Let’s avoid talk of ‘chemical imbalance’: it’s people in distress • Hacker News Board

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#121

Post by DubiousPusher » Thu, Jul 16, 2020, 3:30 PM UTC

Supermancho wrote: post #92

Barrin92 wrote: post #62

Earlier quoted context omitted.

'Chemical imbalance' as a causal explanation seems to me almost useless because every severe change in behaviour pretty much by definition corresponds to change in the brain. How else is it supposed to be manifest? Is there supposed to be drastic change in psychology without change in the brain? There can be a company pouring lead into a river, psychological hazard during a civil war, and it will always manifest in t…

> How else is it supposed to be manifest? Is there supposed to be drastic change in psychology without change in the brain? There is an implication inherent to "chemical imbalance" that assumes a normative range. Modern medicine is universally based on normative ranges. If you are outside this range, it is considered a problem. Chemical imbalance is a generic and apt descriptor.

There are normative ranges but being outside of such a range alone is usually not enough for a diagnosis. Especially in the arena of mental illness, "abnormal" behavior must also present as interfering with life to earn someone a diagnosis as nearly everyone has some "abnormal" behavior and it would be counter productive to literally diagnose everyone.

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#122

Post by stainforth » Thu, Jul 16, 2020, 3:31 PM UTC

tcj_phx wrote: post #57

sillysaurusx wrote: post #13

they struggled against the dehumanising notion that their thoughts, feelings or behaviour were mechanistically caused. Finally, a thread where I can point out my own experiences. Around four years ago, it would be fair to call me slightly crazy. It was a harmless sort of crazy, but it was quite self-destructive. I used to wake up wishing to die, genuinely, and not knowing why. All of that changed after going on Proza…

One of the ways that Prozac helps people is by increasing allopregnanolone in the brain [1]. This is a well-known effect of Prozac, and perhaps the other SSRI's. Allopregnanolone "is a neurosteroid and acts as a positive allosteric modulator of the GABA-A receptor, the major biological target of the inhibitory neurotransmitter γ-aminobutyric acid (GABA)" [0]. GABA -> relaxation [2]. GABA supplements don't work very w…

So market incentives are provably not the way to best outcomes for humanity?

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#123

Post by wolfram74 » Thu, Jul 16, 2020, 3:32 PM UTC

DoreenMichele wrote: post #109

To whatever degree a mental health issue is treatable with drugs, it genuinely is a medical issue. But that's not the only element of actual insanity. Real insanity almost always involves a sick social fabric as well that lies to you about critical information, often blaming you for problems over which you have no real control. They know that schizophrenics often get better with in patient treatment, then go home to…

Many good points, but to clarify, you're arguing that being treatable is merely an obvious indication that it's a medical issue, but not the only indication? Lots of things in non-mental health fields are acknowledge to be medical problems but also remain untreatable.

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#124

Post by kilroy_jones » Thu, Jul 16, 2020, 3:32 PM UTC

dukha wrote: post #56

I've always been depressive and pessimistic person as far as I can remember. I've been looking at other people only to see how happy they are and how content they with their life. They feel motivated, want something from life and in generally think that being alive is alright, which I just couldn't internalize no matter how hard I tried. Essentially, I've come to the conclusion that there _must_ be something wrong wi…

Your view on this and your username are linked I assume?

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#125

Post by Barrin92 » Thu, Jul 16, 2020, 3:32 PM UTC

Supermancho wrote: post #92

Barrin92 wrote: post #62

Earlier quoted context omitted.

'Chemical imbalance' as a causal explanation seems to me almost useless because every severe change in behaviour pretty much by definition corresponds to change in the brain. How else is it supposed to be manifest? Is there supposed to be drastic change in psychology without change in the brain? There can be a company pouring lead into a river, psychological hazard during a civil war, and it will always manifest in t…

> How else is it supposed to be manifest? Is there supposed to be drastic change in psychology without change in the brain? There is an implication inherent to "chemical imbalance" that assumes a normative range. Modern medicine is universally based on normative ranges. If you are outside this range, it is considered a problem. Chemical imbalance is a generic and apt descriptor.

That was not my point. Obviously it's a descriptor of a problem, but not an appropriate explanation for a cause. Say you have high blood pressure. That may be because you weigh 400 pounds, or because you have a genetic condition, or because you smoke, or because you are stressed 18 hours a day, but it's not an explanation for anything, and everyone knows that.

Assuming you had an omniscient scientific tool every abnormal change in behaviour by definition has a correspondence to an abnormal state of the brain, that's just saying the same thing at a different level of abstraction.

When everyone is obese and has high blood pressure the correct cause of correction is probably setting different social incentives to fix a systemic problem, not mass producing insulin and betablockers, because you stopped at an overly reductionist level of description and mistook it for insight.

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#126

Post by ifend » Thu, Jul 16, 2020, 3:33 PM UTC

_ywdj wrote: post #120

I've written several comments about this topic on HN before, but here goes again. I've had a lot of mild/moderate anxiety and depression since early in life, and whilst it's never been severe enough for me to be at risk of doing harm to myself or others, it has been a major complication in achieving good outcomes (i.e., always showed some promise and early success at intellectual, sporting and social pursuits, but co…

> I discovered deep subconscious emotional healing techniques

Can you elaborate on this? Can you recommend any resources?

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#127

Post by [deleted] » Thu, Jul 16, 2020, 3:33 PM UTC

[deleted]

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#128

Post by alex_young » Thu, Jul 16, 2020, 3:35 PM UTC

I really liked the writing in this article, it's compelling and fun to read. I do however think the author misses a broader point somehow.

The idea that 'mental illness' is a boogyman label which one will avoid at all costs is a good one. Who would want to self apply this label? You'll throw your lot in with the person talking to themselves on the street corner.

Instead of this, we are now supposed to start trying to encourage people to humanize mental distress (no need to say disorder now), indeed to extend this even to those suffering from more severe problems.

All of this is well and good, but the problem isn't really the term 'mental illness' is it? It's that we have decided as a society to reject all mentally ill people as hopeless cases, broken beyond repair.

It doesn't have to be this way. Many mental disorders are recoverable, and there is a huge amount of unknown about the rest. We have literally made a poor cost benefit analysis years ago and stuck with it for far too long without much thought.

What we should do is recognize that mental illness impacts most of us at some point in our lives, and that it severely impacts members of our own families (if you don't think it does, they are probably not telling you because of the stigma).

What would we have to do to resolve this? We would have to decide to dedicate large financial resources to helping the mentally ill recover if possible, or to find an existence which is mutually beneficial if not. Many countries have done exactly this, and with the considerable resources we have in this society, there is little doubt that we could find more answers to helping find real recovery.

Once people observe that mental illness is not a badge of shame, but an actual illness like many others, I believe that many more will be encouraged to seek assistance, and that we will all be much better off for it. As a nice side effect, you will no longer have to feel like shit knowing that the bipolar person on the street is likely to get roughed up frequently and meet an early end because we decided that's the way it is.

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#129

Post by mountainboot » Thu, Jul 16, 2020, 3:35 PM UTC

I have tried virtually every ssri. They all make me extremely tired, too tired to function. But still would encourage people with anxiety to try them as there are very few other good options.

Re: Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

#130

Post by AnIdiotOnTheNet » Thu, Jul 16, 2020, 3:36 PM UTC

PragmaticPulp wrote: post #28

Many depressed people are very resistant to accepting treatment. In a perfect world, people would have no hangups about scheduling an appointment with a therapist and/or trialing antidepressant medication as an adjunct to their recovery. However, in the real world many people are resistant to the idea of therapy and/or medication as it feels like admitting defeat. Or perhaps they've read cherry-picked horror stories…

> However, in the real world many people are resistant to the idea of therapy and/or medication as it feels like admitting defeat. Or perhaps they've read cherry-picked horror stories of bad therapists or medication side effects on the internet.

Or, you know, it's a lot of time and money being spent on something that the medical industry has very little success in dealing with.