4 ms·

What's the mechanism? My point is that depression is such a wide category that even if it exists it's useless. You could say that "being human" is a disease, i

What's the mechanism? My point is that depression is such a wide category that even if it exists it's useless. You could say that "being human" is a disease, it always leads to death. I'm not saying "being human" doesn't exist.

matheusmoreira 7y ago
The pathophysiology of depression is not fully understood. It is possible that what we understand as depression today could become several distinct diseases in the future. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181668/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181668/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984887/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984887/ In any case, the impact of depression is known and it can't be ignored. Doctors must at least try to help depressed patients. There are models which guide pharmacological and behavorial treatments employed in current practice. They are proven to be superior to placebo.
- solinent 7y ago
  That's my point. You haven't even come up with a basic taxonomy of depression and you're already applying your theory. In physics this would be blasphemous. > Doctors must at least try to help depressed patients. All the help I've received has been useless or actively harmful. No one even told me to exercise or diet, in fact, some suggested I take it easy, stop blaming myself. That was all wrong. I was to blame. Every morning, by blaming myself, I made better choices w.r.t health. Now I am no longer to blame, I have no depression. I used to be arthritic and asthmatic, now I am biking for hours straight, doing pull-ups every day.
  - matheusmoreira 7y ago
    > You haven't even come up with a basic taxonomy of depression and you're already applying your theory. We have no choice but to apply these theories. The alternative would be to do nothing until they are perfected. That would be negligence. Antidepressants do not have a 100% success rate. Nothing in medicine has. That doesn't mean they shouldn't be used. > In physics this would be blasphemous. Not really. Plenty of theories ended up being revised when humanity's understanding of the world improved. They still had real world applications: even though they were imperfect, they were good enough for a wide variety of uses. We don't fully understand depression. We don't even fully understand how some medications work. However, we have studies showing that by taking these medications patients improve and mortality decreases. That's enough to justify their use.
    - solinent 7y ago
      > Not really. Plenty of theories ended up being revised when humanity's understanding of the world improved. They still had real world applications: even though they were imperfect, they were good enough for a wide variety of uses. Those imperfect theories are applied today, and still work in lots of contexts. They are complete, but subsets. We can make predictions, given certain initial conditions, with accuracy as close to 100% as you require, the only issue is measurement. Comparing psychology to physics in this manner is pretty embarrassing, and shows a lack of understanding of physics. Applying imperfect physical theories causes bombs to explode where they shouldn't, nuclear plants to react when they shouldn't. We don't build fusion reactors today because we still need to determine the safety of isolating the plasma. > We have no choice but to apply these theories. The alternative would be to do nothing until they are perfected. That would be negligence. Antidepressants do not have a 100% success rate. Nothing in medicine has. That doesn't mean they shouldn't be used. I didn't say they needed to have a 100% success rate. You just need to find the mechanism. I'd be happy with a 0.1% success rate if our determination of the mechanism implies that there is no cure once it reaches that stage. Let's do a study--I think drinking alcohol has cured my depression. It doesn't have a 100% success rate, but it would be negligent to tell people that they shouldn't get plastered if they're depressed. edit: Don't drink alcohol to cure your depression. I suspect the mechanism is related to the gut flora. Alcohol kills the gut flora.
      - matheusmoreira 7y ago
        > Applying imperfect physical theories causes bombs to explode where they shouldn't, nuclear plants to react when they shouldn't. We don't build fusion reactors today because we still need to determine the safety of isolating the plasma. Failures in nuclear reactors can have disastrous outcomes for a huge number of people. Is this comparable to the use of prescription drugs under medical supervision? A failure in these cases means the patient may experience adverse effects for no benefit, a risk inherent in any treatment. > You just need to find the mechanism. People are working on it. Meanwhile, we have make the best of what we know right now. > Let's do a study--I think drinking alcohol has cured my depression. It doesn't have a 100% success rate, but it would be negligent to tell people that they shouldn't get plastered if they're depressed. Alcohol and depression aren't a good mix. https://pubmed.ncbi.nlm.nih.gov/21382111/ https://pubmed.ncbi.nlm.nih.gov/21382111/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6799954/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6799954/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712746/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712746/
markroseman 7y ago
I'd agree in so far as it makes pulling scams (or innocently giving useless advice) far too easy: "I had depression, and I tried X, and it worked. You've got depression, so you should try X." Extremely unlikely to be helpful, and often can be harmful.
- solinent 7y ago
  Yes, it's like cancer, we don't know the cure but everyone rushes to tell you that you just need to take a pill and you'll feel better. Which pill?

matheusmoreira 7y ago

The pathophysiology of depression is not fully understood. It is possible that what we understand as depression today could become several distinct diseases in the future. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181668/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181668/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984887/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984887/ In any case, the impact of depression is known and it can't be ignored. Doctors must at least try to help depressed patients. There are models which guide pharmacological and behavorial treatments employed in current practice. They are proven to be superior to placebo.

solinent 7y ago
That's my point. You haven't even come up with a basic taxonomy of depression and you're already applying your theory. In physics this would be blasphemous. > Doctors must at least try to help depressed patients. All the help I've received has been useless or actively harmful. No one even told me to exercise or diet, in fact, some suggested I take it easy, stop blaming myself. That was all wrong. I was to blame. Every morning, by blaming myself, I made better choices w.r.t health. Now I am no longer to blame, I have no depression. I used to be arthritic and asthmatic, now I am biking for hours straight, doing pull-ups every day.
- matheusmoreira 7y ago
  > You haven't even come up with a basic taxonomy of depression and you're already applying your theory. We have no choice but to apply these theories. The alternative would be to do nothing until they are perfected. That would be negligence. Antidepressants do not have a 100% success rate. Nothing in medicine has. That doesn't mean they shouldn't be used. > In physics this would be blasphemous. Not really. Plenty of theories ended up being revised when humanity's understanding of the world improved. They still had real world applications: even though they were imperfect, they were good enough for a wide variety of uses. We don't fully understand depression. We don't even fully understand how some medications work. However, we have studies showing that by taking these medications patients improve and mortality decreases. That's enough to justify their use.
  - solinent 7y ago
    > Not really. Plenty of theories ended up being revised when humanity's understanding of the world improved. They still had real world applications: even though they were imperfect, they were good enough for a wide variety of uses. Those imperfect theories are applied today, and still work in lots of contexts. They are complete, but subsets. We can make predictions, given certain initial conditions, with accuracy as close to 100% as you require, the only issue is measurement. Comparing psychology to physics in this manner is pretty embarrassing, and shows a lack of understanding of physics. Applying imperfect physical theories causes bombs to explode where they shouldn't, nuclear plants to react when they shouldn't. We don't build fusion reactors today because we still need to determine the safety of isolating the plasma. > We have no choice but to apply these theories. The alternative would be to do nothing until they are perfected. That would be negligence. Antidepressants do not have a 100% success rate. Nothing in medicine has. That doesn't mean they shouldn't be used. I didn't say they needed to have a 100% success rate. You just need to find the mechanism. I'd be happy with a 0.1% success rate if our determination of the mechanism implies that there is no cure once it reaches that stage. Let's do a study--I think drinking alcohol has cured my depression. It doesn't have a 100% success rate, but it would be negligent to tell people that they shouldn't get plastered if they're depressed. edit: Don't drink alcohol to cure your depression. I suspect the mechanism is related to the gut flora. Alcohol kills the gut flora.
    - matheusmoreira 7y ago
      > Applying imperfect physical theories causes bombs to explode where they shouldn't, nuclear plants to react when they shouldn't. We don't build fusion reactors today because we still need to determine the safety of isolating the plasma. Failures in nuclear reactors can have disastrous outcomes for a huge number of people. Is this comparable to the use of prescription drugs under medical supervision? A failure in these cases means the patient may experience adverse effects for no benefit, a risk inherent in any treatment. > You just need to find the mechanism. People are working on it. Meanwhile, we have make the best of what we know right now. > Let's do a study--I think drinking alcohol has cured my depression. It doesn't have a 100% success rate, but it would be negligent to tell people that they shouldn't get plastered if they're depressed. Alcohol and depression aren't a good mix. https://pubmed.ncbi.nlm.nih.gov/21382111/ https://pubmed.ncbi.nlm.nih.gov/21382111/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6799954/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6799954/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712746/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712746/

markroseman 7y ago

I'd agree in so far as it makes pulling scams (or innocently giving useless advice) far too easy: "I had depression, and I tried X, and it worked. You've got depression, so you should try X." Extremely unlikely to be helpful, and often can be harmful.

solinent 7y ago
Yes, it's like cancer, we don't know the cure but everyone rushes to tell you that you just need to take a pill and you'll feel better. Which pill?