Siekieatry, again

Dhis is a respons to dhe artikl:

“Kirsch’s conclusion is that antidepressants are just fancy placebos. Obviously, this is not what the individual tests showed. If they had, then none of the drugs tested would have received approval. Drug trials normally test medications against placebos—sugar pills—which are given to a control group. What a successful test typically shows is a small but statistically significant superiority (that is, greater than could be due to chance) of the drug to the placebo. So how can Kirsch claim that the drugs have zero medicinal value?” (mie boelding)

It does not wurk liek dhis. Dher is orlwaes a chans dhat dhe result is due to chans. Dhe signifikans level of such studys, bdw, is typikaly tuu low. A mear p<0.05 (i.e. 1 of 20 studys is bogus) is not enuf and does surtaenly show meen, as dhe rieter klaems, dhat it kud not be due to chans. Given his kredenshals, he shood hav noen beter.

“Depression is a good example of the problem this makes. A fever is not a disease; it’s a symptom of disease, and the disease, not the symptom, is what medicine seeks to cure. Is depression—insomnia, irritability, lack of energy, loss of libido, and so on—like a fever or like a disease? Do patients complain of these symptoms because they have contracted the neurological equivalent of an infection? Or do the accompanying mental states (thoughts that my existence is pointless, nobody loves me, etc.) have real meaning? If people feel depressed because they have a disease in their brains, then there is no reason to pay much attention to their tales of woe, and medication is the most sensible way to cure them. Peter Kramer, in “Against Depression” (2005), describes a patient who, after she recovered from depression, accused him of taking what she had said in therapy too seriously. It was the depression talking, she told him, not her.” (mie boelding)

Too simplified vuew of dhe distinkshon between diseeses and symptoms. Surtaenly, ‘mediseen’ (i.e., doktors and dhe liek) tries to do both: 1) Kuer dhe disees if posible, and (especialy) if not, dhen 2) remoov or redues dhe symptoms. Dhe furst egzampl of doktors trieing to redues symptoms dhat kums to mie miend is dhe ues of paen medikashon. Paen is a symptom most of dhe tiem (if not orlwaes?). In fakt, dhat is wie we feel paen: to alert us dhat sumthing is amis (e.g., ur hand is on dhe stoev). Dher is a raer kondishon wher peepl dont feel paen. Such peepl doent faer wel. Dhis relaets to sumthing he roet erlyer in dhe artikl.

“The conversion of stuff that people used to live with into disorders that physicians can treat is not limited to psychiatry, of course. Once, people had heartburn (“I can’t believe I ate the whole thing”) and bought Alka-Seltzer over the counter; now they are given a diagnosis of gastroesophageal reflux disease (“Ask your doctor whether you might be suffering from GERD”) and are written a prescription for Zantac. But people tend to find the medicalization of mood and personality more distressing. It has been claimed, for example, that up to 18.7 per cent of Americans suffer from social-anxiety disorder. In “Shyness” (2007), Christopher Lane, a professor of English at Northwestern, argues that this is a blatant pathologization of a common personality trait for the financial benefit of the psychiatric profession and the pharmaceutical industry. It’s a case of what David Healy, in his invaluable history “The Antidepressant Era” (1997), calls “the pharmacological scalpel”: if a drug (in this case, Paxil) proves to change something in patients (shyness), then that something becomes a disorder to be treated (social anxiety). The discovery of the remedy creates the disease.“

Perhaps we shood think of another kategory of mental staets insted of only symptom and disees. Perhaps “unwanted staet” wil do. Wedher depreshon is a disees or a symptom of sumthing els, it is an undesierabl mental staet to be in.

Other relevant reeding:

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