Aren't we all somewhere on the spectrum of disease? • Hacker News Board

Re: Aren't we all somewhere on the spectrum of disease?

#41

Post by Talanes » Sun, Jul 19, 2020, 2:43 AM UTC

geofft wrote: post #37

KerryJones wrote: post #14

Earlier quoted context omitted.

The DSM is based off the "top" Psychiatrists at the time voting on the illnesses (literally), without scientific backing. Treatment's don't fix anything, they might lessen one issue and often give a host of other problems that are often more severe. I think more studying of iatrogenics is in order and more data about what "making it better" means -- as often the patient and doctor have different meanings. Again, beca…

> The DSM is based off the "top" Psychiatrists at the time voting on the illnesses (literally), without scientific backing. What, precisely, would provide scientific backing here, if a vote by professional scientists doesn't count? A vote by academics? A committee of academics, appointed by a prior generation? A team at Harvard, because Harvard is the oldest? A committee appointed by the government?

I believe their problem was with the structure of the process, and not with the composition of the governing body.

Re: Aren't we all somewhere on the spectrum of disease?

#42

Post by solinent » Sun, Jul 19, 2020, 2:43 AM UTC

blame_lewis wrote: post #18

This is a really dangerous and misleading way to look at bipolar. The disease proper of bipolar disorder is progressive and degenerative. This progression is accompanied by structural changes in the brain [1] as well as biological changes in the body [2]. If someone had the syndromes of manic or depressed symptoms in response to a medication, that does not prove either way that the person actually has the progressive…

There are also structural changes in the brain as time passes, and hopefully biological ones as well if I'm going to digest this food I just ate. What structural changes are present and can these changes be used to diagnose the condition? Are these changes necessary for the condition? To me it looks like gray matter loss is not exclusive to this condition, these studies only quantify brain matter density, not structure. This study is also not very well designed, it only studies BPD patients without studying patients that may potentially have the identified defect but not the diagnosis.

Our diagnosis of psychological conditions is very vague as well--is bipolar disorder diagnosed as lack of gray matter? If it's not, then why not?

Re: Aren't we all somewhere on the spectrum of disease?

#43

Post by newacct583 » Sun, Jul 19, 2020, 2:44 AM UTC

KerryJones wrote: post #6

It's weird that we consider mental illness to be a disease, in my opinion -- none of the drugs have been linked to physical/chemical shortages in the brain or the like. We're able to mask symptoms but have absolutely no proof about underlying reasons, and so we create names of things and put it in the same classification of a medical disease... but that's very different. Bipolar cannot be identified by any physical m…

> none of the drugs have been linked to physical/chemical shortages in the brain or the like

That's certainly not true. These things aren't understood very well, but it's not at all true that there's NO understanding of how brain chemistry and mental illness interact.

> It can seriously mess someone's life up.

In general drugs for bipolar are prescribed only once someone's life is already "messed up". You seem to be invoking something like the hippocratic oath, but please believe that's already a solid criteria in medicine. These drugs are prescribed because they are known to work (no, not always and not with any certainty, but that they work is not meaningfully disputed).

Re: Aren't we all somewhere on the spectrum of disease?

#44

Post by dwd » Sun, Jul 19, 2020, 2:45 AM UTC

zabzonk wrote: post #25

dwd wrote: post #22

Earlier quoted context omitted.

They all have two aspects, the cause and the disease it triggers. COVID-19 is the disease caused by the SARS-CoV-2 virus like AIDS is caused by HIV. It gets complicated where they don't know or understand the cause like a lot of autoimmune diseases.

> like a lot of autoimmune diseases. I worked for some years in a lab testing for auto-immune conditions - we called it that - a condition. I suppose other labs might have labelled it otherwise. Would you call cancer a disease? I wouldn't. But I suppose this is just arguing over semantics.

It is semantics but then words matter if you're the one affected - having the doctor say you have a condition would be better than having a disease.

I guess it depends on your definition of disease, which is technically broad in the literal sense of an abnormal negative medical condition. A condition in itself can be positive or negative and also has an implied connotation that it's just the current state.

Seem to be hitting that original argument about labeling things that are on a spectrum, where a condition could becalled a disease once it reaches a cetain state. Disease does imply a level of sickness and incapacitation, and maybe a permanent state?

Alternatively we could classify and reclassify disorders but the general public gets left way behind.

EDIT: There's also the notion that a disease is something you catch, which given our understanding of viruses and bacteria in triggering various diseases and conditions (and potentially some cancers) maybe excludes genetic and environmentally caused conditions?

Re: Aren't we all somewhere on the spectrum of disease?

#45

Post by maxerickson » Sun, Jul 19, 2020, 2:45 AM UTC

KerryJones wrote: post #6

It's weird that we consider mental illness to be a disease, in my opinion -- none of the drugs have been linked to physical/chemical shortages in the brain or the like. We're able to mask symptoms but have absolutely no proof about underlying reasons, and so we create names of things and put it in the same classification of a medical disease... but that's very different. Bipolar cannot be identified by any physical m…

People with dementia, which is often driven by clear physical processes (like cell death), exhibit symptoms of mental illness.

They unquestionably have a disease and often respond to drugs.

Re: Aren't we all somewhere on the spectrum of disease?

#46

Post by Talanes » Sun, Jul 19, 2020, 2:48 AM UTC

markdown wrote: post #27

TylerE wrote: post #5

Earlier quoted context omitted.

> He thought he could start an electric car company from scratch Except he didn't. He invested in one that was already started with several employees, and had himself given founder status by fiat as part of the deal.

At what point do you consider a company founded? At the moment the business is registered by the local government?

Regardless of how elastic you can get with the term "founded," the actual assertion of "founded from scratch" is much more specific.

Re: Aren't we all somewhere on the spectrum of disease?

#47

Post by treeman79 » Sun, Jul 19, 2020, 2:48 AM UTC

pdonis wrote: post #16

treeman79 wrote: post #15

Earlier quoted context omitted.

Doctors kept thinking I had a mental disorder. Several years of horrible experiences with medications were a waste Turned out it was a blood disorder. Proper treatment actually solved problems. Depression meds just meant I was cool with my mind not working right. I get some people are bipolar and such, but I think a lot of people have an underlying disorder they’re unaware of.

Part of the diagnostic process is supposed to be checking for "non-mental" things like blood disorders, by doing blood tests and other evaluations. So it sounds like you went through a flawed diagnostic process. Unfortunately that is far more common than it should be. The best way I have found to mitigate that risk is to have an advocate with you (family member or close friend) whenever you talk to doctors or other m…

That was part of if. I had to bring someone to more or less break down in tears or yell at the doctor to get them to listen.

Had several years of only basic blood work run. Check kidney function and the sort. Mri were always clean.

This was across 20+ doctors. I had one that actually guessed correctly, but wasn’t his specialty. The specialist didn’t believe me.

Later I realized the specialist was using very outdated diagnostic criteria. As it turns out this is very common.

Re: Aren't we all somewhere on the spectrum of disease?

#48

Post by Talanes » Sun, Jul 19, 2020, 2:51 AM UTC

dwd wrote: post #44

zabzonk wrote: post #25

Earlier quoted context omitted.

> like a lot of autoimmune diseases. I worked for some years in a lab testing for auto-immune conditions - we called it that - a condition. I suppose other labs might have labelled it otherwise. Would you call cancer a disease? I wouldn't. But I suppose this is just arguing over semantics.

It is semantics but then words matter if you're the one affected - having the doctor say you have a condition would be better than having a disease. I guess it depends on your definition of disease, which is technically broad in the literal sense of an abnormal negative medical condition. A condition in itself can be positive or negative and also has an implied connotation that it's just the current state. Seem to be…

I would ascribe the exact opposite feelings to the permanency of condition vs disease. Disease feels like something you get, you fight off, and you get better. A condition feels like something that you deal with and plan your life around.

Re: Aren't we all somewhere on the spectrum of disease?

#49

Post by blame_lewis » Sun, Jul 19, 2020, 2:58 AM UTC

solinent wrote: post #42

blame_lewis wrote: post #18

This is a really dangerous and misleading way to look at bipolar. The disease proper of bipolar disorder is progressive and degenerative. This progression is accompanied by structural changes in the brain [1] as well as biological changes in the body [2]. If someone had the syndromes of manic or depressed symptoms in response to a medication, that does not prove either way that the person actually has the progressive…

There are also structural changes in the brain as time passes, and hopefully biological ones as well if I'm going to digest this food I just ate. What structural changes are present and can these changes be used to diagnose the condition? Are these changes necessary for the condition? To me it looks like gray matter loss is not exclusive to this condition, these studies only quantify brain matter density, not structu…

I'm pretty sure there is more extensive literature involving the exact types of degradation that is characteristic to the disease, but I do not think I'm competent to cite it correctly.

I'd imagine this process isn't so great for diagnosis given that it's mostly been observed in people with decades of uncontrolled disease behind them.

Re: Aren't we all somewhere on the spectrum of disease?

#50

Post by dwd » Sun, Jul 19, 2020, 3:08 AM UTC

Talanes wrote: post #48

dwd wrote: post #44

Earlier quoted context omitted.

It is semantics but then words matter if you're the one affected - having the doctor say you have a condition would be better than having a disease. I guess it depends on your definition of disease, which is technically broad in the literal sense of an abnormal negative medical condition. A condition in itself can be positive or negative and also has an implied connotation that it's just the current state. Seem to be…

I would ascribe the exact opposite feelings to the permanency of condition vs disease. Disease feels like something you get, you fight off, and you get better. A condition feels like something that you deal with and plan your life around.

Yeah, your right. I added in that disease is historically thought of something that you catch (and hopefully get over). Conditions can also be categorised as chronic which would be that permanent state of you have it, deal with it.