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posted by CoolHand on Friday April 24 2015, @03:11AM   Printer-friendly
from the the-big-corps-would-never-lie dept.

The British Medical Journal provides an editorial from Professor David Healy, Head of Psychiatry at the Hergest psychiatry unit in Bangor in which it is stated:

When concerns emerged about tranquilliser dependence in the early 1980s, an attempt was made to supplant benzodiazepines with a serotonergic drug, buspirone, marketed as a non-dependence producing anxiolytic. This flopped. The lessons seemed to be that patients expected tranquillisers to have an immediate effect and doctors expected them to produce dependence. It was not possible to detoxify the tranquilliser brand.

Instead, drug companies marketed SSRIs for depression, even though they were weaker than older tricyclic antidepressants, and sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety. The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance. The tricyclics did not have a comparable narrative.

Serotonin myth

In the 1990s, no academic could sell a message about lowered serotonin. There was no correlation between serotonin reuptake inhibiting potency and antidepressant efficacy. No one knew if SSRIs raised or lowered serotonin levels; they still don’t know. There was no evidence that treatment corrected anything.

[More...]

This lack of evidence-based practice was apparent to Thomas Insel, Director of the US National Institute Of Mental Health who announced in 2013 that the institute would abandon funding towards the DSM:

While DSM has been described as a "Bible" for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been "reliability" - each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.

In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.

Does this mean that psychiatry is finally moving away from a practice akin to leeches for everything?

Related Stories

Groundbreaking Ketamine-Derived Treatment for Depression Approved by the U.S. FDA 24 comments

Fast-Acting Depression Drug, Newly Approved, Could Help Millions

Of the 16 million American adults who live with depression, as many as one-quarter gain little or no benefit from available treatments, whether drugs or talk therapy. They represent perhaps the greatest unmet need in psychiatry. On Tuesday, the Food and Drug Administration approved a prescription treatment intended to help them, a fast-acting drug derived from an old and widely used anesthetic, ketamine.

The move heralds a shift from the Prozac era of antidepressant drugs. The newly approved treatment, called esketamine, is a nasal spray developed by Janssen Pharmaceuticals Inc., a branch of Johnson & Johnson, that will be marketed under the name Spravato. It contains an active portion of the ketamine molecule, whose antidepressant properties are not well understood yet. "Thank goodness we now have something with a different mechanism of action than previous antidepressants," said Dr. Erick Turner, a former F.D.A. reviewer and an associate professor of psychiatry at Oregon Health & Science University. "But I'm skeptical of the hype, because in this world it's like Lucy holding the football for Charlie Brown: Each time we get our hopes up, the football gets pulled away."

[...] Esketamine, like ketamine, has the potential for abuse, and both drugs can induce psychotic episodes in people who are at high risk for them. The safety monitoring will require doctors to find space for treated patients, which could present a logistical challenge, some psychiatrists said.

The wholesale cost for a course of treatment will be between $2,360 and $3,540, said Janssen, and experts said it will give the company a foothold in the $12 billion global antidepressant market, where most drugs now are generic.

[...] One question that will need to be answered is how well esketamine performs in comparison to intravenous ketamine.

Also at STAT News, Reuters, and NPR.

Previously: Ketamine Reduces Suicidal Thoughts in Depressed Patients
Studies Identify How Ketamine Can Reverse Symptoms of Depression
Ketamine Shows Promise as a Fast-Acting Treatment for Depression

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  • (Score: 0) by Anonymous Coward on Friday April 24 2015, @03:32AM

    by Anonymous Coward on Friday April 24 2015, @03:32AM (#174519)

    I'm told that DSM-6 is going to use brain layout maps to help doctors diagnose and treat mental illnesses.

    • (Score: 5, Informative) by kaszz on Friday April 24 2015, @04:08AM

      by kaszz (4211) on Friday April 24 2015, @04:08AM (#174537) Journal

      I thought it was a map of which pharmaceutical that sponsored what cure. Only diseases that have a clear profit line can be diagnosed, and in any other case we invent one! :D

      For the rest one must just ensure a steady streamlined source of funding that provides the symptoms for more funding.

      • (Score: 0) by Anonymous Coward on Friday April 24 2015, @01:54PM

        by Anonymous Coward on Friday April 24 2015, @01:54PM (#174650)

        Oh, so they are going back to the roots of Phrenology? I am not sure if brain maps are going to help anyone but the makers of maps and the people who navigate them for you.

        • (Score: 2) by kaszz on Saturday April 25 2015, @12:50AM

          by kaszz (4211) on Saturday April 25 2015, @12:50AM (#174905) Journal

          It can map what medicines that are based on actual needs and the ones based on someone elses profit.

  • (Score: 5, Interesting) by frojack on Friday April 24 2015, @03:38AM

    by frojack (1554) Subscriber Badge on Friday April 24 2015, @03:38AM (#174523) Journal

    As long as I have been aware of it the DSM has had major problems in classifications.
    I first ran into it while working on a mental health system for a state government, and even the clinicians hated the DSM because of the ambiguity and redundancy of the coding. Some viewed it as total bull, and openly said so. (Most just looked at it as something they had to do to get paid).

    I think the DSMs, at least since DSM III, have done a lot to discredit Psychiatry, while appearing to prop it up. The field now ranks right up there with Homeopathy in the eyes of a lot of people.
    The difference being most Psychiatrists is (in the US at least) a physician, who should have some medical knowledge to fall back on. Homeopaths might end up tending their herb gardens when people start seeing through the quackery.

         

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    • (Score: 1, Flamebait) by tathra on Friday April 24 2015, @04:05AM

      by tathra (3367) on Friday April 24 2015, @04:05AM (#174535)

      I think the DSMs, at least since DSM III, have done a lot to discredit Psychiatry, while appearing to prop it up. The field now ranks right up there with Homeopathy in the eyes of a lot of people.

      it needs to be discredited. psychiatry is a load of bullshit spewed from a coked-up nutjob with an oedipus complex. none of it ever had any scientific backing or supporting evidence, and now that we're getting evidence, its showing that its always been bullshit. i say good riddance.

      • (Score: 2) by aristarchus on Friday April 24 2015, @07:03AM

        by aristarchus (2645) on Friday April 24 2015, @07:03AM (#174563) Journal

        it needs to be discredited. psychiatry is a load of bullshit spewed from a coked-up nutjob with an oedipus complex. none of it ever had any scientific backing or supporting evidence, and now that we're getting evidence, its showing that its always been bullshit. i say good riddance.

        Well, at least we know what username Tom Cruise is using on Soylent News. Or is Tom smart enough to be the rant prior, and draw attention from himself? Frojack!!!!

        • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @07:24PM

          by Anonymous Coward on Saturday April 25 2015, @07:24PM (#175134)

          Stop the habit of accusing random people of made up bullshit.

          • (Score: 2) by aristarchus on Saturday April 25 2015, @07:46PM

            by aristarchus (2645) on Saturday April 25 2015, @07:46PM (#175142) Journal

            Stop the habit of accusing random people of made up bullshit.

            I know, crazy, isn't it? I wonder what they call it in the DSM? But to your complaint:

            Not a habit. Only as needed when it is definitely needed. Perfectly deliberate and intentional, and I can stop whenever I want.

            accusing random people

            They are not random people, they are Tom Cruise! You know, public persons of whom criticism is perfectly reasonable. And people who seems to be saying exactly the same things as these celebrities, but cannot jump on a couch but cause this is Soylent, not Oprah. But it is the fact that they bullshit that brings the accusation, so it is not random at all.

            Stop the habit of accusing random people of made up bullshit.

            Now here is where there is a problem. Are you suggesting the we not challenge "made up bullshit" on SN? Or are you suggesting I am in error and the bullshit in this instance is not made up, but it would be alright to call it in cases where it were? Or are you possibly suggesting, at the far reaches of intelligible rationality, that this incoherent attack on psychiatry is somehow not bullshit? Sorry, can't follow you there, that's just crazy talk.

            • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @08:40PM

              by Anonymous Coward on Saturday April 25 2015, @08:40PM (#175161)

              Your post shows you can't even if you wanted to and you'll say it's because you never want to.

            • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @08:52PM

              by Anonymous Coward on Saturday April 25 2015, @08:52PM (#175163)

              Crazy people do not understand what crazy is. You are just as crazy in the future when I meet you in the jail where we will be wearing blue ponchos with white butterfly emblems. I'm not looking forward to finding out why they reanimated you but they only did it once.

            • (Score: 2) by tathra on Sunday April 26 2015, @02:21PM

              by tathra (3367) on Sunday April 26 2015, @02:21PM (#175345)

              Or are you possibly suggesting, at the far reaches of intelligible rationality, that this incoherent attack on psychiatry is somehow not bullshit?

              are you suggesting that Sigmund Freud wasn't a coked-up nutjob, that he wasn't obsessed with fucking his mother and didn't project that on to everyone else, or that he didn't influence modern psychiatry more than anyone else?

    • (Score: 2) by kaszz on Friday April 24 2015, @04:10AM

      by kaszz (4211) on Friday April 24 2015, @04:10AM (#174539) Journal

      Use ICD? better, not good?

    • (Score: 0) by Anonymous Coward on Friday April 24 2015, @04:38AM

      by Anonymous Coward on Friday April 24 2015, @04:38AM (#174546)

      That's because DSM is a shopping catalog for drug company, that's why.

    • (Score: 2, Insightful) by OrugTor on Friday April 24 2015, @05:01PM

      by OrugTor (5147) Subscriber Badge on Friday April 24 2015, @05:01PM (#174731)

      YES. Psychiatry is almost entirely empirical. There are no substantive models that explain the hardware/software complex that is the human brain. Don't knock DSM; of course it's just a dictionary, that's how clinicians can at least use the same diagnosis for the same cluster of symptoms. If ever psychiatry becomes a science then DSM will have to shape up.
      On a side note (mark me troll) I have no use for a DSM that has no code for religious belief.

      • (Score: 1, Insightful) by Anonymous Coward on Saturday April 25 2015, @07:14PM

        by Anonymous Coward on Saturday April 25 2015, @07:14PM (#175129)

        You must have meant to say “not empirical” since empiricism [wikipedia.org] is based on experience, revision, and falsification.

  • (Score: 3, Informative) by Anonymous Coward on Friday April 24 2015, @03:40AM

    by Anonymous Coward on Friday April 24 2015, @03:40AM (#174526)

    Having tried multiple medications for my issues, it often seems like the doctors are just making educated guesses.

    My own experiences with SSRIs was moderately successful in lowering anxiety, but at the same time causing sexual dysfunction.
    Wellbutrin made my depression worse, to the point of suicide planning, and made me a nasty angry drunk when I drank.
    Benzos have their own problems, especially if you drink alcohol on them you'll end up regretting it.

    • (Score: 3, Insightful) by Anonymous Coward on Friday April 24 2015, @04:03AM

      by Anonymous Coward on Friday April 24 2015, @04:03AM (#174534)

      I took SSRIs for a few years (don't remember which ones since it was several years ago) and they didn't seem to do anything. I did have several months of withdrawal when I stopped taking them. Random twitching and electric shock sensations. It was more annoying than anything else.

      Benzos are super-duper effective at treating short term anxiety, the trouble is when they are used long term. I've read that if you get addicted to them the withdrawals are worse than heroin. You can even have seizures.

      I'm pretty skeptical about any medication my doctor want's to prescribe me now. I do research on any pill I take. I think more people should take the "trust, but verify" approach when it comes to medical advice/care. I'm not saying that doctors don't have your best interests at heart (generally), but only you can really tell how a medication is making you feel, or if the side effects might be intolerable to you.

    • (Score: 5, Interesting) by gallondr00nk on Friday April 24 2015, @11:15AM

      by gallondr00nk (392) on Friday April 24 2015, @11:15AM (#174599)

      The problem is that (as another commenter below noted) is that they can be helpful. People are different, and clinical psychiatry is well behind the curve on that realisation.

      My experiences are roughly parallel to yours. I've been on and off Citalopram of varying doses, and stopped a year back when I realised that there really was no sweet spot where my symptoms diminished but without unpleasant side effects.

      Even on small doses I found myself robotised - not giving a shit about anything, staring out the window, waiting to (and wanting to) die. There were times when that was actually preferable to what I was suffering from, and that's when I'd take them.

      I'd go and say that the majority of people suffer from depression and anxiety because their lives are genuinely depressing and insecure. Yet our socio-economic system always pins blame for suffering on the individual - it's your fault you're unhappy and anxious. That we prescribe tablets that "cure" our unhappiness underpins that assumption.

      We could probably dispense with billions upon billions of expenditure if we just sat people down and worked out what made them happy, before assisting them in realising that vision. But that wouldn't fit into our industrial age labor force models.

      Isn't it something like 1/4 adults are on some sort of anti-depressant? There's no bigger indictment of the system than that.

    • (Score: 3, Informative) by Reziac on Saturday April 25 2015, @03:17AM

      by Reziac (2489) on Saturday April 25 2015, @03:17AM (#174943) Homepage

      With depression, ALWAYS check thyroid function first. Marginal or low thyroid is probably the single most significant cause of depression, yet the least considered. It causes poor glucose transport which means your brain doesn't get enough energy and consequently just doesn't work right. Incidentally, lithium is known to eventually damage thyroid function.

      And don't just test TSH, which by itself can only tell you someone is sick; it *cannot* tell you if they are well. There is some factor we're not yet considering, since there is a long history of subclinical and "sublaboratory" (untestable) symptomatic hypothyroidism not generally recognised and seldom treated (at least, not since the TSH test put a halt to symptom-driven treatment), yet most of these cases resolve when treated AS hypothyroid, usually but not always requiring natural desiccated thyroid rather than synthetic.

      http://www.altmedrev.com/publications/9/2/157.pdf [altmedrev.com]

      http://hormonerestoration.com/files/TSHWrongtree.pdf [hormonerestoration.com]

    • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @04:43AM

      by Anonymous Coward on Saturday April 25 2015, @04:43AM (#174971)

      > Having tried multiple medications for my issues, it often seems like the doctors are just making educated guesses.
      > My own experiences with SSRIs was moderately successful in lowering anxiety, but at the same time causing sexual dysfunction.
      > Wellbutrin made my depression worse, to the point of suicide planning, and made me a nasty angry drunk when I drank.
      > Benzos have their own problems, especially if you drink alcohol on them you'll end up regretting it.

      I have had close to 50 years of experience with anxiety and panic disorder, beginning with the onset of puberty. Over the years, I have tried every medication available to treat an "anxiety/depression" disorder. I was not always depressed, but I was (am still am) anxious with accompanying spontaneous panic attacks. I have tried tricyclyics, MAOIs (dangerous stuff, almost died twice), SSRIs, a handful of others, all under the care of a couple of psychopharmacologists. Over the years the only thing that has provided any real relief for the anxiety are the benzos. Diazopam (Valium), to be specific. Alprazolam (Zanax) is a shorter acting benzo, and, while great for a quick response to a panic attack, does not provide the longer term effectiveness of diazopam for relief of anxiety symptoms. There have been times in my life when I have been able to go for a few years without taking anything, and times when the problem was so severe that I was unable to work. In all cases, none of the "antidepressents" or other anti-anxiety drugs (Wellbutrin, Buspar, etc.) provided nothing but the side effects, no relief for the anxiety.

      The benzos get a bad rap due to misuse by the general public; they are a "recreational" drug for a lot of folks (especially a handful of Xanax chased by liquor) and, because of that, the are not prescribed very frequently any more. Fortunately, I have an enlightened physician who trusts me not to abuse the drug, and I have never had an addiction problem with benzos. That generally only happens with abusers. For the last year I have been doing some "old school" treatment to address the anxiety/panic issues without assuming there was an underlying depression (I did say that my physician was enlightened) - I am taking 500mg of Depakote and 5-10mg of diazopam daily and, while I was skeptical at first, I'm not the zombie I thought I would be and I have not had any spontaneous panic attacks since starting this combination.

      BTW, even taking this cocktail, I find a couple of glasses of wine to be no more troublesome than a year ago, when I was taking nothing at all (a "good patch" - very few spontaneous attacks). Now, if you're taking 10-20mg of diazopam for yuks and drinking a bottle of wine, you're gonna have problems. And, if you are taking the prescribed dosage and have a bad alcohol reaction, you have to figure out which is more important to you in your life. I've had friends who chose to go with alcohol as a way of "self-medicating" - not really a god choice, but I understand it. It's a frustrating issue, and not well understood or treated by the medical community.

  • (Score: 3, Interesting) by MadTinfoilHatter on Friday April 24 2015, @03:47AM

    by MadTinfoilHatter (4635) on Friday April 24 2015, @03:47AM (#174530)

    Does this mean that psychiatry is finally moving away from a practice akin to leeches for everything?

    No. The problem is more fundamental than that. The root cause is that psychiatry as a whole is unwilling to see man as anything more than a biological machine. This reductionism will of course allow them to look for "chemical" problems, and thus chemical (easy to administer) cures, but it will also place the in the same situation that the guy in the joke, who dropped his keys in the alley but searched for them under the streetlight, because it was easier to search there, was in.

    Until people in this field are willing to humble themselves and study some philosophy of mind, they will keep producing one "leech" cure after another.

    • (Score: 4, Insightful) by Sir Finkus on Friday April 24 2015, @04:07AM

      by Sir Finkus (192) on Friday April 24 2015, @04:07AM (#174536) Journal

      No. The problem is more fundamental than that. The root cause is that psychiatry as a whole is unwilling to see man as anything more than a biological machine.

      Is there any evidence that we are not?

      I don't see how we solve the problem by discarding science altogether.

      • (Score: 3, Interesting) by HiThere on Friday April 24 2015, @05:49PM

        by HiThere (866) on Friday April 24 2015, @05:49PM (#174758) Journal

        Whether it's reasonable to see a human as a machine depends on how you think of machine. As a programmer, I find it a good model, but then my model of what a machine is is a lot more detailed and complex (and less "mechanical") than that of most people. Perhaps as cars become more autonomous more people will understand that model "correctly" enough that it won't be a problem. Currently people seem to have a model of "machine" that is more deterministic than a Pachinko machine.

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      • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @03:28AM

        by Anonymous Coward on Saturday April 25 2015, @03:28AM (#174945)
        Who's saying to discard science altogether?

        A computer is merely a machine, but if Microsoft Exchange isn't running properly it's usually not helpful to fix it by looking at the problem from a Computer Engineering point of view or even an Electronic Engineering or pure Math point of view.

        I doubt with our current technology and scientific knowledge we are able to even 99.99% simulate a single cell difflugia or a white blood cell. They may just be machines, but how much do we really know and understand about how they work that we can say we can build an _equivalent_ thing (in a simulator or for real) instead of merely creating a simplified model of one. You can make a simplified model of Stephen Hawking that appears 99.99% accurate for most scenarios (like his daily movements) but it's 0% accurate for some important scenarios ;).
    • (Score: 5, Informative) by Hartree on Friday April 24 2015, @04:21AM

      by Hartree (195) on Friday April 24 2015, @04:21AM (#174543)

      "study some philosophy of mind"

      Humanity has been studying that diligently for millennia. From the Buddhists to the Greeks to Wittgenstein. And for all of the attempts to "show us the way out of the bottle" it hasn't come up with effective treatments for the misery caused by neurosis and psychosis let alone an understanding of who and what we really are.

      Oh, I greatly value the insights of philosophy and it's application to the mind. But I also recognize its limitations. And for all of your laughing at reductionism as looking under the streetlight, tell me about the noodling around of philosophy. Hasn't it too been pursuing mind by just thinking about it because that's its own streetlight?

      The ability to do real neuroscience to the chemical level is quite recent. I don't know how much it will tell us, but at least it's trying a different tack than centuries of philosophy.

      • (Score: 1, Interesting) by Anonymous Coward on Friday April 24 2015, @04:55AM

        by Anonymous Coward on Friday April 24 2015, @04:55AM (#174549)

        it hasn't come up with effective treatments for the misery caused by neurosis and psychosis let alone an understanding of who and what we really are.

        All of those are not true. The problem is the answers are difficult to understand without years of study. That is one of the issues that has been worked on over the last hundred years. Language expresses ideas poorly. If we could express ideas directly then it would be easy to simply put them out there, but unfortunately we cant. Thus anything that is against our nature (like knowing our nature/the nature of existence*), or recovering from the tangled paradoxes of various mental issues takes massive amounts of work by the individual themselves at a time when they are least able to do the work.

        *a tip: if you don't want to feel the deeper depths of depression, don't go looking for this, especially if you are particularly rational. You will find it and not like it, just as so many before have done.

        • (Score: 3, Insightful) by Hartree on Friday April 24 2015, @01:34PM

          by Hartree (195) on Friday April 24 2015, @01:34PM (#174633)

          So, there is this knowledge that you can't communicate to anyone effectively without years of study. Yet, it solves the problem of neurosis and psychosis as well as explaining the deeper recesses of the mind. And you've not found a way to apply it to the masses or apply it in your own life such that you are demonstrably at an advantage? Yes, being free of neurosis alone would be a huge advantage for a group of people who had found it. One would expect that this would be noticeable in at least some way if a group or person really had that.

          Forgive me, but Scientology makes the same claim to esoteric secret knowledge being the key to everything from self knowledge and rationality to the success of Travolta and Cruz and I'm not convinced.

          • (Score: 1, Interesting) by Anonymous Coward on Friday April 24 2015, @02:24PM

            by Anonymous Coward on Friday April 24 2015, @02:24PM (#174662)

            How would I communicate knowledge of all of mathematics in a forum post in a way that is meaningful to you and immediately understandable? Yet that knowledge exists and has efficacy.

            If you choose to look at people with PhD level knowledge in philosophy, or for that matter devout and experienced Taoists (they come to the same conclusions about the issues we are discussing) you will see that they do in fact have demonstrable advantages in the area that we are discussing.

            As for the silly false comparison to a cult, isn't that what science and every other form of knowledge does too? I am not trying to prove anything, merely inform that something exists knowing that I could never fully convey it to you. As to where to start, you already know, but have not spent enough time on it yet. Sort of the way that someone who has taken an undergraduate physics course or two is not convinced that we know enough to predict complex systems.

            • (Score: 2) by Hartree on Friday April 24 2015, @05:06PM

              by Hartree (195) on Friday April 24 2015, @05:06PM (#174735)

              Well, I'm sure you have found things that you feel are useful and explain a lot. And, they may even do so for you. But, there's little way to distinguish your position from that of many who have said they've found great answers that they can't really communicate. There have been many through the ages. There are many now.

              I can only speak for myself and say that despite a certain amount of study of the problem of mind, I am profoundly ignorant on it. And, I'm sure the psychologists, cognitive scientists and neuro-chemists I work with on a daily basis in my job (I work at a university that has a very large emphasis on understanding intelligence.) would say they were profoundly ignorant on the subject. Oh, they know a lot of things, but certainly not something so simple as how we can form a percept of, say, the color red, whether that percept is the same for all, or even to say just what this consciousness that seems to allow us to be aware of it really is. I suspect I'd mostly get the same answer in the philosophy department.

              So, good luck with that.

              • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @02:05AM

                by Anonymous Coward on Saturday April 25 2015, @02:05AM (#174919)

                It sounds like you are intentionally, or entirely not aware, of the question you are seeking answers to. When presented with help, you go on the attack and change focus to something else. If you carefully defined your question, perhaps you will find an answer.

                • (Score: 2) by Hartree on Saturday April 25 2015, @03:45AM

                  by Hartree (195) on Saturday April 25 2015, @03:45AM (#174954)

                  I'll go with entirely not aware, since I've found that assuming I am ignorant of things is more likely to be right than not.

                  Since I'm not sure, what question am I seeking answers to, or what question should I be seeking answers to?

        • (Score: 2) by HiThere on Friday April 24 2015, @06:01PM

          by HiThere (866) on Friday April 24 2015, @06:01PM (#174765) Journal

          If you are sure you really understand how the mind works, build a model. That will enable you to demonstrate that you are correct. Fortunately computers are flexible enough to implement ANY sufficiently detailed model of a mental process, though they may well run at a lot less than real time.

          FWIW, I'm still working on the problem of understanding language from written text. It may not be soluble without including detailed sensory emulations of the things being referred to, or pieces of them. (I've never seen a unicorn, but imagining one is no problem, so compositions from basic images are a reasonable inclusion, and may well be necessary.)
          P.S.: By understanding language I don't mean understanding the meaning of language. That's a much more difficult problem that includes understanding language as a subset. I mean merely the ability to segregate strings of text into "language" and "not-language". With corner cases like the famous "The Gostak distims the Doshes."), which starts off as a title and turns into legitimate language, though not understood language, by the end of the short story. http://en.wikipedia.org/wiki/Gostak [wikipedia.org]

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          • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @02:13AM

            by Anonymous Coward on Saturday April 25 2015, @02:13AM (#174924)

            A little extra worth looking into is the idea that you can't ever understand the language someone communicates until you know the matrix of assumed knowledge necessary on the part of the communicator in using that language.

            Part of the fun in philosophy is that it reads like really drawn out code. First the dependencies are discussed, then the variables are defined in the form of common language words that are given a very specific meaning, after that the formal logic structure is designed and defined, finally culminating with quality control work through heading off disputes and applications discussions.

      • (Score: 2) by Hairyfeet on Friday April 24 2015, @04:12PM

        by Hairyfeet (75) <bassbeast1968NO@SPAMgmail.com> on Friday April 24 2015, @04:12PM (#174703) Journal

        Not to mention the ancients used drugs to treat mental illness back then too. Look up the Roman health spas, which were often prescribed for those suffering from various mental maladies....the springs where they came from? Heavy in lithium salts.

        The fact is we are still in the dark ages when it comes to understanding how the hardware that is our brain works and it could be decades or even centuries before we get it all figured out. At this point in time its really more of a "lets see what this does" kind of approach and there is gonna be a lot of people that end up with outcomes worse than the disease, just as we messed up a lot of people learning blood types and transplants. Just as we look back on medical books from the 1950s and are horrified by some of the things they did then (such as giving cancer patients such high doses of radiation that some had to be buried in lead lined caskets) I'm sure that 50 years from now people will look back on the treatments for mental illness and go "OMG I can't believe they did that!".

        --
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        • (Score: 2) by Jeremiah Cornelius on Friday April 24 2015, @04:42PM

          by Jeremiah Cornelius (2785) on Friday April 24 2015, @04:42PM (#174720) Journal

          Our bodies are host to a continuum of neurons extending throughout - internal and externally facing. The whole of our neurological being is largely discounted in the "brain science" electro-chemical theorizing. Much of what makes us "me" or "you" as distinct identities and dispositions lies outside our cranium. A large part of our psychological disposition and unconscious or reflexive behavior emerges systemically - or appears as a failure of our rational governing consciousness when responding to conditions from elsewhere in our wiring harness.

          You want someone unreasonably grouchy and belligerent out of any cause or reason? Give him the wrong chronic signaling on the vagus nerve...

          --
          You're betting on the pantomime horse...
          • (Score: 2) by Hartree on Friday April 24 2015, @05:16PM

            by Hartree (195) on Friday April 24 2015, @05:16PM (#174741)

            That's a straw man argument, JC. It's well known in medicine and cognitive science that there are major changes in personality in cases of full and partial paralysis (for just one example).

            Just what is necessary and sufficient for our minds is not clear. It's generally believed that much of it is indeed in the brain, but to put out the picture that cognitive scientists all assume and generally accept that a disconnected brain in a vat would have the same psychology as anyone else is going waaaay out there just to further your argument.

            Besides. I think of myself more as an ice cream sandwich than a popsicle on a stick. ;)

            • (Score: 2) by Jeremiah Cornelius on Friday April 24 2015, @08:05PM

              by Jeremiah Cornelius (2785) on Friday April 24 2015, @08:05PM (#174825) Journal

              There is a popular branch of "brain science research" that attributes everything to brain activity in loci and regions...

              --
              You're betting on the pantomime horse...
        • (Score: 2) by Hartree on Friday April 24 2015, @05:24PM

          by Hartree (195) on Friday April 24 2015, @05:24PM (#174745)

          Oh, I'd say it's even worse than that. I suspect we haven't even scratched the surface in some areas of science. Examples are: Physics where our best theories don't seem to say anything about 95% of the universe. Another is psychology and the understanding of consciousness where we can't even define what it really is we're studying.

          I suspect that in both cases there is a vast dark ocean underneath the bit of foam on top that we can currently see.

          • (Score: 2) by Hairyfeet on Friday April 24 2015, @08:06PM

            by Hairyfeet (75) <bassbeast1968NO@SPAMgmail.com> on Friday April 24 2015, @08:06PM (#174826) Journal

            Well with physics its because...well we're blind as bats really, the things we could detect with traditional tools like telescopes was such a teeny tiny fraction of what is actually there it was like the parable of the blind men and the elephant. We are just now learning that on the very large and the very tiny, such as how stars warp spacetime with their gravity or quantum entanglement, the old rules really don't behave as we thought they did. There could easily be something similar with the brain, our understanding of how various chemicals interact with and against the composition of the brain could be likened to how much we have to learn on physics but I personally think that we are MUCH farther behind on that front.

            --
            ACs are never seen so don't bother. Always ready to show SJWs for the racists they are.
      • (Score: 3, Interesting) by Yog-Yogguth on Saturday April 25 2015, @07:45PM

        by Yog-Yogguth (1862) Subscriber Badge on Saturday April 25 2015, @07:45PM (#175140) Journal

        What? Aren't you forgetting a lot of things? The ability to do neurology is directly linked to philosophy.

        Philosophy invented science! [wikipedia.org]

        We're back to a new dark age if people haven't understood the reasons or heard the explanations of how we escaped the last one.

        --
        Bite harder Ouroboros, bite! tails.boum.org/ linux USB CD secure desktop IRC *crypt tor (not endorsements (XKeyScore))
        • (Score: 2) by Hartree on Monday April 27 2015, @12:54PM

          by Hartree (195) on Monday April 27 2015, @12:54PM (#175678)

          Not at all.

          Philosophy is not only the precursor of science but is a valuable field in itself. I was objecting to the OP saying that "reductionism" (assuming that's just not code for whatever the OP doesn't like) was standing in the way of our understanding the problem of mind.

          Though how our mental life arises (regardless of what is at it's base) is full of emergent behavior at multiple levels, reductionism is still a useful tool for gaining more information. It doesn't give you all of the answers, but then again staring naively at the whole doesn't either. It's such a hard problem that many different fields and viewpoints have to be involved in understanding the problem of mind.

          • (Score: 2) by Yog-Yogguth on Tuesday April 28 2015, @04:50AM

            by Yog-Yogguth (1862) Subscriber Badge on Tuesday April 28 2015, @04:50AM (#175963) Journal

            Sorry I misunderstood you, in addition I have to agree with both of you about reductionism/determinism¹ depending on the specific case (…and a million disagreements bloomed haha :D). It is incredibly easy to ignore that which doesn't give an easy answer or doesn't fit in immediately/intuitively, humans are biased by nature to prefer any easily recognizable pattern over any complicated pattern even if the easy pattern is misleading, wrong, or circumstantial (and the more complicated something is the longer it usually takes to realize). But it can also be very useful and has been very (perhaps even wildly) successful in many sciences which is why this became a problem in the first place as people tried hard to apply it to everything almost no matter what.

            ¹ Determinism is usually the culprit when something has been reduced beyond the meaningful. It easily becomes a game of random chance/luck if one puts far too much value into determinism on levels and/or numbers of steps/iterations far removed from the end result being studied: for each additional level/iteration of determinism the complexity must increase by at least a factor of two if not far more and with a potentially equal decrease in explanatory or predictive power (ouch & thanks: you've reminded me about something I meant to get done long ago).

            --
            Bite harder Ouroboros, bite! tails.boum.org/ linux USB CD secure desktop IRC *crypt tor (not endorsements (XKeyScore))
    • (Score: 1, Insightful) by Anonymous Coward on Friday April 24 2015, @05:44AM

      by Anonymous Coward on Friday April 24 2015, @05:44AM (#174555)

      >>The root cause is that psychiatry as a whole is unwilling to see man as anything more than a
      >>biological machine.

      But many psychiatrists will use meds in conjunction with talk therapy. The former is (possibly) treating the chemistry in the individual and the latter the individual himself. Some patients do not get any meds, just talk therapy.

      One problem is that many people get psychiatric meds from general practitioners, not psychiatrists (especially in the US, where high costs prohibit specialist treatments). The prescription gets the patient out of the office and the patient gets marginal treatment. This can skew the views on the meds.

      BTW - I'm well aware of how problematic these meds are. But I also know that many psychiatrists are doing their best given the available knowledge on the conditions they deal with.

  • (Score: 1, Interesting) by Anonymous Coward on Friday April 24 2015, @04:11AM

    by Anonymous Coward on Friday April 24 2015, @04:11AM (#174540)

    I suspect, though I don't have hard evidence, that many cases of depression and other health and mental related issues, are at least partially related to helminthiasis. Doctors seem to be very bad at detecting them and even when they do prescribe treatments they usually underprescribe which temporarily reduces the symptoms and causes the problem to return with immunity requiring the doctors to prescribe much more of a stronger medication to eliminate the problem.

    • (Score: 0) by Anonymous Coward on Friday April 24 2015, @04:13AM

      by Anonymous Coward on Friday April 24 2015, @04:13AM (#174541)

      Dang it, I meant the topic to be suspicion but my stupid phone changed it somehow.

      • (Score: 2) by Sir Finkus on Friday April 24 2015, @07:41AM

        by Sir Finkus (192) on Friday April 24 2015, @07:41AM (#174569) Journal

        Blame the worms. Anyway, assuming you're the same AC as the parent comment, do you have some more information on this? I've read some other studies about a possible link between depression and gut flora and this sounds similar.

        • (Score: 2) by tibman on Friday April 24 2015, @01:45PM

          by tibman (134) Subscriber Badge on Friday April 24 2015, @01:45PM (#174645)

          1/3 of the cells in your body must count for something more than waste processing. (imo, of course)

          --
          SN won't survive on lurkers alone. Write comments.
        • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @02:00AM

          by Anonymous Coward on Saturday April 25 2015, @02:00AM (#174916)

          Scroll to the section entitled cognitive abilities

          http://en.m.wikipedia.org/wiki/Helminthiasis [wikipedia.org]

    • (Score: 2) by sjames on Saturday April 25 2015, @04:37AM

      by sjames (2882) on Saturday April 25 2015, @04:37AM (#174969) Journal

      I had no idea Pink Floyd meant that literally! :-)

  • (Score: 5, Interesting) by Subsentient on Friday April 24 2015, @04:21AM

    by Subsentient (1111) on Friday April 24 2015, @04:21AM (#174542) Homepage Journal

    I'm on 80mg of Prozac. I'd be dead without it, not from depression, but because my OCD would have convinced me I had magical powers to bring doom on others and should kill myself. My life is 99% normal again thanks to this. It took the two months to start working they said it would, but yeah, I hear it's not so good for depression, and that may be so, but it certainly works wonders for OCD.

    --
    "It is no measure of health to be well adjusted to a profoundly sick society." -Jiddu Krishnamurti
    • (Score: 2) by mhajicek on Friday April 24 2015, @04:53AM

      by mhajicek (51) Subscriber Badge on Friday April 24 2015, @04:53AM (#174548)

      You need to watch DeathNote.

      --
      The spacelike surfaces of time foliations can have a cusp at the surface of discontinuity. - P. Hajicek
      • (Score: 2) by Alfred on Friday April 24 2015, @01:19PM

        by Alfred (4006) on Friday April 24 2015, @01:19PM (#174628) Journal
        I don't think DeathNote has Prozac in it. Maybe Misa was on it?
        • (Score: 2) by mhajicek on Friday April 24 2015, @04:34PM

          by mhajicek (51) Subscriber Badge on Friday April 24 2015, @04:34PM (#174713)

          I was thinking more of the "magical powers to bring doom on others" part.

          --
          The spacelike surfaces of time foliations can have a cusp at the surface of discontinuity. - P. Hajicek
          • (Score: 2) by Alfred on Friday April 24 2015, @05:29PM

            by Alfred (4006) on Friday April 24 2015, @05:29PM (#174748) Journal
            Yeah, sorry. Forgot my sarcasm tags. Or some other way to show snark.
    • (Score: 0, Disagree) by Anonymous Coward on Friday April 24 2015, @01:49PM

      by Anonymous Coward on Friday April 24 2015, @01:49PM (#174648)

      It took the two months to start working they said it would

      I have a hard time believing anything that takes that long to start working is anything except placebo, especially since the withdrawal - sorry, "discontinuation syndrome" - kicks in after a few days at most of not taking it.

      • (Score: 3, Informative) by Yog-Yogguth on Saturday April 25 2015, @08:24PM

        by Yog-Yogguth (1862) Subscriber Badge on Saturday April 25 2015, @08:24PM (#175151) Journal

        Well you're wrong in general there. In medicine/biology the usual reason some things takes a long time to give noticeable effect is that you're building up “something” gradually from a depleted low level in order to get it up and over a threshold value or into a range that is considered healthy/normal. It can of course also be about lowering a value or negating a function as with for example Methotrexate [wikipedia.org].

        But slipping out of such a range often doesn't take much time if you stop with the medication even though it can take a long time before the last remnants of the medicine and all side effects are removed from the body. In the case of Methotrexate it takes upwards of three months after you stopped, but if you were still ill when you stopped then you are sure to notice the lack of medication much faster and far faster than it took to notice improvements when you started.

        What I'm saying is that in most cases where people are sick they are really sick and the changes medicine —and in particular powerful medicine— are used for involve large corrections into relatively narrow ranges: hard to get to due to the illness and easy to slip out of due to the same illness.

        --
        Bite harder Ouroboros, bite! tails.boum.org/ linux USB CD secure desktop IRC *crypt tor (not endorsements (XKeyScore))
  • (Score: 2, Insightful) by Anonymous Coward on Friday April 24 2015, @10:17AM

    by Anonymous Coward on Friday April 24 2015, @10:17AM (#174591)

    Any idiot who has done the slightest bit of research knows that they are not sure why SSRIs (and possibly SNRIs) work. But studies show that many people respond positively to them.

    Busiprone, mentioned above, is a highly effective drug, but only for about a week or so and is used in life-threatening situations.

    The first paragraph on DSM explains it is why it is. If you can work out a better way ... well you should get whatever the equivalent of a Nobel Prize is in the field.

    If you've ever seen a psychiatrist you'll have heard of differential diagnosis. This is hard as the labels/clusters are fuzzy. See also "spectrum disorders".

    This has to be the crappest article yet on Soylent News. (And the crappest comment on an article).

  • (Score: 5, Insightful) by Rivenaleem on Friday April 24 2015, @10:25AM

    by Rivenaleem (3400) on Friday April 24 2015, @10:25AM (#174593)

    Have they tried using G-23 Paxilon Hydrochlorate yet? I've heard great things about it from trials done on Miranda.

    • (Score: 2, Funny) by Anonymous Coward on Friday April 24 2015, @01:04PM

      by Anonymous Coward on Friday April 24 2015, @01:04PM (#174624)

      I hear that there are some fun side-effects. Increased strength, stronger sex drive, and a new perspective on interior and exterior decorating.

      • (Score: 4, Funny) by tibman on Friday April 24 2015, @01:50PM

        by tibman (134) Subscriber Badge on Friday April 24 2015, @01:50PM (#174649)

        2/5 stars. I ate parts of my friend and sewed his face into my chest. Left two stars because my friend was cheering the whole time.

        --
        SN won't survive on lurkers alone. Write comments.
  • (Score: 0) by Anonymous Coward on Friday April 24 2015, @01:04PM

    by Anonymous Coward on Friday April 24 2015, @01:04PM (#174623)

    This Myth I keep hearing about must be a very powerful and versatile substance, since so many great things are based on it.

  • (Score: 2) by ikanreed on Friday April 24 2015, @02:10PM

    by ikanreed (3164) on Friday April 24 2015, @02:10PM (#174657) Journal

    There's more than a little scientific evidence that long term depression symptoms can be reduced by mindfulness training*. A very recent press release [eurekalert.org] and The attached study [rcpsych.org].

    *Be alert that there's a Buddhism-sourced pseudoscientific meditation practice sold under that name that has little to do with the scientific process.

  • (Score: 1, Interesting) by Anonymous Coward on Friday April 24 2015, @05:30PM

    by Anonymous Coward on Friday April 24 2015, @05:30PM (#174750)

    If you have depression and problems with sleep, try the following. It might not cure depression (like diabetes, there are multiple types and the type determines the treatment), but this does help with sleep.

    Try this:
    Use 3 of these per room from waking up until 1 hour before bed time:
    http://www.amazon.com/gp/product/B0019HZQPM/ [amazon.com]

    Yes, this is bright. Very bright from what you are used to. That is the point. That is probably why your circadian rhythm is messed up. So fix your broken environment with this. Yes, it is broken. Residential lighting is closer to living in a cave than being outdoors. Do not simulate living in a cave with 60w incandescent bulbs (or the equivalent 11-14w CFLs & LEDs). The goal is to more closely reproduce sun like light inside. This is still "darker" than being outside, but it is good enough for most people. Your sensitivity may vary from another person.

    1 hour before bed time, one of these per room:
    https://www.earthled.com/collections/new-led-light-bulbs/products/lighting-science-sleepy-baby-led-nursery-light-bulb-12-watt-60w-equal-ls-p15-40we-slpb-120-g1-bx?variant=1259654776 [earthled.com]
    or 3 of these per room:
    http://www.amazon.com/30-Watt-Radio-Golden-Antique/dp/B004H4Z4P6/ [amazon.com]

    • (Score: 0) by Anonymous Coward on Friday April 24 2015, @10:26PM

      by Anonymous Coward on Friday April 24 2015, @10:26PM (#174867)

      Those 30 watt radio bulbs might not be enough. Even though 2 of them is 60 watts, they are more red-shifted than normal incandescent bulbs are. This has a very pleasing effect (think candle light), but is less efficient. So you need more of them. In day mode, those CFLs should flood the room with light. In evening mode, you only need to light what needs to be illuminated. Think task lighting and safety. So you might need more for some tasks. Also, daylight lighting should be positioned above your head, and evening lighting should be below. So table lamps and rope light. A 1900K-2200K LED strip that is dimmed would be the most power efficient.