“Mini-mental state” (1974) [pdf]
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> “MINI-MENTAL STATE” A PRACTICAL METHOD FOR GRADING THE COGNITIVE STATE OF PATIENTS FOR THE CLINICIAN
(..) the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely. It is “mini” because it concentrates only on the cognitive aspects of mental functions, and excludes questions concerning mood, abnormal mental experiences and the form of thinking. But within the cognitive realm it is thorough.
That said, it's certainly better if your exam subjects are suffering from dementia, so they can't memorise the answers ;-)
Despite this paper (and most forms) clearly specifying "three objects", I've always seen this taught as three random/arbitrary words of different "types" - adjective/noun/verb, person/place/thing - or just "two common objects" instead of exactly a pen and a watch.
It's always fascinating to me when patients come up with incorrect-but-clever words for common items: "cutters" for scissors, "timeclock" for watch, "cigarette starter" for a lighter, etc.
I used to literally sit reading the DSM and associated inventories during in school suspensions, if you do not have a chemical imblanace, most of psychiatry is bullshit, and folks should self medicate with cannabis and low caffeine drinks like black tea rather than risk the permanent cognitive harm and withdrawal symptoms of SSRIs often prescribed to bring your behavior into compliance when you are reacting to the antisocial actions of others.
(Therapy, OTOH is useful, but therapy needs to define goals and and exit strategy, or it can turn extortionary -- paying someone to certify your sanity as they siphon up your deepest fears and desires... and then obstructs them through inaction, since if you're on HN, you're going to be as smart or smarter than the therapist.)
I am a huge proponent of SSRIs. I have seen them work wonders. And I haven't seen any "permanent cognitive harm".
Cannabis, on the other hand: Also a drug. Most definitely can cause behavioral changes. I'm not against it, but don't be naïve.
In grad school, my university counseling center tried several (some of which had been tried in childhood), and then diagnosed me with CPTSD and GAD from the treatment I endured in K12, handed me an alaprazolam script, and encouraged me to try to live a fulfilling life on top of being on the autistic spectrum.
OTOH I found cannabis helps when other things didn't, but there were supply chain issues since I was rapidly shifting from nearly joining the NSA to, by my mid 20s, authoring the beginnings of a PhD thesis on how we could better design anonymnity tools for non-computer scientists, which I recently posted in new but don't want to spam.
The issue is that we pretend there is one treatment for all sadnesses, when often sadness is reactive.
Combine that with the fact folks often want to do drugs to feel good, and that IMHO adds value to cannabis -- it's less addictive than alaprazolam or SSRIs and can be stopped more rapidly with less dangerous side effects.
(Feel free to drop contact details if you want to discuss this further, today is the last Friday I will be posting about anything but tech on HN, but it's hard to do that: the personal computer is political.)
I've also never heard about permanent cognitive harm, though going off their requires step-down over time and shouldn't be done "cold turkey."
The same is true for ADD/ADHD meds. They are overprescribed too but for people who actually do have these conditions they can be absolutely miraculous and mean the difference between a fully functioning life and one in permanent discomfort and functioning far below ability.
You could say "This person is depressed because they don't have enough serotonin" - which seems obvious, of course the unhappy person doesn't have happy chemicals, if they did they'd be happy.
Or you could say "This person is depressed because their avoidant defense mechanisms don't allow them to experience positive emotions in fear of getting hurt" - which of course would also lead to a lack of serotonin.
Though to be fair, the chemical approach can be useful for treating things "top-down": instead of working through past traumas, building new coping mechanisms, etc, you can pharmaceutically bolster the lacking neurochemicals. This isn't ideal but in some cases is the only feasible solution, and in other cases it can help the person get into a functional enough state to address their underlying issues and build up better habits.
That being said, I agree that most psychiatry is "bullshit", at least in a sense. I'd leave the self-medicating for the later stages of healing though, once you've got a grasp on yourself and the world, as giving someone with maladaptive coping mechanisms one of the most convenient and potentially harmful(if used incorrectly - which they will be compelled by negative emotions to do) coping mechanisms is likely to end badly.
And I 100% agree about therapy. It's useful, but often used incorrectly. To be honest I think this comes down to incompetence, it's far to easy to get a psych degree and a therapists license and start "helping" patients without being nearly equipped to understand and navigate and repair the mind of a person with mental illness. This is an insanely complicated task that requires some specific and uncommon talents in my opinion, in addition to a large amount of knowledge and theory. On this front I think psychology/psychiatry has been moving backwards since the days of psychoanalysis - there are still branches of analysis being advanced and improved to this day, but they are the fringe, while the majority of resources and effort is being put into more reductive methods while, while easier to train the average person with a bachelors degree to implement, are never going to lead to the level of understanding necessary to make leaps in progress in the treatment of mental illness
Well a lot of it can be enviornmental. Allergies can impede sleep, which impedes cognition, which lead to mistakes that can cost you your job, especially paired with economic precarity.
But if you're ALWAYS sad, even on vacation, even playing video games, even on a date with a beautful girl or guy or whatever... the issue might be chemical.
>I 100% agree about therapy. It's useful, but often used incorrectly. To be honest I think this comes down to incompetence,
Oh, therapists openly admit if you meet them at the GPSO mixers (grad and professional student org) that a big chunk of the industry relies on taking on clients for three sessions then passing them along.
They tend to break down if you show up and say something like "Well, I'm sad because I don't have reoccuring income, and paranoid because folks with a similar IQ and education level to myself seem highly incentivized to take away my autonomy so they can bill for services I don't need, to the point of purposefully misunderstanding what I say.
For example, I had someone try to send me into a facility overnight when I shared I was given an alaprazolam script around the time I found out someone was an agent of foreign power. I had to very bluntly tell her I'm happy to speak to an outpatient psychiatrist to renew my medical card, but if she didn't question the narrative that brought me to her office.
To paint a picture, this was a nurse practitioner who I was seeing to get a strep test and an STD test, which I do regularly. I'd previously been in their clinic after nearly being murdered, since I felt my PCP had been homophobic and they advertised themselves as queer friendly.
She introduced herself as "Doctor [redacted], Nurse Practitioner" and promptly had a narcistic meltdown when I asked if she was a doctor or NP, then said I wanted a strep test to see if I need an antibiotic and to schedule a first session with a PCP other than the one I saw on my first visit, who had lectured me he had been sued for malpractice before but could document he didn't technically harm the person, told me he'd renew my medical card if I "got all my shots" (I'm not trans), then refused to do more than give me new bandages for puncture wounds so deep the ER had said they couldn't be stitched (and to see a PCP about a further round antibiotics to keep them from being infected as they healed)
>On this front I think psychology/psychiatry has been moving backwards since the days of psychoanalysis - there are still branches of analysis being advanced and improved to this day, but they are the fringe, while the majority of resources and effort is being put into more reductive methods while, while easier to train the average person with a bachelors degree to implement, are never going to lead to the level of understanding necessary to make leaps in progress in the treatment of mental illness
You're assuming psychology/psychiatry wants to advance -- I have seen zero evidence of that, the field peaked around 2009 and ever since the barriers have been helping consumers of MH care survive extortionary attempts to coerce them into the old ways if they luck into someone who understands acronyms like CBT instead of trying to throw lithium at anyone who expresses anything but the demeanor what I call a "sullen cherub dream boy". (For an example, watch Mr. Robot. Real mental illness is nothing like... that.)
Then again, Pittsburgh, my hometown just elected a mayor who ran specifically on a platform of making UPMC pay it's fair share in taxes, and it was a known thing I'd knocked a few local party officials out of office, so I can see why sometimes folks in the medical field are on edge -- I'd be a little uneasy if I knew folks had once literally rioted outside Bill Peduto's house after hearing some chicken fingers loving autistic's tight five.
(In addition to being a hacker, I'm also an amateur comedian, and I have one set I used to do back around 2020/2021 where I'd open by telling the audience in a monotone that this is not a movie or TV show, and that if we stop having elections then I'm just a bald, muscular five nine guy who can crash the internet and knows how to break out of the county jail, then move on to joking about how they made a whole Netflix documentary about now outgoing Senator Doyle is literally in a sex cult[1] and that maybe it's because I'm autistic I don't understand why after ten years with no raise of the minimum wage anyone votes for these milquetoast neoliberals :-) )
[1] https://www.newyorker.com/magazine/2010/09/13/frat-house-for...
Better start practicing today so I can get it right in my dotage :)