Change blindness

Antidepressants are awesome. (At least they were for me.)

It’s now been about a year since I started on SSRIs. Since my prescription is about to run out, I scheduled a meeting with a psychiatrist to discuss whether to stay on them. Since my health care provider has changed, I went to my previous one and got a copy of my patient records to bring to the new one.

And wow. It’s kinda shocking to read them: my previous psychiatrist has written down things like: “Patient reports moments of despair and anguish of whether anything is going to lead to anything useful, and is worried for how long this will last. Recently there have been good days as well, but isn’t sure whether those will keep up.”

And the psychologist I spoke with has written down: “At times has very negative views of the future, afraid that will never reach his goals.”

And the thing is, reading that, I remember saying those things. I remember having those feelings of despair, of nothing ever working out. But I only remember them now, when I read through the records. I had mostly forgotten that I even did have those feelings.

When I dig my memory, I can find other such things. A friend commenting to me that, based on her observations, I seem to be roughly functional maybe about half the time. Me posting on social media that I have a constant anxiety, a need to escape, being unable to really even enjoy any free time I have. A feeling that taking even a major risk for the sake of feeling better would be okay, because I didn’t really have all that much to lose. Having regular Skype sessions with another friend, and feeling bad because he seemed to be getting a lot of things done, and my days just seemed to pass by without me managing to make much progress on anything.

All of that had developed so gradually and over the years that it had never really even occurred to me that it wasn’t normal. And then, after I got the antidepressants, those helped me get back on my feet, and then things gradually improved until I no longer even remembered the depths of what I had thought was normal, a year back.

Change blindness. It’s a thing.

For a less anecdotal summary on the effects of SSRIs, see Scott Alexander’s SSRIs: Much More Than You Wanted to Know for a comprehensive look at the current studies.

8 comments

  1. Preach it, brother. Congrats on the nondying.

  2. Just curious: do you think thinking about and working on rationality, AI, existential risks and so on has been among the causes of depression for you?

    • Thinking about AI and x-risk a lot was definitely something that caused me to feel badly a lot for a time, yeah. (Less so now, because I’ve gotten more optimistic about it.) Wouldn’t be at all surprised if it turned out to be a contributing factor.

      Also exposure to the Sequences caused me to think about my desires in an exceedingly formal manner for a long time; after I started abandoning that way of thinking (as described here), things started improving, though it wasn’t enough by itself (that post was made before I got the meds).

      • As someone who’s been suffering from a bit of LW-induced existential anxiety as of late, I’m glad to hear you’ve found ways to feel more positive.

        May I ask what has caused you to have a more optimistic outlook on x-risk and stuff?

      • Hard to point to anything specific, since it’s not so much any single big thing but a bunch of smaller things that have made me suspect that e.g. getting an AI to get our values right might not be so difficult after all and that a takeoff might not be all that hard. Sotala 2015 doesn’t really make the most persuasive possible case possible for that, but it’s vaguely gesturing in the right direction.

        In general my intuitions have shifted towards thinking of intelligence and AI more along the lines that Jacob Cannell outlines here and those kinds of intuitions seem to suggest that the problem might be easier than the intelligence-as-formal-logic-ish kind of thinking that’s been classically prevalent in AI risk writings.

        Also the increased amount of attention and respectability that AI risk has been getting is promising.

  3. Work on solidifying your self care if it’s not already at a zenith: the best nutritional habits as you understand “best”, regular exercise that engages you, some social engagement with a group (at least half a dozen people but less than a hundred) that shares and promotes your values near where you reside, absolutely consistent and reliable sleep etc.

    Because there is a very real risk you will become immune to your antidepressants. You might be lucky another family of drugs will be a replacement. I’ve gone through the entire range of antidepressants and only five ever worked on me, and two had crippling side effects on me. I am saving the one variety I am not immune to for a truly crushing psychological emergency. Because it will only work for a year or two based on past experience.

    I hope this never happens to you but it may be severely disruptive if it does.

    • Thanks for the warning! As it happens, I actually successfully quit my antidepressants a few months back, having used their energy boost to implement the kinds of self-care changes you describe. There have been a few rough spots since then, but it looks like the worst problems are over. :)

  4. Interesting article, thanks!

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