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[Freeza Under The Shower]

Except he never said that, nor has anyone else. but even so: science IS a game calling each other's models into question and if need be "J'accuse!" others of pseudo-science. That is how the game is played.

People in this thread seem to have real issues with the concept of 'models' and 'explanation'. I do not think the dominant model is convincing as a model of how depression works (how to explain it, with the hopes of increasing the rate of recovery), but that doesn't change the empirical phenomenon in any way or form. (meaning: the state of being depressed)

The only way that you can diagnose someone as depressed, is by a self-report. You can claim them to be from the outside as an experienced observer, but that method is unreliable and questionable from historical and ethical perspective. That is all that Karsticles is pointing to, and I really don't see how it's worth calling out as "wrong".

It would be nice to claim that we could look at blood values or fMRI scans and say within a 95% confidence level that someone is depressed, but that is simply not the case. These methods are not reliable to get observed data that is the actual empirical state and not just another measurement error. Particularly MRI scanning is wildly dependent on the physician interpreting the data.


There is great example of models not working or lacking explanation in Smile or Die by Barbara Ehrenreich. During her own months of breast cancer, she would be called upon to start drawing "her immune system battling the cancer cells". Which plently of women do.
Except it's not true. Chemotherapy wipes out the entire (well, a good deal of it anyway) immune system for a short while. It has absolutely nothing to do with battling a cancer that has moved beyond the immune system's control.
If fact, the white blood cells may be playing "for the other team", as they actively assist the cancer cells instead of killing them. (which is why they appear in large numbers at those sites, not because they are 'battling' them, but because they are helping them. At least, that's what Ehrenreich wrote back in 2009).

So, to summarize all this, why exactly would it be wrong to think that the evidence on the serotonin model is not all that convincing (at least not as far as drug testing and ongoing usage goes) and either more complex or other models show more promise for increasing the amount of people we could help by building better models?

And while Stet is banned: no, one does not require a degree to read books and acquire a level of understanding equal to or greater than people with the degree. The chances of this occurring are simply a lot lower than by simply following the curriculum. As far as the theoretical part goes anyway, where it concerns medicine.

 

[Lonely1]

So, what its what you are arguing for? That current treatments don't work or don't well enough? Stop treating people with depression until more reliable test are developed?

And self report isn't empirical? That's BS, unless you believe that your patient is a liar.

 

[Karsticles]

If your knowledge of psychiatry is limited to what you've heard from friends, I don't understand why you feel you have the authority to make the ridiculous proclamations you've made in this thread.

I didn't say my knowledge of psychiatry is limited to what I've heard from friends. I did cite experiences friends have had, though.

And your issue was with subjective reporting, not reporting itself. Stop shifting the goal posts of your argument.

What is "objective reporting"? A self-report is subjective by definition. The rest of your post isn't even part of what I'm talking about.

Where do you live? Your entire rant against the evils of psychiatry is based on the fact that "everyone I know" goes to comically incompetent doctors and those doctors defrauded the medical boards to get their licenses.

There is something especially hilarious that the "evidence" people have that the entire field of medicine is bullshit is hearsay and anecdotes, the very thing they accuse medicine of relying on.

I currently live in Chicago, but I spent most of my life in Michigan (various cities), and was born in Arizona. I don't think psychiatry is evil at all, and I certainly haven't said anything like that.

I don't have a problem with hearsay and anecdotes - that's how humans learn and live for the most part. The difference between my hearsay, and the hearsay of psychiatry (I wouldn't call it hearsay, but I'll just use your claim to make it easy), is that I don't call my hearsay "science". So there's nothing hilarious about it at all unless you think that I think my perspectives are derived scientifically, or something.

And a double "Yikes!" at you equating my thoughts on psychiatric medicine with all medicine in general. Except for responding to another poster about the nature of titles and their relationship to knowledge, I haven't talked about general medicine at all. I've clearly spoken against pseudosciences, which, not necessarily, but almost certainly, presumes that I am in favor of science.

Except he never said that, nor has anyone else. but even so: science IS a game calling each other's models into question and if need be "J'accuse!" others of pseudo-science. That is how the game is played.

People in this thread seem to have real issues with the concept of 'models' and 'explanation'. I do not think the dominant model is convincing as a model of how depression works (how to explain it, with the hopes of increasing the rate of recovery), but that doesn't change the empirical phenomenon in any way or form. (meaning: the state of being depressed)

The only way that you can diagnose someone as depressed, is by a self-report. You can claim them to be from the outside as an experienced observer, but that method is unreliable and questionable from historical and ethical perspective. That is all that Karsticles is pointing to, and I really don't see how it's worth calling out as "wrong".

It would be nice to claim that we could look at blood values or fMRI scans and say within a 95% confidence level that someone is depressed, but that is simply not the case. These methods are not reliable to get observed data that is the actual empirical state and not just another measurement error. Particularly MRI scanning is wildly dependent on the physician interpreting the data.

There is great example of models not working or lacking explanation in Smile or Die by Barbara Ehrenreich. During her own months of breast cancer, she would be called upon to start drawing "her immune system battling the cancer cells". Which plently of women do.
Except it's not true. Chemotherapy wipes out the entire (well, a good deal of it anyway) immune system for a short while. It has absolutely nothing to do with battling a cancer that has moved beyond the immune system's control.
If fact, the white blood cells may be playing "for the other team", as they actively assist the cancer cells instead of killing them. (which is why they appear in large numbers at those sites, not because they are 'battling' them, but because they are helping them. At least, that's what Ehrenreich wrote back in 2009).

So, to summarize all this, why exactly would it be wrong to think that the evidence on the serotonin model is not all that convincing (at least not as far as drug testing and ongoing usage goes) and either more complex or other models show more promise for increasing the amount of people we could help by building better models?

And while Stet is banned: no, one does not require a degree to read books and acquire a level of understanding equal to or greater than people with the degree. The chances of this occurring are simply a lot lower than by simply following the curriculum. As far as the theoretical part goes anyway, where it concerns medicine.

Holy crap, you read my posts and remarked on what I'm talking about! You made my day, because that rarely happens. Although I don't care for the historical/ethical angle you brought up. Still, a happy face I have.

So, what its what you are arguing for? That current treatments don't work or don't well enough? Stop treating people with depression until more reliable test are developed?

And self report isn't empirical? That's BS, unless you believe that your patient is a liar.

Self-report isn't based in empiricism, it's phenomenological at its root.

I don't think I've even talked about the treatments much, just the diagnostic methodologies. I thought some earlier posters in this thread, who had been on anti-depressants, had a very fair view of them: they can definitely help keep your depression from crushing you so that you can put your life on track. I think most people who have been on anti-depressants agree that they don't cure depression, so I haven't really been arguing about that (since to "cure" means to actually have removed the cause of the ailment, and anti-depressants really just mitigate the effects of the ailment).

I'm also fine with people being given anti-depressants, but I am not fine with the diagnostic methodologies being taken to be scientific.

 

[way more]

"I've been hearing voice, I don't sleep for 36 hours, I've lost my sense of taste and I woke up and cleaned the fridge at 4 am because I realized it was filthy."

Doctor: I'm sorry, self-reporting is meaningless. There is nothing wrong with you.

 

[Lonely1]

What is "objective reporting"? A self-report is subjective by definition. The rest of your post isn't even part of what I'm talking about.

Well, you seem to have trouble understanding what "empirical (using the scientific sense of the word here)" means. You object of study is the patient. Your patient reporting things to you is empirical knowledge. On the other hand, you inferring things about the patient without backing evidence is what is subjective.

 

[Karsticles]

"I've been hearing voice, I don't sleep for 36 hours, I've lost my sense of taste and I woke up and cleaned the fridge at 4 am because I realized it was filthy."

Doctor: I'm sorry, self-reporting is meaningless. There is nothing wrong with you.

Unscientific = meaningless to you? Is that really what you take me to be saying?

Well, you seem to have trouble understanding what "empirical (using the scientific sense of the word here)" means. You object of study is the patient. Your patient reporting things to you is empirical knowledge. On the other hand, you inferring things about the patient without backing evidence is what is subjective.

No, the patient reporting things to you is phenomenological knowledge. Self-observation is not empirical. I still want you to give me an example of what an "objective report" would be in comparison to a "subjective report".

 

[IrrelevantNotch]

Can somebody explain me why americans are almost obssessed with various pills and other stuff like Prozac (or whatever the current popular drug is) and so on? Every time I read a thread about depression I see people recommending various drugs. It's sooo strange, it's like killing body heat with pills but not treating the cause of body heat.

or is it just misconception and americans don't use antidepressants that often?

I hate you

 

[Lonely1]

No, the patient reporting things to you is phenomenological knowledge. Self-observation is not empirical. I still want you to give me an example of what an "objective report" would be in comparison to a "subjective report".

Self observation isn't empirical? I see a huge red and smelly sore in my leg. Isn't that empirical knowledge? There's no thing as 'pure knowledge'.

- Objective Knowledge: The patients tells me that he is suffering from sever headaches and can't sleep at night. Chances are that he isn't a liar, so he must be suffering of headaches and some class of insomnia.

- Subjective Knowledge: The patients tells... who cares what the patient tells me? Do an MRI and if nothing shows sends his ass home since there's nothing wrong with him.

In the second example, the observer (you) is making assessments about the patient that he hasn't verified in a sufficient way, using personal bias to derive results.

 

[Chumly]

It always amazes me when people think they know better how to treat other peoples depression.

 

[Freeza Under The Shower]

not trying to ruin the happy face, but ehm:

No, the patient reporting things to you is phenomenological knowledge. Self-observation is not empirical. I still want you to give me an example of what an "objective report" would be in comparison to a "subjective report".

You seem to use 'empiricism' aka positivism and 'empirical' as the same concept. These are two separate concepts. Empiricism / positivism is (was, actually) the idea of being to collect data on the world that is a direct representation of 'the real', an ideology as implied by the -ism at the end. And where all things are directly knowable from nature.

These days, "empirical" just refers to data that has been collected from the real world by the use of some method, be it quantitative, qualitative or perhaps something else. In this case, the self-report data is empirical in the sense that it has been collected from real people with a sufficiently valid and reliable method. Interview data is equally 'empirical', but indeed phenomenological in its 'nature'.

So, what its what you are arguing for? That current treatments don't work or don't well enough? Stop treating people with depression until more reliable test are developed?

And self report isn't empirical? That's BS, unless you believe that your patient is a liar.

I said 'models', not treatment. I would say that treatments don't work well enough either way though, but I think we all feel that way anyway.
"testing" has nothing to with it, unless you mean that more people are diagnosed than there "ought to be". I don't see how that statistical 'noise' could be removed, as discourse changes how people interpret their own states of body and mind.

After all, before 1950, there was no notion of psychological trauma either. But these are questions and things to go beyond the scope of this thread, I think.

 

[Digishine]

Wouldn't you be depressed if half of the world hate's america ?

 

[Dr.Guru of Peru]

I didn't say my knowledge of psychiatry is limited to what I've heard from friends. I did cite experiences friends have had, though.


What is "objective reporting"? A self-report is subjective by definition. The rest of your post isn't even part of what I'm talking about.



I don't have a problem with hearsay and anecdotes - that's how humans learn and live for the most part. The difference between my hearsay, and the hearsay of psychiatry (I wouldn't call it hearsay, but I'll just use your claim to make it easy), is that I don't call my hearsay "science". So there's nothing hilarious about it at all unless you think that I think my perspectives are derived scientifically, or something.

And a double "Yikes!" at you equating my thoughts on psychiatric medicine with all medicine in general. Except for responding to another poster about the nature of titles and their relationship to knowledge, I haven't talked about general medicine at all. I've clearly spoken against pseudosciences, which, not necessarily, but almost certainly, presumes that I am in favor of science.


Holy crap, you read my posts and remarked on what I'm talking about! You made my day, because that rarely happens. Although I don't care for the historical/ethical angle you brought up. Still, a happy face I have.


Self-report isn't based in empiricism, it's phenomenological at its root.

I don't think I've even talked about the treatments much, just the diagnostic methodologies. I thought some earlier posters in this thread, who had been on anti-depressants, had a very fair view of them: they can definitely help keep your depression from crushing you so that you can put your life on track. I think most people who have been on anti-depressants agree that they don't cure depression, so I haven't really been arguing about that (since to "cure" means to actually have removed the cause of the ailment, and anti-depressants really just mitigate the effects of the ailment).

I'm also fine with people being given anti-depressants, but I am not fine with the diagnostic methodologies being taken to be scientific.

I'm sorry, but...

Holy fuck you are a dumbass. What I posted has everything to do with what you're jabbering on about, you simply have no response to it. Psychiatry is BASED ON SCIENCE. The diagnosis is BASED ON SCIENCE. I've provided you with examples of why, but all you can do is spew verbal diarrhea about how your took a course on the history of science that you probably put as much thought into the posts you make here.

Fuck man, you don't have a single clue what science is. Heck, you don't even know what medicine (or any profession that applies science) is. You're throwing out words like empirical without even understanding what they mean.

And no, self-reporting isn't subjective. If I report I've been sleeping 6 hours a day when I used to sleep 9, thats an objective self-report.
.....


Let me make this simple for you:

You claimed that psychiatric diagnoses are not based on science.

The truth is that there is plenty of science out there to support psyciatric diagnoses (see my last post).

Now you counter.

 

[grumble]

What percentage of people on antidepressants in the united states do you guys think actually have a chemical imbalance that requires antidepressants?

 

[Xun]

Big pharmaceutical companies are the reason.

 

[Dr.Guru of Peru]

Except he never said that, nor has anyone else. but even so: science IS a game calling each other's models into question and if need be "J'accuse!" others of pseudo-science. That is how the game is played.

People in this thread seem to have real issues with the concept of 'models' and 'explanation'. I do not think the dominant model is convincing as a model of how depression works (how to explain it, with the hopes of increasing the rate of recovery), but that doesn't change the empirical phenomenon in any way or form. (meaning: the state of being depressed)

The only way that you can diagnose someone as depressed, is by a self-report. You can claim them to be from the outside as an experienced observer, but that method is unreliable and questionable from historical and ethical perspective. That is all that Karsticles is pointing to, and I really don't see how it's worth calling out as "wrong".

It would be nice to claim that we could look at blood values or fMRI scans and say within a 95% confidence level that someone is depressed, but that is simply not the case. These methods are not reliable to get observed data that is the actual empirical state and not just another measurement error. Particularly MRI scanning is wildly dependent on the physician interpreting the data.


There is great example of models not working or lacking explanation in Smile or Die by Barbara Ehrenreich. During her own months of breast cancer, she would be called upon to start drawing "her immune system battling the cancer cells". Which plently of women do.
Except it's not true. Chemotherapy wipes out the entire (well, a good deal of it anyway) immune system for a short while. It has absolutely nothing to do with battling a cancer that has moved beyond the immune system's control.
If fact, the white blood cells may be playing "for the other team", as they actively assist the cancer cells instead of killing them. (which is why they appear in large numbers at those sites, not because they are 'battling' them, but because they are helping them. At least, that's what Ehrenreich wrote back in 2009).

So, to summarize all this, why exactly would it be wrong to think that the evidence on the serotonin model is not all that convincing (at least not as far as drug testing and ongoing usage goes) and either more complex or other models show more promise for increasing the amount of people we could help by building better models?

And while Stet is banned: no, one does not require a degree to read books and acquire a level of understanding equal to or greater than people with the degree. The chances of this occurring are simply a lot lower than by simply following the curriculum. As far as the theoretical part goes anyway, where it concerns medicine.

Our current knowledge may be limited, but it doesn't change that its the best we have.

Regardless, your post is completely tangential to our discussion on the scientific merits of psychiatry.

 

[Karsticles]

Self observation isn't empirical? I see a huge red and smelly sore in my leg. Isn't that empirical knowledge? There's no thing as 'pure knowledge'.

- Objective Knowledge: The patients tells me that he is suffering from sever headaches and can't sleep at night. Chances are that he isn't a liar, so he must be suffering of headaches and some class of insomnia.

- Subjective Knowledge: The patients tells... who cares what the patient tells me? Do an MRI and if nothing shows sends his ass home since there's nothing wrong with him.

In the second example, the observer (you) is making assessments about the patient that he hasn't verified in sufficient way.

Depression isn't an empirical observation, though, it's phenomenological. Yes, seeing a sore on your leg is empirical. However, the feeling of that sore is not. Similarly, talking about my emotional states, which is what psychiatry largely involves, is not empirical.

You also have really weird definitions of objective and subjective.

not trying to ruin the happy face, but ehm:

You seem to use 'empiricism' aka positivism and 'empirical' as the same concept. These are two separate concepts. Empiricism / positivism is (was, actually) the idea of being to collect data on the world that is a direct representation of 'the real', an ideology as implied by the -ism at the end. And where all things are directly knowable from nature.

These days, "empirical" just refers to data that has been collected from the real world by the use of some method, be it quantitative, qualitative or perhaps something else. In this case, the self-report data is empirical in the sense that it has been collected from real people with a sufficiently valid and reliable method. Interview data is equally 'empirical', but indeed phenomenological in its 'nature'.

There's probably been some overlap in the usage. I'm honestly getting exhausted of the conversation, and the terminology tends to get a bit mingled when that happens. I'll try to be clear here:

1) The sensation and report of the mental state is phenomenological.
2) The observation of the report is empirical.

However, in empiricism, one is collecting data on the subject as one experiences the subject. However, psychiatry is attempting to collect data on the subject as the subject experiences itself. Thus I don't consider it to fall under empiricism, as phenomenology is not a shareable experience in the same way "blue" is. A natural scientist is immediate to nature, but the psychiatrist can only operate through the medium of the patient's phenomenology. It's one step removed from science as a result, in my opinion.

I'm sorry, but...

Holy fuck you are a dumbass. What I posted has everything to do with what you're jabbering on about, you simply have no response to it. Psychiatry is BASED ON SCIENCE. The diagnosis is BASED ON SCIENCE. I've provided you with examples of why, but all you can do is spew verbal diarrhea about how your took a course on the history of science that you probably put as much thought into the posts you make here.

Fuck man, you don't have a single clue what science is. Heck, you don't even know what medicine (or any profession that applies science) is. You're throwing out words like empirical without even understanding what they mean.

And no, self-reporting isn't subjective. If I report I've been sleeping 6 hours a day when I used to sleep 9, thats an objective self-report.
.....


Let me make this simple for you:

You claimed that psychiatric diagnoses are not based on science.

The truth is that there is plenty of science out there to support psyciatric diagnoses (see my last post).

Now you counter.

Subjectivity, by definition, is a thing as beheld by the subject. As you are the subject in the phenomenology, it must be a subjective report. Objectivity presumes independence from subjectivity. It's what science strives toward, to remove the subjective as much as possible. A self-report is the furthest thing from objectivity that can be thought of. It's purely phenomenological, the subject's experience of existence as the subject.

I do not think I have ever said "psychiatric diagnoses are not based on science". I have said "psychiatric diagnoses are not scientific". There's a world of difference between these two statements. It would be nice if you could be less hostile and take more time to read what I am saying.

Our current knowledge may be limited, but it doesn't change that its the best we have.

Regardless, your post is completely tangential to our discussion on the scientific merits of psychiatry.

I think it says something about your reading comprehension when you say he's tangential to our discussion, and I just thanked him for being the only person thus far to understand what I'm talking about.

 

[Dr.Guru of Peru]

D
Subjectivity, by definition, is a thing as beheld by the subject. As you are the subject in the phenomenology, it must be a subjective report. Objectivity presumes independence from subjectivity. It's what science strives toward, to remove the subjective as much as possible. A self-report is the furthest thing from objectivity that can be thought of. It's purely phenomenological, the subject's experience of existence as the subject.

I do not think I have ever said "psychiatric diagnoses are not based on science". I have said "psychiatric diagnoses are not scientific". There's a world of difference between these two statements. It would be nice if you could be less hostile and take more time to read what I am saying.

Its hard to really understand what you're trying to say when you keep changing your argument. It began with equating psychiatry to chiropractic. Now you're claiming that you only meant to say that "psychiatric diagnoses are not scientific". Newsflash: Diagnosis is not a science. It doesn't matter what medical field you are in, medical diagnosis is not a science.

It all comes down to you not understanding what science or medicine are. Science is a process of understanding. Medicine is the application that understanding.

I think it says something about your reading comprehension when you say he's tangential to our discussion, and I just thanked him for being the only person thus far to understand what I'm talking about.

Absolutely nothing in his post is supportive of your position.

 

[Karsticles]

Its hard to really understand what you're trying to say when you keep changing your argument. It began with equating psychiatry to chiropractic. Now you're claiming that you only meant to say that "psychiatric diagnoses are not scientific". Newsflash: Diagnosis is not a science. It doesn't matter what medical field you are in, medical diagnosis is not a science.

It all comes down to you not understanding what science or medicine are. Science is a process of understanding. Medicine is the application that understanding.

I definitely feel the overall practice of psychiatry is a pseudoscience. One such aspect of it being a pseudoscience is its diagnostic methods. I've never changed anything. You're right that diagnosis is not a pure science, but it is derived from scientific observations. Psychiatry can't claim such.

Absolutely nothing in his post is supportive of your position.

I didn't say it was. I just said he was on topic. Again, please take the time to read what I say:

Holy crap, you read my posts and remarked on what I'm talking about! You made my day, because that rarely happens. Although I don't care for the historical/ethical angle you brought up. Still, a happy face I have.

 

[Yasae]

Can you talk more about how this feels? I've never been on anti-depressants.

It's more or less emotionless or close to it. Again going back to conversations with other people, I'd feel: who is this person? Why should I care? Why was I interested in what they had to say? Etc. I just couldn't take any delight in their responses like I normally would have. I'd also play games and feel about the same as I was just feeling before. Watch a movie: the same. Listen to music - which should have a huge impact on me, personally - pretty close to no feeling.

Depression really was the opposite. I was a vampire for attention. I would often thank people for talking to me because I felt I wasn't worthy of their gaze. I guess in tandem these things balance out to a pleasant flatline, but once I got over that hump, prozac was dragging me down a lot more than it helped me. Even on light, 10mg dosages I could feel its desensitizing effect.

 

[MC Safety]

Wouldn't you be depressed if half of the world hate's america ?

Not one bit.

 

[way more]

For most people anti-depressants simple alleviate the worst parts of depression and have no "numbing" or "zombie" effects. I don't think you hear about the good they do for the same reason a bad review of a restaurant will be repeated many more times than a good one. Sarah Silvermen is a person who takes and will likely take anti-depressants the rest of her life, does she strike you as numb and zombie-like?


SSRIs are pretty much a placebo when given to people not in the worst stages of depression.

 

[Mammoth Jones]

What scientific evidence is there that depression is more/less prevalent in America? I mean, I think that people have a lot of free time to contemplate their unhappiness compared to someone living in a 3rd world nation. But I'm not convinced that a higher percentage of the people here are unhappy. Just maybe a higher percentage of unhappy people try to do something about it over here.

I honestly don't know.

 

[cajunator]

Anime is my antidepressant

 

[Uchip]

Anime is my antidepressant

you're depressed?

 

[Despera]

you're depressed?

According to your tag, I am

 

[Tomat]

you're depressed?

I'm curious about this too. Say it ain't so Cajunator!

 

[cajunator]

Absolutely not!

 

[Yasae]

For most people anti-depressants simple alleviate the worst parts of depression and have no "numbing" or "zombie" effects. I don't think you hear about the good they do for the same reason a bad review of a restaurant will be repeated many more times than a good one. Sarah Silvermen is a person who takes and will likely take anti-depressants the rest of her life, does she strike you as numb and zombie-like?


SSRIs are pretty much a placebo when given to people not in the worst stages of depression.

Maybe, maybe not.

My experience with prozac was generally positive regardless, but I'm not a chronic sufferer. When it became ineffective, I got the dosage lowered and gradually weened myself off.

 

[disappeared]

Because we've become utterly addicted to being unhappy with the shit we have. And when more doesn't do, the pills will.

 

[eosos]

wow if true, but I suspected something like that.

Ignore the rest of the thread and listen to the people who reinforce your preconceived stereotype. Grats, continue convincing yourself.

 

[Ledsen]

Drugs don't help people get over it, they help them postpone it.

This is completely wrong. Best case scenario, they pick you up out of the depression, and when you stop taking them, you've formed new cognitive habits that will help you avoid another episode.

 

[Trent Strong]

Because we've become utterly addicted to being unhappy with the shit we have. And when more doesn't do, the pills will.

It's not like antidepressants give you a high. If you don't have severe depression, antidepressants probably won't make you feel anything or make any difference in your mood.

 

[Vermillion]

Every time I catch American TV, the adverts are almost exclusively for fast food, 5 hour energy, exercise equipment and a wide variety pharmaceuticals. It's kind of depressing.

We're depressed and tired. Such is life.