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Honestly, my approach is, fuck it, why not?
Well, there are actually reasons why not, such as the hope we can find a less ghoulish cure, things like mirror therapy for phantom limb (well, that one's already gone, its just that maybe there's an equivalent), or the fact that they might go on disability.
But if someone who is otherwise healthy and financially sound wants to chop off pretty much anything for any reason, my opinion as a psychiatrist-about-to-start-training is a shrug, presuming I was convinced that nothing else we could do would help.
Surgeons aren't that gung-ho in my opinion, maybe it's because I worked too long in Onco Surgery, but I've seen more cases turned down as non-resectable or not worth it than those that were done knowing it was futile. Surgeons usually want what's best for the patient too, even if it's in conflict with their wallets. They're rich enough that's not the biggest deal.
Chop off a mole, a limb, a dick, anything at all. As long as you make sure you're not a burden on the rest of us, it's not my business, unless you ask me for my advice.
I feel like psychiatrists are more skittish because they have gone down the "fuck it" lane before and caused horrors. The healthy and financially sound are surprisingly easy to lead down a garden path.
Eh, that's not really my experience with them. What exactly do you think psychiatrists get up to? Leaving aside the gender-affirming types.
Do you want the long list or the short list?
Off the top of my head, naming only the ones that are undeniable crimes against humanity and beyond debate:
Going full Szasz and calling mental illness as a category a myth in reaction is probably going too far, but let us not pretend that the field has clean hands. Few other disciplines ought to be as deeply attuned to the depravity mankind can let itself get up to under the proviso of "doctor says it's okay".
Uh, correct me if I’m wrong- @self_made_human feel free to chime in here- but I thought that electroshock therapy was actually an effectual and not-painful technique that was abandoned for complicated reasons including safetyism?
You are correct, though these days it's evolved into Electroconvulsive Therapy/ECT. Same principle, we just knock people out first and give them muscle relaxants so they don't end up aching all over.
I've considered it for myself, but I'm not sure my depression is quite that bad yet, and it has an annoying effect of minor memory loss, and buddy I rely on my memories for a living. But it's the final backstop for treatment resistant depression, though we've got new things like ketamine therapy and so on.
So it's not gone or abandoned, we've just become more civil about it. It works well when all else has failed.
have you tried taking vitamin D in the morning? I would really love a bigger sample size than just me suggesting that vitamin D has positive mood effects.
I think I've had like 5 tablets in my life. I was deficient the last time I checked ages ago, but so is everyone in India, as paradoxical as that is.
Can't say I particularly miss the sun too much really.
I started taking 2000-10,000k IU at the start of the pandemic, and my lifelong subclinical depression has lifted. It’s the only consistent thing I can credit.
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