i learned that at least one of the victims of the Vesuvius Eruption in 79 C.E was found with a vitrified brain. In other words their brain was turned to glass due to the extreme heat (x)
do you feel like SSRIs are mostly pseudoscience? I'm not sure if I should be open to trying them or avoid them at all costs since I'm not sure if they even work or if they will mess me up permanently
a preliminary note that i don’t find the category ‘pseudoscience’ to be useful & would classify SSRI research more as 'methodologically shoddy science’ or 'ideologically slanted’ or 'part of a centuries-long effort on the part of psychiatrists to secure themselves professional prestige by claiming neurobiological etiologies where none are shown to exist’ &c &c. imo the notion of 'pseudoscience’ is itself pretty positivistic, ahistorical, and ideologically noxious (particularly apparent in any analysis of epistemological imperialism).
that aside: you raise two major issues with SSRIs, namely whether they work and whether they will cause you harm.
efficacy of SSRIs is contested. a 2010 meta-analysis found that in patients with mild or moderate depressive symptoms, the efficacy of SSRIs “may be minimal or nonexistent”, whilst “for patients with very severe depression, the benefit of medications over placebo is substantial”. a 2008 meta-analysis found a similar distinction between mildly vs severely depressed patients, but noted that even in the latter population, drug–placebo differences were “relatively small” and argued that the differences between drug and placebo in severely depressed patients “seems to result from a poorer response to placebo amongst more depressed patients” rather than from a greater efficacy of SSRIs. a 2012 meta-analysis found some SSRIs consistently effective over placebo treatments, but several authors disclosed major relationships with pharmaceutical companies. a 2017 meta-analysis concluded that “SSRIs might have statistically significant effects on depressive symptoms, but all trials were at high risk of bias and the clinical significance seems questionable” (emphasis added) and that “potential small beneficial effects seem to be outweighed by harmful effects”.
A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive.
meta-analyses are not immune to this issue, either. in addition to the problem that a meta-analysis of a bunch of bad studies cannot magically 'cancel out’ the effects of poor study design, the authors of meta-analyses can and do also have financial interests and ties to pharmaceutical companies, and this affects their results just as it does the results of the studies they are studying. according to a 2016 analysis of antidepressant meta-analyses,
Fifty-four meta-analyses (29%) had authors who were employees of the assessed drug manufacturer, and 147 (79%) had some industry link (sponsorship or authors who were industry employees and/or had conflicts of interest). Only 58 meta-analyses (31%) had negative statements in the concluding statement of the abstract. Meta-analyses including an author who were employees of the manufacturer of the assessed drug were 22-fold less likely to have negative statements about the drug than other meta-analyses [1/54 (2%) vs. 57/131 (44%); P < 0.001]. […] There is a massive production of meta-analyses of antidepressants for depression authored by or linked to the industry, and they almost never report any caveats about antidepressants in their abstracts. Our findings add a note of caution for meta-analyses with ties to the manufacturers of the assessed products.
so, do SSRIs work? they are certainly psychoactive substances, which is to say, they do something. whether that something reduces depressive symptoms is simply not known at this point, though it is always worth keeping in mind that the 'chemical imbalance’ narrative of SSRIs (the idea that they work by 'curing’ a 'serotonin deficiency’ in the brain) has always been a profitable myth. look, any medical treatment throughout history has been vouched for by SOME patients who report that it helped them—no matter how wacky it sounds or how little evidence there was to support it. this can be for a lot of reasons: placebo effect, the remedy accidentally treating a different problem than it was intended for, the symptoms coincidentally resolving on their own. sometimes the human body is just weird and unpredictable. sometimes remedies work. i’m sorry i can’t give you a more definitive answer about whether SSRIs would help you.
i don’t mean to sound alarmist; all drugs have side effects, some of the ones above occur rarely, and you may very well decide the risk is acceptable to you to take on. i would, though, always encourage you to do thorough research into potential side effects before starting any drug, including an SSRI. more on SSRI side effects in david healy’s books 'pharmageddon’, 'let them eat prozac’, 'the antidepressant era’, and 'the creation of psychopharmacology’; 'pillaged’ by ronald w maris; and 'the myth of the chemical cure’ by joanna moncrieff.
in addition to the above, SSRIs are known to come with a risk of 'discontinuation syndrome’—that is, chemical withdrawal when stopping the drug. this, too, is often downplayed by physicians; many still deny that it can even happen. some patients don’t experience it at all, though i can tell you purely anecdotally that SSRI withdrawal was so miserable for me i simply gave up on quitting for over a year, despite the fact that at that point i was already thoroughly experienced with chemical withdrawals from other, 'harder’ drugs. again, i am not telling you not to go on SSRIs if you decide these risks are worth it to you! i simply think this is a decision that should always be made with full knowledge (indeed, this is a core, though routinely violated, principle of medical 'informed consent’).
ultimately this is not a decision anyone should make for you; it’s your body and mind that are at stake here. as always i think that anyone considering any kind of medical treatment should have full knowledge about it and should be making all decisions freely and autonomously. i am genuinely not pushing any agenda 'for’ or 'against’ SSRIs, only against prescription of them that is done carelessly, coercively, or without fully informing patients of what risks they’re taking on and what benefits they can hope to see.
On the night of April 30, 1541, the Ming Ancestral Temple in Beijing was struck by lightning and burned to the ground.
[…]
[T]he
fires forced the Jiajing Emperor to resurrect one of the dynasty’s most
expensive, difficult, and destructive projects: the logging of
old-growth timber in the far southwest of China. Disaster struck again
in 1556, when fires burned the Three Halls that form the central axis of
the Forbidden City. The Three Halls burned yet again in 1584. Through
the end of the sixteenth century, repeated damage to the imperial
palaces forced reconstruction. Yet the lightning strikes in Beijing were
also a disaster for the old-growth forests of the southwest, where the
logs to build the palaces had first been cut in the early 1400s. As
logging supervisors soon learned, ancient trees could not be felled on a
regular basis. Officials pressed ever deeper into the gorges of
southern Sichuan and northern Guizhou to find them, bringing massive
transformations to the environment in the process.
—
The foundations of Beijing were laid between 1406 and 1421 by the Yongle
emperor, a junior son of the Ming founder, who moved the court to his
personal appanage in north China.
[…]
Grasping the sinews of power that connected his court to far-flung
regions of the empire, Yongle pulled one million laborers to Beijing to
build his palaces.
Because the weight of Chinese buildings is carried by
their pillar-and-beam frameworks (liangzhu), monumental
buildings required monumental trees (Figure 2). So Yongle also
dispatched a similarly large labor force to the old-growth forests of
the far southwest to cut the fir (Cunninghamia lanceolata) and nanmu (Phoebe zhennan)
that grew straight and tall enough to be used for imperial
construction.
We cannot be certain just how many logs were cut to build
Beijing, but the figure must have been astounding. In 1441, two decades
after the completion of the project, 380,000 large timbers were left
over from the earlier construction. By 1500, these too were gone, used
for repairs or too damaged by rot to be used for construction purposes.
—
In the sixteenth century, logging officials wondered how their
predecessors had been able to obtain so many giant timbers. Li Xianqing,
who supervised more than 40 logging sites in the 1540s, noted that
large trees could still be found, but they could only be transported out
with great difficulty and at great expense. The majority had to be
discarded as hollow or insect-damaged.
Even when a quality log was
found, it took five hundred workers to tow a log over mountain passes.
Skilled craftsmen were on hand to build “flying bridges” (feiqiao), stone-lined slip roads, and enormous capstans (tianche)
to tow the logs up slopes (Figures 3 and 4). In the remote forests of
the southwest, loggers faced attacks by snakes, tigers, and “barbarians”
(manyi); “miasmatic vapors” (yanzhang, probably
malaria); storms, forest fires, rockslides, and raging rivers (Figure
5). Labor teams had to carry their own food and often starved. At the
rivers, logs were tied into massive rafts bound with bamboo for
buoyancy, towed by teams of 40 men, and then launched on the three-year,
three-thousand-kilometer journey to Beijing (Figure 6). Only a small
fraction of the trees reached the capital in a condition where they
could be used for palace building.
—
Expeditions exceeded their budgets up
to fiftyfold.
One official remarked, “the labor force numbers in the
thousands; the days number in the hundreds; the supply costs number in
the tens of thousands each year.” Another saying held that “one thousand
enter the mountains, but only five hundred leave” (rushan yiqian chu shan wubai).
To make matters worse, logging mostly occurred within territory that was
under only loose Ming control, the southwestern borderlands where local
potentates were appointed as “native officials” (tusi)
[…]. But in the 1550s, and again in the 1580s, warfare broke out among […] officials competing to supply the court with increasingly scarce
timber. […]
—
The Yongle Palaces were said to replicate the otherworldly atmosphere of
the old-growth forests where their pillars originated. The presence of
these timbers in Beijing linked the capital, materially and
symbolically, to the southwestern landscape of cliffs and gorges where
the trees had grown.
But ancient sentinel trees could not be reproduced
on demand. The fifteenth-century logging project was a millennial event,
removing the growth of hundreds or even thousands of years. Later
officials were forced to come to terms with the transformations their
predecessors had wrought in the ancient forests. Eventually builders had
to switch to smaller, commercially available timber, using ornate
artisanship and commercial efficiency to substitute for the austere
majesty of the early Ming palaces, and the thousands of years of tree
growth on which they rested.
—
Text by: Ian M. Miller. “The Distant Roots of Beijing’s Palaces.” Rachel Carson Center for Environment and Society, Environment & Society Portal, Arcadia no. 39. Autumn 2020. [Bold emphasis and some paragraph breaks/contractions added by me.]
