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A third of Americans now show signs of clinical anxiety or depression

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Re: A third of Americans now show signs of clinical anxiety or depression

#351

Post by westoncb »

cortesoft wrote: post #345
westoncb wrote: post #329

Earlier quoted context omitted.

> This is approximately the same phenomenon that causes medical students to self-diagnose themselves with every disease they learn about Could you say more about this? It seems pretty counter-intuitive that medical students could look at some diagnostic criteria—which I assume often contain some fairly straightforward things like, "green spots on armpits" or whatever—and come out convinced they have the disease. When…

I think the idea is that an implied symptom in diagnostic criteria is that the person was distressed enough to seek treatment . That bit of info is important for determining likelihood of having the disease. Say you have a test for someone having a heart attack that is 99.9% accurate. If someone comes in complaining of chest pains, and the test says they are having a heart attack, then it is pretty certain they are h…

Hmm. So that looks like two separate issues to me, but maybe I'm missing something. I see:

1. Additional always-present criterion of distress

2. Knowledge of prior base rates as a means of estimating a proportion of false positives.

The first one makes sense to me in connection with the earlier comment. We aren't great at definitively reading our own states: it's easy for us to imagine symptoms, especially when prompted. But if something is actually wrong, an element of distress is typically present.

The second one seems like a separate issues though, or at least I don't see the connection. It seems like there are two important bits of information for correcting false positives. The first is that you have a known accuracy which suggests a 1 in 1000 chance of any diagnosis being incorrect; the second is that through historical record you can estimate how many people in e.g. the US are having a hard attack at any given moment on average.

I don't see the connection between either of those pieces of information and loose diagnostic criteria though.

Re: A third of Americans now show signs of clinical anxiety or depression

#352

Post by rumanator »

op00to wrote: post #332
malandrew wrote: post #143

Earlier quoted context omitted.

> it has completely wrecked with education and entry-level jobs Humans have recovered and prospered from far more dire circumstances, including many immigrants to the US and Europe.

Sure, and the dinosaurs perished. What’s that got to do with the price of tea in China?

You only have to be aware of the recent financial crisis, whose impact went through arguably between 4 to 6 years, to realize that enduring a simple lockdown that takes 4 to 6 weeks is a mere inconvenience, and whining about the devastating impact of staying at home for a few weeks is a kin of whining about not getting a haircut on schedule.

Re: A third of Americans now show signs of clinical anxiety or depression

#353

Post by freehunter »

tjs8rj wrote: post #277
idoby wrote: post #263

Earlier quoted context omitted.

As a non-American, why do you care about who is in the white house so much? How does it affect your life concretely? Try watching less talking heads/browsing Twitter less, maybe, and you'll feel better?

This is very true, as an American. There's almost no difference in the vast majority of daily life for most Americans if you just pretended like the president doesn't exist.

The president has not had a dramatic impact on my life directly. The people who follow him and listen to him absolutely have. I'm getting real tired of seeing armed protests, nazi/confederate flags, and Make America Great Again signs at my state capitol every other day. I'm tired of his threats to punish my state after a massive flood because he doesn't like my governor. I'm tired of one of his cabinet members riling up these armed protests with nazi/confederate flags.

And even if the president hasn't done anything to me specifically, I'm getting real tired of hearing all the stupid shit he does/says every night on the news or the next morning when my coworkers talk about it. If I could figure out a way to block the words "twitter", "hydroxycloroquine", "inject disinfectant", etc... I'm sure he'd make up even stupider things for people to talk about.

It's tiring. It's exhausting. And knowing that nearly half of my countrymen agree with what he says just makes it worse. But the worst part of all is having a president who is actively attacking my state and its elected representatives while we're in not one but MULTIPLE states of emergency.

Have you ever had your president declare war on your state? It's not normal. And it's really hard to pretend it doesn't exist.

Re: A third of Americans now show signs of clinical anxiety or depression

#354

Post by code_duck »

aszantu wrote: post #169

As a person with a history of depression and social anxiety I really do feel calmer since the crisis started, as if my state of mind was made for this kind of life. Less people on the streets, it's quieter, no one breathing down my neck in the supermarket, home office, no expectations on how to pick my clothes, how to behave, no trying to hide the weird stuff I eat (carnivore, high meat, raw, cooked and aged whatever…

Same for me. I was already out of work and could barely eat at restaurants due to a few years of emerging health problems, so the idea that we're supposed to stick around the house and get groceries delivered was easy to accept. It actually felt like a nice change from my habits. I like some of the political changes it is catalyzing, such as how some people are gaining a better understanding of why the government should provide a functional social safety net, and mandate things like paid sick leave.

However, it's been hard to witness and deal with the effects I've seen on other people. My roommate has been extremely stressed out. It makes me feel sad to see all the restaurants and bars that are closed down, and normally busy districts deserted at 6:00 on a Friday. I feel bad for people who have no choice but to continue working in high-risk jobs, and those whose businesses will be interrupted for quite some time, such as concert organizers. And, of course, for the hundreds of thousands of people who have died and their families.

Re: A third of Americans now show signs of clinical anxiety or depression

#355

Post by thelean12 »

ryanwaggoner wrote: post #235
[deleted] wrote: post #190

Earlier quoted context omitted.

[deleted]

What a perfect encapsulation of the individualism that drives the special American breed of blame-the-victim mentality. It allows society to erode the well-being of huge swaths of the population while simultaneously making them feel ashamed of their inability to triumph over the ruthless machine grinding them into the dirt. Yes, we need personal responsibility, but maybe we could also stop making it harder for people…

While the person you're responding to has a horrible tone, I've sort of grown to agree with the general sentiment.

Most of the problems I've seen people face can be solved on their own, or could have been prevented on their own.

Pandemic made you lose your job? Absolutely not your fault. Massive injury or illness wipe out your savings and leave you in debt? Absolutely not your fault. These are things we can and should be improving.

But it's really hard for me to feel bad about people who end up with a massive amount of school loans. There are plenty of state school options available. Work moderately hard in high school and you'll get a massive discount on college, too. Would it be great if it were free? Absolutely. But it isn't. And that shouldn't be an excuse for ending up with a massive loan afterwards.

Job sucks? So many people I meet aren't even trying to apply to new jobs. It was like pulling teeth trying to get my sister to apply to just a few jobs a week (when I applied to a dozen a day when I was starting out).

Re: A third of Americans now show signs of clinical anxiety or depression

#356

Post by freehunter »

rubidium wrote: post #298
freeone3000 wrote: post #203

Earlier quoted context omitted.

9/11 happened to me in grade school. Iraq war happened thereafter. Then the financial crash. Then the subprime crash. And now covid. My life is shaped MORE by crises than by stability - not just the current one, but ALL of them.

Yea, so turns out being a human in a peaceful stable society is pretty rare. Most of humanity has had much more severe crisis than what you experienced. We’re a remarkably resilient species.

I would argue that resilience came from innovation and creative thinking. When we encountered a problem that threatened the species, we came up with solutions to fix it.

There are very few times in human history where we took any steps backwards on that progress. The collapse of the Roman Empire was one of those moments, and it took hundreds of years for civilization to recover from that.

I'm not saying we're getting close to a catastrophic event like that any time soon... but we should definitely not shrug off unnecessary world hardships with a glib "we've survived worse". Because if the worst should happen and Western Civilization takes a step backwards... the consequences aren't going to be pretty. Especially now that we have nuclear weapons.

Re: A third of Americans now show signs of clinical anxiety or depression

#357

Post by jdavis703 »

idoby wrote: post #263
JSavageOne wrote: post #131

As an American it's not surprising at all. Six figures of student loan debt, job insecurity, healthcare insecurity, rampant poverty / homelessness, the most despicable president to disgrace the white house (who didn't even win the popular vote), stay-at-home orders because the U.S. couldn't manage the crisis, lack of community (doesn't help that 99% of the country is sprawl), rampant obesity, and general lack of hope…

As a non-American, why do you care about who is in the white house so much? How does it affect your life concretely? Try watching less talking heads/browsing Twitter less, maybe, and you'll feel better?

Right now the US is the leader in COVID19 cases and deaths. Bigger countries like China have so far performed better than the US. Yes, there are structural issues, like the obesity epidemic. But it doesn't help the government is spending time arguing about masks and drinking disinfectant instead of building out test, trace & quarantine infrastructure.

Re: A third of Americans now show signs of clinical anxiety or depression

#358

Post by anbende »

conistonwater wrote: post #177

Diagnostic criteria for anxiety and depression are very broad because they are necessary as tools for practicing doctors seeing patients (as opposed to applying them to a random selection of people). If you turn the process back, and just ask how many people in the population fit under them, you'll always, even in normal times, get an unexpectedly large number. That doesn't imply that anything is wrong or that anythi…

I'm a PhD in clinical psychology, currently working with clients, whose research has focused on the psychometric evaluation of questionnaire measures.

I have no idea what you're talking about. The diagnostic criteria are not "very broad because they are necessary as tools". The diagnostic criteria are meant to be sufficient criteria for diagnosing a disorder. Questionnaire-based measures act as a scientifically validated proxy for a clinical interview to determine this. With a sufficient score on one of several validated diagnostic questionnaires, you can typically say with 80-90% certainty (specificity is the technical term for that percentage) that the person would receive a diagnosis from a clinical interview.

Psychologists and epidemiologists can and do research prevalence of mental health conditions by randomly sampling the population. This does not "over-diagnose" mental health disorders. That's absolute nonsense. Over-diagnosis is only an issue in cases where prevalence is below the false positive rate (technical term is "sensitivity") of the test. That is not the case here.

If you looked at the linked CDC study, they even mentioned the instruments that were used to support this statement. The PHQ2 and GAD2 are validated very brief measures of depression and anxiety that are sufficient for estimating the likelihood of a depression or anxiety diagnosis respectively. Likelihood of a false positive on the PHQ2[1] and GAD2[2] are both around 20% (100-specificity), which is just fine. Both of these are more than sufficient for epidemiological purposes if not for individual Dx.

The fact of the matter is that nationwide prevalence for diagnosable disorders IS high, and it's on the rise. Coronavirus has made people anxious and quarantine has made them depressed. And a LOT of people need help.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906530/ [2] https://www.hiv.uw.edu/page/mental-health-screening/gad-2

Re: A third of Americans now show signs of clinical anxiety or depression

#359

Post by cortesoft »

westoncb wrote: post #351
cortesoft wrote: post #345

Earlier quoted context omitted.

I think the idea is that an implied symptom in diagnostic criteria is that the person was distressed enough to seek treatment . That bit of info is important for determining likelihood of having the disease. Say you have a test for someone having a heart attack that is 99.9% accurate. If someone comes in complaining of chest pains, and the test says they are having a heart attack, then it is pretty certain they are h…

Hmm. So that looks like two separate issues to me, but maybe I'm missing something. I see: 1. Additional always-present criterion of distress 2. Knowledge of prior base rates as a means of estimating a proportion of false positives. The first one makes sense to me in connection with the earlier comment. We aren't great at definitively reading our own states: it's easy for us to imagine symptoms, especially when promp…

The base rate part is just explaining why the diagnostic doesn't work when applied on a healthy population (like med students)

The instruction would be something like "if the patient complains of x, check for symptom y... if the have symptom y, they are likely suffering from z"

But the med student then checks themselves for symptom y, and thinks they have z, but that is only the case if they are suffering from x. The suffering from x part is what changes the base rate, and can't be ignored.

Re: A third of Americans now show signs of clinical anxiety or depression

#360

Post by [deleted] »

JSavageOne wrote: post #131

As an American it's not surprising at all. Six figures of student loan debt, job insecurity, healthcare insecurity, rampant poverty / homelessness, the most despicable president to disgrace the white house (who didn't even win the popular vote), stay-at-home orders because the U.S. couldn't manage the crisis, lack of community (doesn't help that 99% of the country is sprawl), rampant obesity, and general lack of hope…

[deleted]
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