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

#141

Post by bobthechef » Thu, Jul 16, 2020, 3:46 PM UTC

The categorical pathologizing of ALL human suffering is, of course, stupid. Suffering as such is the result of harm. We may speak of the appropriate amount of suffering, the excess and the deficiency of suffering given the severity and gravity of the harm, but as such, as sensory and affective response to harm, its purpose is no mystery and certainly no pathology.

Mental illness that is constitutional, what used to be called psychosis, may be patholigized, but it is hardly as common as some shrinks seem to think.

There is also another source of mental illness, probably the most common one. In an age that receives the words "sin", "vice", and "immoral" with amusement, discomfort, indifference, or even outright hostility, we seem to have lost the ability to confront this cause of mental illness, namely, sin, vice, and immorality.

There is no crisp line between physical, mental, and moral maladies, so to speak. And in this respect, vice can produce what used to be called neurosis. Sins and vices harm the sinner, and when left unacknowledged and undealt with, the guilt can manifest in a variety of bizarre ways that twist our emotions, appetites, motives, perceptions, and reasoning. It can reinforce cycles of vice. Pathologizing can be one way to find temporary, illusory relief by scapegoating one's guilt by invoking "chemical imabalance". Sure, there may be a chemical change in the brain, but that change in this scenario is the effect and not the cause.

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

#142

Post by centimeter » Thu, Jul 16, 2020, 3:47 PM UTC

realharo wrote: post #5

>She told me she welcomed the diagnosis of a neurobiological disorder, which confirmed her problem was ‘real’ – brought on by a physiological force external to her volition – and that it showed she’s not ‘just a slacker’. That is such an arbitrary distinction. As if being "just a slacker" doesn't have a number of deeper reasons behind it as well. Brains are just machines at the end of the day, every behavior is a res…

Consequentialists often point out that whether things like laziness are moral failings or are physiological problems with no moral bearing, it still makes sense to treat them as a moral failing, because it’s usually more likely to result in incentives and social pressures that lead to the moral failing/physiological problem being fixed, mitigated, or worked around.

There was an SSC article that had some good discussion on this at some point, but thanks to NYT I can no longer link it.

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

#143

Post by whatshisface » Thu, Jul 16, 2020, 3:50 PM UTC

cheerlessbog wrote: post #134

partyboat1586 wrote: post #36

Earlier quoted context omitted.

Brains are not machines like your phone is a machine or your car is a machine. They are complex systems and the result of an emergent process rather than designed systems with discrete components. The analogy that brains are like machines is harmful because it makes it sound like there is some operating manual and simple cause effect relationships that are known. Our knowledge of the brain is in fact very little. It'…

If a space probe discovered some vast alien structure clearly acting fulfilling some strange purpose by some opaque means... would we not usefully describe it as a machine?

Realistically, if it looked like a bacteria or an animal we would call it life, and it if looked like a printer or a lathe we would call it a machine. That's a more realistic picture of how language works, than expecting everyone to be a philosopher about categories.

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

#144

Post by paul7986 » Thu, Jul 16, 2020, 3:53 PM UTC

Personally and from my own experience Prozac, Paxil and Zoloft were only placebos and never helped me. Again my own experience... what helped me in my mid 20s was talking openly to my friends and others my age about my anxieties, unusual thought processes and other silly things you deal with at that age. Upon opening up I learned a more then a few of those I compared myself to were just as crazy as I thought I was and they too were dealing with similar issues or had. Then boom a lot of the zaniness was gone minus one odd OCD that stuck around for a bit longer(still there at 40 but very minorly and all other those silly worries/anxieties in my 20s and very early 30s are a thing of the past). If u have a social anxiety..think your not like others your close to & or compare yourself too..open up to them or some of them..u most likely find they are as crazy as you and in turn your normal like they are.

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

#145

Post by agumonkey » Thu, Jul 16, 2020, 3:53 PM UTC

seesawtron wrote: post #106

It reminds me of what Aldous Huxley wrote (about people in distress): “The real hopeless victims of mental illness are to be found among those who appear to be most normal. "Many of them are normal because they are so well adjusted to our mode of existence, because their human voice has been silenced so early in their lives, that they do not even struggle or suffer or develop symptoms as the neurotic does." They are…

I tried going back to normal life but 6 weeks were enough to erode my mind way too deep.

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

#146

Post by pravus » Thu, Jul 16, 2020, 3:55 PM UTC

koheripbal wrote: post #90

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…

"People in distress" is even more useless. "in distress" could mean anything from having fallen down the stairs, to running out of gas on the highway. I don't mind changing language, as long as we're become more precise, not less. If "chemical imbalance" is bad, suggest something better. I think a bigger problem is that people are fixated on word definitions and offending others instead of solving problems.

How is "distress" not the correct term? It is defined as extreme anxiety, sorrow, or pain which can be caused by any of the factors you described as well as many more you are not even aware of. It is an emotional state that is perceived on the part of the person suffering rather than observers outside of them regardless of the actual physical realities involved.

The term "chemical imbalance" can describe anything from acid reflux to genetic neurological pathologies or even snake bites and can certainly put people "in distress".

The problem is people aren't interested in using correct definitions for anything anymore.

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

#147

Post by Kalium » Thu, Jul 16, 2020, 3:56 PM UTC

AnIdiotOnTheNet wrote: post #118

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…

As a counter point, I was on prozac (fluoxetine) for about a year after being diagnosed with major depression. Everything seemed better at first, but my personality changed in a way that, when I looked at it objectively, I did not like and eventually I felt as though the drug was merely masking depression that never actually went away. My personal opinion having talked to doctors, therapists, and other depression suf…

As far as I can tell, there isn't a clear consensus on the precise causes underlying depression. It's challenging to treat causes when you lack a mechanistic understanding. So, yes, they've developed treatment protocols that use the tools they have available that sometimes work.

I don't think anybody considers this ideal, but many consider it preferable to no ability to treat at all. A world in which a deeper understanding of fundamentals enabled full treatment would be best for everyone.

It's not like nobody is trying! But setting a bone doesn't require a deep understanding of how bone knitting happens, and therefore comes well before.

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

#148

Post by nathan_compton » Thu, Jul 16, 2020, 3:57 PM UTC

realharo wrote: post #135

nathan_compton wrote: post #115

Earlier quoted context omitted.

Another thing: to assert that biological systems are just machines is to subscribe to the same error which allows creationists or intelligent design people to put forward the argument that we ought to take the complexity of life as evidence of a designer. It conflates two totally different phenomena by observing a superficial similarity between the two and ignoring all of their manifold and salient differences.

It's just a metaphor. Because the way it works can be viewed as inputs (sensors, environment, external chemicals) + current state ---> outputs (behavior) + new state kinda like computers or robots, in a deterministic manner (except it is practically impossible to recreate the exact same inputs, or the exact same state). You don't have to take it too literally, people who read it generally understand what it means.

This is either very specific and thus not all that applicable to biological systems (that is, the current state is typically much much much more dominant a determinant of future time evolution in biological systems than in machines) or so general as to characterize literally any physical phenomenon whatsoever, and thus hardly useful to think about how biological systems work specifically. Indeed, one element emphasized by Deacon is that the notion of "current state" is ambiguous or at least non-trivial for biological systems and exists for machines only because they represent a major simplification of the relations characterized by your metaphor.

Machines are in some sense constituted by an enormous, intentional, simplification of the possible dynamics of a clump of matter and its relations to the outside world. Their design is profoundly impacted by both our own cognitive limitations and the contexts in which they are manufactured and used. Biological systems simply don't have these constraints and they operate in what are often totally different ways from machines.

My point is that there is considerable scientific and philosophical scholarship on this issue which casts this metaphor into doubt at least with regard to base utility.

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

#149

Post by danans » Thu, Jul 16, 2020, 3:59 PM UTC

seesawtron wrote: post #106

It reminds me of what Aldous Huxley wrote (about people in distress): “The real hopeless victims of mental illness are to be found among those who appear to be most normal. "Many of them are normal because they are so well adjusted to our mode of existence, because their human voice has been silenced so early in their lives, that they do not even struggle or suffer or develop symptoms as the neurotic does." They are…

> if they were fully human beings, they ought not to be adjusted

The myth/ideal of being "fully human" is an example of essentialism, and is one the techniques that authors like Huxley and many from his era employed. It preys upon the inner authoritarian desire to normalize the world for oneself above all else, even though ironically Huxley opposed authoritarianism himself.

A different take is that people's mental health as individuals is in a constant tug of war with their own circumstances, which are then in their own tug of war with the collective stresses of society. There is no normal/abnormal spectrum as Huxley would have us think. Just a complicated web of complicated agents, sometimes in harmony with their society and other times not. When the net entropy to the agent is relatively low, that's "normal". It's not a value judgement or a mark of inauthenticity the way Huxley might have you think.

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

#150

Post by heavyset_go » Thu, Jul 16, 2020, 4:00 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…

> This is part of why I object to the "homeless people are all junkies and crazies" meme: it actively helps make vulnerable people crazy. It actively blames them for things they don't control and denies the existence of systemic issues to the faces of the victims who have such a low social status and are so openly disrespected that they aren't in a good position to argue with it. They are expected to kowtow and agree with everyone hanging their crap on them.

Agree with your insights. To further this point, people who would be deemed to be suffering from schizophrenia in our culture often have worse outcomes than people with similar symptoms in cultures that accept and integrate their different experiences.

There's research done on this topic, and this article touches upon some of it[1]:

> Stanford anthropologist Tanya Luhrmann found that voice-hearing experiences of people with serious psychotic disorders are shaped by local culture – in the United States, the voices are harsh and threatening; in Africa and India, they are more benign and playful. This may have clinical implications for how to treat people with schizophrenia, she suggests.

[1] https://news.stanford.edu/2014/07/16/voices-culture-luhrmann...