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> I think all of the "science" of using drugs to treat mental issues is at the level of advancement comparable to medieval blacksmiths doing dentistry. Discoun

> I think all of the "science" of using drugs to treat mental issues is at the level of advancement comparable to medieval blacksmiths doing dentistry. Discounting an entire field of science like this, based on a second-hand observations, is exactly the kind of hubris the parent comment was talking about: There’s something about psychiatry and neuroscience that makes a lot of people who are good at engineering/software think that they are qualified to also be experts on the field of psychiatry. You’re right that psychiatry and medication is a lot of trial and error, but that’s the most efficient and accurate way to determine which medications work with a patient. In a hypothetical perfect world we’d have more tools to predict ahead of time and this is an active field of study. However, nothing comes close to the speed and efficiency of just trying medications based on what has worked for many other patients with similar conditions. Note they practitioners aren’t just guessing and hoping for the best. They are using a large body of research, clinical experience, and shared knowledge of their peers.

ambicapter 3y ago
> You’re right that psychiatry and medication is a lot of trial and error, but that’s the most efficient and accurate way to determine which medications work with a patient. > Note they practitioners aren’t just guessing and hoping for the best. Soooo, which is it? You can't have it both ways, either trial and error or "educated guess".
- hnaccount141 3y ago
  > Soooo, which is it? You can't have it both ways, either trial and error or "educated guess". Sure you can -- trial and error doesn't mean the things you're trying have to be picked out of a hat at random. You can choose a starting point based on existing research and iterate from there based on the results experienced by the patient.
at_a_remove 3y ago
Psychiatry has a long history of being absolutely sure that this time, they have it right, then doing something hideous, and then moving on. No, no, this time, we have it right. If you want hubris, look to psychiatry. Nobel Prize for lobotomy in 1949, two decades later that is over with. Not to mention its relentless collusion with governments local and larger. Sure, science progresses. As well it should. But psychiatry occupies a particular corner of a square with self-certainty on one axis and "how much could you really know about that topic" on the other.
burnished 3y ago
Think you're tilting at windmills friend. You've described the same situation they did, just in esteemed tones. I think most folks expectation is that since we know so much about so many things that our level of understanding about the brain and psychiatric treatment is more advanced than it is, who are then surprised to find out that some (all?) treatments are basically just modifying the behavior of a messenger chemical across the whole of the brain.
anotherman554 3y ago
"They are using a large body of research, clinical experience, and shared knowledge of their peers." If a psychiatrist prescribes a placebo instead of a kick to the groin they are "......using a large body of research, clinical experience, and shared knowledge of their peers" that show kicks to the groins are bad for patients, and placebos cause them to report improvements. You can defend anything with this sort of language, it's posturing.
feoren 3y ago
> There’s something about psychiatry and neuroscience that makes a lot of people who are good at engineering/software think that they are qualified to also be experts on the field of psychiatry. This isn't always hypocrisy: There's a self-consistent idea here that you're missing: we recognize that psychology (and by extension psychiatry) is extremely hard. Human brains may be the most complex systems in the entire universe. I didn't get the feeling GP was claiming to be an expert, but rather he was claiming "there are no experts in psychology yet". I don't think that's as strong a claim as you seem to think. In fact I think most Ph.D.-level psychology researchers agree with just how tremendously difficult the subject is, and how little progress anyone is able to make. It's consistent and defensible to believe both that it's absolutely critical for humanity to study its own brains, and also that we haven't done a good job at it yet. It's consistent and defensible to believe both that psychology researchers are smart, dedicated people doing admirable, important work, and also that they have really not made anywhere near the kind of progress to justify the level of confidence that pop-sci magazines, non-fiction writers, and podcasters exude. You don't need to be an expert in psychology to believe these things, either. You simply need to understand how deeply, fundamentally difficult the subject is.

ambicapter 3y ago

> You’re right that psychiatry and medication is a lot of trial and error, but that’s the most efficient and accurate way to determine which medications work with a patient. > Note they practitioners aren’t just guessing and hoping for the best. Soooo, which is it? You can't have it both ways, either trial and error or "educated guess".

hnaccount141 3y ago
> Soooo, which is it? You can't have it both ways, either trial and error or "educated guess". Sure you can -- trial and error doesn't mean the things you're trying have to be picked out of a hat at random. You can choose a starting point based on existing research and iterate from there based on the results experienced by the patient.

at_a_remove 3y ago

Psychiatry has a long history of being absolutely sure that this time, they have it right, then doing something hideous, and then moving on. No, no, this time, we have it right. If you want hubris, look to psychiatry. Nobel Prize for lobotomy in 1949, two decades later that is over with. Not to mention its relentless collusion with governments local and larger. Sure, science progresses. As well it should. But psychiatry occupies a particular corner of a square with self-certainty on one axis and "how much could you really know about that topic" on the other.

burnished 3y ago

Think you're tilting at windmills friend. You've described the same situation they did, just in esteemed tones. I think most folks expectation is that since we know so much about so many things that our level of understanding about the brain and psychiatric treatment is more advanced than it is, who are then surprised to find out that some (all?) treatments are basically just modifying the behavior of a messenger chemical across the whole of the brain.

anotherman554 3y ago

"They are using a large body of research, clinical experience, and shared knowledge of their peers." If a psychiatrist prescribes a placebo instead of a kick to the groin they are "......using a large body of research, clinical experience, and shared knowledge of their peers" that show kicks to the groins are bad for patients, and placebos cause them to report improvements. You can defend anything with this sort of language, it's posturing.

feoren 3y ago

> There’s something about psychiatry and neuroscience that makes a lot of people who are good at engineering/software think that they are qualified to also be experts on the field of psychiatry. This isn't always hypocrisy: There's a self-consistent idea here that you're missing: we recognize that psychology (and by extension psychiatry) is extremely hard. Human brains may be the most complex systems in the entire universe. I didn't get the feeling GP was claiming to be an expert, but rather he was claiming "there are no experts in psychology yet". I don't think that's as strong a claim as you seem to think. In fact I think most Ph.D.-level psychology researchers agree with just how tremendously difficult the subject is, and how little progress anyone is able to make. It's consistent and defensible to believe both that it's absolutely critical for humanity to study its own brains, and also that we haven't done a good job at it yet. It's consistent and defensible to believe both that psychology researchers are smart, dedicated people doing admirable, important work, and also that they have really not made anywhere near the kind of progress to justify the level of confidence that pop-sci magazines, non-fiction writers, and podcasters exude. You don't need to be an expert in psychology to believe these things, either. You simply need to understand how deeply, fundamentally difficult the subject is.