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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?
(Score: 3, Interesting) by MadTinfoilHatter on Friday April 24 2015, @03:47AM
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
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.
Join our Folding@Home team! [stanford.edu]
(Score: 3, Interesting) by HiThere on Friday April 24 2015, @05:49PM
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.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 0) by Anonymous Coward on Saturday April 25 2015, @03:28AM
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
"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
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
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
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
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
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
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
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]
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 0) by Anonymous Coward on Saturday April 25 2015, @02:13AM
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
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!".
ACs are never seen so don't bother. Always ready to show SJWs for the racists they are.
(Score: 2) by Jeremiah Cornelius on Friday April 24 2015, @04:42PM
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
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
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
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
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
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
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
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
>>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.