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by moe091 1282 days ago
The way I see it, the whole "chemical imbalance" thing is just one of many approaches, or ways of interpreting, psychological problems.

You could say "This person is depressed because they don't have enough serotonin" - which seems obvious, of course the unhappy person doesn't have happy chemicals, if they did they'd be happy.

Or you could say "This person is depressed because their avoidant defense mechanisms don't allow them to experience positive emotions in fear of getting hurt" - which of course would also lead to a lack of serotonin.

Though to be fair, the chemical approach can be useful for treating things "top-down": instead of working through past traumas, building new coping mechanisms, etc, you can pharmaceutically bolster the lacking neurochemicals. This isn't ideal but in some cases is the only feasible solution, and in other cases it can help the person get into a functional enough state to address their underlying issues and build up better habits.

That being said, I agree that most psychiatry is "bullshit", at least in a sense. I'd leave the self-medicating for the later stages of healing though, once you've got a grasp on yourself and the world, as giving someone with maladaptive coping mechanisms one of the most convenient and potentially harmful(if used incorrectly - which they will be compelled by negative emotions to do) coping mechanisms is likely to end badly.

And I 100% agree about therapy. It's useful, but often used incorrectly. To be honest I think this comes down to incompetence, it's far to easy to get a psych degree and a therapists license and start "helping" patients without being nearly equipped to understand and navigate and repair the mind of a person with mental illness. This is an insanely complicated task that requires some specific and uncommon talents in my opinion, in addition to a large amount of knowledge and theory. On this front I think psychology/psychiatry has been moving backwards since the days of psychoanalysis - there are still branches of analysis being advanced and improved to this day, but they are the fringe, while the majority of resources and effort is being put into more reductive methods while, while easier to train the average person with a bachelors degree to implement, are never going to lead to the level of understanding necessary to make leaps in progress in the treatment of mental illness

1 comments

> The way I see it, the whole "chemical imbalance" thing is just one of many approaches, or ways of interpreting, psychological problems.

Well a lot of it can be enviornmental. Allergies can impede sleep, which impedes cognition, which lead to mistakes that can cost you your job, especially paired with economic precarity.

But if you're ALWAYS sad, even on vacation, even playing video games, even on a date with a beautful girl or guy or whatever... the issue might be chemical.

>I 100% agree about therapy. It's useful, but often used incorrectly. To be honest I think this comes down to incompetence,

Oh, therapists openly admit if you meet them at the GPSO mixers (grad and professional student org) that a big chunk of the industry relies on taking on clients for three sessions then passing them along.

They tend to break down if you show up and say something like "Well, I'm sad because I don't have reoccuring income, and paranoid because folks with a similar IQ and education level to myself seem highly incentivized to take away my autonomy so they can bill for services I don't need, to the point of purposefully misunderstanding what I say.

For example, I had someone try to send me into a facility overnight when I shared I was given an alaprazolam script around the time I found out someone was an agent of foreign power. I had to very bluntly tell her I'm happy to speak to an outpatient psychiatrist to renew my medical card, but if she didn't question the narrative that brought me to her office.

To paint a picture, this was a nurse practitioner who I was seeing to get a strep test and an STD test, which I do regularly. I'd previously been in their clinic after nearly being murdered, since I felt my PCP had been homophobic and they advertised themselves as queer friendly.

She introduced herself as "Doctor [redacted], Nurse Practitioner" and promptly had a narcistic meltdown when I asked if she was a doctor or NP, then said I wanted a strep test to see if I need an antibiotic and to schedule a first session with a PCP other than the one I saw on my first visit, who had lectured me he had been sued for malpractice before but could document he didn't technically harm the person, told me he'd renew my medical card if I "got all my shots" (I'm not trans), then refused to do more than give me new bandages for puncture wounds so deep the ER had said they couldn't be stitched (and to see a PCP about a further round antibiotics to keep them from being infected as they healed)

>On this front I think psychology/psychiatry has been moving backwards since the days of psychoanalysis - there are still branches of analysis being advanced and improved to this day, but they are the fringe, while the majority of resources and effort is being put into more reductive methods while, while easier to train the average person with a bachelors degree to implement, are never going to lead to the level of understanding necessary to make leaps in progress in the treatment of mental illness

You're assuming psychology/psychiatry wants to advance -- I have seen zero evidence of that, the field peaked around 2009 and ever since the barriers have been helping consumers of MH care survive extortionary attempts to coerce them into the old ways if they luck into someone who understands acronyms like CBT instead of trying to throw lithium at anyone who expresses anything but the demeanor what I call a "sullen cherub dream boy". (For an example, watch Mr. Robot. Real mental illness is nothing like... that.)

Then again, Pittsburgh, my hometown just elected a mayor who ran specifically on a platform of making UPMC pay it's fair share in taxes, and it was a known thing I'd knocked a few local party officials out of office, so I can see why sometimes folks in the medical field are on edge -- I'd be a little uneasy if I knew folks had once literally rioted outside Bill Peduto's house after hearing some chicken fingers loving autistic's tight five.

(In addition to being a hacker, I'm also an amateur comedian, and I have one set I used to do back around 2020/2021 where I'd open by telling the audience in a monotone that this is not a movie or TV show, and that if we stop having elections then I'm just a bald, muscular five nine guy who can crash the internet and knows how to break out of the county jail, then move on to joking about how they made a whole Netflix documentary about now outgoing Senator Doyle is literally in a sex cult[1] and that maybe it's because I'm autistic I don't understand why after ten years with no raise of the minimum wage anyone votes for these milquetoast neoliberals :-) )

[1] https://www.newyorker.com/magazine/2010/09/13/frat-house-for...