3 ms·

An overview of Bipolar disorder: https://www.nhs.uk/mental-health/conditions/bipolar-disorder/ https://www.nhs.uk/mental-health/conditions/bipolar-disorder...

lo_zamoyski 4y ago
Quoting the pages linked above: "Bipolar disorder is widely believed to be the result of chemical imbalances in the brain." As I understand it, the notion of a "chemical imbalance" as the cause of mental and mood disorders is highly dubious and losing support. It may be attractive within the context of a certain kind of reductive psychiatric paradigm and can sometimes sound a lot like New Age woo. What does it mean for neurotransmitters to be "in balance"? What is the cause of imbalances? If there is a cause, then is it really the imbalance that's at issue, or is the imbalance merely a sign of some underlying problem (like having too much bilirubin in the blood can indicate living failure)? Add to this that what are commonly accepted mental disorders are generally descriptive, collections of symptoms, rather than causes, though in common speech we often reify these descriptions into some cohesive cause to which we attribute causal power (this, too, can be appealing because it allows you to feel like the cause has been identified and this can feel comforting if you are suffering). Of course, I am not claiming that constitutional factors cannot cause or contribute to mental disorders. However, it is also possible to ascribe too much to constitution. We often speak of mental, constitutional, and moral factors as if they were distinct, but each can influence the other. Just as constitutional factors can contribute to mental disorders, so can moral factors. A habit of lying, for example, can contribute to depression and anxiety. Denial of truths that we'd rather not face can become expressed as obsessive-compulsive disorders. A hedonistic lifestyle can negatively impact cognition and lead to monomania. I think ignoring these other angles and searching solely for constitutional factors is a disservice. We are seeing an increase of mental disorders today and the causes are very unlikely to be solely constitutional.
- kayodelycaon 4y ago
  Bipolar disorder falls so outside the norm of human functioning to exclude “lack of morals” as a cause or as a contributing factor. For myself, I am a “moral person” in most regards. There is nothing I can do to stop or prevent my episodes without medication. For most people it is a severely limiting disability.
- PuppyTailWags 4y ago
  > A habit of lying, for example, can contribute to depression and anxiety. Denial of truths that we'd rather not face can become expressed as obsessive-compulsive disorders. A hedonistic lifestyle can negatively impact cognition and lead to monomania. I don't really know if any of these are true and I don't understand the correlation of these things. I don't know what correlates lying with depression and anxiety, partially because I know liars who aren't depressed or anxious, liars who are depressed or anxious, and don't know how their lying has a causal factor to anything. This also goes on for hedonistic lifestyles- I've seen depressed dropouts drowning in hedonism and I've seen ultra-wealthy hedonistic celebrities and I don't understand the correlation or causation you're trying to make. Can you please clarify this point? I genuinely don't understand this because it doesn't match my model of reality, which doesn't show any apparent correlations of generic character flaws (such as lying a lot) with specific mood disorders (like generalized anxiety).
- mnemonicsloth 4y ago
  Dude, bipolar disorder can be just about cured in some people by dosing them with ground-up rocks. Lithium is a chemical element. If it isn’t inducing some kind of chemical change, what is it doing?
  - samatman 4y ago
    Inducing some chemical change is so broad as to be meaningless. "Chemical imbalance" is at least a claim, and GP was right to question it before going way off the rails. To address that: major mood disorders are caused by something, and it isn't the decisions of the sufferer. Those can make it better or worse, sure, but to even entertain the idea means you've never encountered this in the wild. Treating something with a chemical doesn't mean what you were treating is a chemical imbalance. If it's vitamin C and scurvy, yes, if it's ulcers and antibiotics, no. No one thinks bipolar disorder is caused by a lack of lithium. The theory of chemical imbalance is just a theory, one I don't happen to think has much going for it.
    - mnemonicsloth 4y ago
      You’re being pedantic. I’m with you that “imbalance” sounds a little new-agey and imprecise, but I’ve talked to a lot of scientific and medical people about BiPD and I haven’t met one yet who didn’t understand what was actually being said: that bipolar disorder has some kind of physical, correctable cause in the brain. Somewhere in there, all those little lithium ions pummel a misfolded protein into shape or clog up an ion channel or something in such a way that the patient experiences relief. It isn’t precise. But back in the real world, the “chemical imbalance“ explanation serves the very important purpose of explaining to a lot of ordinary people who otherwise wouldn’t understand that bipolar people who are manic or depressed are not in control of what they do. And that’s important, because when they’re manic or depressed, bipolar people often act like bad people.
      - samatman 4y ago
        I'm not being pedantic at all, my best bet is that bipolar disorder arises from brain connectome structure, not chemical imbalance. The chemical imbalance theory of various disorders is ascendant but it's by no means universally supported for bipolar disorder. These days "depression is when you don't got serotonin" is likely to get you laughed out of the room.
- jstarfish 4y ago
  > Just as constitutional factors can contribute to mental disorders, so can moral factors. I agreed with you up to here. It seems like you're replacing chemical imbalances with morality. Mental illness does not abide by morality. For example: > A habit of lying, for example, can contribute to depression and anxiety. Sure. People can be anxious about their lies catching up to them. Yet there are people that compulsively lie even when they've been outed and presented with material evidence to the contrary. It defies all logic and appears compulsive, like... > Denial of truths that we'd rather not face can become expressed as obsessive-compulsive disorders. I agree with this too, but two independent statements being True does not imply a causal relationship between them. This behavior is found in Histrionic and Narcissistic personality disorders too (and maybe Borderline?). It has been suggested that pathological lying is a symptom of OCD. The internet is divided on this, but in my anecdotal observations, this has held true. The worst liars I know all have OCD, but not everyone with OCD is a liar. I don't claim to understand why this overlap exists. > A hedonistic lifestyle can negatively impact cognition and lead to monomania. Sure, but what does one "get" from a Hedonistic lifestyle? I would suggest: dopamine surges. This might seem like an easy-to-reach response to Depression, but consider that monomania/ADHD (a cognitive disorder) is literally treated with...induced dopamine surges (in the form of amphetamines). So does the subject drown themselves in sex and drugs because they are a Lazy Glutton, because they are Depressed...or because there was something wrong with their ability to regulate dopamine production in the first place? My pet theory: the biggest shortcoming of modern psychiatry is that we over-extrapolate observations of small groups of people as though their traits universally apply to all humans. That some people thrived during quarantine while others went berserk should attest to how we are more different than we care to admit, but we don't have a non-eugenic way of cataloguing those differences beyond labeling everyone as having some sort of psychiatric disorder because their behavior deviates from arbitrary baselines (which is in itself a problem). Some people just can't follow orders, some are born leaders, some can't sit at a desk for 8-12 hours a day, some can live happily underground, some are liars and storytellers, some overeat. There's probably a genetic reason why individuals are wired to do each of these things, but our best guesses to date have been ridiculous and seem to be discredited with each new generation. Two cats of the same species won't behave identically either. Is either one flawed, or are both optimized for purposes we don't recognize?
- confidantlake 4y ago
  > A habit of lying, for example, can contribute to depression and anxiety. Denial of truths that we'd rather not face can become expressed as obsessive-compulsive disorders. A hedonistic lifestyle can negatively impact cognition and lead to monomania Is there any evidence of this? Not saying you are wrong but without a cite this just seems hand-wavy conjecture. I could just as easily say lying to yourself about the state of the world leads to happiness and it is the realists that are depressed and anxious.

lo_zamoyski 4y ago

Quoting the pages linked above: "Bipolar disorder is widely believed to be the result of chemical imbalances in the brain." As I understand it, the notion of a "chemical imbalance" as the cause of mental and mood disorders is highly dubious and losing support. It may be attractive within the context of a certain kind of reductive psychiatric paradigm and can sometimes sound a lot like New Age woo. What does it mean for neurotransmitters to be "in balance"? What is the cause of imbalances? If there is a cause, then is it really the imbalance that's at issue, or is the imbalance merely a sign of some underlying problem (like having too much bilirubin in the blood can indicate living failure)? Add to this that what are commonly accepted mental disorders are generally descriptive, collections of symptoms, rather than causes, though in common speech we often reify these descriptions into some cohesive cause to which we attribute causal power (this, too, can be appealing because it allows you to feel like the cause has been identified and this can feel comforting if you are suffering). Of course, I am not claiming that constitutional factors cannot cause or contribute to mental disorders. However, it is also possible to ascribe too much to constitution. We often speak of mental, constitutional, and moral factors as if they were distinct, but each can influence the other. Just as constitutional factors can contribute to mental disorders, so can moral factors. A habit of lying, for example, can contribute to depression and anxiety. Denial of truths that we'd rather not face can become expressed as obsessive-compulsive disorders. A hedonistic lifestyle can negatively impact cognition and lead to monomania. I think ignoring these other angles and searching solely for constitutional factors is a disservice. We are seeing an increase of mental disorders today and the causes are very unlikely to be solely constitutional.

kayodelycaon 4y ago
Bipolar disorder falls so outside the norm of human functioning to exclude “lack of morals” as a cause or as a contributing factor. For myself, I am a “moral person” in most regards. There is nothing I can do to stop or prevent my episodes without medication. For most people it is a severely limiting disability.
PuppyTailWags 4y ago
> A habit of lying, for example, can contribute to depression and anxiety. Denial of truths that we'd rather not face can become expressed as obsessive-compulsive disorders. A hedonistic lifestyle can negatively impact cognition and lead to monomania. I don't really know if any of these are true and I don't understand the correlation of these things. I don't know what correlates lying with depression and anxiety, partially because I know liars who aren't depressed or anxious, liars who are depressed or anxious, and don't know how their lying has a causal factor to anything. This also goes on for hedonistic lifestyles- I've seen depressed dropouts drowning in hedonism and I've seen ultra-wealthy hedonistic celebrities and I don't understand the correlation or causation you're trying to make. Can you please clarify this point? I genuinely don't understand this because it doesn't match my model of reality, which doesn't show any apparent correlations of generic character flaws (such as lying a lot) with specific mood disorders (like generalized anxiety).
mnemonicsloth 4y ago
Dude, bipolar disorder can be just about cured in some people by dosing them with ground-up rocks. Lithium is a chemical element. If it isn’t inducing some kind of chemical change, what is it doing?
- samatman 4y ago
  Inducing some chemical change is so broad as to be meaningless. "Chemical imbalance" is at least a claim, and GP was right to question it before going way off the rails. To address that: major mood disorders are caused by something, and it isn't the decisions of the sufferer. Those can make it better or worse, sure, but to even entertain the idea means you've never encountered this in the wild. Treating something with a chemical doesn't mean what you were treating is a chemical imbalance. If it's vitamin C and scurvy, yes, if it's ulcers and antibiotics, no. No one thinks bipolar disorder is caused by a lack of lithium. The theory of chemical imbalance is just a theory, one I don't happen to think has much going for it.
  - mnemonicsloth 4y ago
    You’re being pedantic. I’m with you that “imbalance” sounds a little new-agey and imprecise, but I’ve talked to a lot of scientific and medical people about BiPD and I haven’t met one yet who didn’t understand what was actually being said: that bipolar disorder has some kind of physical, correctable cause in the brain. Somewhere in there, all those little lithium ions pummel a misfolded protein into shape or clog up an ion channel or something in such a way that the patient experiences relief. It isn’t precise. But back in the real world, the “chemical imbalance“ explanation serves the very important purpose of explaining to a lot of ordinary people who otherwise wouldn’t understand that bipolar people who are manic or depressed are not in control of what they do. And that’s important, because when they’re manic or depressed, bipolar people often act like bad people.
    - samatman 4y ago
      I'm not being pedantic at all, my best bet is that bipolar disorder arises from brain connectome structure, not chemical imbalance. The chemical imbalance theory of various disorders is ascendant but it's by no means universally supported for bipolar disorder. These days "depression is when you don't got serotonin" is likely to get you laughed out of the room.
jstarfish 4y ago
> Just as constitutional factors can contribute to mental disorders, so can moral factors. I agreed with you up to here. It seems like you're replacing chemical imbalances with morality. Mental illness does not abide by morality. For example: > A habit of lying, for example, can contribute to depression and anxiety. Sure. People can be anxious about their lies catching up to them. Yet there are people that compulsively lie even when they've been outed and presented with material evidence to the contrary. It defies all logic and appears compulsive, like... > Denial of truths that we'd rather not face can become expressed as obsessive-compulsive disorders. I agree with this too, but two independent statements being True does not imply a causal relationship between them. This behavior is found in Histrionic and Narcissistic personality disorders too (and maybe Borderline?). It has been suggested that pathological lying is a symptom of OCD. The internet is divided on this, but in my anecdotal observations, this has held true. The worst liars I know all have OCD, but not everyone with OCD is a liar. I don't claim to understand why this overlap exists. > A hedonistic lifestyle can negatively impact cognition and lead to monomania. Sure, but what does one "get" from a Hedonistic lifestyle? I would suggest: dopamine surges. This might seem like an easy-to-reach response to Depression, but consider that monomania/ADHD (a cognitive disorder) is literally treated with...induced dopamine surges (in the form of amphetamines). So does the subject drown themselves in sex and drugs because they are a Lazy Glutton, because they are Depressed...or because there was something wrong with their ability to regulate dopamine production in the first place? My pet theory: the biggest shortcoming of modern psychiatry is that we over-extrapolate observations of small groups of people as though their traits universally apply to all humans. That some people thrived during quarantine while others went berserk should attest to how we are more different than we care to admit, but we don't have a non-eugenic way of cataloguing those differences beyond labeling everyone as having some sort of psychiatric disorder because their behavior deviates from arbitrary baselines (which is in itself a problem). Some people just can't follow orders, some are born leaders, some can't sit at a desk for 8-12 hours a day, some can live happily underground, some are liars and storytellers, some overeat. There's probably a genetic reason why individuals are wired to do each of these things, but our best guesses to date have been ridiculous and seem to be discredited with each new generation. Two cats of the same species won't behave identically either. Is either one flawed, or are both optimized for purposes we don't recognize?
confidantlake 4y ago
> A habit of lying, for example, can contribute to depression and anxiety. Denial of truths that we'd rather not face can become expressed as obsessive-compulsive disorders. A hedonistic lifestyle can negatively impact cognition and lead to monomania Is there any evidence of this? Not saying you are wrong but without a cite this just seems hand-wavy conjecture. I could just as easily say lying to yourself about the state of the world leads to happiness and it is the realists that are depressed and anxious.