4 ms·

Well, first of all, only certain professionals are licensed to administer those tests, and for good reason, because otherwise people would self-diagnose too muc

Well, first of all, only certain professionals are licensed to administer those tests, and for good reason, because otherwise people would self-diagnose too much or too little. > […] I don't consider myself to have anxiety. Everyone has anxiety. Some people have anxiety disorders. > Isn't it normal to be anxious in stressful situations […] People with anxiety disorders are anxious in normal, non-stressful situations. They can panic when asking a bus driver which stop they should get off at, when talking to a new coworker, or in other ordinary circumstances. People with depressive disorders are depressed at times even when things are going well. People with severe depression can have a hard time just getting out of bed in the morning, feeding themselves, and going through the motions of ordinary life.

deleted 7y ago
[deleted]
wutbrodo 7y ago
I don't think this was intended as a general purpose argument against ever treating mood disorders. Rather, the parent comment is describing the fact that anxiety and depression are conflated with their corresponding disorders too often. I can somewhat relate from experience: I went to a doctor for terrible trouble sleeping, to the point that it was affecting my physical health, that we assumed was caused by anxiety/depression[1]. I was pretty shocked at the rapidity with which she suggested going on antidepressants, particularly considering the tapering periods and the seriousness of the dependency and side effects that they cause. I pushed back a little but it turns out that my doctor's cavalier attitude towards antidepressants isn't out of the norm: they're considered a "try it and see what happens" first line of defense, without trying to get a better sense of the patient's specific issues and whether therapy or other interventions, sans medication, would be a better fit (though I should note that the doctor recommended that I go to therapy if possible in conjunction). Tangentially, this fits with a larger disillusionment I have with the medical system: a combination of screwy incentives, bad lines of communication between generalists and specialists, and a serious institutional/cultural case of a God complex leading to a lack of critical thinking means that I'm at the point where I pretty much keep anything a doctor tells me as just another unreliable information source, weighted more heavily perhaps than my layman's understanding of the research but on categorically the same level. Ive seen the same disillusionment kick in among my doctor family members: in our conversations over the years, my sister and her husband have gone from a central case of said God complex to as much as telling me not to take doctors' advice without a heavy dose of skepticism. I should note that I don't actually consider this a criticism of any individual physicians as much as the realities of the system. One of the biggest factors is that the average person showing up at the doctor is simultaneously incredibly dumb and incredibly confident in their understanding of the medical problem. It makes sense for doctors to be a somewhat heavy-handed and reductive, and once you build those habits into your institutions and pedagogy, it's hard to turn it off. [1] Turns out it was the other way around: consistently not sleeping causes some pretty crappy psychological problems
- SketchySeaBeast 7y ago
  How did you fix your sleep problem? And if they both disappeared at the same time, how can you be certain that your not the one mixing up cause and effect?
  - wutbrodo 7y ago
    > if they both disappeared at the same time They didn't disappear at the same time. I was on antidepressants for a year and my time on antidepressants was pretty much independent of the degree to which my sleep problems were fixed. I probably was slightly less anxious while on the antidepressants, but this was far overwhelmed by the fact that I get/got anxious & depressed after the nights my sleep was poor and I don't/didn't whenever I sleep well. I was able to narrow it down to this specific direction of causality (bad sleep -> anxious the next day) through the fact that my sleep was often affected by exogenous physical factors. I apologize for not going into too much identifying detail on a pseudonymous account, but I solved it by completely ignoring the medical establishment, reading voraciously about the problem, and experimenting on myself until I got myself to an 85% solution that at least allowed me to get back to work. This happened at a far, far slower and more grinding pace than the counterfactual in which I had any competent doctors around me (or rather, if competency wasn't ludicrously uncommon within medicine), since 1) I was sick, 2) I was employed until I quit to focus on the issue, and 3) I don't have an educational background in medicine the way that a doctor (ostensibly) would. I'm far, far, far more comfortable reading papers in noisy epistemological environments than most people; I can't even imagine how horrible and expensive and drawn-out this process would have been had I not been had the confidence or ability to take this route and had to rely on the medical establishment. After getting most of the way there myself, I still have issues sleeping once every week or two, and I decided to visit the relevant specialist to use them as a reference to expedite my path to a 100% solution[1]. It's a criminal indictment of our medical system that the only recourse for patients with complex, multi-factor health problems is to themselves navigate both medical knowledge and the medical system until they've narrowed it down to a fairly well-defined, simple solution. To the extent that the system's abdication of responsibility is driven by individuals' decisions, they should be ashamed of themselves (though again, I will reiterate once again that I think that the problem is systemic; I think most people of average intelligence would behave similarly in the situations that doctors find themselves in and I haven't seen any evidence that leads me to believe that most doctors are particularly extra-bright). [1] At which point regulatory BS popped up again and I was legally required to have a perfunctory appt (at the cost of several hundred dollars, of course) with a doctor to request a referral to this type of specialist
new2628 7y ago
What is the penalty for mistakes for those "certain professionals"? What are the incentives when they make decisions?
- klodolph 7y ago
  In general you are not penalized for mistakes but for failing to provide the standard of reasonable care. There are various penalties for failing to provide this level of care, including revocation of your license or exposure to malpractice suits (for which you would carry insurance). In the US this varies from state to state so you would want to talk to an expert in your state if you want details.

deleted 7y ago

[deleted]

wutbrodo 7y ago

I don't think this was intended as a general purpose argument against ever treating mood disorders. Rather, the parent comment is describing the fact that anxiety and depression are conflated with their corresponding disorders too often. I can somewhat relate from experience: I went to a doctor for terrible trouble sleeping, to the point that it was affecting my physical health, that we assumed was caused by anxiety/depression[1]. I was pretty shocked at the rapidity with which she suggested going on antidepressants, particularly considering the tapering periods and the seriousness of the dependency and side effects that they cause. I pushed back a little but it turns out that my doctor's cavalier attitude towards antidepressants isn't out of the norm: they're considered a "try it and see what happens" first line of defense, without trying to get a better sense of the patient's specific issues and whether therapy or other interventions, sans medication, would be a better fit (though I should note that the doctor recommended that I go to therapy if possible in conjunction). Tangentially, this fits with a larger disillusionment I have with the medical system: a combination of screwy incentives, bad lines of communication between generalists and specialists, and a serious institutional/cultural case of a God complex leading to a lack of critical thinking means that I'm at the point where I pretty much keep anything a doctor tells me as just another unreliable information source, weighted more heavily perhaps than my layman's understanding of the research but on categorically the same level. Ive seen the same disillusionment kick in among my doctor family members: in our conversations over the years, my sister and her husband have gone from a central case of said God complex to as much as telling me not to take doctors' advice without a heavy dose of skepticism. I should note that I don't actually consider this a criticism of any individual physicians as much as the realities of the system. One of the biggest factors is that the average person showing up at the doctor is simultaneously incredibly dumb and incredibly confident in their understanding of the medical problem. It makes sense for doctors to be a somewhat heavy-handed and reductive, and once you build those habits into your institutions and pedagogy, it's hard to turn it off. [1] Turns out it was the other way around: consistently not sleeping causes some pretty crappy psychological problems

SketchySeaBeast 7y ago
How did you fix your sleep problem? And if they both disappeared at the same time, how can you be certain that your not the one mixing up cause and effect?
- wutbrodo 7y ago
  > if they both disappeared at the same time They didn't disappear at the same time. I was on antidepressants for a year and my time on antidepressants was pretty much independent of the degree to which my sleep problems were fixed. I probably was slightly less anxious while on the antidepressants, but this was far overwhelmed by the fact that I get/got anxious & depressed after the nights my sleep was poor and I don't/didn't whenever I sleep well. I was able to narrow it down to this specific direction of causality (bad sleep -> anxious the next day) through the fact that my sleep was often affected by exogenous physical factors. I apologize for not going into too much identifying detail on a pseudonymous account, but I solved it by completely ignoring the medical establishment, reading voraciously about the problem, and experimenting on myself until I got myself to an 85% solution that at least allowed me to get back to work. This happened at a far, far slower and more grinding pace than the counterfactual in which I had any competent doctors around me (or rather, if competency wasn't ludicrously uncommon within medicine), since 1) I was sick, 2) I was employed until I quit to focus on the issue, and 3) I don't have an educational background in medicine the way that a doctor (ostensibly) would. I'm far, far, far more comfortable reading papers in noisy epistemological environments than most people; I can't even imagine how horrible and expensive and drawn-out this process would have been had I not been had the confidence or ability to take this route and had to rely on the medical establishment. After getting most of the way there myself, I still have issues sleeping once every week or two, and I decided to visit the relevant specialist to use them as a reference to expedite my path to a 100% solution[1]. It's a criminal indictment of our medical system that the only recourse for patients with complex, multi-factor health problems is to themselves navigate both medical knowledge and the medical system until they've narrowed it down to a fairly well-defined, simple solution. To the extent that the system's abdication of responsibility is driven by individuals' decisions, they should be ashamed of themselves (though again, I will reiterate once again that I think that the problem is systemic; I think most people of average intelligence would behave similarly in the situations that doctors find themselves in and I haven't seen any evidence that leads me to believe that most doctors are particularly extra-bright). [1] At which point regulatory BS popped up again and I was legally required to have a perfunctory appt (at the cost of several hundred dollars, of course) with a doctor to request a referral to this type of specialist

new2628 7y ago

What is the penalty for mistakes for those "certain professionals"? What are the incentives when they make decisions?

klodolph 7y ago
In general you are not penalized for mistakes but for failing to provide the standard of reasonable care. There are various penalties for failing to provide this level of care, including revocation of your license or exposure to malpractice suits (for which you would carry insurance). In the US this varies from state to state so you would want to talk to an expert in your state if you want details.