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

The psychiatric drug crisis

newyorker.com

Post reply on HN
Print view View original

41–50 of 153 posts

Re: The psychiatric drug crisis

#41

Post by unono »

sillysaurus2 wrote: post #31
unono wrote: post #28

Hackers can make huge money in psychology/psychiatry (both prescientific fields). Life logging and it's analysis - quantified self. Positive psychology would be the better angle to play it, unregulated, big money in the self-help culture. Mobile apps are the right medium for it. There was recent doc on it 'Monitor Me' by bbc horizon. edit: to replyers, it didn't want to post links for everything, so google 'monitor m…

I'm trying to understand what you're saying, but honestly I have no idea what you just said. Would you clarify your meaning? edit to reply to your edit: no, you'll have to do much better than that if you want to actually communicate with people and not be ignored or dismissed as crazy. Would you please spend at least 10 minutes typing an explanation of (a) what are you talking about, and (b) why is it valuable? Maybe…

OK. I try to see articles and find a positive spin where I can say "hackers could ...". To some people it would be obvious, but to young or non-tech people it might not be, so it could be helpful to them.

As other commenters have said, psychiatry/psychology is an ineffective field and also expensive.

The self-help industry is kind of related to psychology/psyciatry, is unregulated, and a $11 billion a year field.

I gave a mention of a documentary that came out recently about people building apps in this category of self help/health/life monitoring kind of stuff. Some terms to google to find out more are what I typed in the OC.

Re: The psychiatric drug crisis

#42

Post by WildUtah »

pyre wrote: post #27
kyro wrote: post #23

Good riddance. Psychiatry by and large is a sham field. Physicians who practice it love seeing themselves as artists who are experts in identifying the subtleties of human behavior. That's their way of saying there's very little underlying science guiding their practice. Many of the diagnoses given are pulled out of thin air and made to justify a patient's admission, or to appease a patient's desire to feel as if the…

> although that could entirely be due to placebo effect If the drugs had no effect, then why are people (ab)using drugs like Adderall to improve cognition, etc? A big problem with trying to make a science out of the brain, is that it can be very unique to the person. For example, in people that are blind since birth, the pathways in the brain that are normally used for visual processing can get re-purposed over a lif…

Amphetamine is certainly effective and fairly well understood in its clinical effects. There is no doubt about its effectiveness and principal uses and side effects. (Adderall(^tm) is a brand name for amphetamine.)

Serotonin reuptake inhibitors used for mood management are just a matter of trying them and seeing if you like the way they feel. It's exactly as scientific as drinking liquor or smoking marijuana to see if it makes you more mellow.

But doctors are going around collecting rent on their prescription pads by writing scrips for Paxil and Prozac and the like as if they were technical and carefully calibrated professional tools that required twelve years of college and med school and internships and apprenticeships to master and administer. They're doing all that training and then providing the same service as witch doctors -- but for a lot more money.

Re: The psychiatric drug crisis

#43

Post by joe_the_user »

mathattack wrote: post #40
kyro wrote: post #23

Good riddance. Psychiatry by and large is a sham field. Physicians who practice it love seeing themselves as artists who are experts in identifying the subtleties of human behavior. That's their way of saying there's very little underlying science guiding their practice. Many of the diagnoses given are pulled out of thin air and made to justify a patient's admission, or to appease a patient's desire to feel as if the…

Let's play the devil's advocate here... I've known people who have lost their marbles once they stopped taking their meds. Are we rally saying that their grip on sanity was a placebo effect? Or are we saying that we're just treating the symptom? If it's just the symptom, who cares, as long as the drugs help people? For context, I'm not on any psychiatric drugs, have never been on any, and think they're largely being…

Let's play the devil's advocate here... I've known people who have lost their marbles once they stopped taking their meds. Are we rally saying that their grip on sanity was a placebo effect?

Well, the withdrawal effects for quite a few of these drugs includes various acute psychiatric symptoms, include suicide and homicide.

I lost one of my bests friends a number of years ago to this.

Also found: http://ssristories.com/

Re: The psychiatric drug crisis

#44

Post by ninguem2 »

HarryHirsch wrote: post #17
jaredhansen wrote: post #10

Earlier quoted context omitted.

>amount of profit sought by drug companies is stomach churning What's the right amount of profit a company should seek? For reference, following are the latest reported profit margins of several companies: Eli Lilly: 20.34% AstraZeneca: 13.33% Novartis: 17.33% Apple: 19.53% Google: 18.11% Microsoft: 24.95% It's not at all clear to me that drug companies are somehow seeking more profits than other companies (or that t…

It's the fact that pharmaceutical companies are involved in the sphere of public health that makes people uneasy about excessive profits, whatever "excessive" means. It's not only profits: lifestyle drugs, like statins and medication for ED are obviously a source of easy profit, meanwhile research into antibiotics is falling by the wayside. The fact that the existing antibiotics are becoming useless and there is noth…

Statins are a lifestyle drug? Come on.

Re: The psychiatric drug crisis

#45

Post by joe_the_user »

md224 wrote: post #26

Fun Fact: Selective Serotonin Reuptake Inhibitors, the class of drugs used to treat depression and anxiety disorders by increasing the availability of serotonin, have a mirror opposite: Tianeptine ( http://en.wikipedia.org/wiki/Tianeptine ), which acts as a Selective Serotonin Reuptake Enhancer. Incredibly, this drug has also been effective at treating depression . That's right: two classes of drugs with polar opposi…

The Hawthorne Effect for brains

http://en.wikipedia.org/wiki/Hawthorne_effect

Re: The psychiatric drug crisis

#46

Post by OldSchool »

kyro wrote: post #23

Good riddance. Psychiatry by and large is a sham field. Physicians who practice it love seeing themselves as artists who are experts in identifying the subtleties of human behavior. That's their way of saying there's very little underlying science guiding their practice. Many of the diagnoses given are pulled out of thin air and made to justify a patient's admission, or to appease a patient's desire to feel as if the…

As a young engineer-type with no exposure to the psych field, I had about the same opinion when I was in my early 20's.

However, a few decades of real life later I've seen first-hand, successes and turnarounds for people who either found themselves in bad situations or were just plain genetically vulnerable. In fact, I'll go as far as saying that counseling or therapy are nothing compared to the difference that the right medication(s) can make in a life. Finding it is hit-or-miss, and there are still people who ultimately can't be helped but there are countless success stories - they just aren't worth reporting, like every time antibiotics work as expected.

Re: The psychiatric drug crisis

#47

Post by sliverstorm »

kyro wrote: post #23

Good riddance. Psychiatry by and large is a sham field. Physicians who practice it love seeing themselves as artists who are experts in identifying the subtleties of human behavior. That's their way of saying there's very little underlying science guiding their practice. Many of the diagnoses given are pulled out of thin air and made to justify a patient's admission, or to appease a patient's desire to feel as if the…

What needs to happen first is that we need to attain a much deeper understanding of how the brain works on the low and high levels, mechanically and abstractly.

I like this idea. I have one question; in the meantime, while we spend the next five hundred years figuring out the brain (because as we already know, it is wildly complex and we know almost nothing about it), what do we do with the people who really need psychiatric help? Can we hang them out to dry, or would that be too cold?

Re: The psychiatric drug crisis

#48

Post by sliverstorm »

FrankenPC wrote: post #16

Maybe humans are just...unhappy? By that I mean as a race, we are inherently unstable (see: entire human history) and for a long time we kept it together by forming very tight family and community bonds. We had central, realistic, and tangible goals. We had an invisible friend (religion). As science has systematically stripped all that away (for the better mind you...), nothing has filled those needs. We don't need m…

Don't forget about the hedonic treadmill.

Re: The psychiatric drug crisis

#49

Post by kyro »

sliverstorm wrote: post #47
kyro wrote: post #23

Good riddance. Psychiatry by and large is a sham field. Physicians who practice it love seeing themselves as artists who are experts in identifying the subtleties of human behavior. That's their way of saying there's very little underlying science guiding their practice. Many of the diagnoses given are pulled out of thin air and made to justify a patient's admission, or to appease a patient's desire to feel as if the…

What needs to happen first is that we need to attain a much deeper understanding of how the brain works on the low and high levels, mechanically and abstractly. I like this idea. I have one question; in the meantime, while we spend the next five hundred years figuring out the brain (because as we already know, it is wildly complex and we know almost nothing about it), what do we do with the people who really need psy…

Look, if you have debilitating schizophrenia refractory to any therapy because the demons in your ears tell you the FBI is after you, then the benefits of symptomatic treatment may outweigh whatever unknown side-effects there are.

For the millions of those with 'psychiatric' disorders that are diagnosed using incredibly vague guidelines [0] -- do you ever feel tired? do you ever lose attention? do you ever feel really confident? -- using medications that do not have any observable and immediate symptomatic relief is not worth it. Many of these people have dysfunctions of cognitive processes or issues of their childhood that can be attacked in more conservative ways.

[0] http://www.mayoclinic.com/health/depression/DS00175/DSECTION...

Re: The psychiatric drug crisis

#50

Post by kyro »

OldSchool wrote: post #46
kyro wrote: post #23

Good riddance. Psychiatry by and large is a sham field. Physicians who practice it love seeing themselves as artists who are experts in identifying the subtleties of human behavior. That's their way of saying there's very little underlying science guiding their practice. Many of the diagnoses given are pulled out of thin air and made to justify a patient's admission, or to appease a patient's desire to feel as if the…

As a young engineer-type with no exposure to the psych field, I had about the same opinion when I was in my early 20's. However, a few decades of real life later I've seen first-hand, successes and turnarounds for people who either found themselves in bad situations or were just plain genetically vulnerable. In fact, I'll go as far as saying that counseling or therapy are nothing compared to the difference that the r…

I agree with you for the most part. There are people with severe, debilitating conditions that may require medical intervention.

There are many, many more that have been labeled due to loose diagnosing guidelines to have a psychiatric disorder. A psychiatrist might just notice that your affect is slightly off, and label you with schizoaffective disorder, which is pretty well known as the diagnosis you give when you can't really put your finger on what's wrong, and yet they still treat medically.

How many people diagnosed with MDD or hypomania, do you think, genuinely deserve treatment with muddy medications? How many of them do you think may have other rectifiable issues that are leading to their disposition? Psychiatrists tend to overlook identifying those issues, and jump to asking the questions needed to diagnose a disease as per the DSM-IV.

Post reply on HN