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Comment by cromulent | Hacker News Reader

So depression is not pathological but the idea of depression is pathological? How meta.

Your comparison with cancer is odious, as you indicate. The idea of depression may be a cause of depression? Check. The idea of cancer might be a cause of cancer? Ridiculous.

The OP may well have helped people with depression (or their friends) recognize or diagnose or de-stigmatize their condition. Your comment? Not so much.

The social stigma of mental illness is real, and castigating people for relating their experiences, and others for applauding and adding to it, for not being strictly evidence based is not nice. Why didn't he perform a double-blind trial on himself, for goodness sake, and hold off on his blog post for a while? Crikey.

Lots of people commit suicide. Why should it matter to them, or their loved ones, if the cause is neurological or psychological? Why does a better life through SSRI's have to be justified to...anyone?

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> The idea of cancer might be a cause of cancer? Ridiculous.

Not ridiculous at all. There are all kinds of plausible mechanisms for the idea of cancer to cause cancer. Here's just one example off the top of my head: stressing out over the possibility of getting cancer can stimulate the production of excess stomach acid, which can lead to acid reflux, which is known to increase the risk of esophageal cancer.

Stress is not a meaningful cause of stomach ulcers.

Did not know that. Why is that such a commonly held belief?

It's only in relatively recent times been widely known that the majority cause is a bacteria http://en.wikipedia.org/wiki/Peptic_ulcer#History Stress was the common theory beforehand

The fascinating bit is the original researcher proving it by ingesting the bacteria, and giving himself an ulcer, and then curing himself with antibiotics. A Nobel Prize seems reasonable.

Actually, stress does seem to be a significant cause of stomach ulcers. It seems to be a common myth that H.Pylori entirely causes ulcers, but in fact 50% of the world population are infected by H.Pylori and it generally doesn't cause ulcers. Stress seems to be a significant cause. See http://en.wikipedia.org/wiki/Peptic_ulcer#Stress

Anyway, I'm not sure what this has to do with the original post.

H pylori has fulfilled Koch's postulates as a cause of ulcer disease. I don't agree that emotional stress is a major cause of ulcer disease.

From Harrison's 17th ed. ch 287: "H. pylori and NSAID-induced injury account for the majority of DUs."

From Malfertheiner's "Peptic Ulcer Disease" (Lancet 2009): "Emotional stress and psychosocial factors are frequently identified as important contributors to ulcer pathogenesis. Although stress cannot be neglected as a contributing factor, convincing evidence for it being the sole cause of duodenal ulcer is scarce. A good example of stress as a contributory factor was the rise in bleeding gastric ulcers in elderly people after a severe earthquake in Japan."

Note that in general, when the medical establishment talks about "stress", its practitioners generally mean physiologic stress states, such as burns, trauma, sepsis, or multiorgan dysfunction. Does physiologic stress cause ulcers? Indeed. Emotional stress? It may contribute, but is not, in itself, an important cause.

Another: Hypochondria causing lack of sleep and resulting in poor health. Making it less likely to be able to fight disease. Can't cite anything (although it may be out there) but certainly makes intuitive sense.

Lack of sleep of course would also cause one to drink more coffee which can be a gerd type irritant (I speak from personal experience here).

Hypochrondria is not the idea of cancer. It's the idea of having cancer.

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