6 ms·

I've had a small 3rd party encounter with mental health services here in Virginia. I got about half way through the article, couldn't finish it. Honestly, what

I've had a small 3rd party encounter with mental health services here in Virginia. I got about half way through the article, couldn't finish it. Honestly, what this doctor is doing with TMS sounds just like what I saw the doctors do here. Throw crap at the wall and see what sticks. Talk with the patient for fifteen minutes, prescribe them a drug cocktail, hold for a few days, say some mumbo jumbo about having a small spirit child inside you. You have to see a judge before we release you. Nevermind, no you don't. Time to go, boot them out the door. And here's the HN crowd, getting all excited about the potential of micro dosing LSD. I think my baking soda volcano from grade school was more scientific. I'm not saying there's no point in trying. I'm just saying I think we're over confident in what we think we know. At some point, it starts to feel like we're just making it up as we go along.

sangnoir 7y ago
> we're over confident in what we think we know. This should be HN's tagline.
nradov 7y ago
Yes that's basically right. We still don't know enough to reliably diagnose the root cause of most mental health problems based on direct tests or observations. So physicians have to prescribe treatments on a trial and error basis using a mix of intuition and scientific evidence until they find something that seems to work reasonably well for the patient. The long-term effects of many drugs — both legal and illegal — are largely unknown and sometimes impossible to reliably determine.
- bjt2n3904 7y ago
  I'm not aware of any "scientific evidence" that physicians use with patients. There's no way to measure depression objectively. An assertion that someone's "brain chemistry" is off holds about as much water as their chi being misaligned. It sounds sciencey, but if you can't measure it, you're making things up.
  - nradov 7y ago
    There are standardized depression screening questionnaires such as PHQ-9. Those are at least somewhat subjective, but they are widely used in large scale double-blind studies of mental health treatments. If a large fraction of subjects report a significant improvement in symptoms relative to the control group then we can have some scientific confidence in the treatment. http://www.cqaimh.org/pdf/tool_phq9.pdf http://www.cqaimh.org/pdf/tool_phq9.pdf Brain chemistry such as neurotransmitter levels is clearly a factor in some mental health conditions. There is no serious dispute of this fact. But it's also clearly not the only factor.

sangnoir 7y ago

> we're over confident in what we think we know. This should be HN's tagline.

nradov 7y ago

Yes that's basically right. We still don't know enough to reliably diagnose the root cause of most mental health problems based on direct tests or observations. So physicians have to prescribe treatments on a trial and error basis using a mix of intuition and scientific evidence until they find something that seems to work reasonably well for the patient. The long-term effects of many drugs — both legal and illegal — are largely unknown and sometimes impossible to reliably determine.

bjt2n3904 7y ago
I'm not aware of any "scientific evidence" that physicians use with patients. There's no way to measure depression objectively. An assertion that someone's "brain chemistry" is off holds about as much water as their chi being misaligned. It sounds sciencey, but if you can't measure it, you're making things up.
- nradov 7y ago
  There are standardized depression screening questionnaires such as PHQ-9. Those are at least somewhat subjective, but they are widely used in large scale double-blind studies of mental health treatments. If a large fraction of subjects report a significant improvement in symptoms relative to the control group then we can have some scientific confidence in the treatment. http://www.cqaimh.org/pdf/tool_phq9.pdf http://www.cqaimh.org/pdf/tool_phq9.pdf Brain chemistry such as neurotransmitter levels is clearly a factor in some mental health conditions. There is no serious dispute of this fact. But it's also clearly not the only factor.