Anxiety and Depression Are Symptoms, Not Diseases • Hacker News Board

Re: Anxiety and Depression Are Symptoms, Not Diseases

#261

Post by serpix » Tue, Mar 29, 2016, 9:15 PM UTC

Taek wrote: post #216

Dylan16807 wrote: post #61

Earlier quoted context omitted.

> Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc. > Often the individual suffering is fundamentally unaware…

Depression is sometimes described a numbing experience. Everything loses color, loses that spark. Sometimes, everything hurts, nothing feels good. Making the same daily decisions is painful and slow, like walking through an ocean of glass. Depression gives you the power to make really big decisions. Everything hurts about the same. Going to work is about as painful as staying home, meaning it's easier to quit a horri…

This is exactly how I get out of depressive or anxious periods. Somehow the clarity of lying in bed being as painful as getting up hits home and whoop you're on your way out of the slump.

This does not work on all people though, I know of one person who's been resistant to medication, meditation, therapy.. none of it seems to truly change thought patterns. It just keeps coming back time after time.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#262

Post by aminok » Tue, Mar 29, 2016, 9:28 PM UTC

oxide wrote: post #246

DanBC wrote: post #210

Earlier quoted context omitted.

Opioids are not a suitable treatment for long term pain, especially in the elderly. People need rapid access to pain management clinics, with weight loss and strength building exercise, and access to meds (which in long term pain are often not opioids). Giving those people opioids increases their risk of accidental death, and suicide. It gives them an addiction. But worse it does not treat their pain - they will stil…

This is ignorant at best and naive at worst. God help anyone you treat, and if you aren't a medical professional its probably for the best. Your comment makes me physically ill.

You sound like a drug abuse apologist.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#263

Post by serpix » Tue, Mar 29, 2016, 9:30 PM UTC

slaxman wrote: post #122

There is major difference with being depressed and having clinical depression. I have been fighting the latter for the last few years and I can vouch for there being no cause. Example: I was with my extended family members in mountains of coffee plantations enjoying a vacation. There was no internet connection and thus nothing to disturb me. We were all (over 20 of us) having a great time. We were playing a game of c…

I have dropped all anxiety medication after starting a very regular and strict meditation routine. today I was in a large meeting/workshop with mostly unknown (to me) people. This would previously have caused major anxiety symptoms, possibly even an full blown panic attack hours ahead of the meeting or during.

Yet I felt happy and energized by just being with these people and being mindful at the same time. Any racing thought quickly identified and dismissed. Never experienced anything like this before. I now truly think anxiety can be blown to shreds by applying what you learn in meditation in your daily life.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#264

Post by Bjartr » Tue, Mar 29, 2016, 9:40 PM UTC

xlm1717 wrote: post #36

pc2g4d wrote: post #19

Amen to this article. As one who myself once believed my depression "came out of nowhere" (but which, in retrospect, was an obvious symptom of my emotionally destructive family and school environment) and who tried for many years to smother those feelings with antidepressants, I feel strongly that this article presents a wiser path. Evolutionarily speaking, it seems likely that depression/anxiety are there for some p…

Definitely agree with this. The exchange the doctor describes to begin the article is also common online. I've spent a lot of time in anxiety and depression support forums and chat rooms for my own problems with anxiety. The most common view is that anxiety and depression are diseases that you need to take medicine to treat. No doubt medicine has its uses in treating anxiety and depression, a momentary reprieve can g…

Unless we can more reliably distinguish between the cases where it is a neurochemical imbalance that needs medicinal intervention and not, then it can be just as damaging to fight against that viewpoint as it is to fight for it.

What we need is to foster open discussion of both viewpoints because both are fully valid explanations of anxiety and depression. For those who truly do need[1] such medicine it is demeaning and disheartening to hear views like yours touted as the only valid point of view because it implies they are invalid, or that they're cheating because they're not managing without drugs.

I similarly take issue with the article's claim that "anxiety and depression are symptoms of psychosocial needs and threats" because it completely rejects neurological causes of anxiety and depression. There's nothing that says predisposition to neurochemical imbalances will never be more severe than what can be managed without medication. And the same can be said for environmental factors (e.g. ingested and inhaled compounds from the area around where you live, just by happening to live there).

Has anyone done a scientific study on the common root causes of anxiety and depression? Do we even know enough about the brain to be able to confidently identify the root cause?

[1] If you know there are no such people, I'd like to learn about how you know that.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#265

Post by Bjartr » Tue, Mar 29, 2016, 9:44 PM UTC

tim333 wrote: post #197

Dylan16807 wrote: post #61

Earlier quoted context omitted.

> Evolutionarily speaking, it seems likely that depression/anxiety are there for some purpose, and yet we treat them both like meaningless pain meant only to be banished using drugs. I believe both are signals that something in our environment is not working for us. They indicate emotional or physical needs unmet---needs for safety, autonomy, connection, etc. > Often the individual suffering is fundamentally unaware…

>Depression is similarly crippling and unhelpful. Though it must have some function or evolution would have got rid of it. My theory is keeping your head down may be helpful if you are screwing up socially. These days if the people who know you don't like you you can just move but in the hunter gatherer days that may have been fatal.

By that logic, why can I get sick at all? Why must depression only have social roots?

Re: Anxiety and Depression Are Symptoms, Not Diseases

#266

Post by Bjartr » Tue, Mar 29, 2016, 9:51 PM UTC

acscott wrote: post #91

Dis-ease. Semantics. There can be morphological ( http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785515/ ) and biochemical indicators of depression and anxiety. To make mice depressed they will do a forced swimming test (poor mice). So this is another way to induce depression: physical+psychological stress. If there were good science with good funding it's feasible to come up with a lab test for depression--and anxiety…

>Keep in mind the sad reality is that even good science is wrong lots of the time

Similarly, keep in mind the uplifting reality that it's usually a little bit less wrong than what came before it.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#267

Post by DanBC » Tue, Mar 29, 2016, 10:39 PM UTC

oxide wrote: post #246

DanBC wrote: post #210

Earlier quoted context omitted.

Opioids are not a suitable treatment for long term pain, especially in the elderly. People need rapid access to pain management clinics, with weight loss and strength building exercise, and access to meds (which in long term pain are often not opioids). Giving those people opioids increases their risk of accidental death, and suicide. It gives them an addiction. But worse it does not treat their pain - they will stil…

This is ignorant at best and naive at worst. God help anyone you treat, and if you aren't a medical professional its probably for the best. Your comment makes me physically ill.

Which bit is wrong?

You seem to think pain control is opioids or nothing, and that's not true. There are a range of meds that should be used before opioids are tried. You also seem to think that pain control is only medication, and that's not true either. Exercise is a powerful intervention that can cure some long term pain (especially long term lower back pain). This strength building exercise is really important for older people too.

Opioids really don't work for long term pain. People develop a tolerance, which means they need to take more to get the same effect, but that means they end up taking dangerous quantities, and not getting pain relief.

Here's a Pubic Health England project to support prescribing of opioids: https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-awar...

> 1. Opioids are very good analgesics for acute pain and for pain at the end of life but there is little evidence that they are helpful for long term pain.

> 2. A small proportion of people may obtain good pain relief with opioids in the long-term if the dose can be kept low and especially if their use is intermittent (however it is difficult to identify these people at the point of opioid initiation)

> 3. The risk of harm increases substantially at doses above an oral morphine equivalent of 120mg/day, but there is not increased benefit.

> 4. If a patient is using opioids but is still in pain, the opioids are not effective and should be discontinued, even if no other treatment is available.

Here's a BBC Radio programme about health. They visit a pain management clinic. People who visit that clinic usually have to detox from their opioid addiction before they can start the pain management work. This is because opioids really are not suitable for long term pain, and other meds / interventions should be used. http://www.bbc.co.uk/programmes/b04wv052

Here's a physician on HN talking about why opiates are not suitable for long term pain: https://news.ycombinator.com/item?id=10285321

Re: Anxiety and Depression Are Symptoms, Not Diseases

#268

Post by erdojo » Tue, Mar 29, 2016, 11:42 PM UTC

cairo_x wrote: post #232

erdojo wrote: post #174

Earlier quoted context omitted.

Depression isn't the disease, it's a symptom. Perhaps he should have clarified that the cause of the symptom might be situational, or it might be the result of another medical problem, e.g. brain malfunction/chemicals, genetics, nervous system disorder, cortisol issues, thyroid, hormone disorders etc., all shown to correlate with high levels of depression. Most people who I've talked to who say it's a disease seem to…

You are wrong. Many mental illnesses, over the past decade, have been proven to be diseases. They can be tested for. Currently there are a whole hosts of tests and treatments going through the phases. Gregg and his ideas run parallel to a line of thought associated with The Citizens Commission on Human Rights, a group hell bent on denouncing mental illness as a disease. CCHR are/were a nonprofit organization establis…

A syndrome is a collection of symptoms. A disease is a when a symptom or collection of symptoms can be traced back to a root cause.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#269

Post by Swannie » Tue, Mar 29, 2016, 11:49 PM UTC

LandoCalrissian wrote: post #153

darkclarity wrote: post #20

Earlier quoted context omitted.

The way I got out of those sorts of issues was by noticing that the medical system is inadequate. It is geared towards hiding symptoms with drugs - to get people back into work, even if those people are a mess inside. It's all down to personal responsibility. You have to find the drive inside to constantly push. To forget the victim mentality that society encourages. To fix one problem at a time. To fight the hellish…

Honestly that is lot of BS. I get what your saying to a point, but I have never used my depression as an excuse to dismiss any of my normal duties, and I think it's pretty bad that you would assume many would. By all accounts I have a great life, I have friends that have been with me for over 20 years, have a wife who by all my accounts is the greatest person in the world, have an amazing job that I completely love g…

I know someone that would describe themselves in a similar situation as yourself.

I don't know that this article is complete garbage. My friend certainly felt that therapy (recommended by their psychiatrist) was an extremely valuable tool, in addition to medication, to help them manage their day-to-day symptoms, and to understand the things that would trigger the worse periods. They also felt that therapy allowed them to improve their relationships, which improved their support structure, which was slowly reducing the frequency and duration of the bouts of depression.

But yeah, saying that depression can be fixed by therapy is harmful, and after a careful re-read, I'd consider this article as 80% junk.

Re: Anxiety and Depression Are Symptoms, Not Diseases

#270

Post by cairo_x » Wed, Mar 30, 2016, 2:00 AM UTC

studentrob wrote: post #241

cairo_x wrote: post #212

Earlier quoted context omitted.

Gregg is in the business of classifying and tinkering with the way seriously mentally ill people are treated and pigeonholed. Advice being given by people who don't know the answers, especially when it comes to the suicidal, is incredibly irresponsible. You know that feeling you get when something is broken and you see someone trying to fix it, and you know you can do better, and you want to push them out of the way…

> Look at his frikken tree of knowledge model I know you're venting but you're a little off topic and hard to follow. It sounds like you have a bone to pick with this author. This sub-thread began with "warmfuzzykitten" lamenting the HN comments and now you're discussing other work by the author. Venting is totally fine and useful. There are some other techniques for releasing frustration that are more effective. Med…

I know you're acting out your therapist fantasy, but you're being a little passive aggressive.

Meditation has been debunked. CBT has been debunked, Mindfulness has been debunked. Not only that, but meditation has been shown to be counterproductive and even dangerous. CBT is no better. It has become an industry of exploitation and snake oil. Recently two meta studies came out debunking the original CBT studies. Surprise surprise.

Yet psychologists keep going on and on about how it helps some people. Listen. If you are going through a rough patch and you try a bunch of things, the last fad you tried is always going to seem like it might have helped. If a million people are giving anal breathing a go, and half of them come out of their "episode" while practicing, they're all going to proclaim a cure. It's like this never ending loop, over and over of bullshit.

This is basic stuff. I can see you're feeding off my distress, so this is the last I'll say on the matter. Some people really are sick.

cue passive aggressive "I know you're"... "totally fine, and useful" creeping Jesus response