[RD] Mental "disorders" a misnomer

[aimeeandbeatles]

Yeah of course but mental suffering is much more difficult to quantity than say blood sugar levels.

Maybe someday w brain imaging and AI.

It's already been done a bit: https://www.mayoclinic.org/tests-pr...scan-of-the-brain-for-depression/img-20007400

And this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296397/

In conclusion, a number of mostly uncontrolled studies have shown that structural brain imaging is needed to exclude organic brain disorder after the initial clinical diagnosis in Alzheimer disease, depression, bipolar disorder, and schizophrenia. This application is not completely undisputed, however, eg, in schizophrenia. A recent large-scale study comparing patients with schizophrenia with healthy controls identified no excess of brain pathology in the patient group that would explain the psychotic symptomatology.14 This finding was taken by NICE as a lack of evidence for including brain imaging methods in the diagnostic process and included as such in its recent schizophrenia guideline.33 However, in our opinion it is premature to claim that brain imaging methods are not useful and at least one other prospective, well-controlled study is needed to draw such a conclusion.

Beyond this, studies with new biostatistical methods, such as machine learning, have provided evidence that structural imaging allows us to predict the risk for developing the illness, identify prognostic subgroups, and determine the efficacy of treatments in mental disorders, in particular schizophrenia. In schizophrenia, brain imaging parameters predict the risk to develop the illness with a good probability of 0.75 and above,26 help to distinguish between affective and nonaffective psychoses,24 and identify groups with a good or fair outcome.30 Currently, well-controlled prospective studies are trying to replicate these initial findings. If they do so, there will be little doubt that structural brain imaging is clinically useful to exclude organic brain disorder and that it may serve as a biomarker for diagnosis, prognosis and treatment.

 

[ShogunGrumpyBear]

There is a place by me that advertises for QEEG brain mapping. Does anyone know anything about it?

 

[Hrothbern]

@Hrothbern, there is a yardstick. It’s imprecise due to technical limitations, but that shouldn’t stop us from using it if it is directionally accurate.

My issue is not only with the precision of the yardstick but the nature of the yardstick and that includes how well everybody, the group around you, and if relevant your teacher at school, etc and ofc yourself is aware of that nature.

Specialists know already so little despite them having time, the right education and a whole toolset of well defined and precisely used words and concepts.
To get usefull boildowns out of that in colloquial language for laymen...
Mostly more disadvantages than advantages.

But I do believe that the mechanism is there
Here two examples.

Say that we have a bee-hive with a living Queen Bee.
Everything is orderly, everybody in the tredmill of working hard for the group.

Now the Queen Bee dies. From age, disease, predator, beekeeper mistake, or worker bees deciding they needed a new one
and because there is no Queen Bee surpressing larves becoming a Queen Bee with chemicals... a multitude of larves develop into a Queen Bees helped by special attention and food by the workers. If there would be no eggs common worker bees lay eggs.
The new Queen Bees swarm, mate, fight other virgin Queen Bees... and survivors of "the Great Disorder" start their own colony.

=> A month after the Queen is dead, it is by Divine Right long live the Queen... and business as usual... everything orderly and surpressed again.

The old adagium: peasants need Kings as hard as Kings need peasants.
I truly wish mankind emancipates one day so far that this outgroup favoritism mechanism is ended.


Another example the Locust.
The humble grasshopper in its daily life & survival encounters now and then pleasant times with very good food generation and multiplies enormously.
All grasshoppers secrete some special feromone and when the concentration in the air of that feromone passes a certain treshold, the grasshoppers change into locusts which is a huge physical transformation making them good in flying.
The evolutionary advantage simple: when there are too many grasshoppers in an area it is time to fly to new horizons and use the wind instead of just a bit of hopping to far away new grounds thousands of miles distanced.

Both are examples where rather complicated mechanisms are used by evolution.
These minor tweaks from that article have a far lower mutation treshold and are therefore most likely all over the place in our gene pool based on the many permutations that can arise and cause all kinds of (mental & social) diversity. All to the overall benefit for advancing gene pools that are tweaked pushing out the non-tweaked.
So... great for some scientists to dig into, but when this is driven by for profit Big Pharma ?
hm


Another look at the issue:
One of the "disorders" we have is left-handedness.
This is AFAIK a completely natural diversity and around 10%-15% of the people have it.
And yet, depending on country and culture, it is or has been heavily surpressed. Both by casual as forced repression.

I simply believe that surpressing something natural is almost always bad and if it would lead to higher average anxiety etc I will not be surprised.
My father was as kid simply hit with a cane on his hands when he did something left-handed.
Kids normally do not want to be the exception as well.
All are ingredients for small scale misery eroding natural self-respect.
And I believe very strongly that self-respect and respect for your integrity, of your body and mind, is very important.

But hey... here it comes... just like almost all medicinal drugs are being tested first on rodents.... and on male rodents (easier because of more stable hormonal level).... resulting in a skewed sample...
tests being done on anxiety and other mental studies are mostly done on "normal" right-handed people... because researchers want to exclude the "noise" from left-handed people you get from a mixed sample (and doing both separately doubles the cost)
Here an article from the Radboud university, Nijmegen, Netherlands making a plea to get that right: https://www.sciencedaily.com/releases/2014/02/140213112640.htm

And it does matter ! https://www.sciencedaily.com/releases/2018/06/180618222617.htm

Treatment for the most common mental health problems could be ineffective or even detrimental to about 50 percent of the population, according to a radical new model of emotion in the brain.

Since the 1970s, hundreds of studies have suggested that each hemisphere of the brain is home to a specific type of emotion. Emotions linked to approaching and engaging with the world -- like happiness, pride and anger -- lives in the left side of the brain, while emotions associated with avoidance -- like disgust and fear -- are housed in the right.

But those studies were done almost exclusively on right-handed people. That simple fact has given us a skewed understanding of how emotion works in the brain, according to Daniel Casasanto, associate professor of human development and psychology at Cornell University.

According to the new theory, called the "sword and shield hypothesis," the way we perform actions with our hands determines how emotions are organized in our brains. Sword fighters of old would wield their swords in their dominant hand to attack the enemy -- an approach action -- and raise their shields with their non-dominant hand to fend off attack -- an avoidance action. Consistent with these action habits, results show that approach emotions depend on the hemisphere of the brain that controls the dominant "sword" hand, and avoidance emotions on the hemisphere that controls the non-dominant "shield" hand.

The work has implications for a current treatment for recalcitrant anxiety and depression called neural therapy. Similar to the technique used in the study and approved by the Food and Drug Administration, it involves a mild electrical stimulation or a magnetic stimulation to the left side of the brain, to encourage approach-related emotions.

But Casasanto's work suggests the treatment could be damaging for left-handed patients. Stimulation on the left would decrease life-affirming approach emotions. "If you give left-handers the standard treatment, you're probably going to make them worse," Casasanto said.

"And because many people are neither strongly right- nor left-handed, the stimulation won't make any difference for them, because their approach emotions are distributed across both hemispheres," he said.

"This suggests strong righties should get the normal treatment, but they make up only 50 percent of the population. Strong lefties should get the opposite treatment, and people in the middle shouldn't get the treatment at all."

Here below a graph of % left-handedness after cultural (and genetical ?) "corrections" of some countries.
I once digged in into the Japan figures wondering whether it was genetic or cultural... whether perhaps --the long isolation of Japan-- the cultural repression had also effect on eliminating to some degree the genes for left-handedness.
It did not deliver results worth remembering except that there were gender effects as well indicating that repression from a general dominance culture was unsurprisingly stronger affecting female than male. Same seems to be with parents having higher or lower education (higher education leading to less traditional dominance).
https://www.statista.com/chart/20708/rate-of-left-handedness-in-selected-countries/#:~:text=McManus which found that the,China is a good example.

Our understanding of mental "disorders" is imo still very much "work under construction" and we need to be cautious with short cut conclusions with only a bit of scientific aura.

 

[Berzerker]

Recent study said pot smoking during pregnancy is linked to autism, 1.5x higher rate

wonder if tobacco has similar effect

 

[Estebonrober]

Recent study said pot smoking during pregnancy is linked to autism, 1.5x higher rate

wonder if tobacco has similar effect

Nope its the vaccines. . .

@aimeeandbeatles beat me to the punch but PTSD and depression over the long term shows up in MRI scans. Stress kills the body when taken on too long so while in a short term it might be healthy it does flip at a point. This point is different for everyone.

 

[Bugfatty300]

Of course it's a fake diagnosis
but it wasn't to coddle us, it was to pacify us to make us "easier to manage" and bring in drug money.

Having been hit & drugged by family & authority figures both were bad but being hit @ least had more emotional honesty to it.

Some kids "grow out of" ADHD (symptoms can be amplified and exacerbated by the classroom setting) but not if it is severe enough. It only got worse for me as I got older. As for it being fake, I've been independently diagnosed and 2nd opinioned multiple times by multiple doctors and psychiatrists. Fake diagnoses based on anything other than my symptoms won't have this kind of consistency.

 

[Patine]

Some kids "grow out of" ADHD (symptoms can be amplified and exacerbated by the classroom setting) but not if it is severe enough. It only got worse for me as I got older. As for it being fake, I've been independently diagnosed and 2nd opinioned multiple times by multiple doctors and psychiatrists. Fake diagnoses based on anything other than my symptoms won't have this kind of consistency.

I'm still verifiably ADHD at 44. It's a daily struggle.

 

[Berzerker]

do meds help?

I heard speed does something to remedy a chemical imbalance

 

[stinkubus]

I think it's important to remember that if these conditions are not labeled as illnesses or disorders it's unlikely that insurance would pay to treat them. I don't know how the various universal health care schemes employed throughout the world would handle this issue, but I have no doubt that if you dropped the "D" from PTSD insurance companies in the US would try to use it as a pretense not to pay for treatment.

 

[Bugfatty300]

do meds help?

I heard speed does something to remedy a chemical imbalance

Adderall is a miracle drug for me and has vastly improved the quality of my life. Part of ADHD is frequent, sudden and inexplicable loss of interest in things you previously had a passion for which causes frustration and anguish. It's caused by a dopamine deficit and the effects from a stimulant can balance that. It's a double edged sword only because it's a hassle to get prescriptions on a regular basis due schedule II medicinal narcotic nonsense.

 

[Narz]

Adderall is no joke, glad its helped you. Its way too habit forming for me to ever f w it.

 

[Hygro]

Narz, it seemed the way you were medicalized as a kid was not good for you, but it also seems like many of your struggles are consistent with that diagnosis. Sometimes I wonder if I would have had an easier time of it if I got my mental health help (ADHD, depression) as a kid, or if it was better as a later-thing.

I too am greatly helped by adderall. I keep my doses really low. I'm almost 2 years back on with no building tolerance.

 

[Narz]

Narz, it seemed the way you were medicalized as a kid was not good for you, but it also seems like many of your struggles are consistent with that diagnosis.

I'm definitely not nuerotypical but I don't consider myself disabled, disordered or deficient, I just have to be more mindful about all aspects of my life if I want to avoid suffering, just like with food, if I eat a burger and fries I get pain, doesn't mean I need a tum or pepto-bismo or I have broken-stomach disorder, some people are more affected by certain things (social, environmental, visual, olfactory, whatever) & oblivious to other things. It makes sense that all human tribes would have nuerodiversity. It makes little sense that all of a sudden 50+% of humans in the western world are broken.

I too am greatly helped by adderall. I keep my doses really low. I'm almost 2 years back on with no building tolerance.

Cool. It sounds like you pay attention & self-regulate, pretty much everyone takes drugs (if you include caffeine). It also helps to play with one drug at a time until you get the amount just right.

When I was growing up they had kids on like 5 or 6 at a time, one kid we called his meds his skittles (one med trying to manage the side effects of the last). They also told us never to "self-medicate" and let the doctors worry about the doses.

I just realize most of the models I was sold as "correct" as a kid are not only wrong but often deliberately dis-empowering, sometimes maliciously so, sometimes just due to ignorance.

I understand the philosophy of "you can't handle the truth", most people not only can't but don't want to be bothered to but I really want to understand the actual world not some simplified for-dummies version of it and the current model of mental "disease" is on the level of the four humors rn.

 

[Valka D'Ur]

I don't understand why we separate disorders into "mental" or "physical" ones. The brain's still part of the body, isn't it?

It is, but you can be an Olympic athlete and still suffer from depression or other conditions.

Yeah of course but mental suffering is much more difficult to quantity than say blood sugar levels.

Grad student doing his practicum: Tell me on a scale of 1-10 how you're feeling today.

Me: I TOLD YOU I HATE THESE SCALES, THEY DON'T MEAN ANYTHING, LET ME DESCRIBE IT IN WORDS!!!!!

(actually, we got along well enough, except for those <censored> scales that mean nothing to me and he wouldn't let me use fractions)

Blood sugar, on the other hand... something I found out is that the 4-8 range is meant for younger adults, assuming they keep to a particular diet and aren't having problems with medication. It's amazing how many medical professionals can't wrap their minds around the idea that not everyone is able to tolerate metformin.

Also there's much less stigma about physical problems, "you clearly have a broken leg" is a strange insult to throw at someone whereas "you clearly have a personality disorder" is fighting words.

It's not just the aspect of insults and shame. It's being believed. I've had to explain to the manager here when he just assumes that I can pack and move in 3 days that I really can't, and just because he sees me able to get around fairly well one day, that's not how it is all days. I've pointed out that the days when I feel able to get out and around the building and maybe drop by the office for a few minutes' chat are my good days. He never sees me on my worst days.

According to the new theory, called the "sword and shield hypothesis," the way we perform actions with our hands determines how emotions are organized in our brains. Sword fighters of old would wield their swords in their dominant hand to attack the enemy -- an approach action -- and raise their shields with their non-dominant hand to fend off attack -- an avoidance action. Consistent with these action habits, results show that approach emotions depend on the hemisphere of the brain that controls the dominant "sword" hand, and avoidance emotions on the hemisphere that controls the non-dominant "shield" hand.

This is fascinating, for a reason other than disorders. It's something I never thought of, even during my active SCA years when we would have had at least one left-handed fighter in the group, since I never took part in either sword fighting or archery. There's a guy on YT who demonstrates medieval fighting techniques with sword, shield, pole arm, on foot and on horseback. I'm going to have to review those episodes to see if he dealt with right- and left-handedness.

More fodder for my ongoing writing project...

 

[Bugfatty300]

Adderall is no joke, glad its helped you. Its way too habit forming for me to ever f w it.

They do have non-stimulant alternatives that others swear by. It's not like it's amphetamines or nothing if one needs medication for ADHD.

 

[Berzerker]

Adderall is a miracle drug for me and has vastly improved the quality of my life. Part of ADHD is frequent, sudden and inexplicable loss of interest in things you previously had a passion for which causes frustration and anguish. It's caused by a dopamine deficit and the effects from a stimulant can balance that. It's a double edged sword only because it's a hassle to get prescriptions on a regular basis due schedule II medicinal narcotic nonsense.

That sounds like bipolar or manic depressive (maybe they're not the same). My father would alternate between enthusiastic bursts of energy and interest and periods of 'boredom'. For example, he bought a boat and never used it.

I'm surprised they have a non-stimulant med, I wonder if there will be a push to ban the stimulant version.

 

[Hygro]

That sounds like bipolar or manic depressive (maybe they're not the same). My father would alternate between enthusiastic bursts of energy and interest and periods of 'boredom'. For example, he bought a boat and never used it.

I'm surprised they have a non-stimulant med, I wonder if there will be a push to ban the stimulant version.

The non stimulant meds like Strattera and Wellbutrin are norepinephrine reuptake inhibitors so take the labels with a grain of salt.

Before the big recent comparisons between ADHD and autism, the meta was to view ADHD as being similar to low level bipolar. The walls on these categories are porous..

 

[Angst]

I have schizophrenia and would go completely f*ing insane without the meds. Sure, it could be all of society that's doing this to me. But until we usurp the whole planet, I actually have these problems, and the medicine treats me.

 

[bernie14]

The non stimulant meds like Strattera and Wellbutrin are norepinephrine reuptake inhibitors so take the labels with a grain of salt.

Before the big recent comparisons between ADHD and autism, the meta was to view ADHD as being similar to low level bipolar. The walls on these categories are porous..

Yep, diagnosis can be tricky, especially for bipolar 1s, since when symptomatic, they tend to be depressed and just sticking them with serotonergic agents may not significantly benefit or even worsen their symptoms....and the symptoms are identical.

The other day, I was giving a conference to primary care docs, tips for sceening/ increasing indexed suspicion for bipolar depression, such as early age of onset, family history, treatment resistance or activation, sudden severe symptoms and mood reactivity....I even spoke of a screening tool called the MDQ (mood disorder Questionnaire) and after about 10 minutes, the guy asks me ...." is there one question that will help me differentiate a bipolar depression from MDD?...

 

[bernie14]

...so after another minute or two reviewing, I told him to ask this.... At any time in your life, have you ever felt SO good, had so much energy, your mind going a mile a minute, that you DIDN'T NEED to sleep?