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Can Psychiatry Turn Itself Around?

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Re: Can Psychiatry Turn Itself Around?

#121

Post by vonmoltke »

intopieces wrote: post #101
vonmoltke wrote: post #45

Earlier quoted context omitted.

> You'll have to excuse the skepticism of some us who have seen loved ones suffer through debilitating, sometimes permanent side effects from drugs their psychiatrists prescribed. What debilitating side effects are those? How does their frequency compare to side effects for non-psychiatric drugs and treatments?

You know it's odd: in all those years I spent helping my dad with his knees shot from zoloft induced weight gain or waking my roommate up because she drank too much to counteract the stimulants they prescribed to balance the benzos or sleeping next to a partner with a permanent, random, violent parkinsonian tremor caused by antipsychotics, I never considered doing a frequency analysis against the myriad of unrecommen…

You know, it's odd: I don't recall asking you if you had personally done a study or frequency analysis. I recall asking a rhetorical question as a follow-up to a specific question about your claim in order to head off anecdote poker. Seems like you decided to jump straight into it, though. So, how many people have you had to deal with who had night terrors due to Chantix? Who became addicted to opiod pain medications? Who developed T2DM as a result of corticosteroid use? Who nearly bled out because of blood thinners?

You specifically demonized psychiatric medicine. You know people who have had pretty bad experiences with psychiatric medications but none who have had similar with non-psychiatric medications. My point is not to doubt that these side effects exist, but to illustrate that they exist for a host of non-psychiatric medications as well. Many of those are just as over-prescribed as psychiatric medications, and often by the same general practitioners over-prescribing them.

Re: Can Psychiatry Turn Itself Around?

#122

Post by vonmoltke »

atsaloli wrote: post #117
vonmoltke wrote: post #45

Earlier quoted context omitted.

> You'll have to excuse the skepticism of some us who have seen loved ones suffer through debilitating, sometimes permanent side effects from drugs their psychiatrists prescribed. What debilitating side effects are those? How does their frequency compare to side effects for non-psychiatric drugs and treatments?

http://www.nimh.nih.gov/health/topics/mental-health-medicati... . That's from the National Institute for Mental Health Tics, liver damage, abnormal thinking are all listed as side effects. So is violent behaviour.

You can find those side effects for a number of non-psychiatric medications as well.

Re: Can Psychiatry Turn Itself Around?

#123

Post by vonmoltke »

Sone7 wrote: post #113
cgriswald wrote: post #70

Earlier quoted context omitted.

Nonsense. Asking for evidence and examples is not "cruel", especially when a broad claim is being made based on a personal experience. I have many dark, hurtful experiences in my life. And when I share them, the only thing I expect in return is respect. Asking a question about my experience or asking me to provide evidence in support of my broader claims is not disrespectful. It's something I would expect might happe…

There was no implication whatsoever that intopieces couldn't speak on their own behalf. It's disrespectful to suggest there was. I suggest you read intopieces' reply to vonmoltke, and have a think about this exchange from a fresh perspective. Remember that when people talk about losing their loved ones, a little tact goes a long way. Asking so bluntly for research you could look for yourself (that pharma companies wo…

> Asking so bluntly for research you could look for yourself (that pharma companies would never actually publish) comes across as tactless in this situation, which is why you're being greyed.

First, pharmaceutical companies are required to publish study data as part of the approval process. Whether the requirements are sufficient is a tangent all its own.

Second, I can obviously look up research. I have. It indicates debilitating side effects for a host of non-psychiatric medications as well, which intopieces seems to be ignoring because of bad personal experiences.

Third, if you don't want to re-live bad experiences, don't use references to them to score points in a debate.

Re: Can Psychiatry Turn Itself Around?

#124

Post by intopieces »

vonmoltke wrote: post #121
intopieces wrote: post #101

Earlier quoted context omitted.

You know it's odd: in all those years I spent helping my dad with his knees shot from zoloft induced weight gain or waking my roommate up because she drank too much to counteract the stimulants they prescribed to balance the benzos or sleeping next to a partner with a permanent, random, violent parkinsonian tremor caused by antipsychotics, I never considered doing a frequency analysis against the myriad of unrecommen…

You know, it's odd: I don't recall asking you if you had personally done a study or frequency analysis. I recall asking a rhetorical question as a follow-up to a specific question about your claim in order to head off anecdote poker. Seems like you decided to jump straight into it, though. So, how many people have you had to deal with who had night terrors due to Chantix? Who became addicted to opiod pain medications…

How does the existence of side effects in other medicines affect the status of psychiatric medicines and their percieved (in)effectiveness or their overprescription status?

You claim I'm 'demonizing' (i.e., being unfair towards) a subset of the medical profession when in fact I'm only relaying my personal experience and skepticism based on that. I don't doubt that there are a whole host of other medicines whose effictiveness is unknown and whose popularity is primarly due to its availability as free samples in doctor's offices and the U.S.'s notoriously effective prescription drug advertisement industry.

But to make that a point in this discussion seems like a misdirection more than an counter-argument. Two things can be bad at the same time independently.

To answer your questions: I dated someone with night terrors from Chantix, have a relative who is addicted to opoids (but who thinks no one knows when he's high at Christmas dinner), but have thankfully never had to deal with the last two.

Even still -- none of those latter series were prescribed to treat disorders discovered after the invention of the drug itself. This is the primary point of skepticism: horrible side effects for well-advertised drugs for disorders we just recently discovered affecting, what was astutely noted by another commentor, the most complex organ of the body.

Many psychiatric medications are an excellent example of 'when you have a hammer, everything looks like a nail.'

Re: Can Psychiatry Turn Itself Around?

#125

Post by Pica_soO »

selimthegrim wrote: post #79
serge2k wrote: post #24

Earlier quoted context omitted.

I honestly have no idea what you are talking about here.

He's riffing on pop psych theories about the "warrior gene" and suchlike. I'm pretty sure there were institutions predating Holy Mother Church.

Disliking complexity, are we? And having a warrior gene, is actually something worthy of treatment in current society. Warriors, are useless today and will be for the foreseeable time. If there is such a gene, that shapes its owners brain in such a way.

But the main point is, that hunting for local optima of personal happiness, is sacrificing the upholding or even gain regarding personal happiness in the future. And psychiatry is neither cartographic why and for what society became composed of what it is and is neither offering constellations society could become.

BRB Got to go to Turings Barbershop. Best haircut in the city. Though sometimes conversation gets stuck on who shaves the barber.

Re: Can Psychiatry Turn Itself Around?

#126

Post by vonmoltke »

intopieces wrote: post #124
vonmoltke wrote: post #121

Earlier quoted context omitted.

You know, it's odd: I don't recall asking you if you had personally done a study or frequency analysis. I recall asking a rhetorical question as a follow-up to a specific question about your claim in order to head off anecdote poker. Seems like you decided to jump straight into it, though. So, how many people have you had to deal with who had night terrors due to Chantix? Who became addicted to opiod pain medications…

How does the existence of side effects in other medicines affect the status of psychiatric medicines and their percieved (in)effectiveness or their overprescription status? You claim I'm 'demonizing' (i.e., being unfair towards) a subset of the medical profession when in fact I'm only relaying my personal experience and skepticism based on that. I don't doubt that there are a whole host of other medicines whose effic…

> How does the existence of side effects in other medicines affect the status of psychiatric medicines and their percieved (in)effectiveness or their overprescription status?

> You claim I'm 'demonizing' (i.e., being unfair towards) a subset of the medical profession when in fact I'm only relaying my personal experience and skepticism based on that. I don't doubt that there are a whole host of other medicines whose effictiveness is unknown and whose popularity is primarly due to its availability as free samples in doctor's offices and the U.S.'s notoriously effective prescription drug advertisement industry.

Because you singled out and attacked psychiatrists and psychiatry as if there were something inherent to that field of medicine and that class of medications that is not present in other fields and types. You specifically said:

>> Every other medical revolution -- such as the rise of antibiotics, the pioneering of complex surgeries, and the advancements in medical imaging -- have resulted in a net reduction of people suffering from the ailments those tools are involved in treating.

>> Not so with psychiatry. The more drugs that are developed, the more illnesses are discovered to use them on.

That is not merely relating your experience. That is throwing a particular medical specialty under the bus for what are in fact widespread issues with medical practice.

> Even still -- none of those latter series were prescribed to treat disorders discovered after the invention of the drug itself. This is the primary point of skepticism: horrible side effects for well-advertised drugs for disorders we just recently discovered affecting, what was astutely noted by another commentor, the most complex organ of the body.

Are you claiming that there were no mental disorders until the advent of psychiatric drugs? That a subset of disorders are just marketing ploys by a psychiatrist-industrial complex?

Re: Can Psychiatry Turn Itself Around?

#127

Post by cgriswald »

Sone7 wrote: post #113
cgriswald wrote: post #70

Earlier quoted context omitted.

Nonsense. Asking for evidence and examples is not "cruel", especially when a broad claim is being made based on a personal experience. I have many dark, hurtful experiences in my life. And when I share them, the only thing I expect in return is respect. Asking a question about my experience or asking me to provide evidence in support of my broader claims is not disrespectful. It's something I would expect might happe…

There was no implication whatsoever that intopieces couldn't speak on their own behalf. It's disrespectful to suggest there was. I suggest you read intopieces' reply to vonmoltke, and have a think about this exchange from a fresh perspective. Remember that when people talk about losing their loved ones, a little tact goes a long way. Asking so bluntly for research you could look for yourself (that pharma companies wo…

> There was no implication whatsoever that intopieces couldn't speak on their own behalf. It's disrespectful to suggest there was.

Except for that fact that you chose to interject on behalf of the emotions you presumed he would have?

> I suggest you read intopieces' reply to vonmoltke, and have a think about this exchange from a fresh perspective.

I did read it. What you read into it was some kind of assault that isn't necessarily there in the first place. I read it as a challenge to back up his claims (especially now due to subsequent posts), but one could also read it as simply being curious. Perhaps you should try the fresh perspective?

Being challenged on a broad claim that is supported only with anecdote is pretty par for the course on HN. This isn't a support group, it's adult discussion. Should we stop challenging broad claims whenever people bring personal anecdotes to the table? After all, even seemingly innocuous anecdotes could be deeply painful for the people involved.

> Remember that when people talk about losing their loved ones, a little tact goes a long way. Asking so bluntly for research you could look for yourself (that pharma companies would never actually publish) comes across as tactless in this situation...

You've moved the goalposts. You didn't say you had a problem with how he said it (i.e. tact), you said you had a problem with what he said (i.e. "don't do that...") Even so, being "blunt" (your interpretation) isn't being disrespectful. Not everyone wants sugarcoating on their cereal. I'd say your perspective here has quite a lot to do with how you would like to be treated, but that doesn't mean others feel the same way.

> ...which is why you're being greyed.

I've been upvoted, actually. Does that mean I'm right and you're wrong? You seem to think this means something...

Re: Can Psychiatry Turn Itself Around?

#128

Post by epistasis »

force_reboot wrote: post #106
epistasis wrote: post #100

Earlier quoted context omitted.

If you'd look you'd find plenty of evidence of the sort that you think doesn't exist. Try a popular book like Against Depression as a starter. I think that the existence of such evidence also invalidates the rest of your prejudices that you express.

I don't have time to read every book out there, so when I look for answers to questions like this I look for sources that are authoritative, that is, sources that summarize the majority opinion in a field. The book you recommend doesn't seem to be that, and so I'm not convinced that it's worth reading. Are there particular studies in the book that specifically address whether depression is qualitatively different fro…

This is not secret information, some key google terms may be "biology of depression" or something like that.

Just one piece of the literature that you might find convincing (not sure if its from that book or another) that you might find convincing is that there are structural differences in the pre-frontal cortex that can be seen under a microscope. The biological basis of depression is something that's so well established that strident doubt of it means that you can't be troubled to look for anything. It's like being convinced that evolution can't possibly be true because biologists can't be trusted.

Re: Can Psychiatry Turn Itself Around?

#129

Post by wbl »

morgante wrote: post #86

> 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 th…

Working as a psychiatrist is hard. Reimbursement is low, and many serious patients do not have private insurance.

Re: Can Psychiatry Turn Itself Around?

#130

Post by intopieces »

vonmoltke wrote: post #126
intopieces wrote: post #124

Earlier quoted context omitted.

How does the existence of side effects in other medicines affect the status of psychiatric medicines and their percieved (in)effectiveness or their overprescription status? You claim I'm 'demonizing' (i.e., being unfair towards) a subset of the medical profession when in fact I'm only relaying my personal experience and skepticism based on that. I don't doubt that there are a whole host of other medicines whose effic…

> How does the existence of side effects in other medicines affect the status of psychiatric medicines and their percieved (in)effectiveness or their overprescription status? > You claim I'm 'demonizing' (i.e., being unfair towards) a subset of the medical profession when in fact I'm only relaying my personal experience and skepticism based on that. I don't doubt that there are a whole host of other medicines whose e…

It's here you might benefit from the book:

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness

To explain further the unique situation that mental health drugs present. You might benefit especially from the notes section, to which his citations refer.

Am I saying there is a conspiracy between psychiatrists and pharmacuetical companies? Were it only so simple! There are a myriad of complex reasons why we're in the situation we're in -- but claiming that the situation is not unique, that my discussion of my personal experience and the research behind it is somehow a 'demonization' of an otherwise unremarkable industry belies both the thesis of the article and experiences of millions of patients.

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