Do antidepressants give you a false illusion of life?
August 24, 2015 5:05 PM Subscribe
I am on lexapro and wellbutrin. They have worked out well. Lexapro in making me relaxed and not sweat the small stuff, and wellbutrin gives me a kick of energy and happiness. But...is this real?
I feel better on my medication, but part of me wonders if it gives a false illusion about life. I am not sweating the small things. But perhaps I should somewhat at least? And I am happy, but what if it is covering up something I shouldn't be happy about. Does anyone else get paranoid that antidepressants/anti-anxiety meds are covering what you should really be feeling? Sort of a "blue pill" in the Matrix, so to speak.
I feel better on my medication, but part of me wonders if it gives a false illusion about life. I am not sweating the small things. But perhaps I should somewhat at least? And I am happy, but what if it is covering up something I shouldn't be happy about. Does anyone else get paranoid that antidepressants/anti-anxiety meds are covering what you should really be feeling? Sort of a "blue pill" in the Matrix, so to speak.
What is truth?
By which I mean: each person decides for her or himself what is true and what is real.
posted by amtho at 5:11 PM on August 24, 2015 [2 favorites]
By which I mean: each person decides for her or himself what is true and what is real.
posted by amtho at 5:11 PM on August 24, 2015 [2 favorites]
I dont' think it's false either. A depressed brain telling a person that life isn't worth living is surely counter to what nature intended, if we look at animals and plants then they get to just 'be' without having to fight against their own brains giving them destructive signals. A depressed person in a subsistence type society would be a huge burden on others and if left alone, would surely die.
Excessively sweating the small stuff gets in the way of just living. Having that eased doesn't change your essential self, you still see the ups and downs of life but aren't crippled by a severe reaction to them.
At least, this is my experience after 3 years on sertraline.
posted by kitten magic at 5:15 PM on August 24, 2015 [7 favorites]
Excessively sweating the small stuff gets in the way of just living. Having that eased doesn't change your essential self, you still see the ups and downs of life but aren't crippled by a severe reaction to them.
At least, this is my experience after 3 years on sertraline.
posted by kitten magic at 5:15 PM on August 24, 2015 [7 favorites]
Yes, it's real. It's amazing how pleasant life can be when medication goes "nope, that is not something you need to be worrying about."
If you are concerned about the balance of your meds and how they are affecting you, speak to your prescribing physician and your therapist if you have one. If you don't have one, now is probably a good time--therapists, in many ways, are all about seeing the world for the way it is and accepting reality. If you're concerned about how you are experiencing reality, and whether your internal reality is aligned with the external, a therapist is who you need to sort that out.
posted by feckless fecal fear mongering at 5:19 PM on August 24, 2015 [8 favorites]
If you are concerned about the balance of your meds and how they are affecting you, speak to your prescribing physician and your therapist if you have one. If you don't have one, now is probably a good time--therapists, in many ways, are all about seeing the world for the way it is and accepting reality. If you're concerned about how you are experiencing reality, and whether your internal reality is aligned with the external, a therapist is who you need to sort that out.
posted by feckless fecal fear mongering at 5:19 PM on August 24, 2015 [8 favorites]
The first six weeks of my SSRIs taking effect were euphoric. At last, this was who I was meant to be! I was no longer weighed down by a black cloud of Desolation and Despair! No longer was I worried about every little thing that Fate threw my way! No longer did I have to step in the middle of each tile!
...well, the anti-OCD part still works, but I haven't banished anxiety from my head entirely, just needless anxiety.I get anxious about important, testable issues, such as "am I going to be able to afford the house with a pay cut?" And the euphoria of having no more depression eventually went away. I get sad when people die or friendships end, but I'm not going to do anything stupid about it.
You'll know when something should get you down, and you'll be concerned if and when it doesn't. For now, enjoy the euphoria wisely.
posted by infinitewindow at 5:49 PM on August 24, 2015 [11 favorites]
...well, the anti-OCD part still works, but I haven't banished anxiety from my head entirely, just needless anxiety.I get anxious about important, testable issues, such as "am I going to be able to afford the house with a pay cut?" And the euphoria of having no more depression eventually went away. I get sad when people die or friendships end, but I'm not going to do anything stupid about it.
You'll know when something should get you down, and you'll be concerned if and when it doesn't. For now, enjoy the euphoria wisely.
posted by infinitewindow at 5:49 PM on August 24, 2015 [11 favorites]
Spoken like a true person with mental health issues, because you are overthinking it, which is what mental illness does to you. It's taken me years to accept that taking some little pills every day makes me more able to function in life. I used to question it and wonder and get angry that I had to take something to "feel normal". Most people, I realise, just live and really don't worry about life all that much. I think it's good that you have the wondering, because that means you really haven't taken the "blue pill", it's not masking anything & the real you is still there & in control.
posted by ginoiseau at 5:51 PM on August 24, 2015 [10 favorites]
posted by ginoiseau at 5:51 PM on August 24, 2015 [10 favorites]
Well, keep in mind that the answers you will get here will be very much affected by the demographic of this site; many people here report taking medications for mental health, and that may well affect their answers.
There is a theory that depressed people have more accurate cognitions than the non-depressed. It is called the theory of depressive realism (sorry, can't link but there is a reasonable article on Wikipedia about it). Last time I waded through the primary research, I came away with the impression that it was about half true: depressed peoples' cognitions are more accurate than the non-depressed when it comes to some kinds of judgments but not others.
Does this give you a reason to go off your medication? Probably not. It depends how much you prioritize truth over a subjective sense of well being.
posted by girl flaneur at 6:10 PM on August 24, 2015 [4 favorites]
There is a theory that depressed people have more accurate cognitions than the non-depressed. It is called the theory of depressive realism (sorry, can't link but there is a reasonable article on Wikipedia about it). Last time I waded through the primary research, I came away with the impression that it was about half true: depressed peoples' cognitions are more accurate than the non-depressed when it comes to some kinds of judgments but not others.
Does this give you a reason to go off your medication? Probably not. It depends how much you prioritize truth over a subjective sense of well being.
posted by girl flaneur at 6:10 PM on August 24, 2015 [4 favorites]
Here's my take on anti-depressants: I started on anti-depressants for the first time in 1994. I was depressed and had had at least low level depression for quite a while. One of the things that depressed me was that I was unhappy in my marriage, but in part because I was depressed, I felt like I didn't deserve better, I believed that I probably had unrealistic expectations about what "happiness" consisted of, and I couldn't see any way to leave that situation.
Within 4 months of starting on anti-depressants, I had left my now ex-husband.
Because of that, I don't think that anti-depressants give me an unrealistic "happy" view of the world. I think they take away the debilitating aspects of depression that make me think I'm worthless and any attempt to change will be futile. I feel like they give me a solid foundation to stand on while I view my options realistically.
I'm on anti-depressants now (I've been on them a while now, but not consistently since 94, more like consistently since 2010). I still get pissed off at all the things that piss me off. However, I can realistically decide whether to brush them off or try to change them.
I've had a bout of being irritated with my boss recently. My depressed self would likely have quit this job on the theory that it will never get any better. Instead, I've powered through while he's been on vacation and am about to start a vacation myself and I already feel less irritated.
I dunno. I feel like it's a good drug that gives me the ability to do things that are healthy for me (end my marriage) and not do things that I will regret (quit my job) that I would otherwise not be able to do or to not do, as applicable, because of irrational thoughts.
posted by janey47 at 6:35 PM on August 24, 2015 [10 favorites]
Within 4 months of starting on anti-depressants, I had left my now ex-husband.
Because of that, I don't think that anti-depressants give me an unrealistic "happy" view of the world. I think they take away the debilitating aspects of depression that make me think I'm worthless and any attempt to change will be futile. I feel like they give me a solid foundation to stand on while I view my options realistically.
I'm on anti-depressants now (I've been on them a while now, but not consistently since 94, more like consistently since 2010). I still get pissed off at all the things that piss me off. However, I can realistically decide whether to brush them off or try to change them.
I've had a bout of being irritated with my boss recently. My depressed self would likely have quit this job on the theory that it will never get any better. Instead, I've powered through while he's been on vacation and am about to start a vacation myself and I already feel less irritated.
I dunno. I feel like it's a good drug that gives me the ability to do things that are healthy for me (end my marriage) and not do things that I will regret (quit my job) that I would otherwise not be able to do or to not do, as applicable, because of irrational thoughts.
posted by janey47 at 6:35 PM on August 24, 2015 [10 favorites]
Definitely YMMV, but here are some things I did before I was on my meds:
- Worried that people were angry at me (and misinterpreted things they said and did to support this belief), when they weren't.
- Believed that everyone hated me and I was unlovable, when they don't and I'm not.
- Believed that I was terrible at my job, when I am not.
- Worried that the noise I just heard was someone breaking into my apartment. Last time I got up, it was just the cats, but what if it's real this time.
That's not reality.
Here's what I can do now that I'm on meds:
- Believe people when they say they love me, that they're not angry, that everything is ok, etc (provided I don't have actual reasons to believe otherwise).
- Recognize my own strengths (and weaknesses) when I have evidence of them; recognize when I've done something well (or poorly).
- Know that no one remembers that stupid thing I said six months ago and put it out of my mind.
- Recognize that it's still just the cats and go back to sleep.
Depression for me meant my emotions had no basis in reality. Not being depressed means I can influence my emotions using evidence and rational thought.
All that to say: depression is the blue pill.
posted by sleepingcbw at 6:48 PM on August 24, 2015 [31 favorites]
- Worried that people were angry at me (and misinterpreted things they said and did to support this belief), when they weren't.
- Believed that everyone hated me and I was unlovable, when they don't and I'm not.
- Believed that I was terrible at my job, when I am not.
- Worried that the noise I just heard was someone breaking into my apartment. Last time I got up, it was just the cats, but what if it's real this time.
That's not reality.
Here's what I can do now that I'm on meds:
- Believe people when they say they love me, that they're not angry, that everything is ok, etc (provided I don't have actual reasons to believe otherwise).
- Recognize my own strengths (and weaknesses) when I have evidence of them; recognize when I've done something well (or poorly).
- Know that no one remembers that stupid thing I said six months ago and put it out of my mind.
- Recognize that it's still just the cats and go back to sleep.
Depression for me meant my emotions had no basis in reality. Not being depressed means I can influence my emotions using evidence and rational thought.
All that to say: depression is the blue pill.
posted by sleepingcbw at 6:48 PM on August 24, 2015 [31 favorites]
I was on anti-depressants for about a year, and I went off them: I didn't feel like myself, which included the "bad" parts (over-thinking, anxiety, etc). I did feel dulled. I did feel like some part of me that I loved was gone, even if that part of me also caused me most of the stress and anxiety and pain in my life. It was a choice I made, and I don't want to go back to anti-anxiety medication again. This is my personal experience of it. I missed myself, however problematic.
posted by Clotilde at 6:49 PM on August 24, 2015
posted by Clotilde at 6:49 PM on August 24, 2015
One thing to add: I have often noticed that depression acts like a living organism in the respect that it will do whatever is necessary to stay "alive." That includes (but is not limited to) sending you "messages" that whatever is helping you get rid of depression isn't really helping or is somehow detrimental. Don't believe it. If you are manic, then yeah, get the dosage altered. But if you're simply not depressed? Then the medicine is working and I applaud you. Don't listen to unreliable advisors like depression. They will lead you astray.
posted by janey47 at 7:03 PM on August 24, 2015 [12 favorites]
posted by janey47 at 7:03 PM on August 24, 2015 [12 favorites]
It's not false! The meds have simply removed a layer of static that existed between you and the rest of the world, which took the form of irregular brain chemistry. Rejoice in the peace you will find, finally! Now you'll be able to decide what your boundaries are, and stick to them. Such a relief from second guessing yourself all the time!!
posted by wwartorff at 7:26 PM on August 24, 2015 [2 favorites]
posted by wwartorff at 7:26 PM on August 24, 2015 [2 favorites]
I've been on Wellbutrin for years. Here's the thing - depression is the liar. Depression says no one loves me, I'm a failure, I'll never be good enough, etc. Depression says, "oh, you're happy on antidepressants? That's not real. Depression is real. Wanting to sleep all day, plotting your own death, knowing things will never get better, that's real." Eff that. If a friend told me any of the things depression tells me, like that I'm a worthless failure, I'd say, friend, that's wrong, that's a lie. Depression lies. Antidepressants give you the ability to see the lie for what it is.
posted by kat518 at 7:48 PM on August 24, 2015 [22 favorites]
posted by kat518 at 7:48 PM on August 24, 2015 [22 favorites]
If you're feeling happy and yet putting your life and finances at risk, alienating friends and family, and acting in ways most of the people around you are calling irrational and dangerous, then yes, the good feelings are an illusion; that's mania and you need to go back to the doctor.
If, on the other hand, you're feeling happy and finding yourself more able to get out of bed, less prone to overanalyzing, a little more interested in life and the world, and your social connections are getting stronger-- well, that's just not being depressed.
posted by thetortoise at 7:57 PM on August 24, 2015 [5 favorites]
If, on the other hand, you're feeling happy and finding yourself more able to get out of bed, less prone to overanalyzing, a little more interested in life and the world, and your social connections are getting stronger-- well, that's just not being depressed.
posted by thetortoise at 7:57 PM on August 24, 2015 [5 favorites]
Having been on Wellbutrin for a long time I can say this --- it definitely does not "make" you happy. You can be quite unhappy on it, just like anyone can be.
What it does for me is remove some of the bullshit reasons I would be anxious or depressed. But trust me, when the big stuff happens you'll still be upset. It is easier to deal with those when the unimportant stuff becomes less taxing, however.
(I think initially it can almost feel like its making you happy because you're getting some relief from the stuff that was bothering you but not important before. But after a while you'll have some normal up/downs in life and see that the antidepressant is not some magic happy pill thats obscuring reality).
posted by thefoxgod at 8:04 PM on August 24, 2015 [5 favorites]
What it does for me is remove some of the bullshit reasons I would be anxious or depressed. But trust me, when the big stuff happens you'll still be upset. It is easier to deal with those when the unimportant stuff becomes less taxing, however.
(I think initially it can almost feel like its making you happy because you're getting some relief from the stuff that was bothering you but not important before. But after a while you'll have some normal up/downs in life and see that the antidepressant is not some magic happy pill thats obscuring reality).
posted by thefoxgod at 8:04 PM on August 24, 2015 [5 favorites]
Depression lies. Antidepressants give you the ability to see the lie for what it is.
I think it's more complicated than that. But. But.
I spent a long time looking at the early literature around what we now call 'psychology', medical writing that stops treating disordered thinking and behaviour as some kind of possession by something else from without and starts seeing it as something that is part of you and comes from messiness within. (For a good chunk of that time, I was pretty severely depressed. For some of it, I was on anti-depressants.)
Those early writers, grounded in empiricism, rationalism and a Newtonian sense of order, had real problems with the idea that the physical and emotional instruments weighing the outside world could be miscalibrated: that the wrongness was not in how people thought about what was presented to them by the senses and emotions, but how it was sensed and felt to start with.
It's still a problem. It is still difficult to talk about the insidiousness of depression on one's sense of how things are and should be and will be. But it is also problematic to talk in epistemological terms, to treat it as truth and lies. Truth-seeking through the body is, I think, a path that leads you the long way round to nowhere.
Does it feel better? That's the question you ask.
posted by holgate at 8:23 PM on August 24, 2015 [3 favorites]
I think it's more complicated than that. But. But.
I spent a long time looking at the early literature around what we now call 'psychology', medical writing that stops treating disordered thinking and behaviour as some kind of possession by something else from without and starts seeing it as something that is part of you and comes from messiness within. (For a good chunk of that time, I was pretty severely depressed. For some of it, I was on anti-depressants.)
Those early writers, grounded in empiricism, rationalism and a Newtonian sense of order, had real problems with the idea that the physical and emotional instruments weighing the outside world could be miscalibrated: that the wrongness was not in how people thought about what was presented to them by the senses and emotions, but how it was sensed and felt to start with.
It's still a problem. It is still difficult to talk about the insidiousness of depression on one's sense of how things are and should be and will be. But it is also problematic to talk in epistemological terms, to treat it as truth and lies. Truth-seeking through the body is, I think, a path that leads you the long way round to nowhere.
Does it feel better? That's the question you ask.
posted by holgate at 8:23 PM on August 24, 2015 [3 favorites]
I remember the bliss I felt the very first time I realized my antidepressants had kicked in. It wasn't that they were making me artificially happy; rather, it was that the depression had broken and everything felt better without that cloud over it. It's like getting over a nasty cold and being so grateful that you can finally just breathe - which other people do every day.
A word of caution, however: some people with bipolar disorder get initially misdiagnosed with, and medicated for, unipolar depression, which can sometimes exacerbate manic episodes. It's always wise to have regular appointments with the doctor who's prescribing your meds, so they can keep an eye on your moods and help you figure out if they're getting out of hand. Wellbutrin in particular can also exacerbate anxiety; worrying about whether you should worry sounds like anxiety might be a possibility. Worth keeping an eye on.
posted by Metroid Baby at 8:31 PM on August 24, 2015 [1 favorite]
A word of caution, however: some people with bipolar disorder get initially misdiagnosed with, and medicated for, unipolar depression, which can sometimes exacerbate manic episodes. It's always wise to have regular appointments with the doctor who's prescribing your meds, so they can keep an eye on your moods and help you figure out if they're getting out of hand. Wellbutrin in particular can also exacerbate anxiety; worrying about whether you should worry sounds like anxiety might be a possibility. Worth keeping an eye on.
posted by Metroid Baby at 8:31 PM on August 24, 2015 [1 favorite]
Since you referenced the Matrix and are asking what's real, remember:
Morpheus: What is real? How do you define 'real'? If you're talking about what you can feel, what you can smell, what you can taste and see, then 'real' is simply electrical signals interpreted by your brain.
So, what "should" you be feeling? That's not the best way to think about this. A "should" statement is itself a cognitive distortion. Perhaps you should consider some therapy to go along with the meds?
posted by Cool Papa Bell at 8:55 PM on August 24, 2015 [2 favorites]
Morpheus: What is real? How do you define 'real'? If you're talking about what you can feel, what you can smell, what you can taste and see, then 'real' is simply electrical signals interpreted by your brain.
So, what "should" you be feeling? That's not the best way to think about this. A "should" statement is itself a cognitive distortion. Perhaps you should consider some therapy to go along with the meds?
posted by Cool Papa Bell at 8:55 PM on August 24, 2015 [2 favorites]
Ok, some of the skepticism about truth here is troubling: of course our emotions can be accurate or inaccurate. We all recognize this when we say, for example, that Othello's jealousy was inaccurate and he shouldn't have felt it. We aren't making any kind of error in saying that, and those kinds of assessments are the basis for cognitive therapy.
The OP is asking if antidepressant medications undermine the accuracy of our emotions. It is a perfectly coherent question to ask, and one that psychologists have been studying for decades.
In response, many people have offered anecdotes about how antidepressants have worked for them and brought them closer to the truth. While I have nothing against anecdotes, and I use them in my own answers here all the time, they aren't especially helpful in answering this kind of question because it is difficult to determine if one's own emotions are accurate. This is where science comes in.
Psychologists have done studies where they asked the depressed and non-depressed questions like, "did the person you just met see you as likable?" "Did the group you just met rate you as a good public speaker?" "Do you think the other test subject was persuaded by the speech you just gave?" and so on.
The depressed people gave seemingly "pessimistic" responses to these questions and the non-depressed gave optimistic responses. And then the scientists measured subjects' actual effectiveness along these dimensions. It turns out that the judgments of the depressed are more accurate! Nondepressed people are more likely to inflate their estimations of themselves and their performances. Their responses are distorted and often the responses of the depressed were quite accurate. Sadly, many of the seemingly pessimistic responses were actually true. And these studies have pretty good replication rates. The depressed are only accurate in judgments of a certain kind, not across the board, but the standard view that depression always involves distorted judgments has been shown to be false.
Now, as I said at the outset, I don't think this means that people should stop taking their medications or anything. Well being might be more important than truth. But people might want to think a bit more about the potential costs of medication, as well as its obvious benefits.
posted by girl flaneur at 9:44 PM on August 24, 2015 [6 favorites]
The OP is asking if antidepressant medications undermine the accuracy of our emotions. It is a perfectly coherent question to ask, and one that psychologists have been studying for decades.
In response, many people have offered anecdotes about how antidepressants have worked for them and brought them closer to the truth. While I have nothing against anecdotes, and I use them in my own answers here all the time, they aren't especially helpful in answering this kind of question because it is difficult to determine if one's own emotions are accurate. This is where science comes in.
Psychologists have done studies where they asked the depressed and non-depressed questions like, "did the person you just met see you as likable?" "Did the group you just met rate you as a good public speaker?" "Do you think the other test subject was persuaded by the speech you just gave?" and so on.
The depressed people gave seemingly "pessimistic" responses to these questions and the non-depressed gave optimistic responses. And then the scientists measured subjects' actual effectiveness along these dimensions. It turns out that the judgments of the depressed are more accurate! Nondepressed people are more likely to inflate their estimations of themselves and their performances. Their responses are distorted and often the responses of the depressed were quite accurate. Sadly, many of the seemingly pessimistic responses were actually true. And these studies have pretty good replication rates. The depressed are only accurate in judgments of a certain kind, not across the board, but the standard view that depression always involves distorted judgments has been shown to be false.
Now, as I said at the outset, I don't think this means that people should stop taking their medications or anything. Well being might be more important than truth. But people might want to think a bit more about the potential costs of medication, as well as its obvious benefits.
posted by girl flaneur at 9:44 PM on August 24, 2015 [6 favorites]
It might be more accurate to say that the depression was creating a false murkiness on life, and the medication is allowing you to see REAL life again - with all its ups AND downs, and hopefully be able to deal with both in a more productive manner.
posted by stormyteal at 9:51 PM on August 24, 2015
posted by stormyteal at 9:51 PM on August 24, 2015
Unless you find yourself engaging in risky behaviors in the belief that it will all be OK even though you are doing blatantly idiotic things, there is no external reason to quit taking antidepressants. These memes about antidepressants somehow making people's perceptions "unreal" have a very damaging effect in that they keep people who have a very real need for the medication from getting help.
My SIL is constantly convinced that everything she does is wrong, people are always mad at her, and on and on. She finally managed to make it to a doc who prescribed her some Effexor, but after too many days of reading that BS on the Internet decided not to take it after all. It is so infuriating to see her suffer when it's so damn easy to recalibrate her perception to be more in accord with reality.
Antidepressants, properly dosed, do not make you an unfeeling zombie, nor do they make you oblivious to the real problems that do exist in your life. Like stimulants to a person with ADHD, they just dull the roar of the background noise that keeps you from seeing things as they are.
It could definitely be argued that many people who are on antidepressants are either not on the correct medication for them or are not at the correct dose, but that doesn't change the underlying reality that depression does lie to you, including by convincing you that the cure is worse than the disease.
Disclosure: I am not now and have never been on antidepressants, unless you count the copious amount of pot I smoked for some years when I was younger.
posted by wierdo at 10:04 PM on August 24, 2015 [1 favorite]
My SIL is constantly convinced that everything she does is wrong, people are always mad at her, and on and on. She finally managed to make it to a doc who prescribed her some Effexor, but after too many days of reading that BS on the Internet decided not to take it after all. It is so infuriating to see her suffer when it's so damn easy to recalibrate her perception to be more in accord with reality.
Antidepressants, properly dosed, do not make you an unfeeling zombie, nor do they make you oblivious to the real problems that do exist in your life. Like stimulants to a person with ADHD, they just dull the roar of the background noise that keeps you from seeing things as they are.
It could definitely be argued that many people who are on antidepressants are either not on the correct medication for them or are not at the correct dose, but that doesn't change the underlying reality that depression does lie to you, including by convincing you that the cure is worse than the disease.
Disclosure: I am not now and have never been on antidepressants, unless you count the copious amount of pot I smoked for some years when I was younger.
posted by wierdo at 10:04 PM on August 24, 2015 [1 favorite]
What is reality? How do we know that consensus reality has more validity than any individual reality? Is the reality of life as you perceived it in your childhood the same as the reality you perceive now? Which one was right, or true, or real?
My point here is that this is one of those underlying questions of humanity, along with a few others like what is the point of life, does god/supreme/higher being exist etc. Philosophy is all very interesting and fun to pursue in its own way, but you are never going to get a definitive answer from it. You will only ever find the answer that seems to make the most sense to you at this point in your life.
Personally, I think that some of the things I tell myself when depressed probably are true, but also not true at the same time. For example: in the throes of depression, I think that no one would much notice if I didn't exist anymore. Which, in terms of my daily interaction with most of my friends (whom I do not see every day) and my family (who all live in another country) is probably true. My cat would notice, because I feed him. However, the thoughts and feelings that that "truth" leads to, things like "they would be better off without me" or "they wouldn't care if I died" etc are not true. So I don't know how useful the distinction between true/not true is, at least for me.
So maybe it's more useful to think about your quality of life on vs off antidepressants. Which life do you want? Which life would the people who care about you want? Which feels like a more sustainable choice? Which life lets you accomplish more, do more, experience more, connect more? Which life leaves you feeling like you cannot do much of anything, where even getting up and feeding yourself is a massive undertaking? Which life do you want?
For me, my life on medication is closer to the kind of life that I want. Is it real? I don't particularly care; I only get one shot at it and I'd rather have a life that involves less of the being mired in misery and wanting to die which I seem to get when not on medication. But everyone gets to choose.
posted by Athanassiel at 10:10 PM on August 24, 2015 [4 favorites]
My point here is that this is one of those underlying questions of humanity, along with a few others like what is the point of life, does god/supreme/higher being exist etc. Philosophy is all very interesting and fun to pursue in its own way, but you are never going to get a definitive answer from it. You will only ever find the answer that seems to make the most sense to you at this point in your life.
Personally, I think that some of the things I tell myself when depressed probably are true, but also not true at the same time. For example: in the throes of depression, I think that no one would much notice if I didn't exist anymore. Which, in terms of my daily interaction with most of my friends (whom I do not see every day) and my family (who all live in another country) is probably true. My cat would notice, because I feed him. However, the thoughts and feelings that that "truth" leads to, things like "they would be better off without me" or "they wouldn't care if I died" etc are not true. So I don't know how useful the distinction between true/not true is, at least for me.
So maybe it's more useful to think about your quality of life on vs off antidepressants. Which life do you want? Which life would the people who care about you want? Which feels like a more sustainable choice? Which life lets you accomplish more, do more, experience more, connect more? Which life leaves you feeling like you cannot do much of anything, where even getting up and feeding yourself is a massive undertaking? Which life do you want?
For me, my life on medication is closer to the kind of life that I want. Is it real? I don't particularly care; I only get one shot at it and I'd rather have a life that involves less of the being mired in misery and wanting to die which I seem to get when not on medication. But everyone gets to choose.
posted by Athanassiel at 10:10 PM on August 24, 2015 [4 favorites]
Ok, one more comment and then I'll call it a night.
While I disagree with the first part of Athanassiel's post (Depressive Realism is a scientific, testable hypothesis, not mere philosophical speculation), I do agree with the second part: I think overall assessments of quality of life are the most important. I'd probably rather have my thinking a little distorted but feel happy, than have a perfectly accurate assessment and feel miserable.
But I think it is important to acknowledge the loss too. Weirdo seems to be saying that it is dangerous to point out the phenomenon of depressive realism. I think this is wrong: first off, I don't think it is right to lie to patients and pretend this research isn't out there. People weigh pros and cons of medications, including antidepressants, all the time, and I think we owe it to patients to tell then the risks as well as benefits of any medication. Also, I think, in some odd way, it can be reassuring for people who suffer from depression to hear that not all their thinking is distorted; they actually are getting the world right in some ways. Of course, some of their thinking is obviously distorted, but it can be a relief for them to hear that healthy people also have distorted thinking as well.
posted by girl flaneur at 10:32 PM on August 24, 2015 [1 favorite]
While I disagree with the first part of Athanassiel's post (Depressive Realism is a scientific, testable hypothesis, not mere philosophical speculation), I do agree with the second part: I think overall assessments of quality of life are the most important. I'd probably rather have my thinking a little distorted but feel happy, than have a perfectly accurate assessment and feel miserable.
But I think it is important to acknowledge the loss too. Weirdo seems to be saying that it is dangerous to point out the phenomenon of depressive realism. I think this is wrong: first off, I don't think it is right to lie to patients and pretend this research isn't out there. People weigh pros and cons of medications, including antidepressants, all the time, and I think we owe it to patients to tell then the risks as well as benefits of any medication. Also, I think, in some odd way, it can be reassuring for people who suffer from depression to hear that not all their thinking is distorted; they actually are getting the world right in some ways. Of course, some of their thinking is obviously distorted, but it can be a relief for them to hear that healthy people also have distorted thinking as well.
posted by girl flaneur at 10:32 PM on August 24, 2015 [1 favorite]
Depressive realism has also been shown to be valid only in limited scenarios (e.g., evaluating one's own performance immediately after a task) and for mild depression. Some have contested its broad validity and even supporters of the phenomenon caution that it doesn't hold for clinical depression. I'm not a psychologist or anything, just someone who has been through a lot of depressive episodes, but I've noticed this research is easily misused, so anyone wanting to use the concept in the real world should go through it pretty thoroughly to get a sense of how limited the context is. Not that you haven't done this, girl flaneur, but I just want to add more caution to the discussion because this line of thought can be dangerous for someone seriously ill. People in a depressed mindset love to cite depressive realism (I've done this, to psychiatrists, psychologists, and therapists all), but tend to get it far out of proportion from reality.
If you're feeling melancholy, it's fine to contemplate the accuracy of your worldview and how it informs truth. If you have experienced suicidal ideation or severe depression, now or in the past, remember that there are extreme cognitive distortions at work, far greater than anything claimed for depressive realism.
posted by thetortoise at 11:08 PM on August 24, 2015 [10 favorites]
If you're feeling melancholy, it's fine to contemplate the accuracy of your worldview and how it informs truth. If you have experienced suicidal ideation or severe depression, now or in the past, remember that there are extreme cognitive distortions at work, far greater than anything claimed for depressive realism.
posted by thetortoise at 11:08 PM on August 24, 2015 [10 favorites]
Some thoughts, in no particular order (though hopefully, they'll make some kind of sense):
We modulate our moods and thoughts using non-pill-related strategies all the time. These include what I'd say are more voluntary methods, like use of exercise, coffee, alcohol (even carbs, for some), and ones that are probably less consciously controlled, like our exposure to particular people, situations, and representational worlds (e.g. films, tv, books, music, art).
Is that equivalent to using a drug to shape experience? I'm not sure :/ , but with a drug, ideally, there's an expert (and you, you're also an expert on you) monitoring its effects, and evaluating them according to certain criteria meant to assess to your functioning, in the light of risks and benefits. I agree with others above, that's really the benchmark.
So one question is, how well are you functioning in different domains of life? You said this:
I am not sweating the small things. But perhaps I should somewhat at least? And I am happy, but what if it is covering up something I shouldn't be happy about.
What does that mean? Is it just that your anxiety or sadness is lessened, and you can do things you value that you couldn't before? That's good, if so.
Is it that you're no longer responding to certain situations or people in what might be considered appropriate ways, generally, or for you, historically, when you've functioned in healthy ways in the past? That might mean something else, like apathy.
(Example - when I was on Paxil, I was indifferent to the emotional responses of people I cared about in my interactions with them. Like I'd recognize intellectually that someone I cared about was happy or sad, and I didn't care. Or worse, that something I did or said was hurtful or thoughtless or inappropriate, and I didn't care. Also, I no longer cared about activities that had mattered to me deeply before taking the drug. Among a few other things. To me, those were indications that I wasn't actually functioning in a way that served me [or my relationships].)
So, if it were me, I'd ask myself (and I did ask myself): What does it mean to function well - at work or school, with people, in leisure activities - generally? What did it mean for me historically, when I felt good and functioned well (if you had such a time)? What am I able to accomplish now, and is the way I'm living a good way to live?
posted by cotton dress sock at 11:14 PM on August 24, 2015 [6 favorites]
We modulate our moods and thoughts using non-pill-related strategies all the time. These include what I'd say are more voluntary methods, like use of exercise, coffee, alcohol (even carbs, for some), and ones that are probably less consciously controlled, like our exposure to particular people, situations, and representational worlds (e.g. films, tv, books, music, art).
Is that equivalent to using a drug to shape experience? I'm not sure :/ , but with a drug, ideally, there's an expert (and you, you're also an expert on you) monitoring its effects, and evaluating them according to certain criteria meant to assess to your functioning, in the light of risks and benefits. I agree with others above, that's really the benchmark.
So one question is, how well are you functioning in different domains of life? You said this:
I am not sweating the small things. But perhaps I should somewhat at least? And I am happy, but what if it is covering up something I shouldn't be happy about.
What does that mean? Is it just that your anxiety or sadness is lessened, and you can do things you value that you couldn't before? That's good, if so.
Is it that you're no longer responding to certain situations or people in what might be considered appropriate ways, generally, or for you, historically, when you've functioned in healthy ways in the past? That might mean something else, like apathy.
(Example - when I was on Paxil, I was indifferent to the emotional responses of people I cared about in my interactions with them. Like I'd recognize intellectually that someone I cared about was happy or sad, and I didn't care. Or worse, that something I did or said was hurtful or thoughtless or inappropriate, and I didn't care. Also, I no longer cared about activities that had mattered to me deeply before taking the drug. Among a few other things. To me, those were indications that I wasn't actually functioning in a way that served me [or my relationships].)
So, if it were me, I'd ask myself (and I did ask myself): What does it mean to function well - at work or school, with people, in leisure activities - generally? What did it mean for me historically, when I felt good and functioned well (if you had such a time)? What am I able to accomplish now, and is the way I'm living a good way to live?
posted by cotton dress sock at 11:14 PM on August 24, 2015 [6 favorites]
What you describe is how I felt when my depression meds first starting working. The way I described it to my therapist was that it was simply masking reality and the real me. If you're depressed and you are taking anti-depressants that are doing their job, that doesn't mean you aren't depressed, so you maybe feel like you're in this weird in-between limbo.
I would really not get so hung up on what is "real." Take the situation for what it is: You've been depressed and meds are making you feel better and giving you the chance to work your way back to not being depressed at all, meds or not. For me, the meds got me out of the house, got me to stop crying, got me back in school/work, got me seeing people, and got me living my life again. Then that is what helped me move past depression so I didn't need meds anymore. The meds are opening a door that can take you back to your normal self, but now you gotta do the work and walk through the door.
For what it's worth, although I felt like the anti-depressants were masking how I really felt, I now realize that that's actually what depression was doing to me. Depression is what creates the false illusion. Maybe the meds do the same thing to push back against it -- who knows. But whatever it is, go with it and use it to push yourself back to being your old self. As someone who has been depression free for about 10 years now, I can say depression really distorts your sense of reality and it is not the real you.
posted by AppleTurnover at 11:25 PM on August 24, 2015 [4 favorites]
I would really not get so hung up on what is "real." Take the situation for what it is: You've been depressed and meds are making you feel better and giving you the chance to work your way back to not being depressed at all, meds or not. For me, the meds got me out of the house, got me to stop crying, got me back in school/work, got me seeing people, and got me living my life again. Then that is what helped me move past depression so I didn't need meds anymore. The meds are opening a door that can take you back to your normal self, but now you gotta do the work and walk through the door.
For what it's worth, although I felt like the anti-depressants were masking how I really felt, I now realize that that's actually what depression was doing to me. Depression is what creates the false illusion. Maybe the meds do the same thing to push back against it -- who knows. But whatever it is, go with it and use it to push yourself back to being your old self. As someone who has been depression free for about 10 years now, I can say depression really distorts your sense of reality and it is not the real you.
posted by AppleTurnover at 11:25 PM on August 24, 2015 [4 favorites]
Clinical psychologist Jordan B Peterson talks about this, 17 mins in - in the linked video https://youtu.be/DC0faZiBcG0?t=1020 - he makes the distinction between being depressed and having a "terrible life". My interpretation of what he says is that: antidepressants do not give you a false illusion of life, because they cannot fix, in his words a "terrible life" (his definition: "you're unemployed, children hate you" etc).
posted by Speculatist at 6:38 AM on August 25, 2015 [1 favorite]
posted by Speculatist at 6:38 AM on August 25, 2015 [1 favorite]
You're asking if antidepressants are giving you rose-tinted glasses. I think depression gives you blue- or grey-tinted glasses and antidepressants are helping you shed those depression goggles.
In my experience, Wellbutrin made my lows less low. Without antidepressants, if I got a rejection letter, I'd think, that's it, this is never going to get better, trying is futile, I'm going to be miserable forever, why bother living, I'm just making everyone around me miserable too, etc. With antidepressants, if I got a rejection letter, I'd think, bummer, guess I better keep trying if I want to get anywhere. I wasn't suddenly happy all the time ("yay! rejection letter! I love mail!") but it wasn't the end of the world either.
Taking antidepressants and reading about depression helped me identify my cognitive distortions so I could call myself out ("HEY stop thinking things are never going to get better because that's a cognitive distortion and things are always changing, not necessarily getting better or worse but different so let's phrase this differently"). Working with a therapist took that to the next level. For example, I told her that I had to shoulder all of this responsibility at work even though people kept offering to help me with things and she said, why can't you take them up on helping you? That doesn't sound like a big thing but she helped me identify things like that that only existed in my head.
You know how in movies like ET, when people are trying to build something, do an experiment or they Have A Plan and it starts coming together and they're like, "it's working!!"?? I had that moment with my antidepressants. I was coming home from a long day at work and I thought to myself, this is hard but I can do this. I had been doing the same tasks a year earlier and felt overwhelmed but this time, I knew I could do it. Sure, some of that was experience but it was also knowing that the things I was doing were helping and I just needed to stick to the program. Sometimes you need to change up the program and that's okay too. But the feeling of clarity and hope that I felt when I realized the drugs were working is something that I hope you experience.
posted by kat518 at 6:49 AM on August 25, 2015 [3 favorites]
In my experience, Wellbutrin made my lows less low. Without antidepressants, if I got a rejection letter, I'd think, that's it, this is never going to get better, trying is futile, I'm going to be miserable forever, why bother living, I'm just making everyone around me miserable too, etc. With antidepressants, if I got a rejection letter, I'd think, bummer, guess I better keep trying if I want to get anywhere. I wasn't suddenly happy all the time ("yay! rejection letter! I love mail!") but it wasn't the end of the world either.
Taking antidepressants and reading about depression helped me identify my cognitive distortions so I could call myself out ("HEY stop thinking things are never going to get better because that's a cognitive distortion and things are always changing, not necessarily getting better or worse but different so let's phrase this differently"). Working with a therapist took that to the next level. For example, I told her that I had to shoulder all of this responsibility at work even though people kept offering to help me with things and she said, why can't you take them up on helping you? That doesn't sound like a big thing but she helped me identify things like that that only existed in my head.
You know how in movies like ET, when people are trying to build something, do an experiment or they Have A Plan and it starts coming together and they're like, "it's working!!"?? I had that moment with my antidepressants. I was coming home from a long day at work and I thought to myself, this is hard but I can do this. I had been doing the same tasks a year earlier and felt overwhelmed but this time, I knew I could do it. Sure, some of that was experience but it was also knowing that the things I was doing were helping and I just needed to stick to the program. Sometimes you need to change up the program and that's okay too. But the feeling of clarity and hope that I felt when I realized the drugs were working is something that I hope you experience.
posted by kat518 at 6:49 AM on August 25, 2015 [3 favorites]
part of me wonders if it gives a false illusion about life.
If there was ever any false illusion I had about life, it was the constant undercurrent of "if I don't do XYZ, then my life will be ruined" that has gone away since I started taking lexapro. The Wellbutrin stops me from totally dozing off and mitigates the weight gain.
I am still a temperamental pessimist. I just don't catastrophize about things any more or pointlessly obsess about things I have no control over, allowing me to concentrate on more important matters at hand.
posted by bright colored sock puppet at 7:57 PM on August 25, 2015 [1 favorite]
If there was ever any false illusion I had about life, it was the constant undercurrent of "if I don't do XYZ, then my life will be ruined" that has gone away since I started taking lexapro. The Wellbutrin stops me from totally dozing off and mitigates the weight gain.
I am still a temperamental pessimist. I just don't catastrophize about things any more or pointlessly obsess about things I have no control over, allowing me to concentrate on more important matters at hand.
posted by bright colored sock puppet at 7:57 PM on August 25, 2015 [1 favorite]
Like you, I worried that the happiness I was feeling on medication was false or based on incorrect premises. I was concerned about this until I had a shitty week at work capped off by my boss undermining me to colleagues I respected. Then I felt stressed, and sad, and angry, but in proportion to the event. I blew off steam with friends on Saturday night, came up with a plan on Sunday, and anxiously put the plan into action at work on Monday, the mentally-healthy way I've always known I should but could never quite manage before. Previously I would have withdrawn completely or broken down. By the end of the next week I felt much better (if more cautious about that boss).
Basically, medication is not a happy pill, and it's definitely not an anti-arsehole or anti-noticing-shitty-things pill. It can help you take better care of yourself, and that's about it. (If it's not even doing that for you, talk to your doctor about trying something else.) And that can allow other parts of your personality to expand or blossom or stretch, since you don't have to spend all that time on feeling like shit anymore. That's the scary part: who are you when you're not feeling like shit? Now's your chance to find out.
posted by harriet vane at 11:27 PM on September 6, 2015 [3 favorites]
Basically, medication is not a happy pill, and it's definitely not an anti-arsehole or anti-noticing-shitty-things pill. It can help you take better care of yourself, and that's about it. (If it's not even doing that for you, talk to your doctor about trying something else.) And that can allow other parts of your personality to expand or blossom or stretch, since you don't have to spend all that time on feeling like shit anymore. That's the scary part: who are you when you're not feeling like shit? Now's your chance to find out.
posted by harriet vane at 11:27 PM on September 6, 2015 [3 favorites]
This thread is closed to new comments.
posted by flourpot at 5:08 PM on August 24, 2015 [8 favorites]