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540 points drankl | 1 comments | | HN request time: 0.209s | source
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parpfish ◴[] No.44485690[source]
Decades ago in my first abnormal psych course, the prof warned us that there was an almost iron-clad law that students will immediately start self diagnosing themselves with “weak” versions of every disorder we learn about. In my years since then, it has absolutely held true and now is supercharged by a whole industry of TikTok self-diagnoses.

But there are a few things we can learn from this:

- if you give people the chance to place a label on themselves that makes them feel unique, they’ll take it.

- if you give people the chance to place a label on themselves to give a name/form to a problem, they’ll take it.

- most mental disorders are an issue of degree and not something qualitatively different from a typical experience. People should use this to gain greater empathy for those who struggle.

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zug_zug ◴[] No.44485765[source]
It's interesting because there are two diametrically opposed ways to interpret what you said

One is - everybody thinks they have disorders, so just ignore that feeling it'll mess with you.

The other is - everybody thinks they have minor version of disorders, because we all do, we live on continuums, and therefore we should probably all think about it more

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Retric ◴[] No.44485878[source]
Disorders are labels for things which significantly negatively impact people’s lives. Thinking of them in terms of a spectrum generally means stretching a label past the point of meaning.
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zug_zug ◴[] No.44489837[source]
Well, if you're approaching this as a hard-scientist that's not the case (for psychology).

Because "disorder" may be on a spectrum, because "negative" and "impact" may be on a spectrum. Conditions like depression follow a bell-curve, there's no clear line between depressed and not, and we can draw a line in the sand, but statistically there's no justification for where that line falls.

One way to try to draw a line is "the point at which a certain intervention is no longer effective."

For example studies find CBT therapy reduces depression scores for depressed people ~.8 standard deviations (for a while).

But why not try CBT therapy on happy people? Maybe it's even more effective on people who are already happy. Well the reason why not is likely just because of the clumsy nature of healthcare -- interventions are thought of as "treatments" for "conditions", even though that lens doesn't always make sense.

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Retric ◴[] No.44490143[source]
> there's no clear line between depressed and not

There’s a meaningful line in the sand for treatments with major side effects. CBT therapy may be “fine” for normal people, but the most effective treatment for depression is ECT which has major side effects. Including a ~1 in 50k chance of death.

Saying something is a bell curve distribution is an approximation, it doesn’t mean there’s actually a continuous function out to infinity and negative infinity.

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pseudalopex ◴[] No.44491466[source]
When to resort to ECT is a subjective decision of doctor and patient. It is clear it should come after other treatments failed. But there is no clear line.
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Retric ◴[] No.44491802[source]
Everything is subjective at the margins, but that’s ignoring the clear cut examples where it’s not going to be considered.
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pseudalopex ◴[] No.44492218[source]
> that’s ignoring the clear cut examples where it’s not going to be considered

The 2nd sentence outlined when it would be considered and implicitly when it would not.

You seem to believe some cases of depression warrant ECT. Some do not. It's subjective at the margins. But don't call it a spectrum!

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Retric ◴[] No.44492504[source]
No that’s not what I just said.

Spectrums extend continuously from normal to disorders. So if you believe depression is a spectrum you must also believe that no treatment is necessary for some people with depression. However if depression is a disorder there may be some cases that are on the margins that aren’t quite depression that still warrant some forms of treatment.

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pseudalopex ◴[] No.44492713[source]
Your definition of spectrum is not standard. And the disorder called depression commonly is called major depressive disorder clinically.
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1. Retric ◴[] No.44494928[source]
I could list a bunch of sources supporting what I just said but I’ll just say.

https://www.ifeet.org/files/DSM-5-TR.pdf

DSM V has depression as depressive disorders, but lists “Schizophrenia Spectrum” and “Autism Spectrum” so I invite you to consider what distinction for spectrum is being used.