4 ms·

This is psychiatry. We don't know how to cure the underlying diseases, because we don't entirely understand them. When the field can actually cure them, like fo

This is psychiatry. We don't know how to cure the underlying diseases, because we don't entirely understand them. When the field can actually cure them, like for PTSD and certain anxiety disorders, it's very happy to.

aviv 9y ago
It doesn't cure any of these disorders. All they can do is reduce the symptoms just enough between each pill you pop.
- pcwalton 9y ago
  You say that like it's a bad thing! Reducing symptoms of depression has saved lives.
- jdietrich 9y ago
  Psychological treatments like exposure therapy are highly effective in treating PTSD, panic disorder and phobia. A significant proportion of people with severe anxiety-related disorders can be completely cured in a matter of weeks. It doesn't work for everyone, but thousands of lives have been transformed by psychotherapy. The best available evidence suggests that psychological treatments are equally effective as drug treatments for most common psychiatric disorders. Psychological therapies are generally orders of magnitude more expensive than drug treatments, so unfortunately they aren't as widely available. Psychiatry is an incredibly challenging field and there are a lot of things we just don't know. Drug companies might have a strong incentive to keep selling you pills, but insurers have an equally strong incentive to cure you outright. Single-payer healthcare systems like the British NHS have a huge incentive to use the best, most cost-effective treatments available. It's just an unfortunate fact that we can't fix everyone. There is no magic wand to cure all human misery and there's no conspiracy to keep people sick. http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD003388.pub4/abstract http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD0033... http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD011170.pub2/abstract http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD0111...
  - vanderZwan 9y ago
    > Psychiatry is an incredibly challenging field and there are a lot of things we just don't know Yet. Let us remain optimistic :)
- stordoff 9y ago
  How is that a bad thing? Sure, a cure would be _significantly_ better, but reducing symptoms can result in a vastly better quality of life.
  - ada1981 9y ago
    Yes, the attempt to reduce symptoms is admirable when a cure is not available. Fortunately Psychedelic medicines are coming online that can allow for actual healing of the underlying patterns. They saved my life for certain.
  - aviv 9y ago
    Take Crohn's for example. Sure you can be on Remicade for a decade with no significant flare-ups. Then the day Remicade stops being effective you're completely screwed. Plus your situation got worse over time, you just didn't get the messages your body has been trying to send you. Remicade was essentially the firewall.
- azernik 9y ago
  ... which is exactly what I was saying? When you don't know how to cure something, you treat the symptoms.
nashashmi 9y ago
What diseases are there on the field of psychiatry that can be "cured"? It seems to me that all of those diseases are only mitigated enough to help the person recover on their own.
- ada1981 9y ago
  MDMA is in phase 3 clinical trials for PTSD and something like 65-85% of participants don't show any signs of having it 12 months after treatment. Maps.org
vanderZwan 9y ago
I think we're on the verge of some really big breakthroughs when it comes to understanding the brain though. The research group I work for (for only six more days.. sigh..) just released a pre-print of a paper mapping out all of the mouse brain's cell types[0][1]. > The mammalian nervous system executes complex behaviors controlled by specialised, precisely positioned and interacting cell types. Here, we used RNA sequencing of half a million single cells to create a detailed census of cell types in the mouse nervous system. We mapped cell types spatially and derived a hierarchical, data-driven taxonomy. (...) The resource presented here lays a solid foundation for understanding the molecular architecture of the mammalian nervous system, and enables genetic manipulation of specific cell types. (you may wonder what mice have to do with human brains: on a "cellular" and "genetic" level, mice are already close enough to humans to be decent substitutes for researching quite a lot of fundamental stuff about how the brain works) We already had an atlas of where every gene was activated in the mouse brain since 2006, but this was at the tissue level[2][3]. Only recently it has become possible to research at the cellular level which genes are activated. That has enabled the possibility of classifying cell types by gene activation. Not only that, by tracking gene activation over various stages of development, we can see how the genes interact and activate each other, and get a better insight in how the brain develops its various different cell types. I am "merely" a programmer/interaction designer building tools for easier data exploration, and can't pretend to understand the fine details, but that sounds like it is Kind Of A Big Deal for anyone researching brains. For example: until now, we could only see which genes are correlated with higher chances of a certain mental illness (by looking at the genetic makeup of people with and without these illnesses). But that is not the same as knowing what those genes do. Furthermore, many of mental illnesses are partially nature, partially nurture: you have to be unlucky enough to have a mix of genes that makes it possible or more likely to manifest an illness, but for the disease to truly manifest itself you also requires an environmental trigger. When we can follow individual cell development at the genetic expression level, we can start to figure out what changes when certain genes and/or certain stimuli are present or absent. There is an equivalent science project underway to map out all the cell types in the human body, not just the brain[4]. On top of that, the techniques that let scientists analyse the RNA expression in individual cells are getting cheaper and faster all the time[5]. My guess is that major breakthroughs in understanding how the body works, including the brain, will start coming in very quickly. (and I'm not even talking about the implications for machine learning) [0] https://twitter.com/slinnarsson/status/981919808726892545 https://twitter.com/slinnarsson/status/981919808726892545 [1] https://www.biorxiv.org/content/biorxiv/early/2018/04/05/294918.full.pdf https://www.biorxiv.org/content/biorxiv/early/2018/04/05/294... [2] http://mouse.brain-map.org/ http://mouse.brain-map.org/ [3] https://en.wikipedia.org/wiki/Allen_Brain_Atlas#Mouse_Brain https://en.wikipedia.org/wiki/Allen_Brain_Atlas#Mouse_Brain [4] https://www.humancellatlas.org/ https://www.humancellatlas.org/ [5] http://www.alleninstitute.org/what-we-do/brain-science/news-press/articles/democratizing-single-cell-analysis http://www.alleninstitute.org/what-we-do/brain-science/news-...

aviv 9y ago

It doesn't cure any of these disorders. All they can do is reduce the symptoms just enough between each pill you pop.

pcwalton 9y ago
You say that like it's a bad thing! Reducing symptoms of depression has saved lives.
jdietrich 9y ago
Psychological treatments like exposure therapy are highly effective in treating PTSD, panic disorder and phobia. A significant proportion of people with severe anxiety-related disorders can be completely cured in a matter of weeks. It doesn't work for everyone, but thousands of lives have been transformed by psychotherapy. The best available evidence suggests that psychological treatments are equally effective as drug treatments for most common psychiatric disorders. Psychological therapies are generally orders of magnitude more expensive than drug treatments, so unfortunately they aren't as widely available. Psychiatry is an incredibly challenging field and there are a lot of things we just don't know. Drug companies might have a strong incentive to keep selling you pills, but insurers have an equally strong incentive to cure you outright. Single-payer healthcare systems like the British NHS have a huge incentive to use the best, most cost-effective treatments available. It's just an unfortunate fact that we can't fix everyone. There is no magic wand to cure all human misery and there's no conspiracy to keep people sick. http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD003388.pub4/abstract http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD0033... http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD011170.pub2/abstract http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD0111...
- vanderZwan 9y ago
  > Psychiatry is an incredibly challenging field and there are a lot of things we just don't know Yet. Let us remain optimistic :)
stordoff 9y ago
How is that a bad thing? Sure, a cure would be _significantly_ better, but reducing symptoms can result in a vastly better quality of life.
- ada1981 9y ago
  Yes, the attempt to reduce symptoms is admirable when a cure is not available. Fortunately Psychedelic medicines are coming online that can allow for actual healing of the underlying patterns. They saved my life for certain.
- aviv 9y ago
  Take Crohn's for example. Sure you can be on Remicade for a decade with no significant flare-ups. Then the day Remicade stops being effective you're completely screwed. Plus your situation got worse over time, you just didn't get the messages your body has been trying to send you. Remicade was essentially the firewall.
azernik 9y ago
... which is exactly what I was saying? When you don't know how to cure something, you treat the symptoms.

nashashmi 9y ago

What diseases are there on the field of psychiatry that can be "cured"? It seems to me that all of those diseases are only mitigated enough to help the person recover on their own.

ada1981 9y ago
MDMA is in phase 3 clinical trials for PTSD and something like 65-85% of participants don't show any signs of having it 12 months after treatment. Maps.org

vanderZwan 9y ago

I think we're on the verge of some really big breakthroughs when it comes to understanding the brain though. The research group I work for (for only six more days.. sigh..) just released a pre-print of a paper mapping out all of the mouse brain's cell types[0][1]. > The mammalian nervous system executes complex behaviors controlled by specialised, precisely positioned and interacting cell types. Here, we used RNA sequencing of half a million single cells to create a detailed census of cell types in the mouse nervous system. We mapped cell types spatially and derived a hierarchical, data-driven taxonomy. (...) The resource presented here lays a solid foundation for understanding the molecular architecture of the mammalian nervous system, and enables genetic manipulation of specific cell types. (you may wonder what mice have to do with human brains: on a "cellular" and "genetic" level, mice are already close enough to humans to be decent substitutes for researching quite a lot of fundamental stuff about how the brain works) We already had an atlas of where every gene was activated in the mouse brain since 2006, but this was at the tissue level[2][3]. Only recently it has become possible to research at the cellular level which genes are activated. That has enabled the possibility of classifying cell types by gene activation. Not only that, by tracking gene activation over various stages of development, we can see how the genes interact and activate each other, and get a better insight in how the brain develops its various different cell types. I am "merely" a programmer/interaction designer building tools for easier data exploration, and can't pretend to understand the fine details, but that sounds like it is Kind Of A Big Deal for anyone researching brains. For example: until now, we could only see which genes are correlated with higher chances of a certain mental illness (by looking at the genetic makeup of people with and without these illnesses). But that is not the same as knowing what those genes do. Furthermore, many of mental illnesses are partially nature, partially nurture: you have to be unlucky enough to have a mix of genes that makes it possible or more likely to manifest an illness, but for the disease to truly manifest itself you also requires an environmental trigger. When we can follow individual cell development at the genetic expression level, we can start to figure out what changes when certain genes and/or certain stimuli are present or absent. There is an equivalent science project underway to map out all the cell types in the human body, not just the brain[4]. On top of that, the techniques that let scientists analyse the RNA expression in individual cells are getting cheaper and faster all the time[5]. My guess is that major breakthroughs in understanding how the body works, including the brain, will start coming in very quickly. (and I'm not even talking about the implications for machine learning) [0] https://twitter.com/slinnarsson/status/981919808726892545 https://twitter.com/slinnarsson/status/981919808726892545 [1] https://www.biorxiv.org/content/biorxiv/early/2018/04/05/294918.full.pdf https://www.biorxiv.org/content/biorxiv/early/2018/04/05/294... [2] http://mouse.brain-map.org/ http://mouse.brain-map.org/ [3] https://en.wikipedia.org/wiki/Allen_Brain_Atlas#Mouse_Brain https://en.wikipedia.org/wiki/Allen_Brain_Atlas#Mouse_Brain [4] https://www.humancellatlas.org/ https://www.humancellatlas.org/ [5] http://www.alleninstitute.org/what-we-do/brain-science/news-press/articles/democratizing-single-cell-analysis http://www.alleninstitute.org/what-we-do/brain-science/news-...