Serotonin, mood, clinical depression, ineffectiveness

There's lots of things I could title this post. I could just call it the value of personal experience.

I have been unwell. I am unwell, but in a different sense to the unwell I have been which brought me to seek antidepressants, though most of the drivers of the decision are still there.

Self report of subjective unwellness. This is actually little to do with clinical depression. Clinical depression and all the research is based on strict research quality diagnoses. The academic psychiatric idea of depression is very different to self report of subjective unwellness.

It looks at operational behavioural and emotional symptoms. Its 5 out of 9 or something like that. Sort of a best guess. Can't remember if self report of subjective unwellness is even on there. It might be implicit but psychiatry would surprise you.

Low mood might be a substitute as well as, of course, the fact that the patient is reporting sickness so the diagnosis is being tested (I.e. a person reporting depression is probably depressed). But here's the cool shit. Depression isn't just about low mood or self report of unwellness. In fact a person can have no low mood but report unwellness through physical symptoms.

There is depression without low mood. And, of course, there is depression without subjective self report of unwellness. Funky ain't it? What that means is a person who has clinical depression may not be low in that sense. They may also not feel unwell.

And with all that confusion in diagnosis there's the problem of treatment. In short, there's physical and there's psychological caused depressive symptoms. The test and diagnosis don't differentiate. Treatment used to be mainly psychological then mainly bbiological. Then there's adjustment disorders and fuck knows where they fit in.

Is serotonin the only mood chemical? No. Is the complexity of depression always chemical? No. Do drugs help. Hell yeah. But the right ones at the right time.

That goes for treatment in general. But this isn't possible yet. The system of diagnosis does not predict successful treatment.

Least of all...the report of unwellness. When a person says "I am mentally unwell"....there is current no system for that and there's no system to help me. There's just psychiatry but, as you can see, it doesn't and, for all its science, can't help me with the fundamental reason I go to see a doctor to help me with that.