Scientists: Protein IL-17 fights infection, acts on the brain, inducing anxiety

> I do not know why doctors are so hesitant to link the immune system and mood disorders.

People who call themselves doctors — e.g. neurologists — generally aren't hesitant to do this. But psychiatrists — and even moreso, therapists — generally are. And psychiatrists+therapists lead the conversation on mood disorders, since that's who everyone is talking to about their mood disorders.

IMHO it's just the hammer-and-nail thing. To a cardiologist, every medical problem is seen through a potentially cardiovascular lens; to an oncologist, every problem is a question of what type of cancer could cause it.

Psychiatrists are technically medical doctors, but they spend their entire careers (after a few short years of school) focusing on psych cases; where these patients' problems either are purely psychological (e.g. conditioned-response, traumatic-response, coping/defensive, attachment-related, etc.), or at best "we don't know" the degree to which they're psychological vs organic. (If we can recognize a problem as purely organic from the outset, that problem doesn't end up in the hands of a psychiatrist!) And either way, they usually see good results in clinical practice from treating the patient's mind, rather than addressing organic signs/symptoms directly. Even when they prescribe medication, they're measuring their success on a mental basis (using questionnaire-based instruments used to gauge mental changes) rather than observing changes in e.g. measurable behavioral signs. The problems they're faced with, and the successes they have via these models, reinforce in psychiatrists a mind-centered mental model / worldview for psychiatric disease. (A model which is "the right one" to use in many psychological diseases! But not for many others.)

And therapists aren't even medical doctors. They never learn much-at-all in school about potential organic causes of psychological (or medical) problems. They focus purely on this lens of "the mind", ignoring the lens of "the brain as an organ" entirely. This means that in clinical practice, when confronted with a problem that has both mental and organic aspects, a therapist will tend to ignore the organic aspects; and when confronted with a problem where the organic aspects are too large to ignore, the therapist will simply refer to a psychiatrist (or neurologist, maybe) — with no follow-up, and thereby, no way to end up learning what the patient's problem actually was and thereby evolving the neurological side of their understanding.

I don’t know what you’re basing this on. Good psychiatrists absolutely “call themselves doctors” and definitely seek to exclude or treat organic causes of psychiatric symptoms. All the psychiatrists I know absolutely understand there’s a link between the immune system and mood disorders and will involve immunology/rheumatology for these things.

Your ideas about how psychiatry is practiced might have been correct in the 1950’s but they’re a world away from how it’s done in the 2020s.

> Good psychiatrists absolutely “call themselves doctors” and definitely seek to exclude or treat organic causes of psychiatric symptoms.

Well, yeah, you're just stating the contrapositive corollary to my assertion: that psychiatrists who don't "call themselves doctors" [i.e. who don't think of themselves as treating the patient's problem holistically first-and-foremost, and instead just do "talk therapy but you can prescribe"] are bad psychiatrists.

> Your ideas about how psychiatry is practiced might have been correct in the 1950’s

It might just be where I live (Canada), or the particular moment one will find a psychiatrist in their career to have openings to accept new patients to their private practice without a years-long waitlist... but the vast majority of psychiatrists I've interacted with personally as a patient, or have heard about interactions with through friends, have all had a distinctly 1950s mindset.

It might be because most of them have been seemingly nearly old enough to have gone to medical school in the 1950s. Most of them are only a year or two away from retirement.

(Which is frustrating, because it means I and others I know have to keep getting a referral to a new psychiatrist; wait-listing in to see them for an initial consult; seeing them for 1-2 years; and then getting dropped when the psychiatrist retires. And no, none of the psychiatrists I've been to have ever tried to create treatment continuity by cross-referring to another still-working psychiatrist; you just arrive at their office one day for an appointment you scheduled six months back to find it empty.)

But it also seems to imply that — despite the regular continuing education requirements for maintaining licensing — these folks don't seem to actually put the more-modern perspectives they've been exposed to into practice.