I need to express my unending frustrating with the manner in which educators are bringing up the roles of neurotransmitters in psychiatry.
Quoting neurochemical imbalances as originators, or targets to fix, is mostly false. That narrative is also harmful to people's self knowledge, and to progress in the field.
Engineers: how would you feel if someone described a technical problem, a UX issue, a data handling nuance or a security flaw... all as 'down to electricity'. Whilst pedantically correct it serves little use and may harm us by arresting the first tendrils of thought that were reaching out, hoping to understand this mystery.
The narrative that psychiatric illness relates to 'neurochemical imbalances' is largely a hangover from pharma marketing. Of course, neurochemicals are involved, and there will be patterns to be found. But let's collectively reject those oversimplifications that helped sell semi efficacious drugs for decades whilst doing little for societal progress in coping with psychiatric illness.
These mental health problems are bio psycho social. And the bio component is enormously more complex than "low mood, low serotonin".
Its okay to just say, "It's bio psycho social, and it's complicated".
This 2018 talk from Dr Yapko, "Keys to unlock depression: Why skills work better than pills" - https://www.youtube.com/watch?v=TVgQ_tgWMyU - suggests a multidimensional viewpoint rather than purely biological. He says the causes are:
1. Biological. He says "Yes, biology matters, but surprisingly not as much as you would think, that when we look at what’s termed genetic variance, how much do genes play a role in depression? Is there a depression gene? No. Are there genes that make people vulnerable to depression? Definitely. So if we look at biochemistry, yes it’s a factor. If we look at disease processes, there are many diseases where depression is a predictable consequence. If we look at drugs, there are many drugs that have depression as a predictable side effect. Biology matters, but when we look at genetic variance, that figure is between .3 and .4. That represents a mild, moderate at best, genetic influence."
2. Psychological. In particular what is known as "Attributional/Explanatory style" (https://en.wikipedia.org/wiki/Explanatory_style), i.e. the person's habitual or reflexive way of attaching meaning to life events. He says "It isn't what happens to people that increases their risk for depression so much as how they interpret and respond to what happens to them."
3. Social
At the end, he says "the goal is not to cure depression, the goal is to learn how to manage your mood. You don't exercise once and now you're done with the exercise thing."
If you like this, do yourself a favor and go watch the entire Human Behavioral Biology course from Standford, it's also taught by Sapolsky: https://www.youtube.com/watch?v=NNnIGh9g6fA
What I think makes the course so good is that it gives you a brief but solid introduction to many different fields:
I often bring up his lecture series as an shining example of how to explain scientific theories with a critical qualifier that almost always is otherwise missing.
He first explains a concept with logically and narrative consistency in order to explain why something occur. Then at the end he goes and demonstrate all the wholes in the theory and through that shine a light at where the narrative fails. It is only after going through multiple different competing theories that the edges start to get defined.
Cannot recommend this more! Seriously. It has been an eye opener to me. For people who loves books over video, he wrote those books where he covers the same topics:
- Behave: The Biology of Humans at Our Best and Worst
- Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping
Seconded. I've only watched the first five or so, but they are absolutely worth it. They changed a lot about how I think through certain situations and have proven their worth many times.
Great lectures. He even manages to cover chaos theory. Philosophy students should look into this series for some biology orientation, in my humble opinion.
Why Zebras Don't Get Ulcers was the most profound book experience I have had in 50 years' reading.
In the final chapter, it took me a half hour to read each page, because it was tying together threads from the whole rest of the book. Each sentence called out themes from widely separated chapters.
I had always wondered how systems as elaborate as the human body could work at all. This book made it clear that, for any vital process, you have at least three and often more separate systems for each function, and they all suppress one another, so that if one is interrupted, it stops suppressing the others and they step up. But, each system is also doing more than one thing, so you never get just one effect. It's a massive Rube-Goldberg / Heath-Robinson contraption tuned over million of years for a sort of statistical robustness, at the extreme expense to simplicity.
To be an endocrinologist, you need to be several times smarter and more careful and diligent than any other medical specialty.
Another endocrinologist worthy of close attention is Robert Lustig. He has excellent lectures on youtube that, if you pay the close attention he deserves, will lead you to make radical changes in your daily habits.
Sorry for the thread hijacking but I'd like to ask the HN crowd about my problems:
For the past three years I have various health related problems like brain fog, tiredeness, breathing trouble, pain all over my body and a general bad mood. These things come and go (some times are worse some better) but for these years I remember myself always having some difficulty.
I am very sad and can't enjoy anything anymore. I can't enjoy my family and I feel I am a problem to them for being always moody and sad. I don't want to go out with friends, only stay at home and do chores or play games. I am constantly afraid that I have a major health problem and try to think all the time what may I have or how I can get better. Actually I can't really think of anything else beyond my health problems.
However after visiting a number of doctors and done lots of exams they couldn't find anything.
Notice that I have never visited a psychiatrist or psychologist and I don't think that I had ever had any psychological problems. I may have some form of minor autism but that didn't stop me of being happy the years before.
Do you think that I have some psychological problems? Maybe depression or some major anxiety? Should I visit a psychiatrist? I can't think of what to say to the psychiatrist... Should I keep visiting other doctors to do more tests? Any help would be much appreciated.
Your description sounds similar to my case, although I never had any anxiety about my health. And I did have short, sharp flashes of extreme anger. But the ultimate question is up to you: Do you think you have a problem? Is it affecting your life?
I first tried psychological counseling. I also have no idea what to say to them, but that's why they are there. Tell them what you wrote here and they can ask questions to go deeper.
In my case, the counseling helped briefly; I was better for a few days after each session. But at that point I was more comfortable going to my primary doctor and asking about medication, which has helped greatly.
To my knowledge, there aren't any kind of blood tests for psychological issues.
Oh, and be very, very cautious of recommended treatments from randos on the internet. The medical folks don't really understand the machine they're working on, and they're frequently wrong, but they do know a hell of a lot more than someone who just googled 'ivermectin'.
The inability to find joy in things you normally do, feeling tired all the time, even when there is no reason for it, over an extended period of time, are all red flags for depression requiring intervention.
As far as I've seen, there is no physical (i.e. blood/fluids) test that can detect depression, it is diagnosed based on behaviors and history. A common feeling is that you want to make sense of these feelings by attributing it to a more understandable health issue.
Depending on what your mind ruminates on, it can be impossible to talk to others about what your thinking (as they may be dismissive, or alarmed). That's where you need someone who's qualified to talk to, like a doctor or counselor.
I'm surprised by the amount of criticism of medication in this thread. Although it is by no means a cure, it is an extremely powerful tool that can allow your brain to break out of feedback loops, and give you some control over your emotional regulation.
Reach out to your doctor, and be frank. Tell them exactly how low your feeling, and don't sugar coat it. They'll have questions to ask you. Also note that you can get doctors who are not a right fit. If you feel like your doctor is not helping, or you feel worse off from seeing them, then find a new one.
Depending on the severity, know that you can always push the issue, regardless of what friends/parents/teachers/colleagues tell you. If you are in crisis, call a cab, an emergency line, whatever, to get yourself to a clinic or hospital.
This kind of thing takes time and effort to solve, and you're the only one who knows how, you, personally feel. It's not like a broken bone, or infection, you have to do your best to describe to doctors how you're feeling.
If I felt said for a period of months without specific cause, yes, I would see a psychiatrist or psychologist.
What did the doctors who you did see say when you told them about your symptoms? It strikes me as odd that they did not recommend a mental health specialist.
You might also want to look into ME/CFS. I'm very sorry to hear about this, because I had an analogous experience for years and know how hopeless it feels to try to figure out what the issue is (while your cognitive abilities / stamina are limited by brain fog), fail over and over, and in the meanwhile others cannot understand and don't believe you.
You should probably talk to a psychologist regardless, as the psychological impact this is having is very apparent and mental health is just as important as your physical health.
This might be obvious and you may have already done a study for this but have you looked into sleep apnea? I had the first two symptoms you described for about a year and it ended up being mild sleep apnea and acid reflux related. Obviously your case could be completely different, but good to rule out. Now I wear a Somnomed mouth piece at night and take acid reflux medication day and night.
Sorry to be cliche, but have you tried changing your diet and exercising more? Letting them slip always ends up with me feeling like that. To be fair, the one time it ended up being cancer, but even then the cancer felt better when I was moving around and eating more vegetables. My checklist when I start feeling down: Water, Magnesium, vitamin D3, Fiber, squats, full nights sleep, no alchohol, wake up early every day, have sex, pet a dog, go into the woods.
It doesn't always work, but it's still good place to start. I hope you figure it out.
After enjoying Sapolsky's lectures on YouTube (including this one) I began reading his book Behave. I was surprised to see that it refers to theories that fail to replicate (eg priming) as if they were solid theories. Stuart Richie (a psychologist who wrote a book on the replication crisis) enumerates other examples in his review https://www.spectator.co.uk/article/rules-of-behaviour/
Please be wary of this failure to drop unreplicated findings when reading Sapolsky's works.
I've sat this out for long time, but I've got to say that it's hilarious watching the HN community—mostly made up of engineers—constantly harp about the replication crisis in Psychology.
In some cases effect may be real even though the studies aren't replicating today. There are several factors.
Replication in psychology isn't as easy as in the physical sciences.
Let me use an example from another field to give you an idea. If I asked you to translate the sentence: "He took the train for London at eight am." into French, would you translate "London" as "London" or as "Paris?"
In other words the social context—social norms, expectations, attitudes—from when many of these studies which don't replicate today has shifted, such that re-running the study verbatim might fail to...replicate.
However say you do try to adapt the study to adjust for the shift in context, then you could also say that the replication isn't valid because you didn't re-run the study exactly as specified.
People aren't robots, so we can just re-run the unit tests on them and expect the exact same results. People aren't even self contained robots, we are social beings, and are very strongly affected by our peers. We aren't swimming in the same water that we were swimming in when these studies were done.
We need new studies for each of these effects that are designed with today's reality in mind. But. No matter how one tries to 'replicate' an old psychology result, it will leave room for skepticism. It just won't be able to account for the 'translation' required without leaving room for doubt.
I guess the most important thing we could learn from this is that it's important to replicate any current studies right now, and not wait forty years to do so.
I agree on both (great books, great lectures, but not everything stands the test of time).
But the good thing is that the book is very well referenced. So whenever I wondered "Is that really true?" or simply "Why?" I was able to find the original paper(s)/source(s) and then take it from there. For me, that is the gold standard of writing a science book.
I wouldn't give too much importance to Stuart Ritchie. He is right-wing and conservative, and conservatives hate Sapolsky.
Ritchie's political views are evident in his book.
What I ' not sure I understand is why does Dr. Sapolsky insist humans have exactly zero free will. Privileged to have (hmm, I'm not sure if this sounds humble or supercilious in this case) a rather healthy brain with sufficiently developed prefrontal cortex and other areas, no matter how depressed or aroused I am (I have probably never been either in a serious degree but nevertheless) I usually can "wake up", pause, overcome my urges and make a conscious decision to behave this or that way out of some logic, mindfully aware of the fact what I feel and think is subjective and mostly illusory. I agree the degree of freedom of the will in rather humble in the majority of people (me included) but why zero?
Pardon for introducing philosophy here, but Schopenhauer‘s „A man can do what he [wants], but not [want] what he [wants]“ might be a good attempt at an answer. Past and current environment, genetic setup etc would completely predetermine the processes in your brain.
He mentions this in passing on the Mindscape podcast (with Sean Carroll). Essentially, he's read too many studies that have participants perform so called 'rational' tests whose outcomes are largely a function of the environment and not the 'given test' -- ie, the presence of a foul smell caused a statistical difference in the outcome of the test. Our capacity to reflect and internalize is, to him, another output of a vast and continual, unconscious, shaping all life undergoes.
The world is material. In this material world, everything that occurs has a physical consequence. We cannot introduce the concept of free will without introducing a non-material cause, eg souls or magic.
> I usually can […] overcome my urges and make a conscious decision to behave this or that way out of some logic
But what made you make that decision instead of a different one (or none)? You generally have no choice but to make the exact deliberate choice that you make in the given moment.
Adverse childhood experiences (ACE's) have been shown to have a strong correlation with depression rates later in life.
In other words; someone who grows up in a warm and loving family, with both biological parents, is much more likely to end up happy than someone who grew up with an alcoholic father, emotionally absent mother, a handicapped sibling, and an uncle in prison.
This was a very powerful reframing of the idea, especially after setting up the biological sources of aggression. Inventing new, accessible, and even useful outlets or ways to exernalize aggression instead of suppressing it could help a lot of people. The very idea that aggression could be a real need that benefits from relief could be a huge breakthrough in helping people manage their general mental health under extreme conditions like long term isolation. It also implies that suppressing aggression may cause depression, which any situation where you've been made to feel powerless is in effect, defined by.
It sort of makes sense that our societies have created social taboos around aggression needs that started as necessary but metastasized over time, the same way we have managed to dement other needs like sexuality, food, and companionship with primative categorical tools that produce versions and understandings of them that are abominations. Analogously, in that framework, depression may also be such an artifact of a similar cognitive abomination.
The idea of "men not talking about their feelings," makes more sense as men suppressing aggression because our societies use disgust taboos as a tool to manage them, in a very similar way that disgust is used to control womens' sexuality. When you view aggression as a physiological need, and then analogize it to how we obviously pervert other needs by managing them with disgust, some conceptual dominoes start to fall.
Admittedly I'm sounding this out for the first time myself, but if aggression is a physiological response to being threatened, creative activities can relieve our aggression needs because they are a reassertion and expression of self that has been threatened. Powerlessness causes aggression, and creativity is often a response to it. The reason physicality "works," on depression because it directs all the faculties that would be an aggression response outward. Lifting weights, running, martial arts, even more advanced yoga, or any exercise is going to provide some relief of that need. It's different from peace, rest, sympathy, or entertainment and it could also apply to things like gambling and substance abuse, where the masochism (def: craving of intensity) is a release for inverted agressive needs.
My close male friends are all type-A giant personalities, and the things we have in common are these intense activities that in effect, manage aggression. We do hyper intense things together like riding motorcycles and horses, snowboarding, lift weights, make heavy music, perform, code, and write (among other things), which are all high intensity activities that are assertions of self, and in effect, relieving a need for aggression.
Viewed as something essential or a need, engineering people (socially or otherwise) to be immoderately less aggressive would be like doing the same for appetite, sexuality, or sociability, and literally make them the expression of the disgust that motivated altering them.
Unbelievable what the reframing of a concept can unlock.
The entire article is pretty spot on, experience wise at least (can't comment on the chemistry of it)
However
> Inside the body is going through a massive stress response that is similar to what your body would be doing if you were fleeing an armed assailant. All the time.
This right here... is important, and something I don't think most are aware of. It's also something I don't think one can fully understand without having experienced it.
I have been mugged at gunpoint/knifepoint and also had bullets fired in my direction in an attempted carjacking (thank you downtown St. Louis) at an earlier time in my life. The fight or flight reflex was definitely about as strong as you might imagine it would/should be in that situation, perhaps slighty dampened by a hobby that required a lot of situational awareness/vigilance.
Cue coming down with a pretty severe chronic physical illness a couple years later and no financial means nor support to fully deal with it (fuck Vascular Ehlers Danlos and Thoracic Outlet Syndrome) - obviously, some severe depression comes with the hopelessness of things like this. The fight or flight reflex... just, came on as symptoms became severe. It was quite noticable and fluctuated in severity the first month or so, but soon became an all encompassing baseline normal... now going on for years.
Simply put, figuratively, I could walk straight up to somebody shooting at me and touch them on the face without any fear/monkey brain instinct to save my life. Literally, I would likely be quickly dead because bullets do that to you and it's not hard to hit somebody walking straight up to you. I really do not mean this in a suicidal sense whatsoever, just the fact that there is absolutely no further stress response from any situation I may find myself in, no matter how dangerous (well, I haven't been plastered in easily visible US military gear in the middle of Afghanistan with people shooting at me, so perhaps I may be slightly too full of myself).
But, the stress response one would normally get that invokes the fear and adrenaline to run away from imminent dangers, it essentially no longer suddenly happens, as it's just been a part of daily life for so long. I can't walk down a busy street without the instant mental registration of where every sound I'm able to hear is coming from. Basically, extreme hypervigilance. It is outright extremely exhausting, and once in a blue moon slightly convenient (like when not having realized the bar you're coming out of at 2am is less than a block from Skid Row and you've got quite a walk to get where you're headed).
I wish more people were aware of this aspect of this mental illness, and I very much hope that there's not a point of no return from it. Something makes me think that there has to be though - whether that's years, or decades of the non-stop fight or flight stressor, and perhaps dependent on what portion of your development you experience it in.
The chemicalization, medicalization and commercialization of depression is a dead end. While the chemical imbalances might be real, the symptoms are due to actual situations in your life. Treating the symptoms with drugs is a pretend solution that only works because it is often the first step people take to actually better their life.
I don’t agree with you about the « dead end » of medicalization.
Medicalization really help you to break the circle. It temporarily treats the symptoms and allows you a timeframe where you can work towards the origin of your issues. And if for some reason, you can’t, it at least helps you live a more supportable life.
Here we are in a mental disease but you can easily make an analogy with any disease. If you need re-education after an accident that broke something, the first step is generally to treat the symptoms that could block you to achieve re-education.
As an example, my dad completely lost its equilibrium after a brain stroke. Re-education was long and hard, eventually succeeded, but would have been totally impossible without medication against nausea, which you constantly get when your equilibrium system is failing.
And I would add that, AFAIK, some forms of depressions are purely chemical issues. And it isn’t surprising. There exists tons of diseases that are chemical issues.
" it is often the first step people take to actually better their life."
What makes you think this - and what makes you think that so many folks have so much agency in their life? A lot of folks don't, and if you have depression, you generally have even less of it because you wind up with an inability to see options you do have... if any.
It isn't like everyone can escape poverty or a bad spouse (it takes money to divorce someone or even leave if you need to get your own place). It isn't like anyone can magically make a disease diagnosis go away nor does changing jobs always fix things, especially if the reason you stay is because you desperately need the health insurance or because no where else pays as much in your area (and moving costs money).
We don't make sure folks have tools to improve their life.
Additionally, this really just blames the victim and I really hope you don't say this to folks actually suffering.
Would you have any sources to back this up? Seems like a big claim to go against standard practice.
I suffer from chronic episodic depression. But my life is objectively great and fulfilling. Are you saying that I should not be at peace with my lifestyle? Or that my depression is a nurture rather than nature type issue?
I'm both triggered and curious to hear your thoughts.
You can split definitions of depression in a number of ways, but one that's been around for a long time is exogenous (external causes) and endogenous (internal causes). The idea that symptoms are only due to life situations is simplistic and wrong.
This feels a bit like the straw man arguments about economics only treating people as rational actors, whereas economists have been aware of the issues with that for decades.
Is it not contradictory to say it's a 'dead end', and also (only) 'works because it is often the first step people take to actually better their life'? (emphasis mine)
I don't have strong feelings either way (and basically will just do what a doctor tells me to do as long as I somewhat understand it seems to make sense) but I've vouched (not voted) for the parent comment because I think there's already the beginning of interesting discussion here; people can (have) disagree(d), but there's not really a reason to flag it IMO.
Depression is a symptom that can be the result of a multitude of physiological causes and not always psychological. One could induce the effects of serious depression in a person through gene therapy, specific nutritional deficiency, certain drugs, for example.
It can be hard to understand the cause for each person, and I do believe strongly we currently under-treat and under-investigate depression and it’s sources in people
The arguments put forward in the article and video are good and do a better job than I could at explaining what we know about depression
That is a wrong and damaging statement. You are ignoring the reality of depression as a disease. It has been shown that depression, in the medical definition, is often not caused by situations in the patient's life.
Thus it is equally foolish to believe, the patients could "better their life" and thereby alleviate depression. Somehow assuming the symptoms of depression actually allow any of that. Hard to improve your life if you can barely get out of bed.
Your comment is the exact kind of stigmatizing, patient-blaming and "just stop being depressed" bullshit that hasn't worked for centuries and contributes to the problem.
Eh… that really depends on what the source of the depression is. I’m bipolar and I’ll never be free of depression, hypomania, anxiety, and the various parts of my brain that are broken.
While medication and therapy can reduce symptoms, there is no cure. When I get depressed, I just have to ride it out. All I can do is accept that.
There are forms of depression that are biological in nature, just like bipolar is, and there is no cure, only mitigation.
The environment impact the chemical balance of the human body. The chemical balance impact how the environment impacts the chemical balance.
Depression is the inability to recover from loss. With some of the more extreme depressions the mind can even invent losses which does not exist in the form of delusions. There are also seasonal depression where individuals lose temporarily the ability to handle loss. The actual situations in your life is not major factors in those, through the environment could provide protective benefits.
I don't think everyone should be piling on, you're mostly correct. Except that your first and last points are contradictory. A dead end and a first step are different things. Though I thought it was common knowledge that these drugs are supposed to be a first step, that too many people use as a crutch, while thinking they are a cure.
This is complete nonsense as well as damaging for people who suffer from depression and who would believe your nonsense instead of seeking science-based help.
[+] [-] neuroma|4 years ago|reply
I need to express my unending frustrating with the manner in which educators are bringing up the roles of neurotransmitters in psychiatry.
Quoting neurochemical imbalances as originators, or targets to fix, is mostly false. That narrative is also harmful to people's self knowledge, and to progress in the field.
Engineers: how would you feel if someone described a technical problem, a UX issue, a data handling nuance or a security flaw... all as 'down to electricity'. Whilst pedantically correct it serves little use and may harm us by arresting the first tendrils of thought that were reaching out, hoping to understand this mystery.
The narrative that psychiatric illness relates to 'neurochemical imbalances' is largely a hangover from pharma marketing. Of course, neurochemicals are involved, and there will be patterns to be found. But let's collectively reject those oversimplifications that helped sell semi efficacious drugs for decades whilst doing little for societal progress in coping with psychiatric illness.
These mental health problems are bio psycho social. And the bio component is enormously more complex than "low mood, low serotonin".
Its okay to just say, "It's bio psycho social, and it's complicated".
[+] [-] CretinDesAlpes|4 years ago|reply
1. Biological. He says "Yes, biology matters, but surprisingly not as much as you would think, that when we look at what’s termed genetic variance, how much do genes play a role in depression? Is there a depression gene? No. Are there genes that make people vulnerable to depression? Definitely. So if we look at biochemistry, yes it’s a factor. If we look at disease processes, there are many diseases where depression is a predictable consequence. If we look at drugs, there are many drugs that have depression as a predictable side effect. Biology matters, but when we look at genetic variance, that figure is between .3 and .4. That represents a mild, moderate at best, genetic influence."
2. Psychological. In particular what is known as "Attributional/Explanatory style" (https://en.wikipedia.org/wiki/Explanatory_style), i.e. the person's habitual or reflexive way of attaching meaning to life events. He says "It isn't what happens to people that increases their risk for depression so much as how they interpret and respond to what happens to them."
3. Social
At the end, he says "the goal is not to cure depression, the goal is to learn how to manage your mood. You don't exercise once and now you're done with the exercise thing."
[+] [-] SlySherZ|4 years ago|reply
What I think makes the course so good is that it gives you a brief but solid introduction to many different fields:
And then combines all of those to try to make sense of human behavior, by looking at animal and human behavior from all these different lenses.[+] [-] belorn|4 years ago|reply
He first explains a concept with logically and narrative consistency in order to explain why something occur. Then at the end he goes and demonstrate all the wholes in the theory and through that shine a light at where the narrative fails. It is only after going through multiple different competing theories that the edges start to get defined.
[+] [-] ReDeiPirati|4 years ago|reply
- Behave: The Biology of Humans at Our Best and Worst
- Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping
[+] [-] junon|4 years ago|reply
The man is also just an incredible lecturer, too.
[+] [-] arketyp|4 years ago|reply
[+] [-] ncmncm|4 years ago|reply
In the final chapter, it took me a half hour to read each page, because it was tying together threads from the whole rest of the book. Each sentence called out themes from widely separated chapters.
I had always wondered how systems as elaborate as the human body could work at all. This book made it clear that, for any vital process, you have at least three and often more separate systems for each function, and they all suppress one another, so that if one is interrupted, it stops suppressing the others and they step up. But, each system is also doing more than one thing, so you never get just one effect. It's a massive Rube-Goldberg / Heath-Robinson contraption tuned over million of years for a sort of statistical robustness, at the extreme expense to simplicity.
To be an endocrinologist, you need to be several times smarter and more careful and diligent than any other medical specialty.
Another endocrinologist worthy of close attention is Robert Lustig. He has excellent lectures on youtube that, if you pay the close attention he deserves, will lead you to make radical changes in your daily habits.
[+] [-] xorfish|4 years ago|reply
The book changed my view of the world quite a bit. Especially about wealth, poverty, crime and justice.
[+] [-] throwaway111213|4 years ago|reply
For the past three years I have various health related problems like brain fog, tiredeness, breathing trouble, pain all over my body and a general bad mood. These things come and go (some times are worse some better) but for these years I remember myself always having some difficulty.
I am very sad and can't enjoy anything anymore. I can't enjoy my family and I feel I am a problem to them for being always moody and sad. I don't want to go out with friends, only stay at home and do chores or play games. I am constantly afraid that I have a major health problem and try to think all the time what may I have or how I can get better. Actually I can't really think of anything else beyond my health problems.
However after visiting a number of doctors and done lots of exams they couldn't find anything.
Notice that I have never visited a psychiatrist or psychologist and I don't think that I had ever had any psychological problems. I may have some form of minor autism but that didn't stop me of being happy the years before.
Do you think that I have some psychological problems? Maybe depression or some major anxiety? Should I visit a psychiatrist? I can't think of what to say to the psychiatrist... Should I keep visiting other doctors to do more tests? Any help would be much appreciated.
[+] [-] bserge|4 years ago|reply
I found stuff that works for me and then started struggling to get doctors to prescribe it.
The healthcare industry is a massive joke.
Funny enough, this week I witnessed an ambulance driving up to a guy on the ground (not homeless looking by any means), waking him up and... leaving.
I assume he was just drunk af, but come on, at least give him some water, he's literally forced to pay for your "care" :D
Would they even fix a broken arm, I often wonder.
[+] [-] mcguire|4 years ago|reply
I first tried psychological counseling. I also have no idea what to say to them, but that's why they are there. Tell them what you wrote here and they can ask questions to go deeper.
In my case, the counseling helped briefly; I was better for a few days after each session. But at that point I was more comfortable going to my primary doctor and asking about medication, which has helped greatly.
To my knowledge, there aren't any kind of blood tests for psychological issues.
Oh, and be very, very cautious of recommended treatments from randos on the internet. The medical folks don't really understand the machine they're working on, and they're frequently wrong, but they do know a hell of a lot more than someone who just googled 'ivermectin'.
[+] [-] caddywompus|4 years ago|reply
As far as I've seen, there is no physical (i.e. blood/fluids) test that can detect depression, it is diagnosed based on behaviors and history. A common feeling is that you want to make sense of these feelings by attributing it to a more understandable health issue.
Depending on what your mind ruminates on, it can be impossible to talk to others about what your thinking (as they may be dismissive, or alarmed). That's where you need someone who's qualified to talk to, like a doctor or counselor.
I'm surprised by the amount of criticism of medication in this thread. Although it is by no means a cure, it is an extremely powerful tool that can allow your brain to break out of feedback loops, and give you some control over your emotional regulation.
Reach out to your doctor, and be frank. Tell them exactly how low your feeling, and don't sugar coat it. They'll have questions to ask you. Also note that you can get doctors who are not a right fit. If you feel like your doctor is not helping, or you feel worse off from seeing them, then find a new one.
Depending on the severity, know that you can always push the issue, regardless of what friends/parents/teachers/colleagues tell you. If you are in crisis, call a cab, an emergency line, whatever, to get yourself to a clinic or hospital.
This kind of thing takes time and effort to solve, and you're the only one who knows how, you, personally feel. It's not like a broken bone, or infection, you have to do your best to describe to doctors how you're feeling.
[+] [-] fddhjjj|4 years ago|reply
What did the doctors who you did see say when you told them about your symptoms? It strikes me as odd that they did not recommend a mental health specialist.
[+] [-] realitygrill|4 years ago|reply
Feel free to email me if you want to chat.
[+] [-] twostorytower|4 years ago|reply
This might be obvious and you may have already done a study for this but have you looked into sleep apnea? I had the first two symptoms you described for about a year and it ended up being mild sleep apnea and acid reflux related. Obviously your case could be completely different, but good to rule out. Now I wear a Somnomed mouth piece at night and take acid reflux medication day and night.
No more brain fog.
[+] [-] dec0dedab0de|4 years ago|reply
It doesn't always work, but it's still good place to start. I hope you figure it out.
[+] [-] deskglass|4 years ago|reply
Please be wary of this failure to drop unreplicated findings when reading Sapolsky's works.
[+] [-] gerbilly|4 years ago|reply
In some cases effect may be real even though the studies aren't replicating today. There are several factors.
Replication in psychology isn't as easy as in the physical sciences.
Let me use an example from another field to give you an idea. If I asked you to translate the sentence: "He took the train for London at eight am." into French, would you translate "London" as "London" or as "Paris?"
In other words the social context—social norms, expectations, attitudes—from when many of these studies which don't replicate today has shifted, such that re-running the study verbatim might fail to...replicate.
However say you do try to adapt the study to adjust for the shift in context, then you could also say that the replication isn't valid because you didn't re-run the study exactly as specified.
People aren't robots, so we can just re-run the unit tests on them and expect the exact same results. People aren't even self contained robots, we are social beings, and are very strongly affected by our peers. We aren't swimming in the same water that we were swimming in when these studies were done.
We need new studies for each of these effects that are designed with today's reality in mind. But. No matter how one tries to 'replicate' an old psychology result, it will leave room for skepticism. It just won't be able to account for the 'translation' required without leaving room for doubt.
I guess the most important thing we could learn from this is that it's important to replicate any current studies right now, and not wait forty years to do so.
[+] [-] ChemSpider|4 years ago|reply
But the good thing is that the book is very well referenced. So whenever I wondered "Is that really true?" or simply "Why?" I was able to find the original paper(s)/source(s) and then take it from there. For me, that is the gold standard of writing a science book.
[+] [-] fulafel|4 years ago|reply
[+] [-] aritmo|4 years ago|reply
[+] [-] qwerty456127|4 years ago|reply
[+] [-] manmal|4 years ago|reply
https://philosophy.stackexchange.com/a/32734
[+] [-] jessermeyer|4 years ago|reply
[+] [-] nefitty|4 years ago|reply
[+] [-] layer8|4 years ago|reply
But what made you make that decision instead of a different one (or none)? You generally have no choice but to make the exact deliberate choice that you make in the given moment.
[+] [-] steveads|4 years ago|reply
[+] [-] katmannthree|4 years ago|reply
[+] [-] cushychicken|4 years ago|reply
It is without a doubt one of the best books I have ever read. Highly recommended for fans of Finnegan's Barbarian Days.
[+] [-] amin|4 years ago|reply
In other words; someone who grows up in a warm and loving family, with both biological parents, is much more likely to end up happy than someone who grew up with an alcoholic father, emotionally absent mother, a handicapped sibling, and an uncle in prison.
Source: https://pubmed.ncbi.nlm.nih.gov/23595840/
[+] [-] hart_russell|4 years ago|reply
I grind my teeth all night and wake up feeling exhausted.
I’ve tried a SSRI and an SNRI and neither did anything for me.
[+] [-] winrid|4 years ago|reply
Especially when you're a sick family member with depression and want your family to just let you die, but nobody wants that for you.
Going through that right now with a relative.
[+] [-] aasasd|4 years ago|reply
WBM has a mirror: https://web.archive.org/web/20210901085438/https://www.rober...
I don't see images in the mirrored page, but I also have no idea if there were any in the article itself.
[+] [-] iainctduncan|4 years ago|reply
[+] [-] zerop|4 years ago|reply
[+] [-] motohagiography|4 years ago|reply
This was a very powerful reframing of the idea, especially after setting up the biological sources of aggression. Inventing new, accessible, and even useful outlets or ways to exernalize aggression instead of suppressing it could help a lot of people. The very idea that aggression could be a real need that benefits from relief could be a huge breakthrough in helping people manage their general mental health under extreme conditions like long term isolation. It also implies that suppressing aggression may cause depression, which any situation where you've been made to feel powerless is in effect, defined by.
It sort of makes sense that our societies have created social taboos around aggression needs that started as necessary but metastasized over time, the same way we have managed to dement other needs like sexuality, food, and companionship with primative categorical tools that produce versions and understandings of them that are abominations. Analogously, in that framework, depression may also be such an artifact of a similar cognitive abomination.
The idea of "men not talking about their feelings," makes more sense as men suppressing aggression because our societies use disgust taboos as a tool to manage them, in a very similar way that disgust is used to control womens' sexuality. When you view aggression as a physiological need, and then analogize it to how we obviously pervert other needs by managing them with disgust, some conceptual dominoes start to fall.
Admittedly I'm sounding this out for the first time myself, but if aggression is a physiological response to being threatened, creative activities can relieve our aggression needs because they are a reassertion and expression of self that has been threatened. Powerlessness causes aggression, and creativity is often a response to it. The reason physicality "works," on depression because it directs all the faculties that would be an aggression response outward. Lifting weights, running, martial arts, even more advanced yoga, or any exercise is going to provide some relief of that need. It's different from peace, rest, sympathy, or entertainment and it could also apply to things like gambling and substance abuse, where the masochism (def: craving of intensity) is a release for inverted agressive needs.
My close male friends are all type-A giant personalities, and the things we have in common are these intense activities that in effect, manage aggression. We do hyper intense things together like riding motorcycles and horses, snowboarding, lift weights, make heavy music, perform, code, and write (among other things), which are all high intensity activities that are assertions of self, and in effect, relieving a need for aggression.
Viewed as something essential or a need, engineering people (socially or otherwise) to be immoderately less aggressive would be like doing the same for appetite, sexuality, or sociability, and literally make them the expression of the disgust that motivated altering them.
Unbelievable what the reframing of a concept can unlock.
[+] [-] s5300|4 years ago|reply
However
> Inside the body is going through a massive stress response that is similar to what your body would be doing if you were fleeing an armed assailant. All the time.
This right here... is important, and something I don't think most are aware of. It's also something I don't think one can fully understand without having experienced it.
I have been mugged at gunpoint/knifepoint and also had bullets fired in my direction in an attempted carjacking (thank you downtown St. Louis) at an earlier time in my life. The fight or flight reflex was definitely about as strong as you might imagine it would/should be in that situation, perhaps slighty dampened by a hobby that required a lot of situational awareness/vigilance.
Cue coming down with a pretty severe chronic physical illness a couple years later and no financial means nor support to fully deal with it (fuck Vascular Ehlers Danlos and Thoracic Outlet Syndrome) - obviously, some severe depression comes with the hopelessness of things like this. The fight or flight reflex... just, came on as symptoms became severe. It was quite noticable and fluctuated in severity the first month or so, but soon became an all encompassing baseline normal... now going on for years.
Simply put, figuratively, I could walk straight up to somebody shooting at me and touch them on the face without any fear/monkey brain instinct to save my life. Literally, I would likely be quickly dead because bullets do that to you and it's not hard to hit somebody walking straight up to you. I really do not mean this in a suicidal sense whatsoever, just the fact that there is absolutely no further stress response from any situation I may find myself in, no matter how dangerous (well, I haven't been plastered in easily visible US military gear in the middle of Afghanistan with people shooting at me, so perhaps I may be slightly too full of myself).
But, the stress response one would normally get that invokes the fear and adrenaline to run away from imminent dangers, it essentially no longer suddenly happens, as it's just been a part of daily life for so long. I can't walk down a busy street without the instant mental registration of where every sound I'm able to hear is coming from. Basically, extreme hypervigilance. It is outright extremely exhausting, and once in a blue moon slightly convenient (like when not having realized the bar you're coming out of at 2am is less than a block from Skid Row and you've got quite a walk to get where you're headed).
I wish more people were aware of this aspect of this mental illness, and I very much hope that there's not a point of no return from it. Something makes me think that there has to be though - whether that's years, or decades of the non-stop fight or flight stressor, and perhaps dependent on what portion of your development you experience it in.
[+] [-] cung|4 years ago|reply
[+] [-] pjerem|4 years ago|reply
Medicalization really help you to break the circle. It temporarily treats the symptoms and allows you a timeframe where you can work towards the origin of your issues. And if for some reason, you can’t, it at least helps you live a more supportable life.
Here we are in a mental disease but you can easily make an analogy with any disease. If you need re-education after an accident that broke something, the first step is generally to treat the symptoms that could block you to achieve re-education.
As an example, my dad completely lost its equilibrium after a brain stroke. Re-education was long and hard, eventually succeeded, but would have been totally impossible without medication against nausea, which you constantly get when your equilibrium system is failing.
And I would add that, AFAIK, some forms of depressions are purely chemical issues. And it isn’t surprising. There exists tons of diseases that are chemical issues.
[+] [-] Broken_Hippo|4 years ago|reply
What makes you think this - and what makes you think that so many folks have so much agency in their life? A lot of folks don't, and if you have depression, you generally have even less of it because you wind up with an inability to see options you do have... if any.
It isn't like everyone can escape poverty or a bad spouse (it takes money to divorce someone or even leave if you need to get your own place). It isn't like anyone can magically make a disease diagnosis go away nor does changing jobs always fix things, especially if the reason you stay is because you desperately need the health insurance or because no where else pays as much in your area (and moving costs money).
We don't make sure folks have tools to improve their life.
Additionally, this really just blames the victim and I really hope you don't say this to folks actually suffering.
[+] [-] Honga|4 years ago|reply
I suffer from chronic episodic depression. But my life is objectively great and fulfilling. Are you saying that I should not be at peace with my lifestyle? Or that my depression is a nurture rather than nature type issue?
I'm both triggered and curious to hear your thoughts.
[+] [-] frereubu|4 years ago|reply
This feels a bit like the straw man arguments about economics only treating people as rational actors, whereas economists have been aware of the issues with that for decades.
[+] [-] OJFord|4 years ago|reply
I don't have strong feelings either way (and basically will just do what a doctor tells me to do as long as I somewhat understand it seems to make sense) but I've vouched (not voted) for the parent comment because I think there's already the beginning of interesting discussion here; people can (have) disagree(d), but there's not really a reason to flag it IMO.
[+] [-] haxiomic|4 years ago|reply
It can be hard to understand the cause for each person, and I do believe strongly we currently under-treat and under-investigate depression and it’s sources in people
The arguments put forward in the article and video are good and do a better job than I could at explaining what we know about depression
[+] [-] bayesian_horse|4 years ago|reply
Thus it is equally foolish to believe, the patients could "better their life" and thereby alleviate depression. Somehow assuming the symptoms of depression actually allow any of that. Hard to improve your life if you can barely get out of bed.
Your comment is the exact kind of stigmatizing, patient-blaming and "just stop being depressed" bullshit that hasn't worked for centuries and contributes to the problem.
[+] [-] kayodelycaon|4 years ago|reply
While medication and therapy can reduce symptoms, there is no cure. When I get depressed, I just have to ride it out. All I can do is accept that.
There are forms of depression that are biological in nature, just like bipolar is, and there is no cure, only mitigation.
[+] [-] belorn|4 years ago|reply
Depression is the inability to recover from loss. With some of the more extreme depressions the mind can even invent losses which does not exist in the form of delusions. There are also seasonal depression where individuals lose temporarily the ability to handle loss. The actual situations in your life is not major factors in those, through the environment could provide protective benefits.
[+] [-] dec0dedab0de|4 years ago|reply
[+] [-] himinlomax|4 years ago|reply