[some1else]

I wouldn't describe those as "slavish". Unless we're in a negative feedback loop, we should probably follow established principles and improve them constructively. I have seen some conspiracy videos where authors refer to psychiatry as an educated guess. I have never seen a lucid individual diminish science like that. Can you elaborate on what you see as "dogma" in this respect?

Disclosure: I smoke more than most.

[nostrebored]

Psychiatry is not robust. We don't know how the brain works. We're not even close to understanding how parts of the brain interact, we rely on coarse tools and irreplicable neuroscience to try to guess out the intersection of biology, chemistry, neuroscience, etc.

When we consistently see that studies are designed poorly (in many cases by selecting poor metrics, think self-assessed productivity on adderall or amortizing results of SSRIs over multiple severity levels of depression) and mechanisms are poorly understood, what do you think that it is?

Science is in many cases filled with perverse incentives that only complicate this relationship -- do you want citations, a popular publication, tenure, influence on policy decisions? Does your hypothesis align with the ideas which are popular enough to get funding?

The fact of the matter is that science is political, psychiatry is in its infancy, and results are not great in a lot of cases. We treat everything like we couldn't possibly be developing our generations' version of phrenology and it's hubris.

[handsomechad]

It's all anecdotal, but:

When I was an adolescent I was diagnosed with ADD after a few days of examination, and was recommended adderall, which my pareents thankfully refused.

My mom told her GP she had trouble focusing and was prescribed adderall pretty much willy nilly.

I know quite a few people who are perpetually on SSRIs for anxiety or depression, yes it works as a palliative measure for some but I do question both the long term efficacy, if the magnitude of the side effect and dependence risks are understated, and most importantly whether or not the patients worked hard at all of the endogenous variables relating to their lifestyle to optimize for happiness before slavishly accepting their diagnosis.

I don't like that the conspiracy nut / tinfoil hat / anti science pejorative gets thrown around so easily as an argument ender in discussions like this. It is most definitely NOT scientific how these diagnoses are done, it's heuristic based, it's based on observed models and patterns, obviously, since we barely have slightest idea about how our brain is working under the hood / how it differs among individuals / what leads to long term convalescence.

So, for some people, diet, exercise, getting out of unproductive or toxic relationships/jobs, can help, for others, they need the boost of an SSRI or something to get out of the bog, etc. but I definitely suspect that very many people are prematurely getting pushed to the latter option without fully exploring the former, as was the case with my mother and I (except with focus issues instead of depression, though i suspect they're related)

Think of the parent commenter -- Say he went to a doctor or a psychiatrist with his issues. How much time do you think they would spend with him before getting to the point of prescribing him something to take care of his issues. Maybe 10 hours max? Probably more like 2 or 3? Often times less? Whereas he is obviously a thoughtful, intelligent, and diligent person who has probably spent years responsibly experimenting on what works for him and found that it is marijuana. Yet that would never even be an option for the docs to prescribe to him. So if he were to slavishly follow what you deem as "science", he would be stuck in the paradigm that he needs an SSRI or benzo or whatever it may be. Whereas by being anti-scientific, and self-medicating, he's here telling us how happy/successful he is.

Another more prominent example would be the opioid crisis.