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

Can Psychiatry Turn Itself Around?

blogs.scientificamerican.com

Post reply on HN
Print view View original

71–80 of 134 posts

Re: Can Psychiatry Turn Itself Around?

#71

Post by thanatropism »

alleychnt wrote: post #16
phren0logy wrote: post #13

Earlier quoted context omitted.

1.Psychiatrists go to medical school, just like other "doctors." 2. There is a huge evidence base for the practice of psychiatry, though it would be nice if it were adhered to more rigorously. 3. Incomplete understandings of the mechanisms of action of drugs is rife throughout medicine. For example, why does the hypertension drug HCTZ work at sub-diuretic doses? 4. If they were doing great, they probably wouldn't nee…

Show me a guy on psych meds who is doing great and I'll believe you.

(y)

I have taken a stable dose of lithium tricarbonate for many, many, many moons (my whole adult life really, 15+ years) now. I have to have quarterly blood panels to know that my actual levels haven't fluctuated, but otherwise it really fixed me up.

Re: Can Psychiatry Turn Itself Around?

#72

Post by pugz »

alleychnt wrote: post #6
marsrover wrote: post #2

The last Psychiatrist I went to prescribed me 4mg of Klonopin a day for anxiety. The one before that prescribed me 40-50mg of Adderall a day for ADHD and about 600mg of Seroquel a night for sleeping problems. Both times I decided to quit going and tapered myself off. There never really asked how I felt or seemed to care about me in any way shape or form. Just, "Here's your drugs, see you next month." I have a horribl…

Psychiatrists are a bit like chiropractors. They want to be seen as "doctors", but none of what they do has any scientific basis. Ever notice how psychiatrists just prescribe you random medications without knowing how, or even if, they work? The most damning fact is that I've never met anyone on psych meds who is doing really great.

Have we met? I'm a person who takes medication daily for the last 7 years for bipolar and it has improved my quality of life immeasurably. I have a great job, a great relationship, own a house, have a cute dog and my professional and personal relationships have never been better. I haven't seen the inside of a hospital in 7 years.

Re: Can Psychiatry Turn Itself Around?

#73

Post by derefr »

dougmccune wrote: post #12
marsrover wrote: post #2

The last Psychiatrist I went to prescribed me 4mg of Klonopin a day for anxiety. The one before that prescribed me 40-50mg of Adderall a day for ADHD and about 600mg of Seroquel a night for sleeping problems. Both times I decided to quit going and tapered myself off. There never really asked how I felt or seemed to care about me in any way shape or form. Just, "Here's your drugs, see you next month." I have a horribl…

I'm married to a psychologist specializing in evidence-based cognitive behavioral therapy for treating anxiety and insomnia. There are ways to deal with these problems without medication. And these methods are backed up by peer reviewed studies to prove they work. If you do end up needing help in the future I'd recommend reading up on CBT.

What does your spouse think of this paper? http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(...

Re: Can Psychiatry Turn Itself Around?

#74

Post by derefr »

alleychnt wrote: post #42
warfangle wrote: post #26

Earlier quoted context omitted.

o/ heya. I've been on psychiatrist-prescribed meds for a little over two years now. I've gotten a better job, my salary has increased by 52%, I live with less stress, I have a (mostly) tidy home, I am no longer dependent on alcohol, I care for a wonderful dog, I am cultivating healthy relationships and friendships, and I am more involved in my community. I've also been seeing a cognitive-behavioral therapist for abou…

and as soon as you go off the meds?

"You're nearsighted. You need glasses."

"But as soon as I take off the glasses...?"

Re: Can Psychiatry Turn Itself Around?

#75

Post by dredmorbius »

phren0logy wrote: post #21

I'm a psychiatrist. It is always amazing to me that despite four years of medical school, six years of residency and fellowships, and four board certifications, the assumption is that I have no idea what I'm talking about and have evil motives. There are fair criticisms of psychiatry, there are bad psychiatrists, but mostly there are crappy generalizations. Good psychiatrists have an understanding of what medications…

Meta-comment only: interesting handle, in context of your comments.

Re: Can Psychiatry Turn Itself Around?

#76

Post by derefr »

Diederich wrote: post #37
alleychnt wrote: post #16

Earlier quoted context omitted.

Show me a guy on psych meds who is doing great and I'll believe you.

I don't understand the hostility here. There are plenty of people who are doing very well on psych meds. The field is probably a bit too 'medication' heavy, I'll grant you that, but perfect is, as they said, is the enemy of the good.

The important thing about a lot of psychiatric ailments is that people have effectively lost some mental resource that they require to "bootstrap their way" out of the problem. Like, depressed people are usually too depressed to manage to make it to their therapy appointments (which they agree help with their depression, but only if they go...) So just prescribing talk therapy won't do anything; the person can't manage to "take that medicine" correctly.

Psychiatric drugs are great in the same way crutches are great: they let you "take the weight off" the problem, so you can work on the other parts of it. SSRIs let depressed people make it to their CBT therapy appointments. ADHD medications let unmotivated people get a job doing something they're passionate about. Anxiolytics let people make friends to attend social gatherings with. Etc.

Re: Can Psychiatry Turn Itself Around?

#77

Post by derefr »

fuzionhk wrote: post #4

Most drugs on the market today have side effects that are serious to most people. Also the fact is that now a days it seems that almost all kid have "ADHD" or "ADD" and are getting put on stimulants for it. I don't get it at all. I was put on antidepressants when I was young and it really could have fucked me up if my parents kept listening to my doctor.

ADHD is overdiagnosed and under diagnosed. (It's just badly diagnosed, really.)

On the one hand, parents get their kids prescribed stimulants (which necessarily entails a—usually fake—ADD diagnosis) for the same reason university students go pick up illicit stimulants: they think it'll "make" them study. That is not the problem that ADHD causes, nor is that the benefit stimulants provide, but it's what parents think.

On the other hand, many people only discover as adults that they've had ADHD their entire lives, and have suffered unnecessarily through 3+ decades of being unable to motivate themselves to do homework/projects before they're overdue, or practice anything, or focus on reading rather than (badly) multitasking five different things, or put themselves to bed before 4AM, or even remember half the things they need to bring with them when they leave the house.

Re: Can Psychiatry Turn Itself Around?

#78

Post by codefolder »

bitL wrote: post #66
phren0logy wrote: post #21

I'm a psychiatrist. It is always amazing to me that despite four years of medical school, six years of residency and fellowships, and four board certifications, the assumption is that I have no idea what I'm talking about and have evil motives. There are fair criticisms of psychiatry, there are bad psychiatrists, but mostly there are crappy generalizations. Good psychiatrists have an understanding of what medications…

Some of it might come from creepy movies or sad history of psychiatric institutions, which is unfortunate. However, recently there was an unexpected result regarding schizophrenia suggesting it might be just a result of a genetic bug of extensive deletion of redundant neurons in the brain, a bio-computational problem when you look at it with the eyes of a hacker. If confirmed, this would invalidate a lot of previous…

Do you have a reference? I didn't hear about this

Re: Can Psychiatry Turn Itself Around?

#79

Post by selimthegrim »

serge2k wrote: post #24
Pica_soO wrote: post #17

The basic lie that psychiatry is based upon, is that there is a sickness where there is suffering. Not neural phenotype, that yes can suffer, but have been useful for various enterprises and endeavor of humans kind. Manic-Depressive where our "suicidal" explorers, alcoholics stopped us from being nomadic, gays pressured into churches formed the first institutions and created contract security. The list continues near…

I honestly have no idea what you are talking about here.

He's riffing on pop psych theories about the "warrior gene" and suchlike. I'm pretty sure there were institutions predating Holy Mother Church.

Re: Can Psychiatry Turn Itself Around?

#80

Post by mattnewport »

phren0logy wrote: post #21

I'm a psychiatrist. It is always amazing to me that despite four years of medical school, six years of residency and fellowships, and four board certifications, the assumption is that I have no idea what I'm talking about and have evil motives. There are fair criticisms of psychiatry, there are bad psychiatrists, but mostly there are crappy generalizations. Good psychiatrists have an understanding of what medications…

I'm curious what you make of the claims Robert Whitaker makes in "Anatomy of an Epidemic" and elsewhere? Psychiatry comes off looking quite bad in his analysis and he is far from the only critic of the profession. My attempts to find convincing rebuttals of his claims from Psychiatrists have so far drawn a blank.

In a nutshell for those not familiar with the book, he presents convincing evidence that most psychiatric medicines have no significant short term benefits over active placebos and in fact worsen long term outcomes and that the profession has been complicit in presenting unsupported hypotheses about chemical imbalances in the brain causing conditions such as depression as established fact and in pushing drugs as the primary means of treatment without sufficient evidence of their efficacy and largely ignoring worrying evidence of long term harm.

I'll admit to having a pre existing suspicion of psychiatry stemming from taking a degree in psychology in the UK but after reading this book and digging more deeply I have to say it looks far worse for psychiatry than I previously imagined.

Post reply on HN