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Ketamine’s effect bolsters a new theory of mental illness

nautil.us

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Re: Ketamine’s effect bolsters a new theory of mental illness

#131

Post by DanBC »

user_0001 wrote: post #39
Igglyboo wrote: post #32

Earlier quoted context omitted.

> Ketamine has major issues with bladder damage when taken repetitively. At recreational doses, doctors aren't going to be prescribing anywhere near that.

Not recreational dosages. At serious addiction levels yes. It would be like saying having a couple of recreational beers on a Friday causes liver failure. It doesn't. Drinking a bottle of whiskey every day for an extended period of time, perhaps. Same with Ketamine

> Drinking a bottle of whiskey every day for an extended period of time, perhaps.

People drinking far less than that, maybe a glass or two of wine most days, are getting cirrhosis.

Re: Ketamine’s effect bolsters a new theory of mental illness

#132

Post by TeMPOraL »

tedks wrote: post #121
slapshot wrote: post #71

Earlier quoted context omitted.

I am close to somebody who has been strongly affected by depression. She has, in any material respect, a perfect life. She has food, clothes, a supportive family, a great job, plenty of money, etc. There is nothing "wrong" with her life. But she suffers off-and-on depression. Not just "I feel bad" depression. Crippling, "can't get out of bed" depression. Periodic suicidal ideation. Occasional suicide attempts. She kn…

> She has, in any material respect, a perfect life. She has food, clothes, a supportive family, a great job, plenty of money, etc. There is nothing "wrong" with her life. Could it possibly be that there is more to life than these things?

Could be, but those things are the basics; lack of them is a cause of misery for people in today's society. Depression is something that makes you miserable even if all objective factors about your life are stable and comfortable.

Re: Ketamine’s effect bolsters a new theory of mental illness

#133

Post by Synaesthesia »

isolate wrote: post #128
user_0001 wrote: post #127

Earlier quoted context omitted.

yes. Everyone should experience the k-hole

What if you have a psychotic disorder? Prevalence is ~3%.

Many drugs can precipitate a psychotic episode, including stimluants, psychedelics, even Alcohol. It's a risk you take when you take drugs but can be mitigated if you known what to expect and have support.

Ketamine I don't think has a huge problem with this compared to other drugs. It may be a bit of a bizarre experience but not often a tramuatizing one.

Re: Ketamine’s effect bolsters a new theory of mental illness

#134

Post by TeMPOraL »

ninjakeyboard wrote: post #89
astazangasta wrote: post #34

I have been depressed a significant fraction of my adult life. I am also a biologist who abhors the medical description of this problem. I don't even like the word 'mental illness'. This shit is not an illness, its a normal response to a fucked up life! Can I get at least some acknowledgment of this fact? The sine qua non for me was an issue of Nature a few years back that focused on depression, talked about how prev…

Clinical medical illness is often fabricated. Most of the research and analysis and awareness is also funded by the companies that sell the drugs. Calling ADD or Depression "mental illness" is asserting that it's not normal and is a treatable illness randomly encountered - it's almost often a factor of your environment and psychology. It's interesting that the Ketamine research comes to the conclusion that depression…

Personally, I'm strictly on the pragmatic side of thing. As Scott Alexander says[0], "society is fixed; biology is mutable". If we can't on Earth figure out an effective social solution to a problem, but we have a pill that fixes it outright, maybe let's try the pill so that people don't have to go miserable all their lives. Calling something a disease is really about assigning blame[1]. If I'm ill, it's not (entirely) my fault and I need a cure. If it's not a disease, all I'll get from people is pep talks at best, at worst I'll be called lazy and told to get my shit together. We clearly know that latter doesn't work; depression is pretty much defined as a state where you can't just "get your shit together".

BTW. I always considered ADD, ADHD, etc. to be a bit of a fake disease, a product of environment, but I'm no longer sure. I've been struggling with depression and anxiety for many years and responded relatively well to SSRIs which stabilized my mood and helped me quit the recurring panic attacks. The problem is not gone, but with a little more stable emotional situation I managed to figure out that what really causes most of my problems now is total lack of focus. I can't hold my attention on any kind of work-related task (the task doesn't matter; what matters is that it's work) for more than 30 seconds without compulsively seeking something else to do. Be it HN or IMs. With no easy distraction source available, I'll get anxious and sleepy. I can be perfectly well-rested but will still occasionally get sleepy at work just because I refuse to distract myself with Hacker News. A considerable amount of my mental energy goes to fighting this and forcing myself to focus. Now that I've finally dug that up from underneath the layers of anxiety, it's going to be a topic of the next conversation with my doctor.

#HNTherapy

Also, this is what I got googling for ADD[2]. What the shit?

[0] - http://slatestarcodex.com/2014/09/10/society-is-fixed-biolog...

[1] - http://lesswrong.com/lw/2as/diseased_thinking_dissolving_que...

[2] - http://i.imgur.com/n5nhyWt.png

Re: Ketamine’s effect bolsters a new theory of mental illness

#135

Post by walmartian »

I am surprised at the number of anecdotal experiences people are using here to describe depression as a non-disorder. It's unbelievable that people cannot distinguish between depression caused by environment factors and depression caused by physiological differences.

Re: Ketamine’s effect bolsters a new theory of mental illness

#136

Post by jganetsk »

ninjakeyboard wrote: post #89
astazangasta wrote: post #34

I have been depressed a significant fraction of my adult life. I am also a biologist who abhors the medical description of this problem. I don't even like the word 'mental illness'. This shit is not an illness, its a normal response to a fucked up life! Can I get at least some acknowledgment of this fact? The sine qua non for me was an issue of Nature a few years back that focused on depression, talked about how prev…

Clinical medical illness is often fabricated. Most of the research and analysis and awareness is also funded by the companies that sell the drugs. Calling ADD or Depression "mental illness" is asserting that it's not normal and is a treatable illness randomly encountered - it's almost often a factor of your environment and psychology. It's interesting that the Ketamine research comes to the conclusion that depression…

ADHD is a cognitive disorder of executing functioning. Its original name was "minimal brain dysfunction". It has little to do with how you feel, and most to do with how you function. It is easy to demonstrate with cognitive tests. It is now getting easy to demonstrate with brain scans.

Do you doubt the existence of autism? Dyslexia?

Probably not.

Sorry that it can't play the role in your polemic that you were hoping for.

Re: Ketamine’s effect bolsters a new theory of mental illness

#137

Post by cpncrunch »

Abraln wrote: post #118
spangry wrote: post #105

Earlier quoted context omitted.

I'm very much in this category of depression. I have what is unfortunately termed 'melancholic depression'. I should note that I'm very sceptical of the DSM 'disease model' of mental illness, and am glad to see psychiatry and neuroscience beginning to converge. 'Discrete disease' is a poor abstraction for most mental illnesses. A better term for my kind of depression would be 'endogenous depression' (i.e. depression…

It does get pretty tiring explaining the difference between them. Mine is definitely biologically based, although stress exacerbates it like it does many other things like acne. My "eureka" moment came in high school (when brain chemistry changes from puberty can cause such issues). I was at home playing video games online with friends when I noticed my vision was blurry. I went to the bathroom and saw tears streamin…

A lot of the time with depression there is no logical "reason" for it, and no negative thoughts at the time. For example:

- running multiple ultramarathons with too little rest can cause depression, even if you love it. - working very hard in a job you like with too little sleep for a long time can cause depression.

In both cases it's likely your brain it just telling you that you're pushing too hard.

Some people -- like me -- find it easier to get into these mental overdrive situations, and some people might be more likely to suffer depression from the same stressors, but ultimately it seems to be the same factors at work.

Re: Ketamine’s effect bolsters a new theory of mental illness

#138

Post by jganetsk »

lilcarlyung wrote: post #25

What with the pro-drug posts here all the time. I'm guessing that most of the HN audience is American. Is it common among techies in the U.S. to experiment with psychoactive drugs, hence the interest and knowledge? Please, do not mention Steve Jobs acid experiences.

Interesting generalization. Do you have any evidence that Americans are more "pro-drug" than average? Do you think Americans actually consume more drugs, or just that they suffer from less drug stigma in their society?

Re: Ketamine’s effect bolsters a new theory of mental illness

#139

Post by kafkaesq »

DanBC wrote: post #126
kafkaesq wrote: post #36

Earlier quoted context omitted.

Pretty irresponsible to mention "increased risk" without saying what that risk is, nor what the increase actually is. The article makes it perfectly clear what the risk is, how much the increase is, and with what factors it is associated; and what the researchers caveats were about their own findings. The poster you were slamming wasn't spreading FUD or hyperbolizing; he was just simplifying. It's pretty irresponsibl…

> The article makes it perfectly clear what the risk is, how much the increase is, Maybe I'm missing it, but from that article: what's the base rate, what's the rate if a woman takes SSRIs, and what's the increase? (And here rates are provided in X per 100,000)

(And here rates are provided in X per 100,000)

I'm not playing this game with you. Obviously, the information wouldn't expressed that way in the WP article. You may recall that they're a newspaper, not a scholarly journal. So you know perfectly well that it wouldn't have expressed the information in those terms.

The article does mention exactly what the increase is. As to the base rate, the WP article doesn't use that exact term -- but they do give hard numbers for the sample sizes involved, and took care to point out that the smallness of the proportion of infants who developed autism (with or without taking SSRIs) was one of the factors that led the researchers to point out that their findings should be taken with caution.

If you want more data and specifics, read the JAMA article. If you think the researchers themselves made some basic flaw in their statistical reasoning -- and, correspondingly, you'd like to bring their reputations and their future funding channels into question -- then the burden of proof lies on you to show it. And I'm sure JAMA Pediatrics would be very interested in getting an email from you.

But if you're going to fault the WP article for not conveying every facet of detail from the research article, in as many digits of precision -- even though its overall presentation was basically fair, and on point to the level of detail that would be meaningful to its readers -- then you're basically playing head games.

Re: Ketamine’s effect bolsters a new theory of mental illness

#140

Post by DanBC »

kafkaesq wrote: post #139
DanBC wrote: post #126

Earlier quoted context omitted.

> The article makes it perfectly clear what the risk is, how much the increase is, Maybe I'm missing it, but from that article: what's the base rate, what's the rate if a woman takes SSRIs, and what's the increase? (And here rates are provided in X per 100,000)

(And here rates are provided in X per 100,000) I'm not playing this game with you. Obviously, the information wouldn't expressed that way in the WP article. You may recall that they're a newspaper, not a scholarly journal. So you know perfectly well that it wouldn't have expressed the information in those terms. The article does mention exactly what the increase is. As to the base rate, the WP article doesn't use tha…

You start by saying they give all the details. Now you say that it didn't give the information.

Do you at least agree that the article doesn't explain what the quoted 87% increase means in a way the readership is going to understand? Can you explain what that 87% increase means?

The article had almost no relevance to this thread; it was dumped here as yet more pill-shaming bollocks; it targets a group who already have to put up with a lot of bullshit; and it's disappointing to see that kind of behaviour defended.

The original study is irresponsibly presented and poorly reported and I have no problem pointing that out.

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