And SSRIs continue to be moderately effective antidepressants in the people for whom they are indicated.

What does that mean?
That they help many people “moderately”?
Or could it be that they a help few people very much?

That is what decides how good the following advice is: “If one antidepressant didn’t work, just keep trying different ones, because another antidepressant very probably will work.” (for which I’ve never seen ANY evidence, btw)

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>Although it’s ordinarily fenced off from the body’s infection-fighting agents, the brain has a complementary system, called microglia, capable of clearing away damaged neurons and fending off infection. Specialized microglial cells make up 10 to 15 percent of the brain. When they go to work, you feel it. Active microglia interfere with neurotransmitters like serotonin, which activates the pleasure sensors in the brain. “That’s why when we have a fever, we feel flat in our mood,” Khandaker says.

Nautilus, “Yes, You Can Catch Insanity”, April 16, 2015. http://nautil.us/issue/23/dominoes/yes-you-can-catch-insanity

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An excerpt from a NYT piece I was re-reading today:
“What is the limit to neuroimaging therapy?” deCharms muses. “Could you learn to target the reward or serotonin system and up-regulate happiness?

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We must examine the fact that as a profession, we have allowed the bio-psycho-social model to become the bio-bio-bio model.

and

Financial incentives and managed care have contributed to the notion of a ‘quick fix’ by taking a pill and reducing the emphasis on psychotherapy and psychosocial treatments. There is much evidence that there is less psychotherapy provided by psychiatrists than 10 years ago. This is true despite the strong evidence base that many psychotherapies are effective used alone or in combination with medications

Sharfstein made the above comment in 2005, according to John Read (pdf).

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With regard to the benefits of antidepressants, in its large meta-analysis of 100,000 patients, half of whom were depressed, the US Food and Drug Administration (FDA) noted that 10% more patients responded on
antidepressants than did those on placebo,2 and the Cochrane review of depressed patients reported similar results3 (ie, one patient might benefit for every ten patients treated). I believe those results were exaggerated, however,
for several reasons.4 Most importantly, the trials were not effectively blinded. Antidepressants have conspicuous side-effects and many patients and their doctors will therefore know whether the blinded drug is active or placebo. A systematic review of 21 trials5 in a variety of diseases that had both masked and non-masked outcome assessors, and which had mostly used subjective
outcomes, found that the treatment effect was exaggerated by 36% on average (measured as odds ratio) when non-masked observers rather than masked ones assessed the effect.

In other contexts Gøtzsche has referred to SSRIs as anti-sexuality drugs. I.e., that’s their main effect.

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You end by conceding that “this consensus position got simplified and distorted. I have no doubt that drug companies drew from it to do exactly the sort of infomercials that Mr. Wipond describes” and “SSRIs continue to be moderately effective antidepressants in the people for whom they are indicated. (ie somewhere less than half of the people for whom they are prescribed)”

Those statements look pretty much in agreement – the drug companies oversold “chemical imbalance” in order to push their drugs onto people who didn’t benefit from them.

Your position (if I’m reading you correctly and not just projecting my own opinion) is that psychiatry is doing the best it can. That’s not incompatible with screwing up sometimes and needing to do better.

You certainly make a good argument that MiA was intellectually dishonest in their quotations. However, it seems futile to hope for scientific rigor in a blog with the word “Mad” in its title when the quoted “Medical News Today” turns correlation into causation.

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