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I like the article. With psychedelics, it's clear that much of the excitement comes from people (including scientists) who have used them and found their experi
by slibhb 5y ago
I like the article. With psychedelics, it's clear that much of the excitement comes from people (including scientists) who have used them and found their experiences helpful. That's not science but that doesn't mean it's wrong. Not everything is amenable to clinical study and this doesn't mean we should disregard it.
And the issue isn't just psychedelics being hard to study. Mental health is hard to study. An overweight man with no friends who plays computer games all day is not depressed unless he feels bad about it. Mental health depends on subjective feelings. Hard to study that!
My view is that we should continue to think about psychedelics from a religious or spiritual perspective. Even if that's literally incorrect, it's the correct metaphor. I'm also very skeptical of people who think widespread use of psychedelics can make society better. Lots of people used LSD in the 60s and 70s and as far as I can tell they didn't usher in a new age of love, peace, and tolerance.
- kayodelycaon 5y ago> Mental health depends on subjective feelings. This isn’t correct in a lot of places. There is a number of diagnostic criteria. The most important being how much it affects your quality of life. This can be directly measured by looking at how the individual functions day to day. An example is “Was the person able to shower regularly?” (This assumes the person wishes to shower if they have the ability and opportunity.) It’s pretty easy to record the number of panic attacks or how often the person has suicidal ideation. ADHD can be measured by asking the individual to preform tests under specific conditions. Significant changes in psychosis and paranoia can readily be determined with structured interviews. The problem is most of these things are not easily and correctly measured by a questionnaire. You need more expertise to get this information out of a patient.
- slibhb 5y agoIt's worth it to study these things from a behavoral or functional perspective but that is also very hard. If only because, ultimately, people seek treatment or don't based on subjective feelings. I think there's unavoidably an element of subjectivity here. You can attempt to minimize it but it's always there.
- kayodelycaon 5y ago> If only because, ultimately, people seek treatment or don't based on subjective feelings. Well… yes? You’re not going to seek help for mental illness if you don’t think you have a problem. You’re also not going to enroll in a study, either.
- banannaise 5y ago> The most important being how much it affects your quality of life. This is unique among illnesses. Whether or not I have a cold does not depend on how much it affects my quality of life. Why is mental illness different?
- carlob 5y agoUh? If the cold didn't affect your quality of life we would call it an asymptomatic infection. But active symptoms do affect your quality of life...
- zeroonetwothree 5y agoIf you go to a doctor and say "I think I have cold" but then you say you have no symptoms I don't think they are going to take you seriously... By definition symptoms affect your quality of life.
- kayodelycaon 5y agoThe symptoms of a mental illness can overlap with normal variations of personality. It is very important to note this is overlap, *not* a spectrum! A person’s baseline can be altered by mental illness but not severely enough to be indistinguishable from a personality difference. Telling the two apart is damn near impossible. Since we don’t have blood tests, we cannot tell the difference. So we need to fall back on want little objective criteria can be found. Behavioral criteria can be skewed due to environment. An active kid who wants to run around isn’t going to do well being stuck in a classroom for six hours. A curious kid with ADHD, who would otherwise be a good student also won’t do well because they can’t stay on task. These look identical. (This is why ADHD is both over and under diagnosed.) This results in family history and quality of life being more objective than self-reported feelings.
- tsimionescu 5y agoMostly because we know very little about mental illness, so we are just guessing. Previously, we had a terrible habit of identifying "mental illness" by external factors, such as meeting social and moral norms (so being gay was considered a mental illness, as was being troublesome). To avoid this, and given that our understanding of the fundamentals has barely improved, if at all, we have chosen to take an approach that is much less likely to cause extraordinary distress to people who are perfectly well. Remember that being labeled mentally ill can durectly rob you of your most basic human rights, so this is not a diagnostic that should be easily applied.
- dwaltrip 5y agoI really hate the mental health questionnaires. They did a poor job of assessing my difficulties when I was in the thick of it (I’m doing much better now). I also found them quite stressful to fill out. I remember getting scores of “mild anxiety” or “mild depression” and just kind of sitting there confused and somewhat dismayed, thinking… “Why am I having such a hard time? What is actually wrong with me?” Turns out some of my core issues were difficulty knowing and connecting with my emotional state, constantly trying to meet intense expectations that I believed were necessary regardless of how I was feeling, putting (what I imagined to be) the needs of others above my own needs, and having deep fractures in my sense of self-worth. Five years ago, I was largely oblivious to all of that. All though some pieces of the puzzle had been slowly coming together for some time. Some potentially more informative labels for what I’ve been dealing with: C-PTSD, emotional neglect, and / or highly sensitive person. C-PTSD isn’t even in the frickin DSM! I had taken online questionnaires (the anxiety and depression ones mentioned earlier were from medical professionals) for PTSD. It didn’t really match up, which makes sense. There is less material for C-PTSD compared to PTSD. I did try one or two assessments I found online for c-ptsd and I think I got a score that was very close to the “clinical threshold”. Which was a little helpful. But it took me quite a while to get to that point and I was still confused and uncertain. All that to say… The ”best in class” assessments, as well as our general ability to classify and understand the mental health difficulties that people experience, are not very good. We can do much, much better. And doing so would alleviate an immense amount of suffering. P.S. My advice for anyone who relates to this is to find a good somatic therapist who knows how to work with complex trauma / emotional neglect. It’s very difficult to work through this on your own. I was pretty skeptical about therapy… It took me 4 tries to find a good therapist. The first 3 were not that helpful. The somatic approach is important. If you haven’t found a good therapist, keep looking!
- mountainriver 5y agoExactly, the reality of the mental health field is they know very little and their methodologies are largely flawed. I've been diagnosed with so many different things based on their "scientific methods" when at the end of the day they are just making rough guesses. I get really turned off by any article that acts like we have a clear understanding of these things. Most things are actually just reactions to trauma.
- lozenge 5y ago> The problem is most of these things are not easily and correctly measured by a questionnaire. You need more expertise to get this information out of a patient. It sounds like you're agreeing. Mental health is subjective feelings. When we want to study it, we reduce it to an objective measure of a few dimensions, like those diagnostic questionnaires. This removes its complexities, but also allows some level of standardisation across studies.
- standardUser 5y ago"Lots of people used LSD in the 60s and 70s" That's an overblown stereotype. The vast, vast majority of people did not use any drugs in that era.
- slibhb 5y ago"Lots" is not the same thing as "the vast majority". Millions of people used LSD between '66 and '80.
- standardUser 5y agoMillions of people use LSD every year today, in addition to a dozen other hallucinogens. https://www.scientificamerican.com/article/americans-increase-lsd-use-and-a-bleak-outlook-for-the-world-may-be-to-blame1/ https://www.scientificamerican.com/article/americans-increas... "In the late 1970s... 10 percent of high school seniors reported ever using LSD, compared with 6 percent today." Ten percent isn't very much. Americans in the 60's and 70's were far more likely to support endless jail time for drug users than to be one themself.
- slibhb 5y ago> Ten percent isn't very much Is this really a hill you want to die on? Seems like a rather large sample to me... Here's a graph from wikipedia: https://en.wikipedia.org/wiki/History_of_lysergic_acid_diethylamide#/media/File:LSD_annual_new_use_USA_1967-2008.png https://en.wikipedia.org/wiki/History_of_lysergic_acid_dieth...
- aaaaaaaaata 5y ago> Ten percent isn't very much. It took less than that to bring Pokémon-frenzy into my school, and it only takes 1-3% of a population to effect revolution. I don't know, bud.
- vehementi 5y ago> as I can tell they didn't usher in a new age of love, peace, and tolerance. Things did improve, but of course how would you attribute it to that, and of course, how would you account for the effectiveness of the counter forces? Just because something didn't succeed completely doesn't mean we can conclude it has no effect, especially if it wasn't actually tried at the suggested scale. We have this problem in Vancouver with opioid addiction and there are some services in place but they are mostly shit and the government's overall plan is direly incomplete. Then people say "Wow, we spent money on harm reduction and still have addicts".
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- slibhb 5y ago> There was madness in any direction, at any hour. If not across the Bay, then up the Golden Gate or down 101 to Los Altos or La Honda. . . . You could strike sparks anywhere. There was a fantastic universal sense that whatever we were doing was right, that we were winning. . . . > And that, I think, was the handle—that sense of inevitable victory over the forces of Old and Evil. Not in any mean or military sense; we didn’t need that. Our energy would simply prevail. There was no point in fighting—on our side or theirs. We had all the momentum; we were riding the crest of a high and beautiful wave. . . . > So now, less than five years later, you can go up on a steep hill in Las Vegas and look West, and with the right kind of eyes you can almost see the high-water mark—that place where the wave finally broke and rolled back. That's Hunter S. Thompson on the 60s drug movement. I'm not saying it led to nothing but it certainly didn't lead where its members expected and its legacy is far from clear. I think we should continue to study these drugs. I just think there's a lot of unwarranted optimism.
- xyzzy123 5y agoI don't think that vibe was unique to drugs or the 60's, perhaps every generation gets that. For example, I feel the same way about the 90's Internet... It's hard to explain the optimism a lot of people felt at the time. It seemed like it could fix the world, what if everyone could just talk to each other? Couldn't we fix the misunderstandings? We were gonna route around the censorship and cryptography (not crypto...) was going to free us from The Man. State control of "the message" through TV and newspapers was over. I look at what we got and there it is, human nature staring right back at me. Anyway, what a sap.
- dkjaudyeqooe 5y ago> An overweight man with no friends who plays computer games all day is not depressed unless he feels bad about it. This is entirely wrong. You can suffer from depression (and anxiety) and attribute it to other things, such as personality traits. Many people think "that's just me" with those that know them thinking the same. For less acute forms of depression such as dysthymia, that's common. People can think they're entirely normal and they're just not good at certain things. If you talk to sufferers of serious and disruptive mental illnesses such as schizophrenia and bipolar with psychotic features, most of them will deny they're ill at all and rationalise their behavior. They'll generally talk about it by saying "well my doctors say..." and suggest that their doctors have been mislead or have misdiagnosed them. It's much more complicated than it seems. It's all part of the perniciousness of mental illness.
- slibhb 5y ago> This is entirely wrong. You can suffer from depression (and anxiety) and attribute it to other things, such as personality traits. Many people think "that's just me" with those that know them thinking the same. For less acute forms of depression such as dysthymia, that's common. People can think they're entirely normal and they're just not good at certain things. My post explicitly says the hypothetical man is happy, not that he thinks "that's just me". If you want to argue against that, you have to define mental illness from a behavoral or functional perspective which I don't think you've done.
- netizen-936824 5y agoWhat if the subject doesn't realise they're unhappy because they've never been happy and have nothing to compare against? Your statements seem to assume everyone has the same perspective to measure against, but in reality people's perspective can be radically different
- slibhb 5y agoLike I said, you can make that argument, but then you need to provide a criterion for saying someone is unhappy. That's where behavioralism or functionalism or something similar comes in. > Your statements seem to assume everyone has the same perspective to measure against, but in reality people's perspective can be radically different On the contrary, I think people have different perspectives. Two people can be in the exact same situation and their subjective feelings can be radically different.
- mwattsun 5y ago> Lots of people used LSD in the 60s and 70s and as far as I can tell they didn't usher in a new age of love, peace, and tolerance. I would argue that LSD helped end the war in Vietnam. It's also not a fair criticism because governments around the world demonized LSD and made it a crime to partake, so you took it in an atmosphere of fear and paranoia. Hallucinogenics are only now given a fair test. There's already lots of anecdotal evidence that hallucinogens changed lives for the better (Steve Job, Richard Alpert.) A lot more has to change before a new age of love, peace and tolerance comes about, things like human greed and selfishness. No one is claiming that LSD turns people into angels.
- tonguez 5y ago"Mental health is hard to study." is it? what is mental health? "I'm also very skeptical of people who think widespread use of psychedelics can make society better. Lots of people used LSD in the 60s and 70s and as far as I can tell they didn't usher in a new age of love, peace, and tolerance." what was the control in this experiment?
- elliekelly 5y ago> Lots of people used LSD in the 60s and 70s and as far as I can tell they didn't usher in a new age of love, peace, and tolerance. Is there any research that attempts to put a number on what portion of the population was using LSD at this time?
- slibhb 5y agoWikipedia has some sources and a graph (I have no idea how accurate it is): https://en.wikipedia.org/wiki/History_of_lysergic_acid_diethylamide#Recreational_use https://en.wikipedia.org/wiki/History_of_lysergic_acid_dieth...
- PaulDavisThe1st 5y ago> Lots of people used LSD in the 60s and 70s and as far as I can tell they didn't usher in a new age of love, peace, and tolerance There's a documentary on UK late 90's rave culture that noted that perhaps 60-100,000 people in the USA indulged in LSD during the period you mention. By contrast, somewhere on the order of 10-20 MILLION people dropped MDMA/ecstasy during the heyday of UK rave culture. The documentary went on to note that there are a lot of professional, retail and public spaces in the UK that have been built in the last 15 years that show particularly strong connections to the "chill out room" vibe that became significant during the ecstasy+rave period. Even real estate agent office (realtors in the US) design is claimed to show many elements of chill out aesthetics.
- Epiphany21 5y ago>That's not science Why can't it be? Why can't we just start doing studies on people who have already had positive experiences with these drugs? Why is there an assumption that one size has to fit all? The data collected from them would useful as a control group regardless.