Hacker News Reader

Comment by Spod_Gaju | Hacker News Reader

My point is that this was a waste of effort and money. They just need to listen to us patients and stop thinking we cannot be objective. Whenever it comes to mental health people think there is a total loss of objectivity. All you have to do is look at the patient. Is there a need to get a brain scan to see if I am anxious if I am acting objectively anxious?

This need to measure everything is almost pathological.

View on HN

Patients generally can't be relied upon to be objective. There may be exceptions but patients will often say they don't have symptoms that they do and that they do have symptoms that they don't.

Speaking as a patient myself.

I wish there was a way I could get an objective test that spits out exactly what's wrong with me and which treatments are most effective. I've been through several psychiatrists and treatments and am yet to find something effective.

I'm glad research like this is being done.

It's always been interesting to me that psychiatrists and psychologists just have to sort of trust the story they're being told. Recently CVS and other pharmacies have started denying prescriptions from some telehealth based psychiatrists because they believe they're over-prescribing amphetamines. How do they know?

This article also makes me think of the neurologist that unknowingly analyzed his own brain scan only to discover he was a psychopath.

https://www.smithsonianmag.com/science-nature/the-neuroscien...

Am I "telling a story" when I am walking down the street taking pictures of people because I think they are working for the government and spying on me?

The doctors "objectively" thought I was on drugs.

And those tele-health centers are being shutdown because they do no legitimate screening and are pill farms.

https://thehill.com/policy/healthcare/4723163-cdc-disruption...

So I feel you are confusing mental health and mental illness and confusing compassion with a profit making operation.

> Patients generally can't be relied upon to be objective.

Neither can doctors, or researchers. They obviously see something wrong with you, as they did with me, so do we worry about their objectivity? No. Because bias and stigma.

And if you are looking for answers, like I have been for 20 year, you might want to look at the role the purine pathway plays in mood disorders. Here is an article I wrote about it.

https://christianbonanno.substack.com/p/what-caused-my-menta...

Best of luck because I objectively know the crap you are dealing with.

> This need to measure everything is almost pathological.

What's pathological is the tendency to see everything in black or white, right or wrong. There are many different causes for fatigue and tiredness: the flu, atypical depression, chronic fatigue, etc. But those conditions can overlap with depression. Putting the symptoms through a sieve by eliminating some causes helps pinpoint the origin (I over-simplify of course).

edit: this complaint about measuring things is a bit surprising considering what needed to be measured so this article https://christianbonanno.substack.com/p/what-caused-my-menta... (edit: interesting reading btw) could be written ?

You said it. The fact that they are just looking at the brain when it comes to mental illness, is, well, insane.

If one becomes "depressed" when sick, why not investigate the immune dysregulation in depression?

The only way out of a mental illness is personalized medicine but that is something no one care enough to provide.

> Putting the symptoms through a sieve by eliminating some causes helps pinpoint the origin (I over-simplify of course).

That is nothing close to what they are doing. Do you think they are going to be giving these scans to everyone that walk in with fatigue and/or depression? I cannot even get to see a rheumatologist and I am disabled with schizoaffective disorder.

It's true that doctors should listen to patients, and that diagnosing medical problems, especially psychological problems, can be very difficult.

However, your post has a very "we don't need x-rays, we can just tell the bone is broken" vibe. It reads like you think better and more objective, quantitative diagnosis is not worth pursuing.

I do not care about your vibe. I care about finding the truth and telling it like it is from my lived experience.

They diagnosed the patients to get them in the study and they they said "see, it matched out "objective" diagnosis based on the patients "subjective" complaints.

There is nothing quantitative about what they are doing. Take a look at figure 5. How quantitative is that?

Honestly a lot of these diagnosis issues are incredibly difficult.

depression with anxiety is dramatically more difficult to treat than either or.

Bipolar can come across as ADHD in certain parts of the cycle or just usually depression. In fact, you can even have uni-polar depression that does not respond to traditional anti-depressants and you don't necessarily exhibit hypomanic episodes.

Relying on patients to know and understand what they are experiencing other than "this is just normal I assume everyone else experiences this" is not reliable.

Having something that can reliably diagnose and find markers for these conditions would be _huge_.

I wade through whitepapers and books on this stuff because of my own issues. I don't expect the average person to even remotely know about all of this; it's a lot and very subtle.

To add on to all of this, people tend to not seek treatment until there IS a problem. Sometimes this can be really life alteringly bad, sometimes it's benign. But it would be helpful if people could just "take a test" and know or at least have an idea.

The issue with being "objective" is also that your doctor has to be "objective" and I've had a lot of friends that are clearly ADHD and end up with DRs that think they are just trying to get medication and don't have ADHD.

Worse yet; they do get medications and they have to cycle a few different ones because of the way they tolerate it. It would be really nice if we had an idea to correlate your ADHD, your body chemistry, and which drugs would be most effective for you rather than the 3-12 month ordeal of figuring that out.

Reply on news.ycombinator.com