That has nothing to do with whether they are good or evil, it just means that they aren't great tools. Unfortunately, we don't really have any great tools for dealing with depression. Antidepressants, carefully used, are for many people some of the best tools out there.

They're not what I think of as "good medicines", drugs that work very well almost all the time with little or no potential for harm. Ibuprofen is a "good medicine". Ondasterone (an anti-nausea medication) is a "good medicine". Antidepressants, and most psychiatric medications for that matter, are not. They're just the best we have, and often better than nothing. They're not "evil" though. No drugs are evil, just like a hammer or a pair of scissors isn't evil even though it can do harm. The only way that a drug could be evil, to me, is if it were something like a handgun – a tool designed expressly for an evil purpose, and which has little or no potential to be used for anything other than to do harm. I'm not aware of any drugs like that, and antidepressants certainly aren't in that category.
posted by Scientist at 9:10 PM on December 19, 2013 [18 favorites]

"Jacqueline, the comment you're responding to is expressing frustration that people posted about Wellbutrin when the question referenced an SSRI. The question asked for experiences around SSRIs. Wellbutrin is not an SSRI."

Yeah, but I think she was saying that all these psychoactive drugs can, for some people, dramatically alter personality in negative ways and it's important to know that this is the case, as opposed to assuming that they're only either ineffective or effective exclusively at reducing depression. That's a fair point.

But I was annoyed a little about the same thing because bupropion (Wellbutrin) is a poorly-understood drug that is pretty much in its own class and shouldn't be a reference for other antidepressants. And then SNRIs aren't the same thing as SSRIs. The tricyclics and MAOIs are even more different.

It's really more harmful than helpful to try to explain someone else's experience with a member of one class of drugs with your own experience with a member of another.

It's especially not good because responses to all these new antidepressants are often idiosyncratic anyway (which is the point the critics are often trying to emphasize!) so even with the same drug, comparisons of experience can be unhelpful, much worse with different drugs, and even more so with drugs of different classes. It's important to be aware of this.

In this case it's relevant because irritability and rage are much more associated with bupropion and SNRIs than they are with SSRIs, which is what Lexapro is (as the poster knows) and some of the responses are about irritability and rage. On a re-read, it actually doesn't sound like he's irritable or angry or rageful in general, but only more assertive and angry in arguments with her. But she describes his affect in his discussion of leaving as being very rational and cordial.

What I don't recall anyone saying in that thread, and which would be a lot more helpful than many of the responses, is that initial prescription of an antidepressant really oughtn't be by one's primary care physician, but rather by a psychiatrist or other clinician with specific and extensive experience with antidepressants, and even then for the first few months fairly closely monitored for side-effects and unwelcome personality changes.

But antidepressants are far too regularly prescribed by PCPs as if they were more predictable than they really are, and also far too often by physicians who haven't made the correct diagnosis in the first place, as was attested by the several people in the thread who were bipolar and prescribed antidepressants that were harmful to them because it pushed them into hypomania.
posted by Ivan Fyodorovich at 9:30 PM on December 19, 2013 [3 favorites]

Well, knowing this thread is here, I felt obliged to come by. I tried not to be careless in in my response, and wanted to offer my experience to address the idea that while, yes, emotions motivate relationship-enhancing behaviours, but wanting to hold on to your sense of the world’s structure might suffice in their absence, or did in my case. I don’t think I said it well enough. I really hope I didn’t blunder into saying something awful.

As for SSRIs. It’s the enterprise that counts as evil, for me. Some of which is by design (pharmaceutical companies – the backing studies are shameful; the marketing is just as bad) and some of which is accident (whatever health care economics push GPs to take on more than they should, really; a general fetishism of science that insists on locating both cause and treatment of depression ‘in the brain’ – I mean, where else would it go, unless you’re a dualist – and insists again that drugs are required to justify it as an illness).

SSRIs are blunt, not well-understood tools, with equally unknown knock-on effects. Adverse effects are hard to monitor; interpretable as original symptoms; it’s hard to pick out correlations in retrospective analysis. Patients are considered unreliable, once there’s a diagnosis. Which is why it took years after SSRIs were flung into the market for enough people to a) realize what was happening and b) get it together to file a class-action lawsuit to push acknowledgement of some risk. And so many people living with harmful effects, in the meanwhile. Guinea pigs. Trying drug after drug to ‘get the balance right’, as if it could be measured like blood sugar. Thinking they’re ‘crazier’ than they are.

All this is wrong. Costly. I lost three years – two to being a ghoul, and then the one it took to get back to feeling like a human being. (School and work didn’t work out in that time, nothing really did.) I consider the experience a violation of the body, the mind.

What I struggle with is that all those side effects, drug flipping, loss of life and opportunity are unnecessary, when depression can be effectively treated with therapy. Which does not risk pseudo-psychosis, mania or suicidal ideation, or take away the ability to have sex, or engage in beloved activities, or relate to important people in your life.

And I know it’s all personal, painful. What other people do is up to them; I don’t want to begrudge someone’s way of feeling better if they feel it helps. Whether some portion of people have been helped or not, though – and I am glad if they are! – I really feel like there’s an objective wrong that’s been done to a lot of others.
posted by cotton dress sock at 12:58 AM on December 20, 2013 [4 favorites]

cotton dress sock, when you say "[antidepressants and their risks] are unnecessary, when depression can be effectively treated with therapy", are you claiming that they're generally unnecessary because depression can generally be effectively treated with therapy alone, or rather that they're unnecessary in those cases which are effectively treated with therapy? To be honest I read it the first way initially and I've since deleted a chunk of a perfectly good tirade. I'd genuinely like to know which perspective you're coming from.

That said, while I thought your post in the original thread seemed quite well-put, I do notice here a sort of general skepticism (informed by personal experience, no doubt, and fair enough) toward medication as a class of therapy. The language makes me a little nervous: "evil enterprises", "guinea pigs", "fetish[izing] science"?!, "ghoul", "violation"; I see you're trying to be very evenhanded but it does go to the heart of the prejudice Ivan Fyodorovich has been pointing out. Why is the brain the only organ where even the concept of treating illnesses with medications (blunt and clumsy tools as current medications might be, certainly) is greeted with such discomfort? I think your comment about dualism is actually quite apropos in that perhaps those who don't suffer such ailments don't enjoy acknowledging the "ghost in the shell" fallacy as ... intimately as the afflicted are forced to.

(It's worth taking a brief detour to note the many studies which have shown psychotherapy to be most effective in combination with antidepressant medication, and vice versa. Not to mention the effectiveness and statistical significance of those medications is actually strongest on the most severe cases.)

Ivan Fyodorovich's point is also well-taken concerning the further distinction between mood disorders, but particularly depression, in comparison to other mental illnesses. It seems there absolutely is a moralizing component that characterizes the depressive as surely having at least some responsibility for their condition, but paradoxically delegitimizes choices made by that person to improve their situation. That choice could be informed consent to a trial of some medication, perhaps risking "relating to [other] people" but perhaps also improving aspects of themselves that they've realized are intolerable; it could be realizing that a relationship, not necessarily the one in the original thread, is not actually adding value to their own life. And the risks involved in asserting one's own needs are as present in taking a hard look at one's life as they are in boosting one's neurotransmitters.

As much as the melancholic might have some moral or practical obligation to pull themselves up by their bootstraps to an extent, the people around them can simultaneously be uncomfortable they can't be neatly categorized into the box they had for them anymore. I don't think you're out to do this, but even supposing they are weak, diseased, addled, drug-riddled, they shouldn't be denied agency over their own minds and lives.
posted by vsync at 3:12 AM on December 20, 2013 [13 favorites]

What I struggle with is that all those side effects, drug flipping, loss of life and opportunity are unnecessary, when depression can be effectively treated with therapy.

Some depression, in some people, with some kinds of therapy, can be treated effectively in some situations.

Jesus. This thread. What a shit show.
posted by Squeak Attack at 6:23 AM on December 20, 2013 [29 favorites]

What I struggle with is that all those side effects, drug flipping, loss of life and opportunity are unnecessary, when depression can be effectively treated with therapy.

Thanks for letting me know! I can go ahead and stop taking the drugs that make it possible for me to feed myself and uncurl from the fetal position and leave the house with real clothes on! Phew! I knew that managing a disease medically was irresponsible, there had to be a better way!

With less sarcasm: I've done *years* of therapy. All my therapists told me my problem is medical and needs to be treated with drugs. When I take my drugs, I personally *do not need* therapy because my issue is not with how I relate to the world, my issue is that the chemicals in my brain are wonky. This has been confirmed by numerous doctors and therapists, but hey, you total internet stranger know best!
posted by sonika at 6:53 AM on December 20, 2013 [31 favorites]

especially those which reinforce the idea that the depressed person is the authentic person and the undepressed (medicated) person is the inauthentic person, are harmful to depressed people.

The truth is, we don't know. I'd rather see it as a question of whether one can live their best life either off or on antidepressants--a question which is different for each individual--than if one's medicated or unmedicated personality is "real."

I realize that there are increased stigmas around depression significantly, which complicates this, but since you mentioned a comparison to birth control--I personally experienced dysthymia, fits of rage, and loss of libido on birth control that was quite similar to what my husband experienced on both mood stabilizers and SSRIs. Since I was on birth control for about a decade, I assumed it was my authentic self. My life improved when I sought non-chemical means of preventing pregnancy. That doesn't mean that I don't think the pill does enormous good--the liberty it's given women is huge, both on an individual level and a societal level--but their prevalence has also meant that non-pharmaceutical options for preventing pregnancy are limited and that side effects are rarely discussed by the prescribing doctor (I know it wasn't, for me).

Acknowledging all of that--that there are aspects of these medications and the way they're prescribed in are society which are problematic--is not the same as denying that they can do good.
posted by PhoBWanKenobi at 7:08 AM on December 20, 2013 [4 favorites]

I really feel like there’s an objective wrong that’s been done to a lot of others.

I'm really sorry for your bad experiences. At the same time, your type of comment is exactly what i was referring to above.
posted by jessamyn (staff) at 7:33 AM on December 20, 2013 [6 favorites]

I won’t be able to reply to all the responses to the essay I dropped today, so I’m sorry for that. Quickly, though: no, I’m not opposed, in principle, to the thoughtful dissemination of properly tested, well-understood drugs for treatment of what we call mental illnesses (a misnomer to start with imo, they are just illnesses – one example of the ton of sneaky dualism in the discourse around all this). I feel the distribution and management of SSRIs in particular is problematic for a number of reasons. I appreciate that some people are helped by these (particular) drugs. I am not about to say what anyone else should do - they might win out on a roll of the dice. What troubles me tremendously is that no one can say how or why, and that not enough people have access to evidence-based therapies by competent practitioners, which could also help them, with less exposure to risk. My chief criticism is of the ways this fairly ‘dirty’ class of drugs came to market, and the ways they are often handled in practice. (And no, people with depression are not responsible for their illness, of course not.)
posted by cotton dress sock at 8:23 AM on December 20, 2013 [2 favorites]

There's not really anything I can find to disagree with in your last comment, cotton dress sock. I share all those concerns. I think that antidepressants are overprescribed and often by PCPs who don't have the expertise to properly manage medical depression, at least insofar as the initial diagnosis and (often necessary) search for the right drug and dosage. And I say this as someone who very strongly believes that American health care is badly biased toward specialists and PCPs are underutilized and should be acting as, well, the primary care health providers. The varieties and etiology of depression are many and varied, numerous other conditions confound the diagnosis, and as you and many here have pointed out, the antidepressants are difficult and unpredictable drugs. This all requires something much more than "You're depressed? Here's the latest antidepressant that ~~the drug rep~~ studies show to be quite effective. See you in a couple of months."

But all that said, it's undeniable that there's an underlying prejudice in our culture against the medicalization at all of depression. Many, many people simply don't accept the idea that depression could be a medical, neurological disorder rather than purely psychological (whatever that distinction means, but let's not go into that). Or, really, for many people, it's not even that it's psychological, but simply a matter of strength of character. How many times have depressed people heard "Just get out and be active! Stop moping!"? It's simply true that depressed people hear a constant message that depression is a character flaw, not an illness. And this is so much more significant than in the case with many other illnesses, including some other mental illnesses, because a depressed person is much more likely than otherwise to blame themselves and accept such messages.

So "the antidepressants are bad" message really plays into that. Even when it's intended to be nuanced, as your messages in this thread are clearly intended to be; but especially when it's coupled to explicit "you're just trying to take a shortcut" messaging.

I absolutely am not some indiscriminate cheerleader for antidepressants. But then, I also have lived with a chronic and serious medical condition my entire life, have experience with doctors and health care my entire life, and am very aware that pretty much everything about medical treatment has problems like antidepressants. It's all groping in the dark, finding least-harm ways to manage illness, and includes mistakes and confusion. Antidepressants are not exceptional.

It's very hard to get depressed people to begin and continue treatment. Probably not as hard as with manic-depressives or schizophrenics, I suppose, but it's still very difficult. For most of us, there's a lack of motivation to do so and, per what I wrote above, also a tendency to not even recognize depression as something that needs treatment, instead attributing it to whatever is at hand, some life situation or whatever.

For me, it took being in a life situation where I was more happy and satisfied than I ever had been and yet I was falling into dysfunctional depressive episodes that threatened all those things that were going so well, before I finally realized that, hey, maybe I'm not feeling this way because of external crappy things, maybe I'm just feeling this way because something's messed up in my brain. And once I found the right dosage of Prozac, and once I got over the hump of being weirded out that this wasn't how I'd mostly experienced reality before, because I'd fully internalized the broody, deeply melancholy stuff into my self-image, I finally realized that, you know, how I'm feeling now is really exactly in line with all my values and how I really do see the world. The epiphany came when I'd stopped on the street and watched some children in a playground play. I felt happy and content watching them and I realized that I'd always enjoyed watching children and that my worldview was fundamentally positive and joyful, everything about what I believe about the world is built around that, and that the sad and despairing, fundamentally melancholic person I thought was me was actually the distortion, the version of me that didn't really fit with my worldview.

But that was when I was 27 years old, I'd been suffering from severe and suicidal depression since I was a teen. A good portion of my life was lost in a miasma of despair.

Antidepressants aren't a magic answer, but we should be careful about any and all messaging that will discourage depressed people from getting some kind of care, whether it be antidepressants or therapy or both. Anything that plays into the idea that either the depressed person is the "real" person or that the depressed person is depressed because of a character flaw should be carefully, deliberately avoided. And it's no wonder that many depressed people who hear any hint of these messages get really upset about it.
posted by Ivan Fyodorovich at 9:20 AM on December 20, 2013 [14 favorites]

SSRIs are blunt, not well-understood tools, with equally unknown knock-on effects.

This is true of NSAIDs as well, but that doesn't mean that Advil is "evil."
posted by jaguar at 9:49 AM on December 20, 2013 [9 favorites]

For anyone still reading this thread who is now having second thoughts about the anti-depressant they're on or about asking their doctor about it, please don't be discouraged.

One thing I really encourage everyone who goes on any type of crazy med to do is to learn about it. Really. Get your prescription from a bona fide psychiatrist and spend some time discussing how the thing works. Take a neurology class (completely serious!). I really found that learning about these drugs and what they were doing greatly demystified them for me. Because here's the thing - these drugs are science. We actually do know quite a bit about them and what they do. Millions of people have taken them and provided a relatively large sample set from which to gather data. We know a good deal about how neurotransmitters work. Approaching crazy meds this way gets passed all this "mind/body/mystic dualism" nonsense. For real, your personality is just a bunch of chemical reactions, which these drugs affect. It isn't magic. There is no such thing as your 'true personality' which you try to 'uncover' or whatever with these drugs. There is just the state you are in at any given time. There is no perfect state of being one is trying to or can achieve. What is the goal of anti-depressants? To not be depressed. That doesn't mean the goal is to make you perfect or happy or enlightened.

SSRIs are blunt, not well-understood tools, with equally unknown knock-on effects.

You know, the thing is that SSRIs are probably the best understood out of all the crazy med classes, and they are actually pretty well-understood. I reiterate here that it really is critical not to group them all together. Not only do different crazy meds affect totally different neurotransmitters, they often affect them through totally different mechanisms. SSRIs are among the oldest anti-depressants, and we understand waaaay more about them than something like Wellbutrin, which is in fact not super well understood. Lexapro actually has one of the highest efficacy rates with one of the lowest adverse effects rates of any SSRI on the market. It's why it's so popular.

The problem is that while crazy meds affect certain neurotransmitters, neurotransmitters are not responsible for one and only one thing. This is really the crux of the whole anti-depressant issue these days. Consider dopamine. Dopamine is responsible for movement and motivation - two related but certainly drastically different things. A little loss of dopamine and you'll be lazy, a great loss and you'll have Parkinson's. Serotonin plays an essential role in happiness and mood, but it isn't the only thing it does. However, we do know that a boost in serotonin will give you a greater sense of well-being and calm.

And while all the mechanisms of serotonin aren't understood completely, the functioning of SSRIs is relatively simple. When a neurotransmitter crosses a synaptic cleft during a synapse, only a portion of that neurotransmitter is received by the post-synaptic receptors. The rest is either reuptaken by transporters back to the pre-synaptic cleft or it's catalyzed by something like monoamine oxidase (serotonin is a monoamine, in the same class as dopamine and norepinephrine). An SSRI blocks these transporters from attaching to the serotonin and reuptaking it back to the synaptic cleft. As a result, more serotonin is left in the synaptic cleft. This serotonin can then be received by the post-synaptic cleft. However, in order for this to happen, the post synaptic cleft literally has to grow more receptors. This is why it takes many weeks for SSRIs to begin to work. You're just growing more receptors to allow for a greater flow of serotonin through the brain. There are other ways to get a similar effect. Some anti-depressants, for example, are MAO inhibitors, meaning they inhibit monoamine oxidase. So instead of the reuptake being inhibited, this class of drugs inhibits the catalyzing of monoamines in the synaptic cleft, causing a greater flow of monoamines through the brain.

The point of all this is to say that SSRIs and other anti-depressants are just science. Depression is a disease. It is not mystic. Anti-depressants are not "evil." I don't even understand how you could make a qualitative judgement about them. They have saved a lot of lives. They will get better as we learn more. But we've got to get passed this rhetoric of one's "true personality" and "fundamentally changing" who someone is. Such notions are nonsense.
posted by Lutoslawski at 12:08 PM on December 20, 2013 [36 favorites]

Here's my anecdote: The idea that the depressed, unmedicated person was the "true self" and that my medicated, non-depressed self was "fake" and not real led to me flushing my Effexor down the toilet when I was a teenager and stopping a medication cold-turkey that should never be stopped like that. That withdrawal was awful, and potentially dangerous.

But we've got to get passed this rhetoric of one's "true personality" and "fundamentally changing" who someone is. Such notions are nonsense.

It's beyond nonsense. Those notions are dangerous.

I feel for people who have had bad experiences with medications, I have had them too, and it can be brutal. I have had medication prescribed by clueless doctors who weren't properly managing my medication. It can absolutely make you feel like all drugs are evil, and all doctors are idiots. But those kind of blanket statements are not true and not helpful for anyone who needs treatment.
posted by inertia at 1:33 PM on December 20, 2013 [6 favorites]

I agree with everything Lutoslawski said except I take issue with the term "crazy meds" which is... problematic.
posted by rabbitrabbit at 1:48 PM on December 20, 2013

I take issue with the term "crazy meds" which is... problematic.

Yeah, I thought about that after I posted. It is definitely problematic. I mostly just use it out of habit. It has a definite tone of tongue-in-cheekness, or it does for me, or I want it to, or whatever. For whatever reason, referring to it that way has always helped me sort of retain this sense of humor about the whole thing, which I totally get is not everyone's bag.
posted by Lutoslawski at 1:53 PM on December 20, 2013 [2 favorites]

And also probably because the Crazy Meds Board has long been kind of the go-to place for sort of straight forward and helpful info on mental health medication. In any case, many apologies.
posted by Lutoslawski at 1:55 PM on December 20, 2013 [6 favorites]

Yeah, I see the problem with Crazy Meds but then again it is what the forum uses and also the sort of dark humor people use sometimes.

All my therapists told me my problem is medical and needs to be treated with drugs.

I know what you mean by this but depression treated by just talk therapy and not drugs can still be "medical" in nature.
posted by sweetkid at 2:06 PM on December 20, 2013

I know what you mean by this but depression treated by just talk therapy and not drugs can still be "medical" in nature.

Absolutely, I certainly didn't mean to imply otherwise.
posted by sonika at 2:13 PM on December 20, 2013

Stoneandstar, this is not an attack on you, passive-aggressive or otherwise, so get down off your high horse.

I feel passionately about this issue. I explained why in my post here. I speak to people about depression. I've put it in my profile that I am available for help if anyone has questions about depression or treatment or just wants to talk.

Which shouldn't matter, because I should not have to fucking explain myself to you anyway. My advocacy efforts for mental health awareness have a long history which, like me, was in place LONG before you ever showed up on this site.

Everything is not about you. if you have a problem with me pointing out problematic comments in that thread, that's your problem and your ego talking. Stop acting like a spoiled brat and get over yourself
posted by misha at 4:35 PM on December 20, 2013 [3 favorites]

I thought the first answer was appalling, feel chagrined that it was left up, apparently got more faves than flags.

The Tough Love shit gets disgraceful.
posted by ambient2 at 5:14 PM on December 20, 2013 [3 favorites]

uh, misha, you literally made a MeTa about an AskMe and then selectively quoted only me three times in a row as "examples." It is totally an issue you have with me. I mean, you quoted me three times. In a row. You quoted only me. It's not my ego. It's plain and obvious, and you're misrepresenting your behavior for some reason that is beyond me. You can keep pretending like you quoted a vast array of commenters or something but you didn't. The "spoiled brat" stuff is lame and childish, and yet more evidence you have a problem with me. At least have the balls to admit it..

I have depression, and also "speak to people about depression." Your thoughts and "advocacy" for depression are no more valid than mine. This is a very nice MeTa and all but it doesn't sound like you have some kind of special depression experience that is more valid than that of people who said something different than you in that thread. Personally I have a long history of depression in my family and I have my own opinions.

Anyway...

It's beyond nonsense. Those notions are dangerous.

See, I feel like those notions (about "fundamental changes" and "true personality") CAN be very dangerous, to a person who is struggling to stay on meds they need (I know people like this, for instance with severe bipolar). But they are also words I would use to describe my experience with antidepressants-- they did fundamentally change me, I was very unhappy, and didn't feel like my true self. Just because a notion is dangerous, doesn't mean it doesn't describe the truth for someone else, someone to whom it is not dangerous.

I agree that there's a lot of negativity about antidepressants out there, and it did keep me from staying on them for awhile, and I struggled with that, among my family and friends. On the other hand, I did have an iffy experience (on the same drug I struggled to stay on), and I described it in that thread. In general I usually say "they can be super helpful, but monitor yourself, and try to have regular therapy appointments" because I think that's the best way to proceed whether or not the med is working for you.
posted by stoneandstar at 6:00 PM on December 20, 2013 [1 favorite]

Also, I'm pretty baffled that the issue was that people were letting "their baggage" get in the way of the discussion of antidepressants. The entire AskMe was about if anyone had had the experience of going on antidepressants and falling out of love/not feeling love anymore. A lot of people (including myself) have had that precise very scary experience. How is that "baggage" in the context of the Ask? It's the whole content of the Ask. The Ask was not, "should I try antidepressants??" If it had been there would have been very different answers, and people probably would have framed their equivocal experiences differently.

Anyway, calling that "baggage" is kind of inexplicable, especially when the poster provided an interesting article on the phenomenon that helped frame the discussion.
posted by stoneandstar at 6:28 PM on December 20, 2013 [2 favorites]

I would just like to mention that although quoting only stoneandstar, and with three different quotes, is definitely not the same thing as generally calling out behavior in a thread, I strongly disagree with the contention that it's better for someone to specifically name someone else in a post or a comment that's critical of something they wrote. It's not passive-aggressive to not directly criticize someone, it's a kind of discretion that avoids even worse conflict.

If misha had actually named stoneandstar by name in this post, then even if she was aiming for stoneandstar, the resulting conversation here would have been all about stoneandstar and not about the issue that misha says she was writing about. Whatever her true motives, the rest of us discussed this without making it personal to stoneandstar, and the thread was much, much better for it. As we can see by this late appearance of a personal conflict between misha and stoneandstar. It's just not better to call out someone by name, even if it seems (and it used to seem this way to me, too) kind of passive-aggressive. At the very least, everyone else would probably prefer that it not be so personalized, regardless of what the two people directly involved might think about it.
posted by Ivan Fyodorovich at 6:54 PM on December 20, 2013 [3 favorites]

The data on SSRI effectiveness is completely equivocal. That is quite clear to anyone who has paid any attention to the development of the data, and the reporting on the massaging of the data.

It doesn't matter how many times you repeat this canard, you're still off in conspiracy theory land here. Irving Kirsch has not somehow discovered the secret underbelly of corruption in anti-depressant research; the truth is that he is remains way way out of the mainstream.

Do pharmaceutical companies try to cast studies in the best light? Yes, always, for every type of study on every type of drug. Does that in any invalidate hundreds of studies showing positive effects? No. No it does not. Are drug studies with poor results just sort of vanishing? No, researchers' bread and butter is publication, not to mention that there have been plenty of drugs that have failed/been tweaked due to clinical trials. Are people who conduct lab studies for a living so entirely devoid of statistical knowledge that they could only be corrected by a guy who has spent zero time doing studies but rather sits around doing "meta studies" where he doesn't understand the underlying data? No, in fact, they aren't.

At this point I'm pretty sure that Kirsch & co. only get published when a journal needs to liven up the comments section, and I'm sorry to see you continue to spread their gospel.
posted by Tell Me No Lies at 7:42 PM on December 20, 2013 [3 favorites]

I would just like to mention that although quoting only stoneandstar, and with three different quotes, is definitely not the same thing as generally calling out behavior in a thread, I strongly disagree with the contention that it's better for someone to specifically name someone else in a post or a comment that's critical of something they wrote. It's not passive-aggressive to not directly criticize someone, it's a kind of discretion that avoids even worse conflict.

Agreed. Personally I didn't even realize all the posts were from stoneandstar. I thought this was a good MeTa. I think the way we discuss depression and its treatment in Ask can be problematic and it's good to discuss it.

This issue that misha brought up here is exactly why it annoys me when people make fun of the frequent advice on Ask to seek therapy, or even when people post, "I know this is the kneejerk AskMe response, but..." in regard to therapy. If someone had a severely bleeding hand, no one would frame their advice as "I know this is the kneejerk AskMe response, but go to the ER."

Given that we know little about the OP's situation from the question, and that opinions and experiences with SSRIs are so varied and personal, it's pretty difficult for people to answer the question beyond anecdotes. It's a great scenario for a therapist to tackle (individual therapy for the OP).
posted by sweetkid at 8:35 PM on December 20, 2013 [3 favorites]

Whatever her true motives, the rest of us discussed this without making it personal to stoneandstar, and the thread was much, much better for it.

This much is true.

I disagree that this MeTa has accomplished anything. This is the stated purpose of the MeTa:

What concerns me is that I feel like there is a bit of an an abuse of the system going on in that thread. Specifically, people who previously responded are coming back into the thread, under the guise of restating their answers, and using that as a excuse to throw in inflammatory, provocative and just plain erroneous asides, which I feel adds to that contentiousness in the thread.

Which, you can agree or disagree if that sounds like weaselly bullshit to you or not. But let's be clear that that's what was written, versus anything actually specific about what concerned her about the discussion of depression in the thread. Which turns out to be that people discussing their own depression are not 100% agreeing with her as an "advocate," so maybe that's for the best, too. More heat than light. It's a stupid MeTa.
posted by stoneandstar at 8:51 PM on December 20, 2013

uh, misha, you literally made a MeTa about an AskMe and then selectively quoted only me three times in a row as "examples." It is totally an issue you have with me. I mean, you quoted me three times. In a row. You quoted only me

Seriously?! Stoneandstar, I quoted problematic comments full of loaded language and just flat out misinformation regarding antidepressants. I wasn't gunning for anyone. I didn't scope out anyone's name.

But now I am pissed off enough to go back and get all nitpicky right back at you about this, so, having checked that thread and this one, actually I DID NOT ONLY quote you and I DID NOT LITERALLY quote you three times in a row, either. We already discussed "SSRis are evil" before you even entered this thread, in fact. So either you fail at reading comprehension or I guess it is your ego after all.

There is nothing passive-aggressive about this Meta. I was specific and even went into more detail when OmiWise addressed me.

But, you know what, even if I had quoted only you, so what? You could have read any of what I said and just responded to it, and I would have been fine with that.

YOU made this personal. That's on you. It's a Thing you do. Then comes the hyperbole, the scare quotes, and the restating--which is actually misstating--of others' positions.

Why DO you feel so personally threatened when someone disagrees with you that you have to keep returning, with multiple comments in a row, to the point where the mods have to talk to you about dominating threads and arguing with other users?

How about YOU stop making everything about you personally? That would be GREAT.
posted by misha at 8:53 PM on December 20, 2013

This issue that misha brought up here is exactly why it annoys me when people make fun of the frequent advice on Ask to seek therapy, or even when people post, "I know this is the kneejerk AskMe response, but..." in regard to therapy.

How does this have anything to do with what misha brought up? A lot of people who had bad experiences with depression said "Lexapro could be fucking with him, seek professional guidance." Therapy was the answer. This MeTa did not bring that to light.
posted by stoneandstar at 8:53 PM on December 20, 2013

It's a stupid MeTa

More heat than light.

Be the example...
posted by sweetkid at 8:53 PM on December 20, 2013 [1 favorite]

When I saw the phrasing "crazy meds" I immediately thought of those web pages. Some of the best discussion of pros and cons of various drugs I've seen on the web. Really great place to see that that bizarre side effect that doesn't seem to have anything to do with your brain? Yeah, that's real. Someone else has that.
posted by maryr at 8:53 PM on December 20, 2013 [2 favorites]

Really great place to see that that bizarre side effect that doesn't seem to have anything to do with your brain? Yeah, that's real. Someone else has that.

Agreed.
posted by sweetkid at 8:54 PM on December 20, 2013 [2 favorites]

Can you read your own post misha? Three times, under "some examples." You quoted me three times in a row, in the text of the MeTa. You are just lying or else can't remember your own post, which is conveniently at the top of this page.
posted by stoneandstar at 8:55 PM on December 20, 2013

stoneandstar even if this thread had been initially about you it hasn't been for a while and now you seem to be trying to make it about you.
posted by sweetkid at 8:58 PM on December 20, 2013 [6 favorites]

Look, this was a threadbare, obnoxious, and passive-aggressive excuse for a MeTa (it wasn't even really about depression as a topic), and I guess if the MeTa is actually about issues we have with contentiousness and misinformation, I would contend that making MeTas that seem to be very narrowly focused on the behavior of one person but pretending that they're about a general site trend so you can air your grievances publically and feel good about it is a really shitty thing to do.
posted by stoneandstar at 9:02 PM on December 20, 2013

And to be honest, I'm sorry I'm getting hysterical here, but I am pretty upset that misha has only responded to me with really vicious personal language (spoiled brat, high horse, ego, &c.) and weird accusations (about how this is a "thing that I do," when have I done this in the past?), and it is a pretty good indication that I just need to leave, which I will do, but what the fuck. Cut it out.
posted by stoneandstar at 9:06 PM on December 20, 2013 [5 favorites]

Maybe you should take it to MeTa.
posted by Alvy Ampersand at 9:13 PM on December 20, 2013 [8 favorites]

The personal attacks need to get dialed down here, folks.
posted by restless_nomad (staff) at 9:15 PM on December 20, 2013

Thanks, restless_nomad.
posted by misha at 9:38 PM on December 20, 2013

Back on track, I think it really helps to try to avoid using words like "never" and "always" in AskMe and making generalizations. Especially when speaking from personal experience! Because my experience is not your experience, obviously..

But I think we have to be even more careful in threads like that AskMe. It's easy to slip into debate club mode, and want to prove a point. So we can get, as jessamyn would say, into the "Well, actually..." mode, which isn't really helpful to the OP.

And it can go the other way, where maybe we've dealt with something similar to the OP and in answering we are also kinda looking for validation that we did what was the best thing to do. But that means we might be trying to force the OP to fit into our mold. So we get bogged down defending either "SSRIs are lifesavers (literally!)" or "SSRIs are the devil and no one should take them ever" extremes, also not so helpful to the OP.

And even once you've factored that lived experience vs skepticism in, THEN comes the added problem of the preconceptions and stigmas associated with SSRIs that Ivan already brought up!

I don't want to have the antidepressants are not Instant Magic Happy Pills debate every day.

One, because I know they aren't instant happiness. I've been through that struggle where I questioned taking anything at all, and, when it became clear I needed to, that search for the right one to take, and then the struggle again when that one stopped working. I have worried about medication changing me into someone else because most of us worry about that, we really do.

And two, because if you haven't been helped by an antidepressant and maybe even had a bad experience, I get how you feel about them, and I don't really disagree with you, either. They are over-prescribed, and not all are well-understood and pharmaceutical companies have some pretty shady studies backing up their efficacy.

So you aren't telling me anything I don't know.

But still, some of these medications have helped me, and others. We don't take them because we like to, but because we have to.
posted by misha at 11:08 PM on December 20, 2013

Nothing worse than fundamentalists, regardless their faith.
posted by five fresh fish at 3:18 AM on December 21, 2013 [3 favorites]

"I'm sorry to see stoneandstar button. I'm not going to go into details about my reactions to this thread because restless_nomad quite rightly wants to lower the temperature, but stoneandstar was not the aggressor and did not deserve to be driven away."

I'm sorry to see it, too, but I don't think it's that simple. I think both misha and stoneandstar displayed some bad judgment, let their emotions get the better of them, and made it personal and publicly so ... but, also, this is a very sensitive and personal issue for both of them and many other people and I think all of us should be generous and understanding about such strong reactions, including each of them with regard to the other.

Seriously, both of them have experienced serious emotional pain and life problems with these issues and it's totally understandable that they (like many of the rest of us) have hot-buttons and will take things personally and, when feeling hurt, will strike back personally. It's not pretty, but it's human. And forgivable.
posted by Ivan Fyodorovich at 7:32 AM on December 21, 2013 [10 favorites]

It's not pretty, but it's human. And forgivable.

And not appropriate to a public forum.
posted by cjorgensen at 10:08 AM on December 21, 2013

Shoot. When stoneandstar posted about leaving, I thought she just meant leave the thread. I've been busy getting holiday cards out last night and this morning but I came in now to post something generally supportive of stoneandstar's position -- that the OP asked for anecdotal data and that's what she gave, and that maybe the best way to show the other side of that is to give your own side -- and that I didn't think most of the pull quotes in this Meta were really out of line. I know Misha and others are concerned about people with depression being put off by reading about bad experience with depression drugs, but I think the best way to deal is offer your own experience, or leave a note in the AskMe that the thread is looking for anti-drug experiences but for the record there are many, many positive depression drug experiences that save lives, etc.

I know Misha says she is not looking for moderation, and I agree, I don't think we should really be moderating people's different experiences with depression off the site. Neither do I think we should be doing it through the pointy elbow jostling of MetaTalk, really. MAYBE, maybe it would be okay to leave a mod note in the post about some people having a good experience with depression drugs and some having a bad one? But I don't think many of the pull quotes were really spreading misinformation. For example:

assuming that antidepressants always magically lift a haze and reveal the true person underneath is terrifically naive. -- well, this is qualified with always, and I think that's actually true, though maybe naive is strong. But it is wrong to assume the drugs will always reveal the better person under the haze. Some drugs really don't work for some people. I don't really see any problem with this statement, and I don't think we should be trying to stop someone from saying it in AskMe.

I do hope stoneandstar comes back, because I think she has a valuable perspective and I've enjoyed reading her contributions here.
posted by onlyconnect at 10:58 AM on December 21, 2013 [3 favorites]

I don't think we should really be moderating people's different experiences with depression off the site. Neither do I think we should be doing it through the pointy elbow jostling of MetaTalk, really. MAYBE, maybe it would be okay to leave a mod note in the post about some people having a good experience with depression drugs and some having a bad one?

I think the only note we'd leave is the "Hey folks people have different opinions, quit being so aggressive about yours" type. Both misha and stoneandstar (as well as many others) had many opportunities to be a lot less abrasive to their fellow MeFites than they were, regardless of the content of their contributions. I hope stoneandstar comes back but they and they alone are responsible for their decision to close their account.
posted by jessamyn (staff) at 12:09 PM on December 21, 2013 [7 favorites]

And the mods and the mods alone area responsible for (and by implication condoning) the continuing presence of some remarkably nasty, mean-spirited comments.
posted by ambient2 at 3:05 PM on December 21, 2013 [1 favorite]

Languagehat, stoneandstar came into this thread accusing me of all kinds of stuff for no good reason. She took a potshot at me personally and then she went threadshitting. She called me a liar; she went on and on.

Maybe I could have responded better, but I don't know how you can say she wasn't the aggressor when I was the one being repeatedly personally attacked.
posted by misha at 3:18 PM on December 21, 2013 [1 favorite]

It's sort of shitty to bring up further grievances with someone who can't defend themselves.
posted by elizardbits at 3:22 PM on December 21, 2013 [5 favorites]

But see, onlyconnect, the problem with the phrase you quoted was that in the AskMe thread, no one was assuming that in the first place!

When people come into an AskMe thread and share that taking antidepressants made them realize that a situation was unhealthy, that is just as valid a perspective as those saying that for them taking antidepressants was a negative or harmful experience. Both of those perspectives are helpful in a thread asking for experiences with antidepressants.

Characterizing the former group as being guilty of "assuming that antidepressants always magically lift a haze" is glib and dismissive and there's no call for that. Accusing them of naïveté just adds to that dismissiveness.

How is that helpful to the OP, or to anyone looking for answers?
posted by misha at 3:35 PM on December 21, 2013

It's sort of shitty to bring up further grievances with someone who can't defend themselves.

Very emphatically seconding this. Just drop it.
posted by palomar at 4:09 PM on December 21, 2013 [5 favorites]

stoneandstar made a lot of thoughtful, intellgent, down-to-earth comments about issues I care about, and sometimes has prompted me to rethink my own positions. It's understandable if she realized she was losing her temper and needed to take a break from the site for a bit, but I hope she comes back.
posted by nangar at 4:15 PM on December 21, 2013 [7 favorites]

And frankly, misha, you may have felt attacked, but you were giving just as good as you got. Calling someone a spoiled brat and telling them to get off their high horse and check their ego looks pretty damn aggressive from over here.
posted by palomar at 4:20 PM on December 21, 2013 [5 favorites]

do we have to be team misha or team stoneandstar though? That exchange seemed to come out of nowhere and was weird. It's almost like we can't have civilized MeTas anymore.
posted by sweetkid at 4:32 PM on December 21, 2013 [6 favorites]

I'm not team anyone, unless Team Not Being A Dick To People Unnecessarily is an option, in which case, I'm totally on that team.
posted by palomar at 4:44 PM on December 21, 2013 [7 favorites]

Just depends on font size.
posted by palomar at 4:52 PM on December 21, 2013 [2 favorites]

That would be Team Wheaton.
posted by h00py at 5:07 PM on December 21, 2013 [3 favorites]

I'm Team Wheaton.
posted by sweetkid at 5:12 PM on December 21, 2013

It's sort of shitty to bring up further grievances with someone who can't defend themselves.

This is a bit disingenuous. As jessamyn stated above "they and they alone are responsible for their decision to close their account." It's not that this person can't engage. They have just chosen not to. Just because someone has decided to leave doesn't canonize them and doesn't mean nothing bad can be said at their expense. On top of this, the comment wasn't even aimed at that person.

This said, I think things went beyond tedious on this one. The original thread went a predictable path. The meta did as well.
posted by cjorgensen at 5:32 PM on December 21, 2013 [7 favorites]

do we have to be team misha or team stoneandstar though? That exchange seemed to come out of nowhere and was weird. It's almost like we can't have civilized MeTas anymore.

I think that an AskMe/MeTa like this, which touches on extremely painful, personal topics for a lot of people, is a different case than a "regular" thread going haywire. Personally, I'm not going to hold a grudge because someone got upset while engaging in a topic that I find too upsetting to engage in much myself.

And not appropriate to a public forum.

Personally, I don't think anyone said or did anything that was so egregious that it shouldn't be allowed in public. Seems to me that people got upset about something upsetting, and people shared anecdotes based on personal experience -- I don't see what's inappropriate or what would need to be kept hidden about any of that.

*stoneandstar, if you're reading this, I've found your contributions across the site thoughtful and thought-provoking, and I hope that you'll come back.
posted by rue72 at 5:57 PM on December 21, 2013

I'm sorry to see stoneandstar button. I'm not going to go into details about my reactions to this thread because restless_nomad quite rightly wants to lower the temperature, but stoneandstar was not the aggressor and did not deserve to be driven away.

Remember folks, even though i'll allow people to passive aggressively attack you on mefi because you don't adhere to my particular narrative, it's still your decision to close your account.
posted by sgt.serenity at 6:01 PM on December 21, 2013

the mods and the mods alone area responsible for (and by implication condoning) the continuing presence of some remarkably nasty, mean-spirited comments.

Here in MetaTalk? We basically don't delete anything that isn't an outright threat. Which does not at all mean that we condone some of the crap that goes on here. Do you mean in the original thread? I think that's one of those "reasonable people can disagree on this" situations. I might have axed those early comments, it wasn't my call. I can see why the call was made the way it was. It is not at all reasonable to say that we condone that which we do not delete or specifically call out. We mostly want people to manage their own interactions here. Most of the time they do.
posted by jessamyn (staff) at 6:03 PM on December 21, 2013 [3 favorites]

i have no papal authority to canonize anyone but thank you for believing me worthy of such an august office i guess
posted by elizardbits at 6:49 PM on December 21, 2013 [1 favorite]

jessamyn what if i outright threaten to send you delicious cookies
posted by elizardbits at 6:50 PM on December 21, 2013 [1 favorite]

you have to share with the rest of the class elizardbits
posted by sweetkid at 6:51 PM on December 21, 2013

I made apple cake earlier, you are all welcome to have a slice. No passion play involved. Just apples and, well, cake. And maybe some hugs. Lots of them. I put a bit of allspice in it, if that's okay.
posted by Marie Mon Dieu at 8:07 PM on December 21, 2013 [2 favorites]

The idea that the mods are condoning something if they don't delete it is just weird. I post all kinds of crazy shit that doesn't get deleted but I'm not confused enough to believe that means everyone on Team Mod agrees with me...
posted by Justinian at 9:50 PM on December 21, 2013 [7 favorites]

I think threads like the one being commented on, where people discuss their personal experience with psychoactive drugs honestly, are of great value. For many years there was a great deal of misrepresentation of the effects of anti-depressants by the medical industry, minimizing side effects, pushing misleading and unproven ideas like depression being a 'chemical imbalance' caused by a lack of serotonin, portraying powerful psychoactive drugs as a straightforward medication that simply restores the 'true' healthy/undepressed self, etc. Honest exchange of views and experiences on the web had a big impact on changing that story. (It became much harder to deny side effects and withdrawal symptoms, etc.). Such discussions shouldn't be censored. Those who have benefited from anti-depressants can state their own story side by side with the experiences of others, and the reader can get a perspective on the range of outcomes.
posted by zipadee at 10:14 PM on December 21, 2013 [6 favorites]

The debate over this question of course raises fascinating questions regarding the actual mechanism of SSRIs and the role of psychiatric language in our culture. It is a clash of beliefs. Probably not a discussion that will lead anywhere positive - everyone has an interest in keeping their made-up mind made-up. If you think SSRIs work, you need to keep believing that because they might stop working if you don't. If you don't, you need to keep believing that for some other personal reason. Fascinating discussion.
posted by Teakettle at 8:57 AM on December 23, 2013

Probably not a discussion that will lead anywhere positive - everyone has an interest in keeping their made-up mind made-up. If you think SSRIs work, you need to keep believing that because they might stop working if you don't. If you don't, you need to keep believing that for some other personal reason.

I don't think anyone has been arguing that SSRIs work psychosomatically.
posted by PhoBWanKenobi at 9:14 AM on December 23, 2013

If you think SSRIs work, you need to keep believing that because they might stop working if you don't.

Nope, that's actually not what the literature is saying is happening at all. People don't argue that they work because of the placebo effect, they're just not sure of what the exact mechanism is that leads to improved outcomes. Do you actually not know this?
posted by jessamyn (staff) at 9:22 AM on December 23, 2013 [14 favorites]

It is a clash of beliefs. Probably not a discussion that will lead anywhere positive - everyone has an interest in keeping their made-up mind made-up. If you think SSRIs work, you need to keep believing that because they might stop working if you don't. If you don't, you need to keep believing that for some other personal reason. Fascinating discussion.

I have to disagree with this - I don't really want to get into the specifics, but SSRIs have not worked properly for me (had very drastic, unusual side effects to the point that doctors were like yeah, no more of that/major adjustments) on separate tries years apart and for now at least, I've decided they're not for me. However, I believe very passionately that they do help a lot of people, are neither "happy pills" nor evil, and have documented medical value, although the exact mechanism is still unclear as jessamyn points out.

I think it's fine for people to share their personal experiences as long as they don't try to say, "This negative personal experience means that this drug is 'evil'" or "This positive personal experience means this should definitely work for you!"

It's not about belief, it's about where we are in the availabilty and knowledge of treatments for mental illness.

Sure, a lot is not known about SSRIs and other classes of psychiatric drugs, but a lot is known. It's disappointing that there's so much uninformed pop culture criticism of these drugs (and even talk therapy) when the previous options were so horrific - lifetime commitment to group homes, lobotomies, indiscriminately performed electroshock therapy, and of course untreated illness that resulted in early death by suicide, addiction, etc.
posted by sweetkid at 10:40 AM on December 23, 2013 [5 favorites]

Are we defining "work" as being the same thing as "effective at treating x symptoms of y disorder?"

Because SSRIs have never helped me manage my depression, but I've experienced SSRI discontinuation syndrome. So, in my opinion, SSRIs "work" (in the sense that they do something), they just don't work for me for their intended purpose. It's not a belief system so much as it is a biological fact.
posted by sm1tten at 6:02 PM on December 23, 2013 [1 favorite]

Hell, I wish they worked for me.
posted by sm1tten at 6:08 PM on December 23, 2013 [1 favorite]

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