4 ms·

Disorders are labels for things which significantly negatively impact people’s lives. Thinking of them in terms of a spectrum generally means stretching a labe

by Retric 1y ago

Disorders are labels for things which significantly negatively impact people’s lives. Thinking of them in terms of a spectrum generally means stretching a label past the point of meaning.

cheschire 1y ago
So it’s a 1 or a 0? The kid is either full autistic or just a socially maladjusted asshole? No room for a middle ground with you then?
- Yossarrian22 1y ago
  It’s a 1 if it goes above 0.6
  - Spivak 1y ago
    You just invented 0,1 again but gave a weird label to the 1.
- Retric 1y ago
  That’t not it, what many disorders are describing isn’t just the obvious symptoms. ICE engines heat up because they burn fuel, but if it’s overheating in normal operation that’s from something else breaking down. Not that people are so simple, but that transition point to disorder often represents a meaningful transition.
  - wredcoll 1y ago
    Much like addiction, a key facet of a "diagnosed" disorder tends to be whether or not it (negatively) affects your life. As the guy said, if you think you hear voices but they tell you to go to sleep on time and do a good job at work, you probably don't need treatment.
    - freehorse 1y ago
      > a key facet of a "diagnosed" disorder tends to be whether or not it (negatively) affects your life. Which also brings us to an important point that is totally missed in the article and most of the discussion imo: maybe one of the (many) things that have changed is that lives are more negatively affected by stuff nowadays (or more reported to be so). We live in increasingly complex societies, we have to socialise with more and more people and navigate more demanding and fluid social dynamics. Traits that can be advantageous in a certain context can be disadvantageous in another (and affect one's life negatively).
  - Mtinie 1y ago
    An engine is an assembly of parts. When an engine breaks down it does so because it broke down. An engine does not exist without its cylinders, fuel system, gaskets, lubricants, etc. I believe your analogy is flawed. Can you restate your first statement in any other way?
    - Retric 1y ago
      Someone who is clinically depressed isn’t just sad, they are unable to return to normal. Things that help normal people feel better simply fail, it’s a meaningfully different situation. Similarly treatments for depression like electroconvulsive therapy shouldn’t be applied to normal people. OCD, clinical addiction, etc are all more involved than just feeling the desire to do something. The lack of control is the issue not just the momentary impulse. Intrusive thoughts are fine, acting on them isn’t.
      - Mtinie 1y ago
        Are there people who don’t have clinical diagnoses of depression being subjected to electro convulsive therapies? Addendum: I believe I’m close to figuring out what you are communicating but for me it’s not working. I’m reasonably sure we’d agree that neurological conditions are complex and that labels only tell part of the story.
        Retric 1y ago
        I’m sure ECT is being misused occasionally, but what I’m referring to is the underlying condition such treatments are addressing as well as the research associated with finding what treatments are useful in which situations. Seasonal affective disorder and bereavement-related depression may have similar symptoms on the surface, but there’s different treatments due to differences in underlying causes. Some conditions may be a continuum with the same underlying cause taken to different extremes, but that continuum need not be continuous down to normal human behavior.
      - pxoe 1y ago
        What is normal human behavior though? Is it some combination of things that's gonna end up being so rare that only so many people fall under it, and is it normal if it's so rare? Is it gonna be "what most/average people are", and if so, well then, isn't everybody gonna have something going on, and isn't that just normal then? With how widespread it is, labeling, self-diagnosing, inquiring about yourself, is kind of normal human behavior. It is everywhere, and has been historically. Putting it like it's just 'labels for significant things' and then 'normal', and that these things would stand far enough apart to actually make a clear distinction without dismissing people in between is pretty much just wishful thinking. There's way too many things and even more combinations of then. It's gotten so complicated and convoluted only because it is that way. Wishing for a binary clarity in a complex world.
zug_zug 1y ago
Well, if you're approaching this as a hard-scientist that's not the case (for psychology). Because "disorder" may be on a spectrum, because "negative" and "impact" may be on a spectrum. Conditions like depression follow a bell-curve, there's no clear line between depressed and not, and we can draw a line in the sand, but statistically there's no justification for where that line falls. One way to try to draw a line is "the point at which a certain intervention is no longer effective." For example studies find CBT therapy reduces depression scores for depressed people ~.8 standard deviations (for a while). But why not try CBT therapy on happy people? Maybe it's even more effective on people who are already happy. Well the reason why not is likely just because of the clumsy nature of healthcare -- interventions are thought of as "treatments" for "conditions", even though that lens doesn't always make sense.
- Retric 1y ago
  > there's no clear line between depressed and not There’s a meaningful line in the sand for treatments with major side effects. CBT therapy may be “fine” for normal people, but the most effective treatment for depression is ECT which has major side effects. Including a ~1 in 50k chance of death. Saying something is a bell curve distribution is an approximation, it doesn’t mean there’s actually a continuous function out to infinity and negative infinity.
  - pseudalopex 1y ago
    When to resort to ECT is a subjective decision of doctor and patient. It is clear it should come after other treatments failed. But there is no clear line.
    - Retric 1y ago
      Everything is subjective at the margins, but that’s ignoring the clear cut examples where it’s not going to be considered.
      - pseudalopex 1y ago

by Retric 1y ago

Disorders are labels for things which significantly negatively impact people’s lives. Thinking of them in terms of a spectrum generally means stretching a label past the point of meaning.

cheschire 1y ago

So it’s a 1 or a 0? The kid is either full autistic or just a socially maladjusted asshole? No room for a middle ground with you then?

Yossarrian22 1y ago
It’s a 1 if it goes above 0.6
- Spivak 1y ago
  You just invented 0,1 again but gave a weird label to the 1.
Retric 1y ago
That’t not it, what many disorders are describing isn’t just the obvious symptoms. ICE engines heat up because they burn fuel, but if it’s overheating in normal operation that’s from something else breaking down. Not that people are so simple, but that transition point to disorder often represents a meaningful transition.
- wredcoll 1y ago
  Much like addiction, a key facet of a "diagnosed" disorder tends to be whether or not it (negatively) affects your life. As the guy said, if you think you hear voices but they tell you to go to sleep on time and do a good job at work, you probably don't need treatment.
  - freehorse 1y ago
    > a key facet of a "diagnosed" disorder tends to be whether or not it (negatively) affects your life. Which also brings us to an important point that is totally missed in the article and most of the discussion imo: maybe one of the (many) things that have changed is that lives are more negatively affected by stuff nowadays (or more reported to be so). We live in increasingly complex societies, we have to socialise with more and more people and navigate more demanding and fluid social dynamics. Traits that can be advantageous in a certain context can be disadvantageous in another (and affect one's life negatively).
- Mtinie 1y ago
  An engine is an assembly of parts. When an engine breaks down it does so because it broke down. An engine does not exist without its cylinders, fuel system, gaskets, lubricants, etc. I believe your analogy is flawed. Can you restate your first statement in any other way?
  - Retric 1y ago
    Someone who is clinically depressed isn’t just sad, they are unable to return to normal. Things that help normal people feel better simply fail, it’s a meaningfully different situation. Similarly treatments for depression like electroconvulsive therapy shouldn’t be applied to normal people. OCD, clinical addiction, etc are all more involved than just feeling the desire to do something. The lack of control is the issue not just the momentary impulse. Intrusive thoughts are fine, acting on them isn’t.
    - Mtinie 1y ago
      Are there people who don’t have clinical diagnoses of depression being subjected to electro convulsive therapies? Addendum: I believe I’m close to figuring out what you are communicating but for me it’s not working. I’m reasonably sure we’d agree that neurological conditions are complex and that labels only tell part of the story.
      - Retric 1y ago
        I’m sure ECT is being misused occasionally, but what I’m referring to is the underlying condition such treatments are addressing as well as the research associated with finding what treatments are useful in which situations. Seasonal affective disorder and bereavement-related depression may have similar symptoms on the surface, but there’s different treatments due to differences in underlying causes. Some conditions may be a continuum with the same underlying cause taken to different extremes, but that continuum need not be continuous down to normal human behavior.
    - pxoe 1y ago
      What is normal human behavior though? Is it some combination of things that's gonna end up being so rare that only so many people fall under it, and is it normal if it's so rare? Is it gonna be "what most/average people are", and if so, well then, isn't everybody gonna have something going on, and isn't that just normal then? With how widespread it is, labeling, self-diagnosing, inquiring about yourself, is kind of normal human behavior. It is everywhere, and has been historically. Putting it like it's just 'labels for significant things' and then 'normal', and that these things would stand far enough apart to actually make a clear distinction without dismissing people in between is pretty much just wishful thinking. There's way too many things and even more combinations of then. It's gotten so complicated and convoluted only because it is that way. Wishing for a binary clarity in a complex world.

zug_zug 1y ago

Well, if you're approaching this as a hard-scientist that's not the case (for psychology). Because "disorder" may be on a spectrum, because "negative" and "impact" may be on a spectrum. Conditions like depression follow a bell-curve, there's no clear line between depressed and not, and we can draw a line in the sand, but statistically there's no justification for where that line falls. One way to try to draw a line is "the point at which a certain intervention is no longer effective." For example studies find CBT therapy reduces depression scores for depressed people ~.8 standard deviations (for a while). But why not try CBT therapy on happy people? Maybe it's even more effective on people who are already happy. Well the reason why not is likely just because of the clumsy nature of healthcare -- interventions are thought of as "treatments" for "conditions", even though that lens doesn't always make sense.

Retric 1y ago
> there's no clear line between depressed and not There’s a meaningful line in the sand for treatments with major side effects. CBT therapy may be “fine” for normal people, but the most effective treatment for depression is ECT which has major side effects. Including a ~1 in 50k chance of death. Saying something is a bell curve distribution is an approximation, it doesn’t mean there’s actually a continuous function out to infinity and negative infinity.
- pseudalopex 1y ago
  When to resort to ECT is a subjective decision of doctor and patient. It is clear it should come after other treatments failed. But there is no clear line.
  - Retric 1y ago
    Everything is subjective at the margins, but that’s ignoring the clear cut examples where it’s not going to be considered.
    - pseudalopex 1y ago