D-Machine

The idea that simple serotonin deficiency is the whole entirety of all depressions is 100% discredited and completely incoherent in the face of current evidence, but yes, for sure it remains clear and plausible that some forms or aspects of depression involve a serotonin deficiency.

However, tianeptine is serotonin reuptake enhancer and also can help with depression, so any simple deficiency hypothesis also doesn't look good either.

Broadly, the "chemical imbalance" theory, left vague and unspecified, is still basically sane (though not specific enough to be super useful).

Agreed. They have to be significantly helping at least some, but we can't say who these people are for certain yet, or how many there really are.

And yes, in some cases, no other options are possible, so even if the evidence is pretty dismal for their effectiveness, they are still broadly safe enough to definitely be worth a try. They probably just shouldn't be the first-line approach.

> The truth is antidepressants have a larger effect on mental health than actually gets reported because of how improvements are measured.

The truth is actually exactly the opposite, and I provided very high-quality evidence demonstrating this to be the case. You have nothing but bald assertions.

I am not sure, but recommendations to prescribe in mild cases have quietly been reigned in a bit by e.g. NICE https://www.nice.org.uk/guidance/ng222/chapter/Recommendatio....

For some people the emotional blunting is desirable, especially as you said, if the problem is chronic anxiety. But for many other people, their depression is defined by a lack of positive affect and anhedonia, meaning that emotional blunting is literally making things worse.

Depression is highly heterogenous, and I am glad the medication helped you.

Yup, I would agree. The meta-research / methodological research and awareness here is really quite impressive, even though its conclusions are a bit grim and not well-known.

Best way to manage the withdrawal would be to dramatically reduce them being prescribed in the first place.

The linked article says they have "small to moderate effectiveness", but this is being far too generous. The correct way to measure drug effectiveness is if the treatment meets the standard of a minimal important difference. I.e. you measure depression on various rating scales, like the 17-point HAM-D, and research suggests a minimal important difference (i.e. one patients and clinicians can actually notice) needs to be about 3-5 points. But the average effects of almost all antidepressants do not meet these thresholds, i.e. the effect actually appears practically invisible. [1]

Then you'll get waffling like "oh, but it really has a big effect for some people", but, well, no, we've looked at that too, and the placebo groups get just as miraculous "big effects", i.e. evidence supporting the idea "they really help some people" is also largely lacking [2-3]. All the other attempted saves ("oh, but eventually you find one that works for you") are also not really well supported either [4].

Like, maybe they really help some people, but it is far, far less clear than most assume, and should be balanced with concerns like withdrawal and serious side effects like emotional blunting and sexual dysfunction.

EDIT: And just to be clear to anyone doing a drive-by downvote thinking this is about recent asinine US politics, it emphatically isn't. There are serious methodological concerns here that desperately need to be communicated to the public.

[1] https://pubmed.ncbi.nlm.nih.gov/33593736/

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC7451660/

[3] https://pubmed.ncbi.nlm.nih.gov/33175895/

[4] https://pmc.ncbi.nlm.nih.gov/articles/PMC11844611/

Almost certainly there is also a "latent" representation that isn't just based on sensory imagery (i.e. some kinds of logical relations).

But it is also not likely that an absence of sensory imagery is without impact, i.e. that only the latent representations matter. You can see this in studies where aphantasics can't be subconsciously primed by images as easily [1], have skin conductance responses to visual stimuli less to imagery compared to normal people [2], and miss more visual details when attempting to redraw complex images from memory [3]. I.e. the visualizations are likely important in some cases, with the latent (non-visual) representations alone being deficient in some very particular cases, at least.

[1] https://pubmed.ncbi.nlm.nih.gov/29175093/

[2] https://pubmed.ncbi.nlm.nih.gov/33715433/

[3] https://pubmed.ncbi.nlm.nih.gov/33383478/

Radical or hard or global social constructionism [1] (or perhaps more accurately radical/hard/global relativism about truth [2]) are discredited because both are manifestly incoherent and prevent any serious thought from being possible, since they amount to a total denial of the existence of any kind of observer- or society-independent reality, i.e. they devolve to a solipsism of some form. Solipsism is not a coherent (or workable, at least) worldview, so can safely dismissed.

It is hard to provide a citation for these points because these points are so philosophically obvious that few waste time spelling them out, but searching for "hard/global constructionism" or "hard/global relativism" (on e.g. Google Scholar), or asking an AI about problems with these views I hope will make it clear why they are dumb, if it isn't already obvious to you.

Soft forms are of course totally fine. But to say "conscious is only and exactly whatever we say it to be" is hard constructionism / relativism, so completely unserious. Very obviously there are aspects of consciousness that do not merely depend on what we believe or say about it, even if some social constructionist aspects are also involved.

[1] https://plato.stanford.edu/entries/social-construction-natur...

[2] https://plato.stanford.edu/entries/relativism/#RelAboTruAleR...

Cool, I was really worried I might be sounding dismissive. This has been an obsession of mine since long before it got popular, and I've been enjoying your comments particularly in this thread.

Reducing it to a binary "it is / isn't a skill issue" is surely wrong and unhelpful, but given that practicing visualization can enhance the richness and durability of those images (or that e.g. psychedelics or meditative and spiritual practices also can), there is clearly some skill involved, and so obviously for some people, some aspects of aphantasia can plausibly involve a skill issue.

Note that being hyperphantasic can also be an advantage because you can create much more complex visual models to aid thinking in similar ways.

I think the bigger takeaway is not to think that having a particular sort of richness of any kind of mental imagery (regardless of the sense modality) is somehow automatically better or worse. The mind is malleable and an intelligent mind can find clever ways to exploit what it has most richly, and there are surely disadvantages to imagery of some sensory modalities being too rich or real (e.g. schizophrenia).

> when I close my eyes I cannot see things. That is what seeing is. [...] The visualization is akin to seeing, but obviously I am not seeing them. [...] a lot of people like you are saying "well, I can 'see' but I can't 'see-see'

I most definitely am not accusing you of this, and your other comments I think make clear you have considered this, but I would be wary of collapsing a continuum to a binary here. Most of the time, visualizing is indeed only analogous to seeing, i.e. visualizing is "seeing, but not 'see-see'ing". However, with extreme focus, regular practice, and/or altered states, this distinction breaks down, and it is harder to make the separation so clear.

I suspect the more hyperphantasic you are, the more easily you can find examples in experience that blur the boundary between seeing vs. visualization, but with normal visualization capacity, these blurred cases are likely quite rare. But I don't think, fundamentally, except in true aphantasics, that there is always a 100% clear dividing line between seeing and visualization.

You might find it interesting to read up a bit on blindsight and the neural plasticity of the congenitally blind.

E.g. fMRI experiments on some such people show rich activation of the visual cortex when the blind person is going about and space and hearing and feeling things. This could just mean that region has been recruited to do non-visual processing, but it could also be that the visual cortex is producing strange and unimaginable images in their mind's eye in response to sounds and feelings, such that they are really literally "seeing" sound and such.

In case you missed my other comment linking to similar polls and stuff on Reddit: https://news.ycombinator.com/item?id=49469522. The hyperphantasia subreddit covers all other sense imagery too, and I am high on all of them.

Also, to be clear, my images usually are NOT spatially located, but I can choose to make them so if needed, and occasionally they just are spontaneously.

You might also find the work of Louis Sass ("Madness and Modernism", and other works) to be relevant, as he notes it is extremely common for schizophrenics to always be localizing (sensing) their thoughts have specific locations in space, or e.g. are "moving from the front of my head to the back", and other such extreme (and arguably unhelpful) spatialization of aspects of the mind's eye. He argues this might be part of why they are prone to hallucinations and delusion.

See also Reddit, there has been lots of discussion and some similar polls. E.g. https://www.reddit.com/r/hyperphantasia/, and https://www.reddit.com/r/hyperphantasia/comments/kkbxom/when... for the specific poll.

Certainly some self-diagnoses (positive or negative) are definitely based on misunderstanding, much semantic, as I already agreed in this very thread: https://news.ycombinator.com/item?id=49468528.

The projected image is not typically indistinguishable from normal vision, namely in that there will be an "ephemerality" to the image. Some examples of this ephemerality:

- the projected image usually has a translucency, i.e. it doesn't also block what is behind where it would be physically if it were really there

- the projected image requires sustained concentration and mental effort to maintain detail, and if you let any aspect of your mind wander or stray from the task, the translucency increases, it may pop out of the visual field, or lose details

- the projected image (say, an apple) doesn't have full details at every particular point, i.e. if I focus on where the stem would be, that detail intensifies, but the surrounding areas become more ephemeral; with a real apple, this happens somewhat depending on the focal point too, but not nearly as much

- the projected image can be made less ephemeral and more rich and stable with the use of pscychedelics (e.g. psilocybin) or quasi-psychedelics (e.g. cannabis)

So, yes, you can "see" it in reality, but not, in most cases, to the degree that you "see" a real apple. Often the ephemerality really does manifest in a way extremely similar to how an afterimage persists, but this isn't always the case.

> I have always suspected that people with “aphantasia” simply misunderstand the idea of a “mind’s eye,” believing that others can somehow visualize something in their actual field of vision at will.

Many people can do precisely this, though the projected image is not usually 100% clear in some form, i.e. it may have a translucence or impermanence, and it can indeed take some practice to develop this skill. But it isn't uncommon at all, and comes up regularly in some spiritual and meditation practices.

> Can anyone confirm that they have this ability, which specifically is to superimpose imagined objects inside your actual field of vision? If the answer to this is yes, then okay, I guess I have aphantasia.

Yes, this is utterly trivial for me, but then I am hyperphantasic by any measure or definition.

It is also common to read people telling others to explicitly do this kind of superimposition (or "projection") in early psychological experiments, and meditative and/or spiritual and esoteric practices. It would be really odd for people to spontaneously just give such specific nonsense instructions if they couldn't just do it.

This is interesting and I wonder if it might explain some apparent cases of aphantasia. Also seems relevant to some aphantasics experiencing mental imagery when using psychedelics.

Then you are almost certainly aphantasic. "It is all just semantics" has to do some incredible acrobatics to make sense of so much language and reported experiences, and doesn't seem biologically plausible either.

Of course, we can never be sure, but from a theoretical and empirical standpoint "all aphantasia discussion is just semantic confusion" is not useful and a complete non-starter.

Yeah, you don't sound aphantasic to me then either. I am certain you are right some self-diagnosed aphantasics are caught up in semantics: psychology instruments in general are quite terrible, and certainly anyone that just does some self-report test and reads no further I could very easily see becoming confused here.

But the more a person thinks and read about it, especially given how much easier it is to find people writing and talking about it today, then I think the likelihood of being caught in such a semantic trap will go down a lot. Or at least, that should happen so long as one doesn't attach excessive moral value to or get bogged down in "identifying" as aphantasic/not.

I think a couple of the comments in this very thread above, e.g. https://news.ycombinator.com/item?id=49467695 and https://news.ycombinator.com/user?id=slibhb are quite relevant to your case. Thinking this is just semantics is a strong indicator you are likely highly aphantasic.

It is highly unlikely to just be semantics, because when it comes to visualizing complex objects as a non-aphantasic, the specific details spring forth unbidden as an image first, and then you attach the language, and it isn't the reverse order. I suspect also tests of visual memory of complex pictures should reveal similar things here, because e.g. language and other things don't really seem to be able to represent such details, and neurobiologically, there isn't much plausible other way your brain could be memorizing a complex photo without retaining / having activation patterns similar to the actual viewing (and this is what we see in fMRI studies).

If you are careful at noticing your thoughts (and not aphantasic), you can also notice if you are a highly visual thinker, you might sometimes confuse certain memories of things (spellings, place names, other things) that are similar only visually, but not logically or in any other sense modality representation. This would suggest the representations are genuinely visual in these cases.

But yes, no way to be 100% certain, but the "it is just semantics" case is very weak and can't explain much.

If you have good visualization ability, you can project your image onto a location in the real world, maybe sort of like a translucent layer or image placed on a clear film placed over reality, or you can just sort of visualize the image in "mental space" which doesn't correspond to any particular location. Likely what is more common depends on the person.

It depends on if when you visualize e.g. an "8", you visualize something like a lemniscate turned 90 degrees, or e.g. visualize a number line, e.g. maybe a straight line with dashes at the 7, 8, 9, and with these dashes having e.g. some visual label, and so on.

I.e. if your "visualization" of eight is something like a picture, such that I can show you various pictures and you can say "yes, my visualization is sort of like drawing A, but also has such and such elements from drawing B", and so on, then, yes, this is clearly not total aphantasia. But if no such picture could ever have any similarity to your visualization, and you are somehow just experiencing some kind of non-pictorial "logic content" here, then, yeah, that sounds pretty aphantasic to me.

Well, by contrast HN doesn't allow user blocking or muting, or keyword muting, nor do most other social media sites. So I tend to see Twitter as offering the user far more curation and control than most, even if it is imperfect.

Never had any significant issues with these features, I tend to suspect a skill issue when people say things like this. Muting is the most effective option, but it does require you use it with some careful thought.

No one is banning or prohibiting AI generated music from being listened to hear, just they are saying that to be considered on a very specific chart, there need to be limits on the amount of AI used. Very weak overall, especially given the irrelevance of these kinds of charts today.

Most complaints about Twitter look quite lazy once you understand you choose your followers, can block accounts, and mute words. It's not like these are hidden features that are hard to use even.