Throwaway05
16hr ago
The conversation about SSRIs is more complicated than just "such and such recent paper says X." But that's not the point. The point is that their is a variety of pathology in Psychiatry and the Psychiatry adjacent fields and focusing your thoughts on SSRIs and low severity pathology misses dementia, autoimmune encephalitis, schizophrenia, bipolar disorder, and so on.
If you are lucky all you have to think about is depression/anxiety/adhd/"autism spectrum" but that's not all the stuff!
Throwaway05
16hr ago
Ultimately the point is that the people complaining about the scientific state of mental health research don't really seem to know anything about the state of mental health research.
It's easy to grab one specific thing (commonly: the trans issue) and assume it's representative of the whole field but that isn't a fair conclusion nor is it accurate.
I see the same thing happen all the time with general medicine, people here often complain about their doctor being a barrier to the medication they want, and that's a topic, and a high frequency topic because outpatient medicine is a lot of medicine by number of patient encounters, but it's a very small portion of medicine by the number of jobs or specialties or research topics. Insight into that one specific issue does not provide a lot of experience with respect to the whole field.
Throwaway05
19hr ago
I’m still fiercely critical of the “medical model” of mental health, and find much in contemporary “therapy culture” that is deeply disagreeable to me.
Keep in mind that tens of thousands of experts in a variety of fields over multiple decades and many paradigm shifts are actually thinking about this and working on epistemic certainty.
Not every therapist is academically minded (and many types of degrees don't engage with this at all) but despite anti-psychiatry people the field is more scientifically minded then you might imagine but it rarely comes out in frustrated opinions by people who are mad that things aren't going the way they them to.
For instance for nearly a hundred years, there was a pipeline from Psychiatry to neurology. Once medicine understood the disorder better (for example, Alzheimer disease) it moved fields. This means that Psychiatry is naturally left with the less understood stuff.
However diagnostic entities like Schizophrenia are pretty well understood with clear medical shit (such as direct identification of neurotransmitters and pathways).
The more common and less severe things (such as simple anxiety and depression) are less understood but you better bet that experts in the field have a decent enough understanding of what's a severe biochemically mediated depression and what's more likely to be SLS (shit life syndrome).
These conversations and investigations happen they just don't make it to you.
Throwaway05
1d ago
How is everyone's experience with janitorial staff post-COVID?
I work in a hospital that any US physician would recognize by name but half the time I show up at work in the morning and the staff bathroom looks like a bomb went off. Thankfully clinical areas are better, but it's unacceptable. Is this one of the classic hospital problems or is stuff still shittier in say, the Google offices too?
Throwaway05
2d ago
Are you me??????
Throwaway05
4d ago
Listening to politics inside baseball podcasts,
Any recs? I listen to 2Way.
Throwaway05
4d ago
I sometimes see him on reddit posting. The fact that he is a troll is easier to spot when he's posting on PCM blatantly trolling.
Throwaway05
4d ago
A zombie and a resident are indistinguishable.
Throwaway05
6d ago
I really think LeGOAT makes the team amazing, regardless of what happens. We all know the best predictor of future behavior is past behavior - random embarrassing bullshit or injuries is inevitable. But.
I mean the NFL let Brady and to a less extent Mahomes get away with shenanigans, if the star wants to bring greatness to the league and cost the owners millions less dollars? They'll allow it.
Maxey is great.
Throwaway05
6d ago
Bron is still so fucking good. If the knees stay blessed Sixers are going to go all the way.
High-quality care involves things like doing nothing, prescribing lifestyle interventions, and therapy as a first line and sometimes only line.
I know this happens. It really does, but -
Corporate medicine disincentivizes this - most physicians are owned now and most patients show up expecting medication and get mad if they are told to exercise to fix their mild depression.
The traditional model for mild to moderate pathology is that you sit down with a psychiatrist for 90-120 minutes, they get to know you, they talk through what you are experiencing and they try and address things without medication. Most physicians prefer this.
The current corporate model is that you show up, have a 20 minutes appointment, say you are depressed and want it fixed, and get prescribed Zoloft.
That absolutely does work for some people but it isn't great and it's something physicians don't have much control over and they do complain about.
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