The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
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Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
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Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
Jump in the discussion.
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It depends on the thing, but it is important to keep in mind that for many problems diagnosis is not important (especially in psychiatry). Fixing a problem is important, but a clear diagnosis? Nah. In psychiatry most problems are fixed by an SSRI or an antipsychotic - who cares if they have schizophrenia, schizoaffective, or bipolar disorder if the solution is the same. Who cares what the cause of the hypertension is? Rule out some important things to rule out, and then move on.
Also because the level of specificity - sick, infection, bacterial infection, anaerobic bacterial infection, a specific organism, the specific genetic profile of the specific strain of that organism, all of these are accurate diagnosis, but you can stop early and often should.
So it's hard to answer some of these questions without being reductive or ponderous.
Our tools aren't magic - for a long time the start of the art for identifying bacteria was dumping dye on it. Identifying something as weird as your own bits during slightly weird shit is hard as hell.
You're giving me exam PTSD, and I haven't even given the exam. SSRIs are not just what you'd rely on for BPAD, there's a ton of context for when they're actively harmful, or when you need antipsychotics and mood stabilizers. Good to know that the exam prep prepares me for discussions on this underwater basket weaving forum.
All granny with a UTI needs is Prozac and Zyprexa!
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But diagnosis is about defining what the problem is, right? Scope, range, severity, etc. In psychiatry I’d imagine it’s even more difficult than a standard internal medicine practice or surgery for instance. Last I’d read, some reports have indicated that most SSRI’s probably don’t work, which I assume demonstrates how robust the placebo effect can be. A bandaid doesn’t cure a cut. A bandaid creates a space for the wound to heal on its own. And for some injuries that’s all that’s necessary from a medical perspective. Suppose the medical efficacy for SSRI’s were 100% though. The treatment takes the form of a bandaid more than it does a fix if you ask me. The latter isn’t exactly what I’m asking a psychiatrist to do, that’s a near impossible task; I’m only saying that’s more what I’d liken it to.
Should the average person be surprised about the fragility and active debate over active cases? I don’t think there should be concern or worry over it TBF, what other alternative is there to trust when you’re in agonizing pain?
I mean lifestyle interventions are always the first recommendation for everything - lose weight and your BP improves. Socialize and exercise more and your depression improves. People don't do these things so we hit the second line interventions of actual medicine that are a band-aid not a solution.
In the case of SSRIs, if one doesn't work....you just switch to the next thing. Psych has more viable first and second line agents than most disciplines. Even if hit rates are lower it isn't a big deal.
Additionally, depression is more of a syndrome than a disease - shit life syndrome, major depression due to a cardiac problems, classic melancholic depression, all of these things manifest slightly differently but more or less the same and zero percent chance we have a full understanding of the underlying pathophysiology. Shit life syndrome likely responds poorly to medication, but how are you going to define that and separate it for the purposes of research?
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