
Mental Disorder - lainon
https://plato.stanford.edu/entries/mental-disorder/
======
astazangasta
One of the interesting problems with the medical model that emerged during our
regular contact with it when our first kid was born is that medicine is
intensely normative - that is, it assumes a median condition and looks for
outliers that require correction. From a statistical and biological
perspective this does not make sense. There is no underlying biological norm -
variation is real (as in, our fundamental biology differs), and any normal
behavior is merely the result of the central limit theorem, etc. Defining this
real variation as disordered seems a fundamental problem. This becomes
particularly problematic when those norms are measured using a non-
representative sample (e.g. white Americans) and applied to everyone else.

~~~
SketchySeaBeast
> that is, it assumes a median condition and looks for outliers that require
> correction

I think that's all evidence based medicine can really do. It's just a series
of "well, people with high blood pressure tend to die early" and "people with
high cholesterol have heart attacks". I don't know how they would approach it
differently - if it was assumed that everyone was different with entirely
different baselines, I don't know how it would be possible to make any sort of
predictive assumptions. Really, the best solution would be to increase the
granularity of the samples, but that's all they can do, develop more diverse
pools of generalizations.

~~~
astazangasta
Increasing the pool of generalizations would certainly help. So would keeping
this fundamental problem in front of mind.

My kid was an outlier because my genetics tend to being tall and thin. If he
was being measured against a set of healthy people with similar genetics he
would not be considered an outlier - but this calculus is not considered when
he is measured and judged aberrant. Our doctor being Indian was able to see
from her experience that he was "normal" \- for a kid with an Indian parent.
Another doctor (like all the ones I grew up with) might not have the same
insight and conclude there is a problem.

~~~
SketchySeaBeast
Could I ask what concerns they had with your child being tall and thin for his
age? I was a 99%'er growing up but I don't remember there being health
concerns.

------
pietrod
I have lot of questions on the whole psychology seriousness, but I will skip
on them and just ask a simple one:

In the case of, let's say, 60% of the population suffering of depression, is
that a mental disorder or something that have to be ascribed to external
conditions (maybe political, related to environment etc)?

~~~
jdietrich
_In the case of, let 's say, 60% of the population suffering of depression, is
that a mental disorder or something that have to be ascribed to external
conditions (maybe political, related to environment etc)?_

Possibly either, possibly both, possibly neither.

It might be the case that social or environmental factors are causing people
to become depressed, in a way that could only be fixed by addressing those
external factors. It might be the case that people are experiencing difficulty
in coping with those external factors, but could learn to thrive with the
right cognitive tools. It might be the case that we're over-diagnosing
depression, or that the concept of depression itself has caused an iatrogenic
epidemic. It might be something totally unexpected, like a hitherto-
unrecognised prion disease or a strange reaction to an organic pollutant.

It's worth noting that, while rates of depression have been rising in recent
decades, only 7.3% of the US population suffer from a depressive illness at
any given moment; a larger proportion suffer from diabetes. Most people who
are diagnosed with depression do get better with the right treatment. We're
still a very long way from the point where we can reasonably argue "what does
depression even mean if depression is the new norm?".

[https://www.sciencedaily.com/releases/2017/10/171030134631.h...](https://www.sciencedaily.com/releases/2017/10/171030134631.htm)

[http://www.diabetes.org/diabetes-
basics/statistics/](http://www.diabetes.org/diabetes-basics/statistics/)

------
dr_dshiv
"Works of ancient philosophy are focused more on the psyche’s health (or
eudaimonia) than its illness. Nonetheless, there are hints that just as a
unified soul is one that is healthy (as well as rational and virtuous), a soul
lacking unity will be disturbed, or mad. Offering an account of the harmonious
soul, whose rational and non-rational elements achieve a unified whole,
Aristotle leaves us a picture of the warring and fractured state of an
unhealthy soul, for example."

~~~
PavlovsCat
> Socrates used to say, ‘What do you want? To have the souls of rational or
> irrational beings?’ ‘Of rational beings.’ And of what kind of rational
> beings, those that are sound or depraved?’ ‘Those that are sound.’ ‘Then why
> are you not seeking for them?’ ‘Because we have them.’ ‘Then why all this
> fighting and quarrelling?’

\-- Marcus Aurelius, "Meditations"

On the other hand, I also _really_ like this, even though it's probably one of
those fake internet quotes:

> If your heart is broken, don't try to fix it, they work better that way.

\-- Tibetan monk

~~~
mikeash
If you keep spreading that last quote, eventually a Tibetan monk will read it
and repeat it, and it’ll no longer be fake.

------
skilled
This looks interesting. Going to need to set time aside for something this
extensive though.

~~~
PavlovsCat
Yes, this is the kind of thing that doesn't work well with this short window
of time during which something is on the front page, I wish it was possible to
subscribe to discussions to follow them over a few weeks, rather than hours or
1-2 days at most.

I know this is the opposite of helping, but just in case anyone isn't aware
just _how_ extensive the whole site is:
[https://plato.stanford.edu/contents.html](https://plato.stanford.edu/contents.html)

~~~
HNLurker2
Exactly, only lurkers view them 9 months or years after. To the downside they
cannot comment, but at least some provide useful links and resources was
fascinated to read wikipedia views on:
[https://en.m.wikipedia.org/wiki/Suicide](https://en.m.wikipedia.org/wiki/Suicide)
[https://en.m.wikipedia.org/wiki/Depression](https://en.m.wikipedia.org/wiki/Depression)
, and boredom seeing them as learned helplessness.

