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The fact is psychiatry today still lacks tests or any proof of its claims of "chemical imbalance", which remains unproven. No one had established a profile for

The fact is psychiatry today still lacks tests or any proof of its claims of "chemical imbalance", which remains unproven. No one had established a profile for what a "balanced brain chemistry"looks like, nor do they test for any brain chemistry imbalance. Diagnosis is still left to the subjective assessment of the practitioner before prescribing powerful psychotropics that DO change brain chemistry in unpredictable ways, and cause a host of side effects often worse than the original symptoms. So the argument today that psychiatry lacks any scientific basis and rigor for its practices is still very valid and legitimate.

Angostura 7y ago
This seems overly pessimistic to me, there are drugs that significantly improve patients wellbeing and do so consistently and repeatably, despite the fact that we don't have a complete understanding of the complete mechanism of action. If I do a study showing that handwashing in surgeons measurably reduces risk of infection, does the fact that I don't know about microbes make lacking in scientific rigor and remove its scientific basis?
- phkahler 7y ago
  >> there are drugs that significantly improve patients wellbeing and do so consistently and repeatably, No, there are not. A given drug may work consistently for some people, while having no effect, or detrimental effects on other people with the same diagnosis.
  - JohnBooty 7y ago
    Either you misunderstand or you're being disingenuous here. "Consistently and repeatedly" does not mean "this works 100.0% of the time." Would you deny that exercise fails to consistently and repeatably help people lose weight? Would you say that existing treatments for heart attack victims fail to consistently and repeatably help victims? Would you say umbrellas fail to consistently and repeatably stop rain from falling on your head? None of these things work 100% of the time, but they are frequently successful. Psychiatry is a field still in its infancy due to the difficulty of studying the mind. We should hold it accountable for its failings and work to make sure it improves. But, it has successes as well. It's not the only game in town when it comes to mental health, for sure, but it's also compatible with a lot of other things that can have great benefits for mental health. Meditation, lifestyle changes, exercise, therapy, environment... none are incompatible with psychiatry, which is not perfect but can be a valuable tool in the toolbox.
- dredmorbius 7y ago
  There are, in cases, effective drugs. There's also a long history of failed or discredited treatments (chemical and otherwise), as well as theoretical models. Mind: I'm not arguing that science doesn't make mistakes. Science is a mistake-making-and-correcting process. But there are certain fields of science, somewhat more so in the social than physical and biological sciences, in which a widely-adopted plausible theoretical understanding seems missing. Science seems to move through stages, of observation and categorisation, to individual models of localised predictive (or descriptive) understanding, to a fundamental theoretical underpinning. Geology and biology are interesting cases, each being effectively ancient, but for which the establishment of the underlying theory lies largely within human memory. In the case of biology, taxonomic classification, Darwin's theory of evolution based on variation, inheritence, and selection, Mendelian genetics, and finally the discovery of the structure and reading of DNA and RNA by Watson, Crick, and others (1950s) cast the final links in the chain. We're strengthening those, but the underlying model seems largely complete. (I'd count concepts of dissipative systems as largely conformant with this model, though important additions.) For geology, similarly, there was the notion of stratigraphy, which established an ordering but not a specific timescale for geology. Understanding of that didn't occur until the work of Rutherford, Soddy, Holmes, and Boltwood, largely in the first decade of the 20th century. At the time, the leading scientific value for the age of the Earth was 20 millions of years, by William Thomson, Lord Kelvin (reduced from an earlier estimate of 100 million years). Rutherford and Boltwood's initial measurements based on radioactive decay demonstrated a timescale of billions of years, subsequently refined to the present value of 4.6 billion +/- 1% in the 1950s. That still didn't explain much geological activity, particularly vulcanology, earthquakes, uplifts, and subsidence (though sedimentation and erosion were well understood). That required the notion of plate tectonics and continental drift, formally adopted only in 1965-1967 (by various conferences / professional bodies). Plate tectonics, driven by residual thermal heat of formation and radioactive decay in the Earth's core and mantle is now considered the theoretical underpinning of all of geology. It's formal adoption is 55 years old, for a study that's existed since the time of ancient Greece. The social sciences -- sociology, psychology, political economy, and political science -- lack any such empirically demonstratable and falsifiable theoretcal underpinning. To a large extent they've resisted adopting one. That last point isn't uncommon -- biology certainaly resisted evolution, and geology plate tectonic (see Naomi Oreske's works on this topic, themselves fascinating studies of the evolution of scientific theory: https://www.worldcat.org/search?qt=worldcat_org_all&q=au%3Aoreskes%20naomi%20kw%3Atectonics https://www.worldcat.org/search?qt=worldcat_org_all&q=au%3Ao...). And as with pre-genetic biology, pre-tectonic geology, pre-Newtonian physics, and pre-Mendeleevian chemistry, there are useful concepts, models, methods, and mathematical relations in these fields. But not a true unifying theoretic basis.
mjevans 7y ago
It needn't even be chemical; any sort of differential test that proves a deviation from baseline measure and treatment that helps mediate a return to that profile would at least be good science and may good medicine. Maybe someday we'll have wide access to inexpensive monitoring techniques that could fill this need.
elfexec 7y ago
> So the argument today that psychiatry lacks any scientific basis and rigor for its practices is still very valid and legitimate. It's been said that psychiatry is the new religion and psychiatrists the new priests for a reason. Any good actor with enough information can pretend he has a mental illness and fool psychiatrists. Not only that, you can have psychiatrists come up with different diagnoses for the same individual - even to the point of contradicting each other. And there is no scientific way to show one psychiatrist is correct or not. Just like religion was the best we could do with level of knowledge we had in the past. Psychiatry is sadly the best we can do with the current level of knowledge. It's pretty much voodoo, but it's better than the voodoo that came before it. If neuroscience ( an actual science ) lives up to its potential, then we'll finally be able to toss psychology into the same waste bin we put astrology in and perhaps psychiatry can have a scientific foundation.
DanBC 7y ago
> any proof of its claims of "chemical imbalance", Can you find me any psychiatrist that's pushing the chemical imbalance theory? Every single doctor I know thinks chemical imbalance is bunk.

Angostura 7y ago

This seems overly pessimistic to me, there are drugs that significantly improve patients wellbeing and do so consistently and repeatably, despite the fact that we don't have a complete understanding of the complete mechanism of action. If I do a study showing that handwashing in surgeons measurably reduces risk of infection, does the fact that I don't know about microbes make lacking in scientific rigor and remove its scientific basis?

phkahler 7y ago
>> there are drugs that significantly improve patients wellbeing and do so consistently and repeatably, No, there are not. A given drug may work consistently for some people, while having no effect, or detrimental effects on other people with the same diagnosis.
- JohnBooty 7y ago
  Either you misunderstand or you're being disingenuous here. "Consistently and repeatedly" does not mean "this works 100.0% of the time." Would you deny that exercise fails to consistently and repeatably help people lose weight? Would you say that existing treatments for heart attack victims fail to consistently and repeatably help victims? Would you say umbrellas fail to consistently and repeatably stop rain from falling on your head? None of these things work 100% of the time, but they are frequently successful. Psychiatry is a field still in its infancy due to the difficulty of studying the mind. We should hold it accountable for its failings and work to make sure it improves. But, it has successes as well. It's not the only game in town when it comes to mental health, for sure, but it's also compatible with a lot of other things that can have great benefits for mental health. Meditation, lifestyle changes, exercise, therapy, environment... none are incompatible with psychiatry, which is not perfect but can be a valuable tool in the toolbox.
dredmorbius 7y ago
There are, in cases, effective drugs. There's also a long history of failed or discredited treatments (chemical and otherwise), as well as theoretical models. Mind: I'm not arguing that science doesn't make mistakes. Science is a mistake-making-and-correcting process. But there are certain fields of science, somewhat more so in the social than physical and biological sciences, in which a widely-adopted plausible theoretical understanding seems missing. Science seems to move through stages, of observation and categorisation, to individual models of localised predictive (or descriptive) understanding, to a fundamental theoretical underpinning. Geology and biology are interesting cases, each being effectively ancient, but for which the establishment of the underlying theory lies largely within human memory. In the case of biology, taxonomic classification, Darwin's theory of evolution based on variation, inheritence, and selection, Mendelian genetics, and finally the discovery of the structure and reading of DNA and RNA by Watson, Crick, and others (1950s) cast the final links in the chain. We're strengthening those, but the underlying model seems largely complete. (I'd count concepts of dissipative systems as largely conformant with this model, though important additions.) For geology, similarly, there was the notion of stratigraphy, which established an ordering but not a specific timescale for geology. Understanding of that didn't occur until the work of Rutherford, Soddy, Holmes, and Boltwood, largely in the first decade of the 20th century. At the time, the leading scientific value for the age of the Earth was 20 millions of years, by William Thomson, Lord Kelvin (reduced from an earlier estimate of 100 million years). Rutherford and Boltwood's initial measurements based on radioactive decay demonstrated a timescale of billions of years, subsequently refined to the present value of 4.6 billion +/- 1% in the 1950s. That still didn't explain much geological activity, particularly vulcanology, earthquakes, uplifts, and subsidence (though sedimentation and erosion were well understood). That required the notion of plate tectonics and continental drift, formally adopted only in 1965-1967 (by various conferences / professional bodies). Plate tectonics, driven by residual thermal heat of formation and radioactive decay in the Earth's core and mantle is now considered the theoretical underpinning of all of geology. It's formal adoption is 55 years old, for a study that's existed since the time of ancient Greece. The social sciences -- sociology, psychology, political economy, and political science -- lack any such empirically demonstratable and falsifiable theoretcal underpinning. To a large extent they've resisted adopting one. That last point isn't uncommon -- biology certainaly resisted evolution, and geology plate tectonic (see Naomi Oreske's works on this topic, themselves fascinating studies of the evolution of scientific theory: https://www.worldcat.org/search?qt=worldcat_org_all&q=au%3Aoreskes%20naomi%20kw%3Atectonics https://www.worldcat.org/search?qt=worldcat_org_all&q=au%3Ao...). And as with pre-genetic biology, pre-tectonic geology, pre-Newtonian physics, and pre-Mendeleevian chemistry, there are useful concepts, models, methods, and mathematical relations in these fields. But not a true unifying theoretic basis.

mjevans 7y ago

It needn't even be chemical; any sort of differential test that proves a deviation from baseline measure and treatment that helps mediate a return to that profile would at least be good science and may good medicine. Maybe someday we'll have wide access to inexpensive monitoring techniques that could fill this need.

elfexec 7y ago

> So the argument today that psychiatry lacks any scientific basis and rigor for its practices is still very valid and legitimate. It's been said that psychiatry is the new religion and psychiatrists the new priests for a reason. Any good actor with enough information can pretend he has a mental illness and fool psychiatrists. Not only that, you can have psychiatrists come up with different diagnoses for the same individual - even to the point of contradicting each other. And there is no scientific way to show one psychiatrist is correct or not. Just like religion was the best we could do with level of knowledge we had in the past. Psychiatry is sadly the best we can do with the current level of knowledge. It's pretty much voodoo, but it's better than the voodoo that came before it. If neuroscience ( an actual science ) lives up to its potential, then we'll finally be able to toss psychology into the same waste bin we put astrology in and perhaps psychiatry can have a scientific foundation.

DanBC 7y ago

> any proof of its claims of "chemical imbalance", Can you find me any psychiatrist that's pushing the chemical imbalance theory? Every single doctor I know thinks chemical imbalance is bunk.