171–180 of 225 posts
The DSM is a bunch of nonsense. As long as they don’t provide physical mechanisms for disorders, it’s worthless. It clusters symptoms without knowing the underlying causes. It’s like going to the doctor with a runny nose, who the claims it’s influenza, due to the runny nose, without testing for Covid.
Hundreds of millions of people whose lives have been saved or improved thanks to broader recognition and treatment of their disorder would disagree.
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> only the catastrophic is worth addressing This is a very privileged view of the mind. I have ADHD (and autism). But I also have a quite high IQ, if one cares about such things. I'm pretty successful, professionally. But it took until around 40yo to get the ADHD diagnosis and get a prescription for medication that has been life-altering. Was I suffering from catastrophic failures? Absolutely not: married, have kids,…
Why do you presume I'm neurotypical and undiagnosed with any psychiatric disorder? I'm formally diagnosed with severe OCD, depression, and ADHD. I was on SSRI, then SNRI and additionally methylphenidate for years. Eventually I got tired for feeling like a shell of a human being, and weaned off of the SNRI. It took a lot of effort to induce neuroplasticity and ease my OCD and depression, but I did it. Eventually, I we…
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> only the catastrophic is worth addressing This is a very privileged view of the mind. I have ADHD (and autism). But I also have a quite high IQ, if one cares about such things. I'm pretty successful, professionally. But it took until around 40yo to get the ADHD diagnosis and get a prescription for medication that has been life-altering. Was I suffering from catastrophic failures? Absolutely not: married, have kids,…
Hold on.. did you just say there is a drug I can take that will making talking to people less boring and doing housework fun?
Benzodiazepines, opioids, stimulants, opioid-like substances like carisoprodol (there is a reason why people call it Soma). these are the first that come to my mind. contrary to popular belief, downers often give you euphoria.
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> This kind of contradictory phrasing is standard in the DSM. I'm not sure I see what's contradictory in your example. Could you elaborate?
How can one identify an illness where one can't even tell who and how often have said illness? In fact, there is a way of doing that. And we, as programmers, have access to those methods. It's called Numerical Analisys. At times it's quite amazing to see how well mathematics can estimate data. One of the examples, is German Tank Problem. https://www.numberphile.com/videos/clever-way-to-count-tanks While being an extr…
Also, I think its still helpful to define a disorder even if you haven't researched globally how many people have it.
> The reason for my beef in here mainly that all the numbers are just stated, with no respect to what numbers are. And I would expect either an explanation of a numerical method to estimate this number, or a source as to where this number has been gotten from. I agree that it would be nice have references. However, if you are just diagnosing an illness, it probably doesn't matter that much how many people in the world have this illness, just if the person in front of you has it or not. So the people that are actually using this text don't really need the sources.
It seems to me like the main purpose of DSM-5 is to define a bunch of disorders, so everyone has a common language to talk about the actually useful stuff like treatments. So even if it mistakenly says 2% instead of 0.2%, that doesn't really matter, I think.
Also, even if it is non-obvious to us, there might still be someplace where sources are listed. (IE maybe if you look at some meeting notes of the author committee)
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How can one identify an illness where one can't even tell who and how often have said illness? In fact, there is a way of doing that. And we, as programmers, have access to those methods. It's called Numerical Analisys. At times it's quite amazing to see how well mathematics can estimate data. One of the examples, is German Tank Problem. https://www.numberphile.com/videos/clever-way-to-count-tanks While being an extr…
How I see it is that they are very careful with the statements they make. It seems to me like there was a study of this disorder in lower income communities in the uk, which leaded to the 2%. However, it is unreasonable to then draw the conclusion that it is also 2% in the entirety of the USA, or that it must be lower or higher. Also, I think its still helpful to define a disorder even if you haven't researched globa…
A well written scientific book would never leave a reader in a state of “maybe”.
Also, if the numbers go down to 0.2% I can’t help but notice that this can’t be defined as a disorder. It is a statistical error.
There is a placebo effect. Furthermore any doctor knows the rule of self-diagnosis. “Any patient, given a chance, will self-diagnose anything”.
With no data on how the data about illness was obtained I can’t say if this is a statistical error or a fluke.
Also, as noted above, should there be a method of testing for such a condition that is objective, I would live with 2% or 0.2%. (For example, 0.001% of people are missing this and this chromosome, and we know that because we can do a DNA test.) But there is no way of saying something like this just cause you did a survey and ask people some vague questions about their mental state. There are people who would just fake answers in their responses for fun. And just cause of that I don’t trust numbers like 2% in this specific case.
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> only the catastrophic is worth addressing This is a very privileged view of the mind. I have ADHD (and autism). But I also have a quite high IQ, if one cares about such things. I'm pretty successful, professionally. But it took until around 40yo to get the ADHD diagnosis and get a prescription for medication that has been life-altering. Was I suffering from catastrophic failures? Absolutely not: married, have kids,…
Why do you presume I'm neurotypical and undiagnosed with any psychiatric disorder? I'm formally diagnosed with severe OCD, depression, and ADHD. I was on SSRI, then SNRI and additionally methylphenidate for years. Eventually I got tired for feeling like a shell of a human being, and weaned off of the SNRI. It took a lot of effort to induce neuroplasticity and ease my OCD and depression, but I did it. Eventually, I we…
Like many other biological systems, neurological wiring is multidimensional and not a natural fit into our arbitrary culturally defined abstractions, or even language. And the dimensions themselves are multifaceted expressions of multiple genes and environmental factors. I am happy to hear stories like yours, of people who can ultimately achieve "normal" functional parity without medication.
Have you considered if that would have been possible without the journey? Had you, on day 1, cancelled that first therapist appointment and decided to grit your teeth and "try" instead, could you have "accepted discomfort" on your own? Or is it possible that the methylphenidate created supportive conditions that improved your chances?
I ask because there is a body of well reproduced research demonstrating not only that ADHD patients have specific genetic and neurobiological differences from neurotypicals in areas associated with executive function, but that long term ADHD medication use can permanently bring the neurological differences into line with neurotypical controls. Something like 20% of medicated childhood ADHD patients can ultimately stop medication without losing points in functional testing or the associated brain structures. It's a lower percentage in adults and less well studied, but still exists. It's a big difference from the results of every non-chemical intervention we've studied, which have single digit efficacy percentages if they beat P at all.
I'm interested in your feelings about this because ADHD is by far the most-studied psychological disorder in the world, and ADHD medications as a group are not only equally well studied, but also the most successful and least harmful of any psychiatric drug. There are more safety and efficacy studies for ADHD medication than for ibuprofen.
So... if you feel your recovery was not helped by the neurogenetic compensations provided by methylphenidate, you should know that you are flying so far in the face of some of the best-validated medical science, that you imply invalidity of pharmaceutical or medical science as a whole.
... which is fine of course - it's your body and brain! But I bet it would help readers to know how you think this aligns with the science, or maybe what you think of medical science altogether. Questions like "Do you take ibuprofen?" And "Do you vaccinate?" Become relevant.
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Yes, that did unfortunately happen in the history of psychiatry. I am talking about modern American psychiatric practices (say, the last 10-20 years). If the proposition here is that mental health disorders are fabricated maliciously in order to sell more medication or enforce some sort of social order, then I don't see how the very rare court-ordered enforcement of short-term stays at psychiatric institutions could…
> The vast majority of people in the US who receive psychiatric care do so voluntarily That's true, but that's not what the parent comment claimed. They didn't say a majority receive psychiatric care involuntarily, they said it's not hard to find examples who receive it involuntarily, and that's true. Lots of people are forced to take psychiatric medication right now, in developed countries including the US.
Just as an example, in the UK the verb "to section" is shorthand for "to commit to involuntary confinement in hospital under the legal authority of one or more sections of the Mental Health Act"
https://www.mind.org.uk/information-support/legal-rights/sec...
For example, you can be detained for up to 6 months under Section 3, if all four of these conditions are met:
1. you have a mental disorder
2. you need to be detained for your own health or safety or for the protection of other people
3. doctors agree that appropriate treatment is available for you
4. treatment can't be given unless you are detained in hospital
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“Chemical imbalance” lol. You have inadvertently outed yourself as not having a clue by your reply. It’s nothing personal but you just clearly don’t have a clue and/or don’t have skin in the game. It’s fine. I don’t know anything about professional juggling because I have zero skin in that game. Paging Dr. Brochacho: fMRI and brain networks have been around for a while!
You're behind the times https://www.nature.com/articles/s41380-022-01661-0 https://www.psychiatrictimes.com/view/debunking-two-chemical... https://www.psychologytoday.com/us/blog/insight-therapy/2022...
Your articles also say that:
- depression medication does appear to be effective in some cases regardless, indicating some other neurochemical mechanism at work.
- the existence of a "neurochemical imbalance myth" underpinning psychology as a whole is, itself, a myth.
- the idea that this mythical myth about neurochemical imbalance has been debunked, is also a myth.
- that the psychological scientific consensus has, since the first peer-reviewed mention of the word "neurochemical" in the 60s, quite consistently been aligned with the 1978 synthesis statement by the then president of the APA:
> "Psychiatric disorders result from the complex interaction of physical, psycho-logical, and social factors and treatment may be directed toward any or all three of these areas."
Your second article is particularly clear in explaining all this.
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As someone who has been here many, many years - this is truly mystifying to me. And not just me, apparently. And also notably, no one responded that way to that comment. But sure, it’s your show.
> no one responded that way to that comment You're right, but we have to moderate based on how these things work in the general case. > this is truly mystifying to me It's inevitable that there will be different interpretations of specific comments, so I hope you can at least 'upgrade' us to "wrong in this case" and hopefully we will make more sense in the future! p.s. I know what you mean about "it's your show" but…
The DSM is a bunch of nonsense. As long as they don’t provide physical mechanisms for disorders, it’s worthless. It clusters symptoms without knowing the underlying causes. It’s like going to the doctor with a runny nose, who the claims it’s influenza, due to the runny nose, without testing for Covid.
> it’s worthless Hundreds of millions of people whose lives have been saved or improved thanks to broader recognition and treatment of their disorder would disagree.