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

Common infections can spark psychiatric illnesses in children

economist.com

Post reply on HN
Print view View original

191–200 of 245 posts

Re: Common infections can spark psychiatric illnesses in children

#191

Post by xpe »

geye1234 wrote: post #181
LeifCarrotson wrote: post #166

Earlier quoted context omitted.

If you consider the processes of the mind to be acausal, that also removes the possibility of rational argument. It's possible that I'm a Boltzmann brain with nonsensical memories about environmental stimuli that mislead me about what reality is, but it's tedious to prepend every statement about reality with "the conception of reality that my state at time t-1 and my environment have lead me to believe is the most li…

I didn't claim the mind's processes were acausal; simply that they could not be reduced to cause, to the exclusion of anything else. If they can be so reduced, rational argument is impossible, because causal processes are not the same as rational argument. When I punch "2 + 2 =" into a calculator and the screen says "4", it's a causal process. When my kid grasps that 2 + 2 = 4, it's different. His mind has reasoned i…

> causal processes are not the same as rational argument

Yes.

...I'm taking this step-by-step...

But causal processes can _generate_ rational argument. Agree or disagree?

Re: Common infections can spark psychiatric illnesses in children

#192

Post by s0kr8s »

ekanes wrote: post #111
ericskiff wrote: post #74

For any parents reading this and wondering if their kid is affected, I highly recommend reading up on PANS and PANDAS. Watching our happy, healthy kid change before our eyes with sudden-onset OCD, vocal and motor tics, terrible mood lability and sleep issues, and other strange symptoms like handwriting regression was heartbreaking. His doctor suggested it was Tourette’s and I happened to notice that his symptoms incl…

Very similar story over here. Similar treatment and recovery, BH. For people curious about this syndrome, the most salient symptom is a sudden onset of multiple things that people don't usually develop in later childhood, let alone all at once. (OCD, tics, etc)

I have been told that kids with PANS / PANDAS often get better spontaneously when they hit puberty as well, which some speculate is due to changes in the immune system that occur at that phase of development (the body stops producing T-cells), so there is hope for families that have young children that things can improve gradually with time on their own if you hang in there as well.

Re: Common infections can spark psychiatric illnesses in children

#193

Post by xpe »

kelseyfrog wrote: post #163
xpe wrote: post #118

Earlier quoted context omitted.

> Doxastic voluntarism is a philosophical view that people elect their own beliefs; that is, that subjects have a certain amount of control over what they believe Do you hold such a view as a first principle? Or did you arrive at it via consideration of other factors?

Do you mean to ask if someone can choose not to be a doxastic voluntarist? You can't choose to be a doxastic voluntarist as much as you can't choose not to be one. One can only become one involuntarily.

Ah, now this is getting fun.

> Do you mean to ask if someone can choose not to be a doxastic voluntarist?

No, I did not. :)

My question remains: "Do you hold such a view as a first principle? Or did you arrive at it via consideration of other factors?"

If you look closely, you can see my question doesn't assume choice was/wasn't involved. Simply how you got there.

Re: Common infections can spark psychiatric illnesses in children

#194

Post by kelseyfrog »

xpe wrote: post #193
kelseyfrog wrote: post #163

Earlier quoted context omitted.

Do you mean to ask if someone can choose not to be a doxastic voluntarist? You can't choose to be a doxastic voluntarist as much as you can't choose not to be one. One can only become one involuntarily.

Ah, now this is getting fun. > Do you mean to ask if someone can choose not to be a doxastic voluntarist? No, I did not. :) My question remains: "Do you hold such a view as a first principle? Or did you arrive at it via consideration of other factors?" If you look closely, you can see my question doesn't assume choice was/wasn't involved. Simply how you got there.

I decided to change my preferences and it worked. It's simply evidentially true.

Re: Common infections can spark psychiatric illnesses in children

#195

Post by xpe »

TimTheTinker wrote: post #147
xpe wrote: post #94

Earlier quoted context omitted.

Yes, and that raises the question: by what mechanisms do we change our habits? I like an idea mentioned by James Clear (author of the "Atomic Habits" book) that each action we take is a "vote" towards establishing or breaking a habit. There are connections between this notion and neurochemistry, such as Hebbian learning.

One important mechanism for changing habits is to join a community of people who are practicing the habits you wish to practice. A thoughtful, intentional choice of whom to associate with is one of the most powerful forms of agency we possess. Zooming out a bit, local communities of people who practice virtuous habits are an indispensable cornerstone of society, for by them we gain agency to desire and do what is vir…

> Zooming out a bit, local communities of people who practice virtuous habits are an indispensable cornerstone of society

That's a pretty big claim, and I'm the kind of person that tends to challenge almost everything ... but heck, I have to admit that I largely agree. Well said.

I've lived many places, and the lived experience in some particular places, in some particular ways, just works better. It often has to do with most people being both trusting and trustworthy.

I would add that _locality_ isn't only about spatial dimensions. Some online communities have high degrees of locality, in a sense.

> for by them we gain agency to desire and do what is virtuous.

Again, at first I was going to push back on how you used 'agency' here, but I think I see what you probably mean: being in a better environment _helps_ an individual to choose from a better set of options, allowing them to be the best version of themself.

Re: Common infections can spark psychiatric illnesses in children

#196

Post by xpe »

kelseyfrog wrote: post #194
xpe wrote: post #193

Earlier quoted context omitted.

Ah, now this is getting fun. > Do you mean to ask if someone can choose not to be a doxastic voluntarist? No, I did not. :) My question remains: "Do you hold such a view as a first principle? Or did you arrive at it via consideration of other factors?" If you look closely, you can see my question doesn't assume choice was/wasn't involved. Simply how you got there.

I decided to change my preferences and it worked. It's simply evidentially true.

(involuntary laughter) well played

Re: Common infections can spark psychiatric illnesses in children

#197

Post by s0kr8s »

NeuroCoder wrote: post #136

Met a kid with this my first pediatric clerkship in med school. I was told it was super rare and then had to memorize a bunch more stuff and forgot all the details about the visit. Always wish I could remember that patient better

These cases aren't nearly as rare as the medical system would have you believe. Go to a residential psych hospital for kids, or a day treatment program for level 3 or 4 EBD children, and you'll see a bunch of them, many of whom have been languishing there for years.

These kids are are more of an ugly and inconvenient truth that the medical world would prefer to ignore, so these kids get chucked over the wall to the mental health system instead, which is better prepared to simply lock them up and quarantine them from the rest of society.

For the most part, I think doctors want to work mostly with helpless and grateful children, who willingly submit to tests and follow orders, not angry, aggressive children who claw and bite you no matter what you do or say. If you don't "behave" then medicine doesn't want you. Go see a shrink.

This is part of why I hate the term "behavioral health," because the emphasis is on restoring compliance. There was a movement in the 90's to rebrand "mental health" as "behavioral health" in order to make it seem more reputable and science-y, but I think that move back-fired. I think we delivered more compassionate care when the emphasis was on trying to some notion of a person's healthy subjective mental state, rather than trying to get them to behave.

Re: Common infections can spark psychiatric illnesses in children

#198

Post by xpe »

TedDoesntTalk wrote: post #167
krisoft wrote: post #161

Earlier quoted context omitted.

> There is no way those non-physical thoughts are changing the physical processes I don’t believe this to be correct. There is nothing non-physical about thoughts. Thoughts are mater interacting with mater. Thoughts are to the brain what waves are to the ocean. They are not less physical than the brain itself.

You cannot point to a neurotransmitter or neuron or synapse and say "that's a thought." Thoughts are not material. You might say they are not real. Even if you can point to a group of neurons and processes in the brain and associate it with a particular thought, the thought itself is not real. The neurons and their behaviors are.

First, saying "x is not real" is a proven way to make a mess of a conversation. I suggest we all would be better off avoiding that phrasing, unless we're willing to really dig in and carefully clarify our definitions.

> You cannot point to a neurotransmitter or neuron or synapse and say "that's a thought."

Are you claiming it is (a) categorically impossible or (b) practically impossible? Why not?

> Thoughts are not material.

To be clear, when modern philosophers talk about 'materialism' that tends to include all of the abstractions of physics: matter, energy, waves, etc.

> You might say [thoughts] are not real.

I wouldn't say that. Here is what I would say; there are at least three key different aspects of thoughts:

1. the perceptual level; i.e. the _experience_ of having a thought

2. the conceptual level; i.e. a _concept_ that people use

3. the physical level; the physical things that are happening; may be a set of things; not necessarily contiguous

> Even if you can point to a group of neurons and processes in the brain and associate it with a particular thought, the thought itself is not real.

My top-most paragraph explains that "X is not real" statements tend to have a lot of downsides. Am I missing something? Does this add something to the discussion?

Re: Common infections can spark psychiatric illnesses in children

#199

Post by s0kr8s »

Aurornis wrote: post #41
badcppdev wrote: post #8

This is sad: "years spent campaigning to get doctors to take the illnesses seriously." It's like that saying, "Capitalism: The worst economic system, except for all the others". Our medical system where we rely on individual doctors for primary care is really flawed but it's better than any alternatives that we have (or that we can afford anyway)

The problem is more complicated than it sounds. The official treatment protocol for PANDAS is to perform a throat culture for strep and then treat with antibiotics if the result is positive. (Source: https://www.nimh.nih.gov/health/publications/pandas ). In other words, it's the same as normal treatment protocols for strep. The idea of PANDAS from occult (aka hidden, not producing positive test results) strep infecti…

On the other hand, if someone has a child who is aggressively attacking anything and everything in site, no matter how they might have heard about PANDAS, I would argue that antibiotics might still be the lowest risk intervention and most prudent option to try if they fit the profile.

Yes, antibiotic resistance is a concern if you start handing out antibiotics like candy, but if PANDAS is truly as rare as everyone would have you believe, then prescribing antibiotics to every kid that comes in with a PANDAS profile is not going to move the needle much with regard to global antibiotic resistance.

Alternatives:

Prescribe them anti-psychotics or some other medication to sedate them?

Likely much higher side-effects and risk profiles than antibiotics.

Send them to a therapist in hopes that the therapist can behaviorally condition that aggression away?

Bad news: talk-therapy for aggressive behavior in children has terrible outcomes. Most likely scenario in the mental health system is that they end up in an intensive group treatment setting somewhere with other aggressive children, learn more sophisticated aggressive behaviors, and gradually get worse.

On the other hand, antibiotics have a fairly low risk profile. Some pediatricians do literally hand them out like candy when kids come in with an ear infection or sore throat. Maybe stop prescribing antibiotics for those kids, tell them to try some tea tree oil or some other natural remedy, and save the antibiotics for the kids who fit a PANDAS profile instead?

Post reply on HN