I self host a lot, including jellyfin, but I've never tried to do the Linux HTPC. Whenever I look into it everything has changed from a few years ago, it all sounds difficult to get working and keep working, and I give up. I didn't know we had a whole new set of software. It was once MythTV, then XBMC, then something else I can't remember, and now I've lost track.
> I self host a lot, including jellyfin, but I've never tried to do the Linux HTPC.
I think now is the right time to revisit the Linux HTPC, mostly because Plasma 6.7 integrated the new Bigscreen interface. This is a genuine 10-foot desktop environment optimized for TV remotes and controllers. Previously, most Linux HTPCs simply used GNOME/KDE, with the scaling cranked up to 200 or 300%. In terms of apps, I suggest Kodi for local files, VacuumTube as a Youtube TV/Leanback substitute, and Steam or SteamLink for gaming, depending on hardware. With an airmouse remote you can also simply use Firefox or Chromium and stream from pretty much anywhere, subject to resolution restrictions for Netflix and some other services.
Kodi is essentially a media player; it's not a general purpose TV UI like Plasma Bigscreen. Yes, there are a couple of distros out there like OSMC designed to use Kodi for everything, but in my experience they are way too limited. And you really do want a Web browser for streaming, because you are unlikely to find dedicated Linux apps for whatever streaming platform you intend to use. You could presumably run Waydroid and use Android apps, but using the Bigscreen virtual keyboard or a remote with a keyboard on the back is much easier.
Yea competition only enforces integrity if consumers are selecting for integrity. Without getting into a nitty grityy morality debate, you've got an obvious first issue here that many if not most people dont know what they are buying when it comes to tech, so we cant expect a market to correct for our perceived morality if the consumers havent even got a clue they're being slighted in the first place.
I experienced a lot of stuff I didn't really notice how bad they were until I was off of them. Anhedonia, apathy, lack of volition, and sexual side effects. I also have trouble remembering parts of my life when I was on SSRIs.
I don't regret trying or even taking them for extended periods. They make the bad thoughts go away and raised the floor for my mood. But they also put a pretty low ceiling on it, too. I was probably on them for too long but clearly medicine doesn't have a perfect framework for handling every corner of this space, so I don't really blame anyone. There's a goldilocks zone for drug, dosage, and treatment length and I don't think I was always in it.
I've talked to many people who have bad things to say about SSRIs. On the other hand, my girlfriend is on one right now and seems very satisfied.
So, this is not supported by the data when people are asked.
Sexual effects alone hit about 50–70% people. Then you could face nausea, insomnia, profuse sweating when you’re still, emotional blunting, and weight gain.
I don’t want to discourage anyone, they can save lives. It is a net benefit for some people, but even then most people will experience side effects and wish they didn’t have to take them.
> The most common side effects reported by patients in the study by Hu et al1 of 401 outpatients taking SSRIs were drowsiness (38%), dry mouth (34%), and sexual dysfunction (34%)
> which was conducted in 1999-2000, questioned patients about side effects via phone interviews within 75 to 105 days of starting antidepressant therapy. The side effects deemed most bothersome were sexual dysfunction (17%)
Just because one study has the number 34% in it, does not prove the numbers I gave were wrong and does not mean they are anecdotal.
This is something that’s been studied from many angles and there’s more than one number that’s defensible based on the context and dataset.
For example, even the study you cited says:
“In a study of 344 patients by Montejo-Gonzalez et al, 58% of patients reported sexual dysfunction when physicians directly inquired”, and “14% with spontaneous reporting”.
Do you think the one 25 year old short-term study that you found by yourself is the only study that has been done, and that anything that deviates from it is a distortion?
FWIW findings about adverse events vary considerably:
> The proportion of patients reporting adverse events ranged from 16% to 98% (median 80%) under SSRI treatment and from 17% to 94% (median 70%) under placebo [1]
So the answer IMO depends on whether we can attribute adverse effects to treatment, which is difficult to disentangle from adverse effects of disease
I’m open to being shown more certainty if available from the literature but meta-analyses are high-strength evidence
What's wild about that? What does the science say?
I've tried a variety and I can't say whether I've experienced side effects. That's just an anecdote but that's the thing with this discussion, that's all you will get. If people don't suffer side effects, they're not likley to get on HN and post about them, etc.
The bigger issue is the person dealing with these issues is taking them because they are not well-off. If you deal with reduced desire, for example, is that a side effect of the medication or is that a side effect of being depressed.
I think your "wild" is a little flippant or telling because it just points back to anecdotes.
They don't post on HN but a cousin post references an entire subreddit dedicated to it.
They are also anecdotal, hundreds, thousands of people suffering side effects. Given dozen of millions people in the U.S alone are prescribed those things daily, that a drop in the ocean. But not everyone post on Reddit either
Yes but again this is the exact example of anecdotes. Those not suffering aren't going to seek out subreddits to post about their non-problems. You can find a subreddit about everything, whether that's representative of anything or not.
I never found a sub reddit talking about the side effects of mineral water, how eating apples regularily lowered their libidos, on that sleeping on a mattress made them senile.
At some point common sense primes over what funded science wants people to believe.
The side effects exist since some doctors do warn about them, one may also find them in the counter indications mentioning those things. It isn't unfounded.
What's taboo today is to criticize SSRIs over prescriptions. Odd, given that over 25% of the U.S population are taking them, or some other form of legal psycho active substance, just to be able to "function".
> Despite considerable improvements in side-effect profiles, antidepressants continue to be associated with a significant burden of side effects that affect, treatment adherence and quality of life. Hu et al1 studied 401 patients with depression who had recently been prescribed an SSRI, and found that, after 75 to 105 days of treatment, 86% of patients reported at least, one side effect, and 55% experienced one or more bothersome side effects.
> In both research and clinical contexts, an important challenge is presented by the phenomenological overlap between side effects and residual symptoms of depression. Thus, fatigue, cognitive impairment, apathy, jitteriness and irritability, and sleep and appetite changes are core features of depression, but may also be related to antidepressant, treatment. In a small study of 43 depressed inpatients,6 which investigated the rate of somatic symptoms and complaints that were present before and after treatment, many symptoms often considered to be side effects of drugs were also present prior to treatment, including dry mouth, lightheadedness, sweating, tremors, and constipation. The distinction between residual symptoms and side effects is crucial, as they call for very different responses.
Not OP, but my primary side effect being on Sertraline from 2002-2012 was lack of control over my anger or violent outbursts. I was primarily ok if things were good, but if something upset me, it would go from 0 to 10 in an instant. I did not even notice this as unusual until I got off the drug and it was a night and day difference how much more mellow I became. I have not been on any SSRI since then.
I was on a very low dose of Bupropion for about 5 years and did mostly well; it only made my existing brain fog slightly worse. I usually recommend that one over SSRIs due to my experiences.
EDIT: I forgot to mention the damn brain zaps on SSRIs. Even if I missed a dose by 18 hours, I would get the zaps.
That's not true. https://pmc.ncbi.nlm.nih.gov/articles/PMC2719451/ places the figure experiencing side effects at 40%, with 25% reporting those effects as serious. It's also telling that only just under half of those experiencing side effects ever reported those side effects to their providers - likely contributing to doctors getting a skewed perception of the real adverse effects risk.
What's missing is also follow up - for some those effects don't resolve after stopping the drug.
It’s not a myth - the vast majority of women on birth control experience no side effects at all, and many actually get improvement in adjacent conditions like endometriosis and PCOS.
It's cool that you have not encountered any issues but especially birth control pills are also no smarties but many use them as they were candy.
In my personal circle I only new of a single woman who had no issues. The majority had all flowers off issues. During and afterwards. No most of the time it got downplayed or simply ignored but doctors and society a like.
I'm personally glad that birth control pills are not longer sold as a wonder pill because many woman suffered needlessly and the worst part is that many did not knew that is was the pill in the first place.
I already answered why, it's chemistry. Everyone has side effects, not everyone notices them. You can not introduce a medication, or any substance for that matter, into the human body that does not have any side effects — it's impossible.
Normally when people say side effects they mean things that you can actually observe. Hence your earlier point about going off the meds and noticing a difference. If I don't notice any difference other than I don't think your point really stands.
But how does one know? According to some studies, spontaneous remission happens in about half the cases of depression in a given year.
It's happened to me plenty of times. That's why I refuse to medications. All I have to do is just wait it out.
I am not claiming no one gets any benefits, rather how can one be certain the benefits are actually not from something else? If the goal is to improve, then I suppose it does not truly matter. But I just like to understand things when I can.
I regularly had a depression for years without even knowing it was a depression. Until a neurologist told me, after examination of brain imaging, it's best to take this pill for at least a week. Only after feeling its effect, I knew it was really depression causing the symptoms, even though I did not feel depressed! I felt exhausted and stressed and had several physical side effects like dizzyness and stomach ache.
Part of diagnostic criteria is how long something lasts.
If you have a really good week you aren't going to get diagnosed with mania.
If you have a really good month where you quit your job, move to Italy, and try to start a new job carving marble statues (and you've never carved stone in your life), well those will all be factors in any diagnoses given.
On the other hand, if you feel sad because your dog died, no one should be writing you a script for anything.
But if your dog died and you can't even function enough to go to work for a month, yeah it is probably temporary, but maybe some help is warranted, be that therapy or meds.
SSRI's saved my life with no side effects that I can discern, yet I still have the urge to try and get off of them from time and so do friends and family of mine that also benefit from them. Maybe that urge needs more study because it is not taking us in a good direction. I'm not saying that because of the difficulty of weaning off, but because of the benefits of staying on. For those of us that need them, trying to wean off of them is like trying to wean off of I don't know, vitamin C or something else essential. Don't do it! Be glad you found something that helps! Keep taking it!
Ok, Freud. You’ve successfully diagnosed the cause of Churchill’s chronic depression. Now what?
What is your treatment given that you’ve identified the cause as a past childhood experience. You got a time machine? Or do you treat the disease in the present?
There's situational depression (my mom died, my girlfriend dumped me, etc.) and then there's depression. Winston Churchill called his The Black Dog. It is relentless and not related to any situation you are in. If you don't understand then be thankful.
The cause is not entirely clear. SSRIs do not help you "bury it." It's not an emotional problem or a lifestyle problem or anything like that. There's no "it" to bury. SSRIs seem to remove whatever cause is in your brain/nervous system. They literally are lifesaving drugs with almost no side effects for many people!
If it comforts you to believe that depression always has a discernable cause that can be fixed without medication then go ahead and keep believing that.
This particular comment about Churchill and your dismissal of the experience of many depressed people sounds pretty spiteful to me (to borrow your diagnosis). Maybe some self examination could help you
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