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Areas › Low mood and hard feelings › When everything feels flat
Antidepressants lean in different directions, and one or two are weighted more towards the system carrying energy and alertness than towards serotonin. Whether or not that route is taken, the useful move is to describe what is missing precisely. Saying you feel a bit low and saying you cannot make yourself start anything and ache all day point at quite different choices.
Look, then, at the imprints of God's mercy, how He restores the earth to life after death (Quran 30:50). Being told to look means the return of life may be something you have to go and notice rather than something that announces itself.
الروم
فَٱنظُرۡ إِلَىٰٓ ءَاثَٰرِ رَحۡمَتِ ٱللَّهِ كَيۡفَ يُحۡيِ ٱلۡأَرۡضَ بَعۡدَ مَوۡتِهَآۚ إِنَّ ذَٰلِكَ لَمُحۡيِ ٱلۡمَوۡتَىٰۖ وَهُوَ عَلَىٰ كُلِّ شَيۡءࣲ قَدِيرࣱ
Look, then, at the imprints of God’s mercy, how He restores the earth to life after death: this same God is the one who will return people to life after death- He has power over all things
Qur’an 30:50read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
Low energy is not a small obstacle. In a meta analysis of people with severe mental illness, low mood and low energy were the barriers to exercising that people reported most often, while wanting to improve mood was among the strongest motivators. What is depleted and what motivates sit in the same person at the same time.
Firth J, Rosenbaum S, Stubbs B, Gorczynski P, Yung AR, Vancampfort D. (2016). Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis.. Psychological medicine doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Describing what is missing precisely gives the person prescribing something to aim at.
Match the tablet to the person rather than to the diagnosis. For someone flattened and slowed who has said clearly that they will not accept sexual side effects, paroxetine is close to the worst choice available.
Try putting a sentence between you and the mood: this is what my brain is doing right now. It does not make me a bad person, and it does not mean I cannot cope. It just feels that way today.
The chemistry story runs backwards from how it is usually told. Nobody found a low chemical and then built a drug. They noticed what certain drugs did to mood and reasoned back to what must have been missing.