Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Can Psychiatry Turn Itself Around?

blogs.scientificamerican.com

Post reply on HN
Print view View original

81–90 of 134 posts

Re: Can Psychiatry Turn Itself Around?

#81

Post by digitalarborist »

slededit wrote: post #65
digitalarborist wrote: post #39

Earlier quoted context omitted.

There's a reason those laws exist. Mental health is still a taboo topic and as soon as anyone knows there's an issue the reflex is for everything to go into lockdown. This comes up on reddit with some frequency [1][2]. Some of the stories are pretty harrowing. Though a lot of this is to do with the poor state of many mental health institutions. 1) https://www.reddit.com/r/AskReddit/comments/3hlcyu/serious_r... 2) htt…

You know the one interesting thing about these "sane person stuck in a mental institution" stories, is they always talk about how nuts the other people were. If it were as common as suggested that normal people end up there for slips of the tongue or other mundane reasons then I'd expect there to be more "normal" people finding each other in these stories.

Probably that otherwise normal people just don't make it into the stories because they're not as memorable. Though often you'll hear of people otherwise healthy who are down on their luck, addiction problems, abuse, or just general anxiety and depression. The other problem is that the definition of sane changes depending on context.

I recall watching a documentary on Japanese school children and their attitudes towards baseball, ritualistically crying when they lost a game. A western therapist could easily justify feeding them all meds, but in reality it wasn't particularly unhealthy. I feel like a lot of ADHD is kids being kids and teachers and parents wanting an easy way to deal with it. Lobotomies used to be common less because anyone believe they cured anyone but because they rendered the patient docile. Mental health ends up being as much about societies easy function as it is about helping the patients.

Re: Can Psychiatry Turn Itself Around?

#82

Post by Yxven »

phren0logy wrote: post #41
heygiraffe wrote: post #35

Earlier quoted context omitted.

Any chance you could answer some questions? I'll get to them after a couple of (relevant) anecdotes. I was diagnosed with depression by a psychologist. I got a referral to a psychiatrist, and I was told that the psychiatrist would probably want to do his own assessment of where I was at & what kind of therapy would best benefit me. Nope. It was, "You've got such & such diagnosis; let's try such & such drug. Bye!" Som…

1. These experiences are not the norm, but still much too common. 2. Psychiatrists might not recommend talk therapies for a number of reasons (even though they probably should). Many insurance plans don't cover it, and lots of people aren't interested and want a "quick fix" to the problem in the form of a pill. Finally, the education for licensed therapist varies WILDLY , and there are a lot of really bad ones. That…

How does one find a good psychiatrist?

Re: Can Psychiatry Turn Itself Around?

#83

Post by force_reboot »

There seems to be a huge gap between what psychiatrists believe and how psychiatric knowledge is presented to the general public.

For example, I'm not aware of any scientific evidence that depression is qualitatively different from being unhappy, or that depression can't be caused by events that would make a typical person unhappy, or cured by the opposite. And I'm fairly certain that very little such evidence exists, because this is not the concern of psychiatrists, they just want to treat the person, not define categories per se. But I believe that psychiatrists allow the public to form this flawed understanding because they think it will lead people to treat people with depression with more sympathy and treat depression like a real problem. To me the more honest approach would be to simply say that unhappiness is a real problem and any approach or treatment that works should be considered.

Re: Can Psychiatry Turn Itself Around?

#85

Post by [deleted] »

phren0logy wrote: post #21

I'm a psychiatrist. It is always amazing to me that despite four years of medical school, six years of residency and fellowships, and four board certifications, the assumption is that I have no idea what I'm talking about and have evil motives. There are fair criticisms of psychiatry, there are bad psychiatrists, but mostly there are crappy generalizations. Good psychiatrists have an understanding of what medications…

[deleted]

Re: Can Psychiatry Turn Itself Around?

#86

Post by morgante »

> Psychiatry programs attract medical students with lower board scores and fewer academic honors on average compared to other specialties.

It sounds like a self-reinforcing problem. Psychiatry's bad reputation leads to it having less qualified practitioners, thereby justifying the poor reputation.

I personally do not place much value in the field. It seems to monopolize on creating problems where none existed, and thereby increasing profits. In particular, the fact that most treatments seem to be lifetime is suspicious.

Re: Can Psychiatry Turn Itself Around?

#87

Post by morgante »

phren0logy wrote: post #21

I'm a psychiatrist. It is always amazing to me that despite four years of medical school, six years of residency and fellowships, and four board certifications, the assumption is that I have no idea what I'm talking about and have evil motives. There are fair criticisms of psychiatry, there are bad psychiatrists, but mostly there are crappy generalizations. Good psychiatrists have an understanding of what medications…

How often do you cure your patients?

I'm skeptical of any medical profession which seems to build and depend on lifetime customers.

Re: Can Psychiatry Turn Itself Around?

#88

Post by artimaeis »

morgante wrote: post #87
phren0logy wrote: post #21

I'm a psychiatrist. It is always amazing to me that despite four years of medical school, six years of residency and fellowships, and four board certifications, the assumption is that I have no idea what I'm talking about and have evil motives. There are fair criticisms of psychiatry, there are bad psychiatrists, but mostly there are crappy generalizations. Good psychiatrists have an understanding of what medications…

How often do you cure your patients? I'm skeptical of any medical profession which seems to build and depend on lifetime customers.

What a strange question, what does it mean to cure a patient?

Say a patient goes to a doctor and is diagnosed with heart disease - is there anything that can be done to cure this? Or do we simply alleviate the symptoms to make way for a better life? This is the case with so many illnesses: diabetes, cancer, arthritis, the list is so long.

But do you have the same skepticism of a doctor? Of a surgeon? We are not simple machines, us humans. When there are bugs in us they are often not currently fixable. This applies to psychiatry as much as it does to internal medicine.

Re: Can Psychiatry Turn Itself Around?

#89

Post by tcj_phx »

_greim_ wrote: post #84

Doesn't scientology have some kind of weird self-declared feud with psychiatry? I wonder if they've perhaps been sowing FUD whenever and wherever possible.

Last week I posted a section [1] from Robert Whitaker's book Anatomy of an Epidemic about how Scientology was probably used to deflect attention from the ineffectiveness of commonly used drugs.

[1] https://news.ycombinator.com/item?id=12222898

Re: Can Psychiatry Turn Itself Around?

#90

Post by morgante »

artimaeis wrote: post #88
morgante wrote: post #87

Earlier quoted context omitted.

How often do you cure your patients? I'm skeptical of any medical profession which seems to build and depend on lifetime customers.

What a strange question, what does it mean to cure a patient? Say a patient goes to a doctor and is diagnosed with heart disease - is there anything that can be done to cure this? Or do we simply alleviate the symptoms to make way for a better life? This is the case with so many illnesses: diabetes, cancer, arthritis, the list is so long. But do you have the same skepticism of a doctor? Of a surgeon? We are not simpl…

It means to restore them to a level of health where they are not dependent on the doctor or medicine for continued care.

> Say a patient goes to a doctor and is diagnosed with heart disease - is there anything that can be done to cure this?

And they'd say there possibly is (such as lifestyle changes), and encourage them to pursue those changes while providing temporary medical relief.

> This is the case with so many illnesses: diabetes, cancer, arthritis, the list is so long.

The fact that we don't yet have a permanent cure for some of these illnesses is considered a major problem. Medical professionals are working tirelessly to find cures for conditions like cancer.

Meanwhile, psychiatrists seem to be almost completely uninterested in finding or promoting permanent cures (even when such cures likely exist, including through lifestyle changes). They want to put you on a lifetime drug regime.

I recognize that we're not going to have permanent cures for everything. But psychiatrists don't have permanent cures for anything. If internal medicine insisted that every condition required costly lifetime treatment, I'd be equally skeptical of it. In cases where a cure isn't available, other specialties admit that the best they can do is treat the symptoms—meanwhile, psychiatrists have an attitude that lifetime drug use is the "cure."

Post reply on HN