6 ms·

I can't and don't want to judge American/Western/whatever attitude towards these serious problem, but I've 2 cents to add: > Isn't a friend/family member much

by pif 10y ago

I can't and don't want to judge American/Western/whatever attitude towards these serious problem, but I've 2 cents to add: > Isn't a friend/family member much better positioned to understand your problems and offer some perspective? While full support from your social environment is important, seeking good professional help is even more important. The more serious the mental issue, the less friendliness can substitute proper therapy.

zaptheimpaler 10y ago
Agreed for more serious problems. But if you have a milder problem, maybe a little bit of depression or anxiety I think social help is more effective than professional help. And that is the more common case.
- eivarv 10y ago
  Why draw the line at those disorders? Or ar you perhaps talking about experiencing some of the symptoms of these disorders to a healthy extent - i.e. normal emotions? Anxiety disorders and depressive disorders can be bad enough to wreak havoc on a persons life.
  - zaptheimpaler 10y ago
    >Why draw the line at those disorders? >Anxiety disorders and depressive disorders can be bad enough to wreak havoc on a persons life. I am sure they can wreak havoc, having faced some myself. Not saying they are not real problems. I just think that in many cases, support of social groups, exercise etc. are more effective treatments than going to a therapist/psychiatrist or taking medication. For example, exercise is now proven to be about as effective or more as an antidepressant. Mindfulness is now being talked about as a very effective treatment for anxiety/depression. People have been saying this kind of stuff for years, but they had zero legitimacy and were laughed at before the science came along. Meditation/mindfulness was considered spiritual hippie-bullshit, now all of a sudden its a viable and effective treatment.. So it just makes me think, when we are talking about as nascent and complicated a science as psychology, there is some value in "folk remedies" and "common sense" which are all too often dismissed as not being scientific enough. Yet that still happens. Do we really have to wait for a hundred studies before we accept that there might be better solutions in common wisdom outside of the current science? Particularly given that many of those remedies can't cause any harm, there is no risk to trying it. Anyways, I am all for therapy and medication if thats what one wants. Just saying that an environment of disconnection breeds more mental illness, like an unsanitary environment breeds more physical illness.
    - eivarv 10y ago
      > I just think that in many cases, support of social groups, exercise etc. are more effective treatments than going to a therapist/psychiatrist or taking medication. I'd be interested to know why you think so. If I remember correctly, exercise is not proven to be "about as effective or more as an antidepressant", but has been proven to provide some positive effect (i.e. relieve negative symptoms) in those suffering from mild to moderate depression (relative to controls). This might have changed since last I checked though - please correct me if I'm wrong! Mindfulness has been shown to be helpful in some circumstances, but then in a strictly defined sense - not just any old meditation. We definitely have to wait for many studies to draw any conclusions, that much is clear. Common wisdom might as well be common ignorance if we aren't rigorous. Mind you, I'm not trying to justify past or current practices or societal ills; I'm just saying that we can't throw epistemology to the wind because of our experiences, wants or beliefs.
      - yequalsx 10y ago
        My wife is a psychiatrist. She says that for anything less than severe depression anti-depressants don't work. Exercise and forcing oneself to be active and do stuff is more effective than drugs.
        pif 10y ago
        > My wife is a psychiatrist. With all the due respect, one psychiatrist's opinion is not necessarily the same as many other psychiatrists' opinions.
        yequalsx 10y ago
        No it is not. It is however better than my opinion or yours on the subject.
        pif 10y ago
        > It is however better than my opinion or yours on the subject. Sure, it is.
  - DanBC 10y ago
    The jargon buzzword is "bio-psycho-social". Mild to moderate depression may respond to anti-depressants, may respond to an evidence based talking therapy, may respond to something like a gardening group activity, may respond to debt planning and financial advice. Treatment plans for depression should not focus on a single aspect of the bio-psycho-social stuff, but should try to address all of it.
- moron4hire 10y ago
  That's a bit like saying "if all you have is a sinus infection instead of full on cancer, I think asking your friends for help is more effective than going to see a physician." Your friends aren't efforts in how the brain works. Depression isn't just "feeling sad because something bad happened to you." Depression is a disease and it doesn't have to have an external cause. Indeed, it's often the perception "what do I have to be sad about" than keeps people from seeking treatment. Can't wait for some psychiatrists to come in here and say something about, "yeah, unless you've got a big site like Facebook, you should probably just ask your friend who is sort of good with computers to make it for you."
mrob 10y ago
The only example I can think of where that's obviously true is bipolar I disorder, where the most effective treatment (lithium) is very dangerous, but leaving it untreated can be very dangerous too. For other conditions professional treatment often does more harm than good.
- eivarv 10y ago
  Is that really the only example you can think of? What about schizophrenia, borderline personality disorder, PTSD, serious major depressive disorder, and so on?
  - mrob 10y ago
    Those can be successfully managed with community support. American culture favors medicalizing those conditions, but I've not seen any convincing evidence that it results in better outcomes. BP-I is different because lithium very effectively stops mania, but effective dose is almost as high as the toxic dose, and long term treatment has a high risk of causing kidney damage even with accurate dosing. This unique combination of danger + effectiveness makes medical supervision mandatory IMO.
    - pif 10y ago
      > Those can be successfully managed with community support. Citation needed.
    - openasocket 10y ago
      How the hell will community support lessen the symptoms of schizophrenia? It's a chemical imbalance in the brain.
- pif 10y ago
  > For other conditions professional treatment often does more harm than good. Citation needed.
yummyfajitas 10y ago
Do we have evidence that "professional" help results in better outcomes than otherwise? I've not seen such evidence, so if someone has hard evidence I'd love to see it. I'm sure many psychiatrists assert this to be true (pay us, don't use free resources!), but an RCT would be great.
- pif 10y ago
  I don't know in general, but I'm discovering a new life thanks to doctors. The psychologist helped a bit; the first psychiatrist and some chemistry helped much more; the second psychiatrist and less of the same drug made a miracle. I couldn't even imagine life without panic attacks, and there it is!
- wu-ikkyu 10y ago
  I too share your doubt, however psychology is a "soft science"[1], so you will not find much "hard evidence". [1]https://en.wikipedia.org/wiki/Hard_and_soft_science https://en.wikipedia.org/wiki/Hard_and_soft_science
  - yummyfajitas 10y ago
    Step 1: Define your field as a soft science and call yourself a professional. Charge $100/hour. Step 2: Convince customers/government to give you "parity" with hard sciences (c.f. "mental health parity" in Obamacare, etc), in spite of providing no hard scientific evidence. Step 3: Profit.
    - openasocket 10y ago
      It's not like psychology chose to be a soft science, it just is because providing the hard scientific evidence required is either impossible, unethical, or both. To prove psychotherapy is effective for depression, you would have to gather up thousands of people with clinical depression, give half therapy and let the others go it alone, which raises serious ethical questions and makes it difficult to find volunteers. And that's just a regular study, how would you go about making a blind study? For pills you can just use a sugar pill, what's the placebo form of therapy? Do you just have a random lay person pretend to be a therapist? Doesn't that raise all kinds of ethical questions? So we have to content ourselves with correlation studies

by pif 10y ago

zaptheimpaler 10y ago

Agreed for more serious problems. But if you have a milder problem, maybe a little bit of depression or anxiety I think social help is more effective than professional help. And that is the more common case.

eivarv 10y ago
Why draw the line at those disorders? Or ar you perhaps talking about experiencing some of the symptoms of these disorders to a healthy extent - i.e. normal emotions? Anxiety disorders and depressive disorders can be bad enough to wreak havoc on a persons life.
- zaptheimpaler 10y ago
  >Why draw the line at those disorders? >Anxiety disorders and depressive disorders can be bad enough to wreak havoc on a persons life. I am sure they can wreak havoc, having faced some myself. Not saying they are not real problems. I just think that in many cases, support of social groups, exercise etc. are more effective treatments than going to a therapist/psychiatrist or taking medication. For example, exercise is now proven to be about as effective or more as an antidepressant. Mindfulness is now being talked about as a very effective treatment for anxiety/depression. People have been saying this kind of stuff for years, but they had zero legitimacy and were laughed at before the science came along. Meditation/mindfulness was considered spiritual hippie-bullshit, now all of a sudden its a viable and effective treatment.. So it just makes me think, when we are talking about as nascent and complicated a science as psychology, there is some value in "folk remedies" and "common sense" which are all too often dismissed as not being scientific enough. Yet that still happens. Do we really have to wait for a hundred studies before we accept that there might be better solutions in common wisdom outside of the current science? Particularly given that many of those remedies can't cause any harm, there is no risk to trying it. Anyways, I am all for therapy and medication if thats what one wants. Just saying that an environment of disconnection breeds more mental illness, like an unsanitary environment breeds more physical illness.
  - eivarv 10y ago
    > I just think that in many cases, support of social groups, exercise etc. are more effective treatments than going to a therapist/psychiatrist or taking medication. I'd be interested to know why you think so. If I remember correctly, exercise is not proven to be "about as effective or more as an antidepressant", but has been proven to provide some positive effect (i.e. relieve negative symptoms) in those suffering from mild to moderate depression (relative to controls). This might have changed since last I checked though - please correct me if I'm wrong! Mindfulness has been shown to be helpful in some circumstances, but then in a strictly defined sense - not just any old meditation. We definitely have to wait for many studies to draw any conclusions, that much is clear. Common wisdom might as well be common ignorance if we aren't rigorous. Mind you, I'm not trying to justify past or current practices or societal ills; I'm just saying that we can't throw epistemology to the wind because of our experiences, wants or beliefs.
    - yequalsx 10y ago
      My wife is a psychiatrist. She says that for anything less than severe depression anti-depressants don't work. Exercise and forcing oneself to be active and do stuff is more effective than drugs.
      - pif 10y ago
        > My wife is a psychiatrist. With all the due respect, one psychiatrist's opinion is not necessarily the same as many other psychiatrists' opinions.
        yequalsx 10y ago
        No it is not. It is however better than my opinion or yours on the subject.
        pif 10y ago
        > It is however better than my opinion or yours on the subject. Sure, it is.
- DanBC 10y ago
  The jargon buzzword is "bio-psycho-social". Mild to moderate depression may respond to anti-depressants, may respond to an evidence based talking therapy, may respond to something like a gardening group activity, may respond to debt planning and financial advice. Treatment plans for depression should not focus on a single aspect of the bio-psycho-social stuff, but should try to address all of it.
moron4hire 10y ago
That's a bit like saying "if all you have is a sinus infection instead of full on cancer, I think asking your friends for help is more effective than going to see a physician." Your friends aren't efforts in how the brain works. Depression isn't just "feeling sad because something bad happened to you." Depression is a disease and it doesn't have to have an external cause. Indeed, it's often the perception "what do I have to be sad about" than keeps people from seeking treatment. Can't wait for some psychiatrists to come in here and say something about, "yeah, unless you've got a big site like Facebook, you should probably just ask your friend who is sort of good with computers to make it for you."

mrob 10y ago

The only example I can think of where that's obviously true is bipolar I disorder, where the most effective treatment (lithium) is very dangerous, but leaving it untreated can be very dangerous too. For other conditions professional treatment often does more harm than good.

eivarv 10y ago
Is that really the only example you can think of? What about schizophrenia, borderline personality disorder, PTSD, serious major depressive disorder, and so on?
- mrob 10y ago
  Those can be successfully managed with community support. American culture favors medicalizing those conditions, but I've not seen any convincing evidence that it results in better outcomes. BP-I is different because lithium very effectively stops mania, but effective dose is almost as high as the toxic dose, and long term treatment has a high risk of causing kidney damage even with accurate dosing. This unique combination of danger + effectiveness makes medical supervision mandatory IMO.
  - pif 10y ago
    > Those can be successfully managed with community support. Citation needed.
  - openasocket 10y ago
    How the hell will community support lessen the symptoms of schizophrenia? It's a chemical imbalance in the brain.
pif 10y ago
> For other conditions professional treatment often does more harm than good. Citation needed.

yummyfajitas 10y ago

Do we have evidence that "professional" help results in better outcomes than otherwise? I've not seen such evidence, so if someone has hard evidence I'd love to see it. I'm sure many psychiatrists assert this to be true (pay us, don't use free resources!), but an RCT would be great.

pif 10y ago
I don't know in general, but I'm discovering a new life thanks to doctors. The psychologist helped a bit; the first psychiatrist and some chemistry helped much more; the second psychiatrist and less of the same drug made a miracle. I couldn't even imagine life without panic attacks, and there it is!
wu-ikkyu 10y ago
I too share your doubt, however psychology is a "soft science"[1], so you will not find much "hard evidence". [1]https://en.wikipedia.org/wiki/Hard_and_soft_science https://en.wikipedia.org/wiki/Hard_and_soft_science
- yummyfajitas 10y ago
  Step 1: Define your field as a soft science and call yourself a professional. Charge $100/hour. Step 2: Convince customers/government to give you "parity" with hard sciences (c.f. "mental health parity" in Obamacare, etc), in spite of providing no hard scientific evidence. Step 3: Profit.
  - openasocket 10y ago
    It's not like psychology chose to be a soft science, it just is because providing the hard scientific evidence required is either impossible, unethical, or both. To prove psychotherapy is effective for depression, you would have to gather up thousands of people with clinical depression, give half therapy and let the others go it alone, which raises serious ethical questions and makes it difficult to find volunteers. And that's just a regular study, how would you go about making a blind study? For pills you can just use a sugar pill, what's the placebo form of therapy? Do you just have a random lay person pretend to be a therapist? Doesn't that raise all kinds of ethical questions? So we have to content ourselves with correlation studies