6 ms·

> 4) I suspect depression is seriously underdiagnosed in med students and MORE students should be taking antidepressants than those currently on them. I find t

by yayana 8y ago

> 4) I suspect depression is seriously underdiagnosed in med students and MORE students should be taking antidepressants than those currently on them. I find that seriously messed up. Maybe it's not 75%, but let's assume an extra margin should be taking antidepressants to exist in the highly competitive med school environment. Further, let's assume that antidepressants progress and competitive programs keep raising the bar based on entrants and dropout rate.. Our public health goal seems to be to develop a society so stressful that psychiatric drugs are not for unbalance in the patient compared to a healthy control but to make unhealthy people that can survive hyper-competition and are maximally profitable for institutions.

ravenstine 8y ago
If med students ought to take antidepressants, then athletes ought to take anabolic steroids.
- rscho 8y ago
  And if payers had their life depending on your 100m dash, they would absolutely do nothing to prevent it and its exactly what would happen.
  - jackpirate 8y ago
    Plenty of soldiers' lives depend on other soldiers' 100m dash times in combat... yet the military is quite good at preventing illegal drug use... and the drugs that soldiers most want to take are drugs that would harm physical performance
    - rscho 8y ago
      Yes, except that people who care for soldiers' lives outside of other soldiers are few and far in between.
    - Permit 8y ago
      No they don't. The marginal running ability (or strength) of a soldier does not save lives. That is, a solider who runs a 12.5s 100m dash will not save more lives than a soldier who runs a 12.6s 100m dash. Obviously there are minimum physical requirements to serve in the military, but once you're in you are not going to start saving more lives because you can run a little bit faster.
    - kvee 8y ago
      Soldiers use stimulants too - https://www.nytimes.com/2012/04/22/opinion/sunday/why-are-we-drugging-our-soldiers.html https://www.nytimes.com/2012/04/22/opinion/sunday/why-are-we... https://en.wikipedia.org/wiki/History_and_culture_of_substituted_amphetamines#Military_use https://en.wikipedia.org/wiki/History_and_culture_of_substit...
    - nradov 8y ago
      Anecdotal reports indicate that illegal steroids and similar performance enhancing drugs are quite common in ground combat units. The military doesn't routinely test for those.
    - strken 8y ago
      https://en.wikipedia.org/wiki/List_of_drugs_used_by_militaries https://en.wikipedia.org/wiki/List_of_drugs_used_by_militari... Modafinil, one of the common study drugs that med students are known to use, is used by quite a few militaries.
      - FiveSquared25 8y ago
        And also see morphine use during Vietnam war
- derefr 8y ago
  Doctors and athletes aren't quite comparable. For doctors, brain drugs → knowledge → saving lives. For athletes, body drugs → strength → showing off. "Showing off" isn't really something we require much of in society, or see as a moral good (however entertaining we happen to find it when it is done well.) "Saving lives" is something we want to happen as much as possible, to the point that we might be willing to ask the people doing so to harm themselves a bit to get it done. A better comparison to doctors might be, say, firefighters: body drugs → strength → saving lives. Would it make sense for a firefighter to take anabolic steroids if it increased the maximum weight they could lift-and-carry out of a burning building? I don't know. I don't think there's an automatic answer to that.
  - wonderwonder 8y ago
    Playing devil's advocate, if you believe that we are a capitalist society (not advocating for or against capitalism) and operating under an efficient market then society does in fact value professional athletes on an individual basis more than doctors as they are paid far more. Also I would argue that professional athletes playing their chosen sport for the entertainment of those watching are doing far more than showing off, they are in fact paid employees of high revenue corporations. With that said I don't think athletes should be using anabolics nor do I think doctors should be using anti depressants except under the recommendation of a neutral psychiatrist.
    - derefr 8y ago
      > society does in fact value professional athletes on an individual basis more than doctors as they are paid far more Yes, we value professional athletes more as people. However, we value the work of doctors more. In fact, the doctors themselves value the work more. That's why—like firefighters, or rescue workers, or police, or soldiers—they're willing to "burn their lives" (or risk their lives) to get the job done. Micro-econ 101 isn't enough to explain this effect. You need an understanding of the desirability of jobs (and preference-functions that go into making jobs desirable), and how people are willing to trade off capturing less value as pay, for satisfying more of their other preferences. You're right that professional athletes are paid employees of high-revenue corporations. Which is to say: they're paid a lot because 1. the corporation is getting a lot of benefit from their work, but 2. the athlete themselves is not getting much terminal-preference-satisfaction from the job itself, and so the athlete demands high monetary compensation for the work. (Compare: coal miners, oil-rig workers, etc. These people have risky jobs that they don't have any intrinsic desire to do; they're highly paid jobs because nobody would do the job if they weren't.) In the case of professional athletes, it's not quite that nobody would do the job, but rather that nobody with as much skill would do the job—the talent pool as a whole is large, but the top of the talent pool (the people everyone wants to see, and so the only valuable people from advertisers' perspectives) is small enough to create a seller's market for that talent. Doctors, meanwhile, want the job (saving lives) to get done more than anyone else. That's often a large part of why they became doctors—because their preference-function ranks "saving lives" quite highly, so they will enjoy a little "saving lives" more than a large amount of something else. Thus, even though we as a society also value saving lives, we don't have to compensate doctors as much as professional athletes for doing it.
kendallpark 8y ago
I'm confused as to why blanket "antidepressants" are being treated as performance enhancing drugs in the same line as stimulants (as u/ravenstine has posited in a sibling comment). Med school is psychologically taxing which can cause or exacerbate depression. People that have clinical depression should get some sort of treatment for their depression. Yes, I agree with you that the environment needs to be changed so that it is more hospitable from a mental health standpoint. But this doesn't change the fact that you have medical students right now that are not being treated for the clinical depression from which they are suffering. One of the absolute issues with the statement "75% of med students are on antidepressants or stimulants" is that it conflates appropriate medication for diagnosed disorders with illegal misuse of Schedule II stimulants for competition. Your typical first-line antidepressants (eg, sertraline, escitalopram) aren't scheduled and are pretty easy to obtain via a PCP visit. They don't offer a "competitive advantage" unless people consider stuff like "being happy" or "not wanting to kill oneself" as an unfair competitive advantage in medical school. > keep raising the bar based on entrants and dropout rate.. Dropout rates in med school are actually extremely low, at least in the US. Burnout rates as physicians, however...
erikpukinskis 8y ago
You have to think about what's the system that will lead to the most economic growth. If you have constant problems and no social support network, you need to spend your way out of all of those problems. That leads to people maxing out their credit, working as hard as possible for their employer, and being afraid to leave their jobs. Which equals mondo economic growth. We used to have a society where people generally took care of each other and made a little money for specialty items as part of their career. Money was used to change your position, not to maintain it. The economy was much smaller then.

by yayana 8y ago

ravenstine 8y ago

If med students ought to take antidepressants, then athletes ought to take anabolic steroids.

rscho 8y ago
And if payers had their life depending on your 100m dash, they would absolutely do nothing to prevent it and its exactly what would happen.
- jackpirate 8y ago
  Plenty of soldiers' lives depend on other soldiers' 100m dash times in combat... yet the military is quite good at preventing illegal drug use... and the drugs that soldiers most want to take are drugs that would harm physical performance
  - rscho 8y ago
    Yes, except that people who care for soldiers' lives outside of other soldiers are few and far in between.
  - Permit 8y ago
    No they don't. The marginal running ability (or strength) of a soldier does not save lives. That is, a solider who runs a 12.5s 100m dash will not save more lives than a soldier who runs a 12.6s 100m dash. Obviously there are minimum physical requirements to serve in the military, but once you're in you are not going to start saving more lives because you can run a little bit faster.
  - kvee 8y ago
    Soldiers use stimulants too - https://www.nytimes.com/2012/04/22/opinion/sunday/why-are-we-drugging-our-soldiers.html https://www.nytimes.com/2012/04/22/opinion/sunday/why-are-we... https://en.wikipedia.org/wiki/History_and_culture_of_substituted_amphetamines#Military_use https://en.wikipedia.org/wiki/History_and_culture_of_substit...
  - nradov 8y ago
    Anecdotal reports indicate that illegal steroids and similar performance enhancing drugs are quite common in ground combat units. The military doesn't routinely test for those.
  - strken 8y ago
    https://en.wikipedia.org/wiki/List_of_drugs_used_by_militaries https://en.wikipedia.org/wiki/List_of_drugs_used_by_militari... Modafinil, one of the common study drugs that med students are known to use, is used by quite a few militaries.
    - FiveSquared25 8y ago
      And also see morphine use during Vietnam war
derefr 8y ago
Doctors and athletes aren't quite comparable. For doctors, brain drugs → knowledge → saving lives. For athletes, body drugs → strength → showing off. "Showing off" isn't really something we require much of in society, or see as a moral good (however entertaining we happen to find it when it is done well.) "Saving lives" is something we want to happen as much as possible, to the point that we might be willing to ask the people doing so to harm themselves a bit to get it done. A better comparison to doctors might be, say, firefighters: body drugs → strength → saving lives. Would it make sense for a firefighter to take anabolic steroids if it increased the maximum weight they could lift-and-carry out of a burning building? I don't know. I don't think there's an automatic answer to that.
- wonderwonder 8y ago
  Playing devil's advocate, if you believe that we are a capitalist society (not advocating for or against capitalism) and operating under an efficient market then society does in fact value professional athletes on an individual basis more than doctors as they are paid far more. Also I would argue that professional athletes playing their chosen sport for the entertainment of those watching are doing far more than showing off, they are in fact paid employees of high revenue corporations. With that said I don't think athletes should be using anabolics nor do I think doctors should be using anti depressants except under the recommendation of a neutral psychiatrist.
  - derefr 8y ago
    > society does in fact value professional athletes on an individual basis more than doctors as they are paid far more Yes, we value professional athletes more as people. However, we value the work of doctors more. In fact, the doctors themselves value the work more. That's why—like firefighters, or rescue workers, or police, or soldiers—they're willing to "burn their lives" (or risk their lives) to get the job done. Micro-econ 101 isn't enough to explain this effect. You need an understanding of the desirability of jobs (and preference-functions that go into making jobs desirable), and how people are willing to trade off capturing less value as pay, for satisfying more of their other preferences. You're right that professional athletes are paid employees of high-revenue corporations. Which is to say: they're paid a lot because 1. the corporation is getting a lot of benefit from their work, but 2. the athlete themselves is not getting much terminal-preference-satisfaction from the job itself, and so the athlete demands high monetary compensation for the work. (Compare: coal miners, oil-rig workers, etc. These people have risky jobs that they don't have any intrinsic desire to do; they're highly paid jobs because nobody would do the job if they weren't.) In the case of professional athletes, it's not quite that nobody would do the job, but rather that nobody with as much skill would do the job—the talent pool as a whole is large, but the top of the talent pool (the people everyone wants to see, and so the only valuable people from advertisers' perspectives) is small enough to create a seller's market for that talent. Doctors, meanwhile, want the job (saving lives) to get done more than anyone else. That's often a large part of why they became doctors—because their preference-function ranks "saving lives" quite highly, so they will enjoy a little "saving lives" more than a large amount of something else. Thus, even though we as a society also value saving lives, we don't have to compensate doctors as much as professional athletes for doing it.

kendallpark 8y ago

I'm confused as to why blanket "antidepressants" are being treated as performance enhancing drugs in the same line as stimulants (as u/ravenstine has posited in a sibling comment). Med school is psychologically taxing which can cause or exacerbate depression. People that have clinical depression should get some sort of treatment for their depression. Yes, I agree with you that the environment needs to be changed so that it is more hospitable from a mental health standpoint. But this doesn't change the fact that you have medical students right now that are not being treated for the clinical depression from which they are suffering. One of the absolute issues with the statement "75% of med students are on antidepressants or stimulants" is that it conflates appropriate medication for diagnosed disorders with illegal misuse of Schedule II stimulants for competition. Your typical first-line antidepressants (eg, sertraline, escitalopram) aren't scheduled and are pretty easy to obtain via a PCP visit. They don't offer a "competitive advantage" unless people consider stuff like "being happy" or "not wanting to kill oneself" as an unfair competitive advantage in medical school. > keep raising the bar based on entrants and dropout rate.. Dropout rates in med school are actually extremely low, at least in the US. Burnout rates as physicians, however...

erikpukinskis 8y ago

You have to think about what's the system that will lead to the most economic growth. If you have constant problems and no social support network, you need to spend your way out of all of those problems. That leads to people maxing out their credit, working as hard as possible for their employer, and being afraid to leave their jobs. Which equals mondo economic growth. We used to have a society where people generally took care of each other and made a little money for specialty items as part of their career. Money was used to change your position, not to maintain it. The economy was much smaller then.