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The problem with depression is that it is hard to diagnose. If anything we are still in the dark ages of mental illness. If you have an infection we have a way

by jtchang 14y ago

The problem with depression is that it is hard to diagnose. If anything we are still in the dark ages of mental illness. If you have an infection we have a way to tell you what infection. Right now there is no way to test for depression. More scientific research is definitely needed.

ekianjo 14y ago
We are no more in the "dark ages of mental illness". You must be kidding. Before we used to burn people who were mentally deficient and heard voices or had hallucinations as they were thought to be possessed by the Devil. That was the "dark ages of mental illness" you are talking about. There is now information, testing, diagnostic methods everywhere available, and efficient medication. Keep yourself up to date.
- jtchang 14y ago
  How do you definitively test for depression? Are the diagnostic methods pretty good? Both accurate and precise with very low false positive rates? Is the medication proven to work for depression? Sorry but I think a lot of that can be argued that we are still shooting in the dark. I want a test for depression like I test for strep throat. AND I want the "cure" to be repeatable. Yes we are still in the dark ages.
  - erikpukinskis 14y ago
    Are the diagnostic methods pretty good? Both accurate and precise with very low false positive rates? Yes: "Overall sensitivity was 84% (95% CI, 79% to 89%); overall specificity was 72% (CI, 67% to 77%)" (http://www.ncbi.nlm.nih.gov/pubmed/7755226 http://www.ncbi.nlm.nih.gov/pubmed/7755226) Is the medication proven to work for depression? There's no such thing as proof in science. A recent meta-analysis: "Most patients treated with serotonergic antidepressants showed a clinical trajectory over time that is superior to that of placebo-treated patients. However, some patients receiving these medications did more poorly than patients receiving placebo. These data highlight the importance of ongoing monitoring of medication risks and benefits during serotonergic antidepressant treatment" (http://archpsyc.jamanetwork.com/article.aspx?articleid=1107437 http://archpsyc.jamanetwork.com/article.aspx?articleid=11074...)
    - jtchang 14y ago
      Interesting...do you have the full article?
      - marvin 14y ago
        I'll Swartz it for you. https://www.dropbox.com/s/3uz18obebxavgff/Gueorguieva-et-al.pdf https://www.dropbox.com/s/3uz18obebxavgff/Gueorguieva-et-al....
- chaostheory 14y ago
  He's not completely off. Psychology is still in its infancy. That's putting it lightly.
jwdunne 14y ago
A test can't be done in a lab on bloods but most of the time you can usually see the signs simply by observation and just talking to the person. I say the real problem is that it's hard to treat. When you see a close family member or friend suffering, you can't force them to go the doctors, where depression would certainly be diagnosed, and many often just don't go. The standard set of medication for depression usually takes a couple of weeks to kick in. It's common to see symptoms worsen before they get better during this timeframe. It's gut wrenching to watch if you have personal experience with it. Effective therapies require effort from the sufferer. If you're feeling really low, it's hard to the put the effort into anything - drops in personal hygiene standards are not rare. It sucks we don't have a test for it like we have for physical disease but I think a bigger problem is treatment, which is done in a "see what works" manner if the first line of defence doesn't work, which is really damaging when you consider the above.
- jtchang 14y ago
  And what I'm getting at is the fact that there SHOULD be a blood test. Or a biopsy. Or something more concrete. Is it not possible? I'd like scientific research to say that it is impossible.
  - jwdunne 14y ago
    What I'm saying is a clear cut test would be great but it's not actually hard twit out it and a bigger problem is the treatment. I think the answer to both lies in the same area though, since the source of depression is not clear in the brain (I believe there was a study that shown SSRIs have an immediate effect on serotonin re-uptake yet takes a number of weeks to ease depression - implying serotonin doesn't play such a direct role as once believed).
    - jtchang 14y ago
      We have to study it from multiple angles. I don't have a problem with more research into SSRIs. Hell I don't even have a problem with SSRIs. The main issue I have is that people think our understanding of mental illness / psychiatry is as good as say pathology.
marvin 14y ago
Depression can be diagnosed pretty easily by running through a form of questions and checking off checkboxes. You are depressed if some statistical measures score above a certain value. To which degree are you...Sad? Have trouble getting things done? Don't find joy in the things that used to make you happy? Thinking about death? Feel any emotions at all? Afraid that something terrible is about to happen? Thinking about killing yourself? Planning to kill yourself? Etc. It's not an exact science the way physics is, but we are only in the dark ages of mental illness in the sense that a lot of uninformed people don't have any idea how these illnesses are treated by professionals.
- jtchang 14y ago
  Why isn't it an exact science? Science teaches us that things should be repeatable and reproducible. Running through a form of questions and ticking off boxes doesn't seem very "advanced" to me. In fact it seems like the very definition of backwards. Why aren't we aiming for a physics level of understanding in psychology?
  - kanzure 14y ago
    > Why aren't we aiming for a physics level of understanding in psychology? We call that neuroscience. On a related note, Henry Markram just got $1.3 billion EUR for whole brain emulation. So there's that.
  - InclinedPlane 14y ago
    We're not talking about clock work machinery, we're talking about the human brain. Asking why issues of the brain aren't an exact science is like asking why we haven't solved the halting problem yet. Cognition and sentience are still far from solved problems. Moreover, the way that different minds react to different physical problems of the brain is inevitably going to be hugely complex. Some people will brood alone in their room and write poetry like Emily Dickinson, some people will throw themselves off a bridge.
    - baddox 14y ago

by jtchang 14y ago

ekianjo 14y ago

We are no more in the "dark ages of mental illness". You must be kidding. Before we used to burn people who were mentally deficient and heard voices or had hallucinations as they were thought to be possessed by the Devil. That was the "dark ages of mental illness" you are talking about. There is now information, testing, diagnostic methods everywhere available, and efficient medication. Keep yourself up to date.

jtchang 14y ago
How do you definitively test for depression? Are the diagnostic methods pretty good? Both accurate and precise with very low false positive rates? Is the medication proven to work for depression? Sorry but I think a lot of that can be argued that we are still shooting in the dark. I want a test for depression like I test for strep throat. AND I want the "cure" to be repeatable. Yes we are still in the dark ages.
- erikpukinskis 14y ago
  Are the diagnostic methods pretty good? Both accurate and precise with very low false positive rates? Yes: "Overall sensitivity was 84% (95% CI, 79% to 89%); overall specificity was 72% (CI, 67% to 77%)" (http://www.ncbi.nlm.nih.gov/pubmed/7755226 http://www.ncbi.nlm.nih.gov/pubmed/7755226) Is the medication proven to work for depression? There's no such thing as proof in science. A recent meta-analysis: "Most patients treated with serotonergic antidepressants showed a clinical trajectory over time that is superior to that of placebo-treated patients. However, some patients receiving these medications did more poorly than patients receiving placebo. These data highlight the importance of ongoing monitoring of medication risks and benefits during serotonergic antidepressant treatment" (http://archpsyc.jamanetwork.com/article.aspx?articleid=1107437 http://archpsyc.jamanetwork.com/article.aspx?articleid=11074...)
  - jtchang 14y ago
    Interesting...do you have the full article?
    - marvin 14y ago
      I'll Swartz it for you. https://www.dropbox.com/s/3uz18obebxavgff/Gueorguieva-et-al.pdf https://www.dropbox.com/s/3uz18obebxavgff/Gueorguieva-et-al....
chaostheory 14y ago
He's not completely off. Psychology is still in its infancy. That's putting it lightly.

jwdunne 14y ago

A test can't be done in a lab on bloods but most of the time you can usually see the signs simply by observation and just talking to the person. I say the real problem is that it's hard to treat. When you see a close family member or friend suffering, you can't force them to go the doctors, where depression would certainly be diagnosed, and many often just don't go. The standard set of medication for depression usually takes a couple of weeks to kick in. It's common to see symptoms worsen before they get better during this timeframe. It's gut wrenching to watch if you have personal experience with it. Effective therapies require effort from the sufferer. If you're feeling really low, it's hard to the put the effort into anything - drops in personal hygiene standards are not rare. It sucks we don't have a test for it like we have for physical disease but I think a bigger problem is treatment, which is done in a "see what works" manner if the first line of defence doesn't work, which is really damaging when you consider the above.

jtchang 14y ago
And what I'm getting at is the fact that there SHOULD be a blood test. Or a biopsy. Or something more concrete. Is it not possible? I'd like scientific research to say that it is impossible.
- jwdunne 14y ago
  What I'm saying is a clear cut test would be great but it's not actually hard twit out it and a bigger problem is the treatment. I think the answer to both lies in the same area though, since the source of depression is not clear in the brain (I believe there was a study that shown SSRIs have an immediate effect on serotonin re-uptake yet takes a number of weeks to ease depression - implying serotonin doesn't play such a direct role as once believed).
  - jtchang 14y ago
    We have to study it from multiple angles. I don't have a problem with more research into SSRIs. Hell I don't even have a problem with SSRIs. The main issue I have is that people think our understanding of mental illness / psychiatry is as good as say pathology.

marvin 14y ago

Depression can be diagnosed pretty easily by running through a form of questions and checking off checkboxes. You are depressed if some statistical measures score above a certain value. To which degree are you...Sad? Have trouble getting things done? Don't find joy in the things that used to make you happy? Thinking about death? Feel any emotions at all? Afraid that something terrible is about to happen? Thinking about killing yourself? Planning to kill yourself? Etc. It's not an exact science the way physics is, but we are only in the dark ages of mental illness in the sense that a lot of uninformed people don't have any idea how these illnesses are treated by professionals.

jtchang 14y ago
Why isn't it an exact science? Science teaches us that things should be repeatable and reproducible. Running through a form of questions and ticking off boxes doesn't seem very "advanced" to me. In fact it seems like the very definition of backwards. Why aren't we aiming for a physics level of understanding in psychology?
- kanzure 14y ago
  > Why aren't we aiming for a physics level of understanding in psychology? We call that neuroscience. On a related note, Henry Markram just got $1.3 billion EUR for whole brain emulation. So there's that.
- InclinedPlane 14y ago
  We're not talking about clock work machinery, we're talking about the human brain. Asking why issues of the brain aren't an exact science is like asking why we haven't solved the halting problem yet. Cognition and sentience are still far from solved problems. Moreover, the way that different minds react to different physical problems of the brain is inevitably going to be hugely complex. Some people will brood alone in their room and write poetry like Emily Dickinson, some people will throw themselves off a bridge.
  - baddox 14y ago