Comment by neuroma | Hacker News Reader

Comment by neuroma | Hacker News Reader

Parent Full thread

Okay how about a new analogy:

Your web app malfunctions, and a diagnostic sweep suggests the code is compromised. It's cloud hosted and open source. You're part of a team and see various recent revisions that could have exposed the app to malicious use. Furthermore your cloud provider is upgrading their hardware. Your app has to come offline whilst it's patched. Its a critical service for some clients who are hounding you.

You ask for help from a professional to get things back and working.

They say, "It is due to an electrical imbalance in the computers."

In psychiatry people are analogously doing just that.

We know sure that neurotransmitters have a role in mental health, in the same way as engine oil has a role in a car. Right amount in right place is necessary, but not sufficient, for good operating. If I brough you my faulty car and you jept harking on about engine oil, I'd be miffed.

Incidentally I'm a staunch monoist materialist and believe brain states and mind are facets of the same phenomena. My gripe is with pharma marketing penetrating our collective psychology. Equating depression to monoamine derangement was a very attractive notion for all but in 30 years remains unproven, and not very helpful in guiding treatment.

I think I might have a slightly more apt analogy, though I do understand yours and pretty much agree.

To immediately jump to the "chemical imbalance" problem/solution is like if you have a web app that's performing really slow, so you hire a consultant to take a look.

They tell you that you need to horizontally scale your app in order for it to perform better. In many cases, this would actually work (for a while anyway), but it probably doesn't explain the real issue.

In reality, the problem could be that you wrote your app to do way too many things per request rather than picking and choosing which things are going to be treated as first-class. Perhaps there's even one little thing that's O(n^2) and it simply is going to take a lot of time to work out.

> We know sure that neurotransmitters have a role in mental health

While they have a "role", differences in neurotransmitter levels do not predict mental health state.

My understanding is that "chemical imbalance" theory was a popular misunderstanding of a more limited and specific theory called the ”catecholamine hypothesis" which has itself been pretty much debunked.

For decades the explanatory psychiatric theory behind depression has been the the "bio-psycho-social" model. While we know that biology is an import part of the picture, that part can include a bunch of different factors besides neurochemi cals, such as possibly inflammation, neuron growth factors and more.

[0] https://www.psychiatrictimes.com/view/debunking-two-chemical...

> Equating depression to monoamine derangement was a very attractive notion for all but in 30 years remains unproven, and not very helpful in guiding treatment.

I believe that theory has been mostly disproven, but that doesn't change solid evidence behind the efficacy antidepressants that were developed using that theory.

If someone tells me there is an electrical imbalance with the computer, then I will know we need to fix the computer, rather than the software that runs on it.

with your engine oil analogy, it seems like you are agreeing that brain chemistry is an important part of good mental health, just not the only one.

So if all the other parts of good mental health are in order, that leaves brain chemistry, hormones, etc. As the problem.

Reply on news.ycombinator.com