
Good people behaving badly on the Internet - raganwald
http://raganwald.posterous.com/good-people-behaving-badly-on-the-internet
======
fogus
I like to live by a certain mantra:

    
    
        No problem worth solving has ever been solved 
        on an Internet forum.
    

It doesn't matter if it's not wholly accurate. What matters is that it keeps
me out of some nasty exchanges. Missing a rare island of illumination is worth
circumventing the otherwise vast sea of bile.

I am not likely to respond to attempts at refutation to my mantra. You see, I
have this mantra...

~~~
frou_dh
I had a similar thought when I saw people angrily debating religion in the
text chat of an online shooting game. Some venues are simply pointless to
attempt to produce lasting outcomes in.

------
neilk
Raganwald's point is well taken - going out and reading some research is much
better than head-butting for karma. But I feel that he's not appreciating the
value of informal conversation enough.

First of all, depression is characterized by people who have distorted
thinking about themselves and rationalizations for avoiding treatment. So that
discussion is going to be necessary to have.

Secondly, it's reasonable to be skeptical about psychiatry and self-help
books. The industry is saturated with snake oil. One has to rely on one's own
judgment or one would be endlessly drowning in research. Judging books by
their cover isn't just appropriate, it's mandatory.

Sometimes literally. One of the best-selling self-help books for CBT depicts a
guy with a lobotomized smile floating in a dreamy cloudscape with the title
"Feeling Good".[1] When it was prescribed to me I was _disgusted_. It looks
like Stuart Smalley.[2]

But people who made the same mistake were corrected by others who had read
research, or had personal knowledge. Which leads me to my last point: head-
butting has its place. In the wild, animals who butt heads are doing so to
determine which is the stronger, without actually engaging in wasteful combat.
Similarly we are often arguing to probe which argument might be better,
without fully testing it. It's enough, sometimes, to sense someone's
confidence, to see a glimpse of the detail of their knowledge, even if they
don't cite anything.

That heuristic is highly exploitable by people who have abnormal abilities to
project confidence (aka, "confidence men"). But it's all we've got in a world
that none of us have time to fully investigate.

At the very least, in that discussion, I hope people learned they couldn't
just dismiss CBT out of hand; intelligent and experienced people had decent
arguments for it.

[1] [http://www.amazon.com/Feeling-Good-Handbook-David-
Burns/dp/0...](http://www.amazon.com/Feeling-Good-Handbook-David-
Burns/dp/0452281326) [2] [http://schlegelrock.com/wp-
content/uploads/2011/03/stuart-sm...](http://schlegelrock.com/wp-
content/uploads/2011/03/stuart-smalley-on-snl.jpg)

~~~
ddfisher
While I agree that being skeptical about self-help books is a good thing, I
think you made a big mistake in your specific example. I have not looked at
"The Feeling Good Handbook" that you linked to, but I am _quite_ familiar its
predecessor (by the same author), "Feeling Good", which is excellent. It has
helped a couple of my friends, and at least one other HN reader.[1] Further,
its efficacy is supported by at least one clinical study.[2]

You're right about the image, but the book is worthwhile.

[1] <http://news.ycombinator.com/item?id=4509281>

[2] <http://www.ncbi.nlm.nih.gov/pubmed/2738212> (The book is not cited in the
abstract, unfortunately, but I believe this is the correct study.)

~~~
neilk
That's what I was trying to say, but I guess I was unclear.

~~~
ddfisher
Re-reading, I can see that now. Oops! (I think the paragraph break confused
me.)

------
adamc
Thanks so much for the post. Once upon a time I took a grad course in social
anthropology, and the professor said something like "read for the best Marx",
by which he meant "don't assume an interpretation that makes him out to be an
idiot; start with the assumption that he probably had something coherent to
say, and try to understand it first."

I've found that to be good advice in general, and for internet conversations
in particular. Start with the assumption that you are communicating with
someone who is not an idiot, who has something to say, and try not to give
reflexive, dismissive answers.

Not that I'm so perfect as to always remember, but I try.

------
mattmaroon
This is especially true of legal issues here. I routinely see people giving
advice for, or arguing over, points of law they clearly have only a surface
level understanding of. I see people asking for legal advice on important
topics, on which they could be seriously screwed by simple missteps no decent
lawyer would make, and getting it from non-lawyers. I've probably sounded like
a broken record over the years by saying "stop reading these and ask a
lawyer".

It doesn't surprise me that the same thing happens with medical or other types
of advice.

The bottom line is, don't take advice on anything specialized over the
internet. Talk to a specialist, or do the loads of research yourself that it
requires to form an educated opinion.

~~~
praptak
This is true, but: for many areas of expertise where I am pretty much
ignorant, I wouldn't even know about existence of certain terms, ideas and
starting points if I haven't first read about them on internet forums. With
the obvious disclaimer that I usually do a followup readup on such topics.

So "stop reading these and ask an expert" is obviously a good piece of advice
for someone seeking resolution of their own serious problems but there's still
value in reading internet discussions.

------
lutusp
A quote: "Well, people are arguing the efficacy of treatment for depression on
the Internet. Quite honestly, this dismays me. The matter has been studied.
There are papers. There are books. There are (pardon me while I appeal to
authority) people who spend their careers arguing for and against certain
treatment modalities."

You would do well to avoid appeals to authority in scientific matters. It
happens that a recent meta-analysis demonstrates that depression medications
simply do not work for the majority of people.

It seems that, over the years, Big Pharma funded a lot of studies of
depression medications, and systematically threw out those that didn't support
their position:

[http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj...](http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0050045)

A quote: "Meta-analyses of antidepressant medications have reported only
modest benefits over placebo treatment, and when unpublished trial data are
included, _the benefit falls below accepted criteria for clinical
significance_."

Read the last sentence carefully. It means the depression medications don't
work any better than placebos for the majority of people. This is perhaps the
best-kept secret in psychology.

The nest time you're tempted to say, "The matter has been studied. There are
papers. There are books", remember this study -- it summarizes all those
papers and books, and shows that these drugs _do not work_.

~~~
jacques_chester
Firstly, the authors still found a difference in effect depending on the
severity of the depression of the presenting patient.

 _Which is exactly what one would expect_.

Second, this paper is not without its critics (just look in the comments):

"Huedo-Medina et al report that decreasing placebo response with increasing
baseline severity of depression is their paper’s “unique contribution”.
However, it is clear that this is an artefact of using the standardised mean
difference. Analyses using the raw HRSD scores reveal that mean placebo
response remains constant with greater response to antidepressant treatment
with increasing baseline severity".

Thirdly, you do a disservice to psychologist and psychiatrists if you believe
they are further behind on their reading than either you or I.

~~~
lutusp
> Firstly, the authors still found a difference in effect depending on the
> severity of the depression of the presenting patient.

Yes, and they came to the same conclusion that I stated in my original post --
for the majority of people, antidepression medications do not work. This is a
fact that's being kept out of the public's view the the degree possible.

But those efforts seem to be eroding:

[http://www.usatoday.com/news/health/2008-02-26-depression-
st...](http://www.usatoday.com/news/health/2008-02-26-depression-study_N.htm)

A quote: "Given these results, there seems little reason to prescribe
antidepressant medication to any but the most severely depressed patients
unless alternative treatments have failed to provide a benefit."

> Second, this paper is not without its critics ...

And that is the way it should be. But until the critics perform their own
studies of equal quality, the result stands. This is how science works --
authority means nothing -- evidence trumps eminence.

> Thirdly, you do a disservice to psychologist and psychiatrists if you
> believe they are further behind on their reading than either you or I.

Believe me when I tell you, based on my voluminous correspondence with
psychiatrists and psychologists, they aren't very well-read at all on this
topic. That is how they justify writing all those prescriptions for
ineffective drugs.

------
ChuckMcM
Must be meta-wednesday. Nice post on how online conversations about complex
subjects that people are emotionally invested in the outcome evolved. Medical
conditions, nuclear energy, gun control, human rights, all evoke similar
patterns.

~~~
raganwald
Meta-posts are my way of saying, "I have run out of fresh ideas but not my
enthusiasm for listening to the sound of my own voice."

~~~
mcguire
I would be interested in reading your thoughts on that topic.

------
tokenadult
Hear. Hear.

As participants in an online community, let's try to help one another.
Raganwald has been very constructive in discussions about depression treatment
here on HN. I try to do the same, and am always happy to upvote one of his
stories or comments on the issue. One of my most disappointing memories of my
early participation on Hacker News is hearing that Dan Haubert of
Ticketstumbler (HN username "fallentimes") had died.

<http://news.ycombinator.com/item?id=859117>

Just shortly before that, there had been a thread here on Hacker News in which
too many users were taking the point of view that people who seek effective
medical treatment for depression are weak or fools, and that they should just
man up and not talk to a doctor about how they are feeling. I'd hate to think
that someone here pushed fallentimes to taking his life, by trash-talking the
help that anyone feeling depressed can seek from professionals.

The paradox of mood disorders is that they are disorders of thinking, either
being glum beyond the warrant of objective life facts (depression) or elated
beyond warrant (mania). Prescribed medication is one means, and thoughtful
cognitive therapy is another means, to help people who have mood disorders get
back in touch with the reality of their lives and go on coping with the
uncertainties of human life. The prescribed medicines usually work more
effectively when combined with the cognitive therapy, and cognitive therapy,
which is very helpful, often meets a person's needs better when the person is
also taking prescribed medicine.

Because the human brain is enormously biochemically complicated, and because
mood disorders are largely a disruption of a complicated regulatory system
("mood" has many interconnections of cause and effect with other aspects of
human behavior), it is currently hard to predict which medicines will be
helpful for which patients. Sufferers of mood disorders do not all have the
same genetically influenced biological substrate for their difficulties in
mood regulation. So part of medical practice in dealing with depression is
still quite empirical--prescribe a first-line medicine, and see if it works,
and then try something else if the first medicine doesn't work or if it has
debilitating side effects. Patients who have a history of both low and high
mood states have to be particularly careful in choosing medicines, because
some effective antidepressant medicines can prompt episodes of mania. (Some
medicines are categorized as "mood stabilizers" and are helpful for the downs
of depression and the ups of mania.) But doctors who have a strong clinical
experience base can help patients a lot with advice on which medications to
try first, and many patients benefit soon after starting medication by being
much better able to gain from cognitive therapy and much better able to cope
with life stresses.

By the way, repeated studies of life stress and its relationship to mood
disorders show that generally people who suffer bad mood disorder symptoms are
persons who have more stressful life events (family, employment, housing, or
other major changes) than related persons who have don't fall victim to mood
disorder symptoms. And the usual twin study methodology and other behavioral
genetic studies show that mood disorders plainly have some genetic influence,
although genome association studies have yet to show ANY particular gene with
a strong effect on mood regulation. Simply put, mood disorders appear to be a
polygenic, multifactorial disease with diverse underlying genetic
vulnerabilities leading to greater risk from life stresses than some other
people undergo. More research on the issue is still being done, but meanwhile
seek competent current treatment, and don't give up.

~~~
nicholassmith
The people who go down the route of 'just man up and deal with it' are
foolish. I've been around people who suffer depression for a large chunk of my
life and I've seen that taking the step to get help to deal with it is
probably the hardest thing they'll ever do.

------
tlb
While it's true that depression has been exhaustively studied by experts in
white coats, they were studying "average" people. HN exists because the
community has certain mental characteristics in common, and perhaps there is
something useful to be said about how human problems affect hackers in
particular.

~~~
raganwald
Very true! Here is one of my personal favourite essays about how human
problems affect hackers in particular:

<http://www.lambdassociates.org/blog/bipolar.htm>

------
moistgorilla
Thank you for posting this. I have been mildly depressed for the last 8 years.
I thought that depression medications and therapy were bogus and I never
considered getting help. Mental Illness is such a sensitive issue and there is
this belief out there that if you take anti-depressants and do therapy you are
being scammed and you are weak. I believed all of this until I had a major
depressive episode. I would be sitting in the middle of a lecture and all of a
sudden a pain began to grow in my forehead. It was the feeling of wanting to
cry but not being able to and the pressure concentrating at a point in the
middle of my head. This happened for hours 4 or 5 times a week. After the 4th
time I contemplated ending my life I went to my school counselling center. The
therapist I saw convinced me to start taking medication and to see her once a
week. This was possibly the best decision I have ever made. The medication
gave me the boost I needed to actually be receptive to what the therapist was
telling me and the therapist helped me change ways of thinking that got me
into this mess.

An example: I used to tell my therapist that whenever I was in a social
gathering I felt as if I was getting negative reactions from everyone and that
I wasn't wanted. Keep in mind, these people invited me to be with them, I
didn't tag on.

The main problem with this thought pattern was that you can't "feel" that you
are getting a negative reaction. You believe you are getting a negative
reaction. I logically understand that I'm not a psychic. I do not know what
these people are thinking, yet I believe they don't like me, even though they
are inviting me to hang out with them. That doesn't make sense does it.

This is just one example of many.

As for the medication, it worked wonders. I had to try out different types
however. The first medication I tried was welbutrin. It worked at first, I
actually though about happy things. Probably something most take for granted
but it felt like night and day for me. After going up in dosage however it
made me feel more like a machine. Then I switched to prozac and have been
going strong since. Prozac is working much better for me. I feel normal. Not
sad, not necessarily happy all the time, but I am not having extreme pain
inducing headaches 5 times a week for hours on end.

One of the ways my therapist framed using medication to me was that if I
wasn't depressed the medication wouldn't work first of all. It doesn't
magically make you happy. Also, if you are actually depressed, you have
extremely low amounts of certain chemicals in your brain that are necessary to
properly function. So it's not like you don't have an actual ailment that
requires treating.

Also, to those that claim that you can get better from depression by eating
better, excersize and sleeping. It's very difficult to put in that sort of
effort when you can't get out of bed.

To add: The main thing I want people to get out of this is that we need to
remove this negative attitude towards getting treatment for things like
depression. I imagine a ton of people that would have gotten help if they
weren't afraid of being perceived as weak especially to themselves. Cognitive
therapy wont work if you go into a session and expect nothing out of it and
are completely uncooperative.

~~~
GFischer
My girlfriend has similar symptoms.

She feels that people don't like her. She also gets extreme pain inducing
headaches several times a week (which I actually thought she should treat
separately, I didn't relate it to the first). She also shows other symptoms
(lots of time spent on Facebook doing nothing, she only works 20 hours a week
and we have no children)

She recognizes she's depressed (which I think is a huge positive), but she
refuses to seek outside aid (and she's a psychologist with a postgraduate
specialization in learning disabilities).

I've also failed to convince more distant relatives to seek aid.

How would you go about convincing someone to seek outside aid?

~~~
teach
You don't. "You can lead a horse to water...." If she knows your opinion, then
all you can do is respect her choice and wait.

~~~
GFischer
Thanks for the reply :) . That's what I thought.

At least she recognizes it, and I think she's slowly getting out of it.

------
stephengillie
You're concerned with maintaining your authorial credibility - if others find
you're incorrect on one topic, you believe they'll lose confidence in your
knowledge of other topics. Thus you're uncertain about asserting your opinion
in a public forum. Basically, you're the "intelligent" parents in "Idiocracy",
allowing your concerns about your actions prevent you from taking action.

So because of this, you're hesitant to point out that another person is
incorrect on the internet. You don't want to enter a flame war for fear of
losing face.

~~~
raganwald
That is not the case for me personally. I've written about this at length:

[http://raganwald.posterous.com/how-to-win-friends-and-
influe...](http://raganwald.posterous.com/how-to-win-friends-and-influence-
people-with)

I believe that in the long term, personal credibility is bolstered by wins and
losses are forgotten. So I'm happy to risk losing face in exchange for once in
a while saying something that might be a big win for everyone on certain
subjects, like programming.

Depression is different. It probably works the same way where karma is
concerned, but the difference is that with programming, I am motivated by
getting people to think. If they try some hair-brained programming scheme like
"The Williams Style:"

[https://github.com/raganwald/homoiconic/blob/master/2011/11/...](https://github.com/raganwald/homoiconic/blob/master/2011/11/COMEFROM.md#williams-
master-of-the-come-from)

I don't lose sleep over the result: They are adults, they made a choice, they
are smart enough to rewrite/refactor, they learned something, their colleagues
can stop them, &c.

With Depression, I am motivated by people's outcomes. If I tell them CBT is
wonderful but it doesn't work for them, I might have steered them towards a
very poor outcome. It may not be so easy to just start all over again. I fear
giving bad advice about depression because I believe the consequences are far
more serious than writing conjectures and anecdotes about programming.

With programming, I sincerely believe that a beautiful failure is a win unto
itself. With depression, a failure may have fatal consequences. This isn't a
face or karma issue for me personally. I can't speak to anybody else's
eagerness or reticence to speak to programmin or depression.

~~~
stephengillie
It may help to reframe the discussion as measures of progress in a direction,
not in terms of success and failure. These are all tools to help people manage
these overwhelming emotions and keep them as fellow productive humans in
society. Neither you nor the strawman-on-the-internet are necessarily _wrong_
, as both of your statements may provide some utility to the depressed person
you want to help.

------
mcantor

        To make things worse, the experienced person hesitates before wading
        into an Internet debate, while the inexperienced fanatic takes typing
        classes so that he can reply to everyone within 6 seconds of their
        posting a comment. So the debates are dominated by the people least
        able to offer insight.
    

Oh, God.

Oh, dear.

------
gojomo
One cannot reliably obtain wisdom from internet forums, because as soon as
someone there obtains wisdom, they depart.

------
rooshdi
Insightful post, but don't take my word for it. I'm just another person on the
Internet.

------
CrazedGeek
(Small typo in the last paragraph: "Go tot he source.")

~~~
raganwald
Sorry... I can't seem to get Posterous to update any of my posts. I can edit
them, and both the Rich Text editor and the HTML source views persist my
changes, but the published post does not.

I'm guessing that they have some sort of publish to static HTML worker that is
ignoring my blog, but in the spirit of my post, I'll try not to speak out of
ignorance :-)

------
mrpsbrk
so basically trolls == Dunning-Kruger?

~~~
RyanMcGreal
In the spirit of the post, I'd rather compose it as: troll _ing_ == Dunning-
Kruger.

~~~
sliverstorm
Isn't "trolling" intentional? If it's just because you don't know better, it
isn't trolling.

~~~
NinetyNine
"Trolling" is a term of perspective, if you are witnessing the trolling then
you have no information about the original intent.

~~~
batista
I find trolling used as a "term of perspective" an extremely vague blanket
accusation that hinders discussion.

If it's an obvious trolling, e.g something that can not be considered anything
else than an attempt at troll, it's ok.

But characterizing anything else trolling is just an easy cop-out of the
discussion.

------
nkurz
It's a good post, but I think it sells short the other participants in the
discussion.

 _It is entirely the wrong kind of anecdotal evidence, dominated by the least
experienced people, under the worst possible circumstances: Pseudo-anonymous
debate where you win points for getting people to click a little up-arrow and
you have zero emotional investment in what people do with their lives._

Perhaps, but this diverges from the point you started with, which is that many
people with whom one disagrees act as they do because they are trying to offer
their insights for the benefit others. And for the most part, their intentions
_are_ good. It's offensive (and I think wrong) to say that those who dominate
are the least experienced or not genuinely concerned by how others will be
affected.

I think that bad_user's comment about concentrating on the self and not
properly considering the effect on others has merit, and should be discussed.
I read Seligman's Learned Optimism based on the recommendations of you and
others here, and felt I must be missing something. I went to a half dozen
group CBT therapy sessions, and felt that I never connected with it or the
group. The sense of "selfishness" I got from it concerned me, and was part of
what turned me off.

I think CBT is probably effective for many, and probably could be for me as
well if I could get beyond feeling that for it to work I would have to toss
aside too many of my moral values. Rather than becoming more perceptive of my
thought process, I felt that I would need to desensitize myself to self
deceit, and give up my sense of truth. So for better or worse, I stopped
going, but continued with the medications.

Still, I appreciated (and still appreciate) your recommendation of the book,
and your willingness to share some of the ways it benefited you. I'm glad I
read it, as it gives me greater understanding of the thought process behind
CBT. Had I started with just the therapy, I probably wouldn't have bothered
with the book. And I wouldn't have read it if you hadn't made clear that you
were recommending it very strongly.

Which brings us back to the start. I read your post, I evaluate your
recommendation, and I choose to act. I presume that you are acting with good
will and in good intent. If instead I presume you are acting with ulterior
motive and lack of concern for others, I miss the benefit of the discussion.
And if you hang back and let the loudest dominant, I miss the benefit of your
insight.

Engagement between different parties with different viewpoints, each offering
their own solution, is the goal, not something to lament. What works for one
doesn't work for all. bad_user may be wrong, but the best we can hope for is
that his intents are good. It's when we stop assuming that that the
communication and learning stops.

~~~
raganwald
I may not have expressed myself very well, but what I would hope is that
people do as you say and after reading something in a forum, go to more
credible sources. That applies to positive recommendations as well as negative
criticisms.

So if that one comment struck you as having some merit, what I hope is that
you say, "Hmm, there's something to look into" rather than "Aha! Obviously
it's bad."

------
michaelochurch
A cultural problem with depression is that it's very poorly understood, but a
lot of people feel qualified to have an opinion about it. (People don't claim
to be experts on other diseases, but a lot of people have pet theories on
depression.) Yes, getting more exercise and sleeping better will help a lot of
people clear out the mild, annoying but usually not life-threatening,
depression that normal people get if they get sloppy. People with actual,
_bona fide_ clinical depression need medical treatment, however. (If you're
sleeping 18 hours per day and brutally lethargic for the other six, it's hard
to get physical exercise in the first place, and getting to the grocery store
to buy fruit is an ordeal. Think of depression as like a really bad flu that
last weeks and you won't be far off.) They aren't "weak" in any moral sense;
they're weakened by a horrible, largely physical, disease.

You run into the same thing if you talk about panic, because a lot of people
think of the low-level anxiety attacks that everyone gets, not the intense
kind that literally feel like you're drowning in air.

I think the problem is that our society (especially in white-collar
workplaces) measures people based on a war of attrition. Most companies
intentionally create unnecessary stress and promote the last people standing
after the rest develop mental illnesses (usually the mild, situational kind)
that cause them to be unable to perform. The losing competitors are the ones
who experience stress-related, career-rupturing anxiety or depression.
(Sometimes this is called "nervous breakdown", but I fucking hate that
phrase.) The winners are the ones left over, who are taken to have "proven
their loyalty" by out-surviving the rest. This is absurd given that, if a
company's running well, it should never see anything remotely like the
rightward tail of the decline curve. But this is how the corporate ladder game
has been run for decades.

A lot of people won't admit this, but they feel the same way about therapy and
mood-regulating medications that they do about doping in sports. They're
indignant that "the weak" aren't dropping off as quick as they'd like, and
that normal people have to compete harder as a result because the people who
used to drop off around 30-35 hours per day can now go to the standard 40-50
or more. This is pure speculation, but I've often thought that the emergence
of good anti-anxiety drugs and anti-depressants has been a contributing factor
to the increasing hours expected in white-collar work (not to say that these
drugs are bad-- they aren't, they're lifesaving-- or that people who need them
shouldn't use them-- they should) as well as the increasing prevalence of
open-plan office layouts where open-back visibility is the norm. Before
benzodiazepines, the economics didn't favor open-back visibility. Now, they
might. (I still think open-back visibility is a disaster. Not everyone can
afford individual offices, but have some decency.)

What makes us unusual in the "hacker" community is that most of us tend to
have volatile and steep curves. Under decent conditions where human creativity
is at the maximum, we're the top performers. Under pressure-cooker conditions
that push people well along the decline curve, we're among the first to fail.

What's changing (in our favor) is economics. Pareto distributions (80-20 laws)
can be cruel in terms of the inequality they represent, but those winner-take-
all contests (which cause inequality in macroscopic business success, but we
never get too tied to a business unless we're founders) are _good_ for us as
mercenary programmers. Upper-tier creativity and engineering talent are now
_worth something_. We can sell our skills, finally, for what they're worth.

In the old-style corporate world, work was intellectually easy and tedious,
even at executive levels. Coveted positions had to be allocated based on some
competition, but the work wasn't deep or genuinely difficult, so the contest
became one of doing _large amounts of_ easy commodity work-- 2 to 5 times what
a typical person would accomplish in an 8-hour day-- and remaining socially
pleasant ("bubbly", even) while doing it. _That_ was how people got ahead. So
it was all about the rightward tail of the decline curve, and situational
anxiety and depression (again, not severe enough to be life-threatening, but
the kind that would make you unemployable for a couple months) were what
separated the winners from the losers.

In the new, technological world, the value of commodity work is approaching
zero. Upper-level creativity and technological skill, on the other hand, are
gold. This means we need to stop the ratrace nonsense and focus on unlocking
human potential.

In my personal experience, and I'll keep the details limited, pursuing proper
treatment for mental conditions does _not_ reduce creativity for most people.
In fact, it's much easier to see creativity through when your brain isn't
constantly trolling you. There probably are rare exceptions but, in general,
however, altered states without insight (this applies to most drug use and
mental illness) are not interesting or creativity-inducing, but unbearably
boring and upsetting.

I hope this explains why the cultural issues surrounding anxiety and
depression are so hard to address. They're an unspoken but huge player in the
corporate ladder game, and there are a lot of people who are afraid that
they'll lose ground if more people can seek treatment for these illnesses.

~~~
flatline3
I'd be interested in hearing more about benzodiazepines and open-back
visibility. I assume you're referring to nervousness about having your back
facing a room?

My wife is "neurotic" about other people being behind her and being able to
see her computer. She also has significant hang-ups with believing that people
don't like her (as far as I can tell, they do), and general depression.

I'd love to get a better idea about whether these are symptoms of a real
problem, or just "personality quirks". I've tried to get her to see a doctor
about her symptoms of depression and somewhat odd neurosis, but she seems to
largely believe the problem external to herself.

Lastly (and I intentionally left this for the end) -- I don't say this
lightly, but your position -- that the "normal" people are indignant about
having to somehow compete harder due to "the weak" having access to anti-
anxiety drugs and anti-depressants -- seems unfounded in the available
evidence.

I do think people with mental illnesses are judged harshly, but I don't think
it has to do with concern regarding "doping" or some other form of unfair
competition.

~~~
tdavis
If your wife is anything like me—and her symptoms are identical to ones I had
during an earlier stage of my depression—then they are real and should be
examined. Even if they never worsen, they are needless anxieties to carry
around.

There are no external problems. Everything is as it is; we choose to interpret
the stream of input as problematic, or not. Sometimes we inject falsehoods
into the stream ("nobody likes me") to nurse our fear.

It isn't necessary for your wife to live every day peering over her shoulder.
Nor convincing herself that her friends and coworkers dislike her. Nor
experiencing any of the other anxieties she no doubt simply takes for granted.
As someone who carted so many around for not less than a decade, believe me:
they're not worth the luggage fees.

