
The links between mental disorders - BerislavLopac
https://www.nature.com/articles/d41586-020-00922-8
======
tomhoward
A few thoughts, as someone who has been deeply researching this topic for my
own reasons and for several loved ones over many years (I think I first
started looking up the DSM-IV in 2005).

\- This article reveals the folly of viewing a complex system (the mind)
through a mechanistic lens. We want to be able to look at the mind the way we
look at a malfunctioning car ("ah, the timing belt's out") or computer ("one
of the memory sticks died"), repair/replace that component and expect it to
carry on as "normal". This can never work. The mind is an organic, emergent
phenomenon, not something that has been "designed" to work in any "normal"
way; it has evolved to adapt to circumstances that can change and differ
dramatically for all kinds of reasons. So, trying to categorise "disorders"
into discrete definitions with distinct "causes" in order to restore the mind
to some "normal" state cannot possibly work.

\- I realised after a few years of researching this stuff that the notion that
psychiatric "disorders" manifest due to "bad genes" doesn't make sense. The
whole point of evolution is that only genes that promote survival and
replication can make it through. Sure, you can get random mutations, but that
doesn't explain why so many people have the same kinds of "disorders". So
whatever are the genes that "cause psychiatric disorders" in big enough
clusters that they can even be attempted to be named and described in the DSM,
those genes must be there for a reason that has aided our survival - even if
they have some negative aspects too (nature is all about tradeoffs after all).
Realising this changed the way I view mental "illness". I realised that my
depression was my mind's way of telling me that something was wrong in my life
(relationships, career, physiological health) and I needed time out to examine
it, understand it and correct it. Schizophrenia can be seen as an alteration
of your perceptions to numb you from a stressful/traumatic situation, a
trigger of extreme creative thinking to help solve serious life problems, or a
display of aberrant behaviour to signal to outsiders that you are in need of
help (see studies of how often schizophrenia manifests after a period of
severe stress or trauma). Bipolar can be seen as a pattern of swinging between
a high energy/creativity state in order to get important things achieved
quickly, and a low-energy state for recovery.

\- The discussion in this article seems astonishingly simplistic and naïve to
anyone who has read/heard any of the many researchers who have spent years
examining mental "illness" from the perspective of trauma, and who have found
success treating all kinds of conditions through trauma healing techniques.
Such figures include Stan Grof, Ram Dass, Iain McGilchrist, Peter Levine and
Gabor Maté.

\- My own experience: I'm one of those who has fit the diagnosis for several
conditions at times in my life; depression and anxiety most clearly, but also
(at least mildly) bipolar, borderline PD, ADHD, some addiction. I tried all
the conventional things (pharmaceuticals, mainstream psychiatric talk therapy)
and didn't get much relief. About 8 years ago I discovered unconventional
approaches to subconscious trauma healing, and have undertaken these
consistently ever since, and my "disorders" have steadily resolved. All that's
left is some latent anxiety, but that continues to improve too.

~~~
watwut
> The whole point of evolution is that only genes that promote survival and
> replication can make it through

There are plenty of inheritable genetic physical diseases. The evolution is
not machine to make us perfect not God. You can't treat it this way.

~~~
tomhoward
> There are plenty of inheritable genetic physical diseases

So I can respond to something solid, can you name some?

~~~
lostdog
Here's dozens of them:
[https://en.wikipedia.org/wiki/List_of_genetic_disorders](https://en.wikipedia.org/wiki/List_of_genetic_disorders)

If you want a few well-known examples: Cystic fibrosis, Muscular Dystrophy,
Canavan Disease, and Hemophilia.

There's lots of obvious bad stuff floating around in our genomes. It's not
surprising that the roots of mental illness, heart disease, diabetes, and
others are hereditary too.

~~~
tomhoward
Of the conditions you mentioned, cystic fibrosis and haemophilia are due to
specific, single-gene mutations, and both are quite rare.

There's a huge difference between conditions that are caused by a single-gene
defect vs conditions that _sometimes_ arise when a combination of genes are
present/expressed in combination with other (e.g. environmental) factors.

> _There 's lots of obvious bad stuff floating around in our genomes_

Too handwavy. Please be specific :)

~~~
igravious
Not handwavy. They were specific. The article makes this exact point:

“In the genes \------------

One pillar of this future approach is a better understanding of the genetics
of mental illness. In the past decade, studies of psychopathological genetics
have become large enough to draw robust conclusions.

The studies reveal that no individual gene contributes much to the risk of a
psychopathology; instead, hundreds of genes each have a small effect. A 2009
study found that thousands of gene variants were risk factors for
schizophrenia. Many were also associated with bipolar disorder, suggesting
that some genes contribute to both disorders.

This is not to say that the same genes are involved in all brain disorders:
far from it. A team led by geneticist Benjamin Neale at Massachusetts General
Hospital in Boston and psychiatrist Aiden Corvin at Trinity College Dublin
found in 2018 that neurological disorders such as epilepsy and multiple
sclerosis are genetically distinct from psychiatric disorders such as
schizophrenia and depression (see ‘Mental map’).”

~~~
tomhoward
My point is that it's not "obvious bad stuff", and the continued presumption
that it is is probably the reason why so little progress has been made in the
field.

Even that passage of the article you quote doesn't characterise the genes as
"bad stuff"; just known genes that seem to correlate with the (contextually
undesirable) conditions manifesting.

~~~
igravious
You asked someone for examples. They gave them to you. You decried those
examples as handwavy and not specific (which they clearly were not). I
countered that they had been specific and not handwavy, explained why, and
pointed out that moreover this ground had already been covered in the article
and that the article concurred with those examples.

Your reply to me misses the point that I was making and argues against a point
I wasn't making – which strikingly is the very thing that prompted me to
counter your top-level post.

~~~
tomhoward
Firstly, please let's drop the hostility. I'm not here to win arguments or
score points. I engage in these discussions to test my understanding of the
topic and further develop my knowledge, and to share my perspective with
others who are open to it.

In response to your comment:

> _You decried those examples as handwavy_

To clarify, I didn't say the examples were handwavy; I pointed out the crucial
distinction between disorders specifically attributable to specific gene
defects (like Huntington's and cystic fibrosis), vs. conditions that arise
through the interaction between positively-selected genes and environmental
triggers. It's a category error.

What I referred to as "handwavy" was the sentence "There's lots of obvious bad
stuff floating around in our genomes" \- specifically the phrase "lots of
obvious bad stuff".

I was calling this out as an unexamined assumption, rather than a the simple
incontrovertible fact that it was presented as.

> _and pointed out that moreover this ground had already been covered in the
> article and that the article concurred with those examples_

But the article doesn't concur with those examples.

The commenter listed illnesses caused by specific-gene defects, and the
passage you quoted names several psychiatric conditions that are known to not
be caused directly by specific-gene defects. Again, a category error.

> _Your reply to me misses the point that I was making and argues against a
> point I wasn 't making – which strikingly is the very thing that prompted me
> to counter your top-level post._

You seem to have read my top comment as directly critiquing the article
itself, rather than the approach that has dominated the field (along with the
rest of medicine) for decades. (Fair enough that you read it that way.)

I acknowledged to you that the article conveys that some researchers are
rethinking the approach, but I don't see evidence of enough of a rethink.

Most importantly, they're still looking at things mechanistically; studying
brain structure, going deeper trying to find particular genetic "causes"
(after the many years of looking at genes have yielded little useful insight),
and proposing some mysterious "p factor" and asserting: "if it is real, it has
a startling implication: there could be a single therapeutic target for
psychiatric disorders". That's what I mean by the "mechanistic lens".

The core position I'm arguing against, which is presented in the article and
by several commenters, is that mental "illness" is likely caused by "bad"
genes or biological processes "going wrong". My position is that we should
generally assume that the genes are meant to be there, and focus on what in
the person's life is causing the genes or biological systems to express in an
undesirable way (which is what the practitioners I've named have been doing
for years/decades with great success).

I've expressed my position at length in other comments. At the time of
writing, the position I've articulated in detail hasn't been refuted. I'd
welcome anyone to do so, so I can learn more about the topic.

------
rl3
Layperson here.

Having hit my head quite a few times over the past years, I've dug into
cutting-edge mTBI (concussion) research pretty hard.

What I learned was that the long-term effects of concussion are now
fundamentally thought of as neurometabolic in nature. That is, the loss of
metabolic homeostasis within the brain due to an initial trauma. Unless this
process arrests, what you're left with is neurodegeneration. How much really
depends on the circumstance and patient.

The most striking takeaway I had, was that much of the latest research is
suggesting that different etiologies lead to the same pathology in many
instances. For example, it may be that you can acquire Alzheimer's Disease, or
Parkinson's Disease, or even ALS via way of: chronic poor sleep quality (poor
glymhpatic performance), history of frequent subconcussive head trauma (CTE),
history of concussive or severe head truama (mTBI/TBI), neuroimmune factors,
and of course genetic factors. Often times a combination thereof. That example
isn't even remotely comprehensive on either the etiology or pathology side.

Point being, your brain is like a washing machine. If it goes out of balance,
sometimes it will only oscillate further out of balance unless the process is
arrested.

Psychiatric disorders are much the same way. I suspect it is for this reason
that comorbidity is so commonplace.

The interesting part about psychiatric disorders however, is to a degree they
can self-reinforce in a unique way. Your behavior and thought literally
influence your brain's neurochemical state. Likewise, your brain's
neurochemical state influences behavior and thought. I suspect this is why
behavioral intervention in conjunction with medication generally works better
than medication alone in treating psychiatric disorders.

Of course, it's not as simple as brain chemistry affecting thought and vice
versa. You brain chemistry (and as such your behavior and thought) is still
subject to effects of neurodegeneration, neurostructural changes,
neuroinflammation, immune activation, and so forth.

So what we have is a very, very complex puzzle wherein you have many different
factors—often vastly different in mechanism—each affecting the other.

~~~
enchiridion
Is there the implication that a single concussion could cause long-term
neurodegeneration?

~~~
rl3
In most cases probably not, or if so mild. It depends on the hit, and it
depends on the person. It's worth noting the second order effects of mTBI
(such as sleep disturbance) can in some cases kick off neurodegenerative
processes.[0]

If it's acute (TBI), then almost certainly yes.[1] It's no longer considered a
concussion at that point however.

[0] [https://www.neuroskills.com/brain-injury/mtbi-and-
concussion...](https://www.neuroskills.com/brain-injury/mtbi-and-
concussion/does-mtbi-contribute-to-neurodegenerative-disease/)

[1]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057689/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057689/)

------
afarrell
Not a psychiatrist, but I'm pretty skeptical of the approach of trying to sort
things according to a few dimensions. I understand the appeal -- There is a
reason why memes like sanguine vs melancholic or The Political Spectrum are
popular -- but I don't see why it should be likely to cleave reality at its
joints.

I'd naively think we're more likely to get a useful theory by trying to push a
Predictive Processing approach too far for a while and then find a way to
incorporate the signaling impact of hormones & ambient levels of
neurotransmitters on various feedback loops.

I certainly found [https://slatestarcodex.com/2017/09/12/toward-a-predictive-
th...](https://slatestarcodex.com/2017/09/12/toward-a-predictive-theory-of-
depression/) useful for overcoming my writing anxiety and issues with
motivation.

~~~
Oekeai
Abstraction does not happen at 3D or higher dimensions. Abstraction happens in
the second dimension. The Greeks made lifelike marble sculptures during the
Hellenistic era (300 B.C.) but it took almost 2,000 more years before artists
could make lifelike 2D pictures.

~~~
mkl
I'm not sure that's true. Marble sculptures last much longer than paintings
(case in point: the paint that used to cover the sculptures is gone), and
Roman artists were able to paint well not much later. Most Roman paintings are
gone too, but some have been uncovered in Pompeii, Herculaneum, etc.

------
afarrell
One challenge here is that there is that a lot of disorders are diagnosed with
reference to moods and life experiences.

An ADHDer who repeatedly finds that their distractibility leads to them to
fail at obvious tasks and disappoint the people around them can very easily
develop symptoms of depression. Would that require having the biological
underpinnings of depression?

~~~
DaiPlusPlus
I understand Clinical Depression is more than just feeling down, “depressed”,
or demotivated - it’s an actual depression in brain activity (which tends to
manifest itself as feelings of sadness, but not necessarily - and people with
CD can still laugh, smile, and have a good time... at times).

(I wish they’d change the name of CD to something that avoids the layperson’s
concept of “depression” - that alone would help the well-meaning but ignorant
people who think it’s just a matter of finding a way to cheer oneself up and
certainly nothing to do with serotonin...).

~~~
Ensorceled
Clinical depression is often associated the ADHD exactly as the parent said,
so please leave off with the “well actually” explanation.

[https://www.webmd.com/add-adhd/depression-adhd-
link](https://www.webmd.com/add-adhd/depression-adhd-link)

~~~
jdudhebee
It seems like you're the one who should be laying off the "well actually"
explanations. The example they were responding to, as it was laid out, is not
an example of clinical depression. Just because a person in with adhd is
depressed due to factors catalyzed by their adhd does not mean they have
clinical depression.

~~~
username90
> The example they were responding to, as it was laid out, is not an example
> of clinical depression.

There is nothing in the original post that was wrong about clinical
depression.

------
ThrustVectoring
There's a couple related shared factors that cause correlation between
diagnosis of various mental disorders.

1\. People who are doing okay don't seek out diagnosis. One big example is
Bill Gross, the "Bond King" who manages mutual funds - he happened to read the
description of Asperger's and realize he had it _in his seventies_.
Psychologists do not see a representative sample of society. If diagnosis A
and B are both mild enough to cause some people with it to not seek treatment,
but everyone with _both_ to do so, you'll see a correlation between A and B.

2\. All mental health diagnostic criteria share a clause that sounds like "and
these symptoms cause a significant amount of distress or ill-functioning to
the patient." This is similar to the first factor, but happens after people
seek treatment; if you tell a psychologist that you aren't having _any_
problems in your life, they do not diagnose you with depression, anxiety,
ADHD, etc. It almost doesn't matter what you have going on, if it doesn't
cause problems its not worth using medical care on, so it doesn't get
diagnosed. And again, if you only have one kind of thing causing you problems,
it's more likely to not be severe enough to warrant some kind of diagnosis.

3\. Similar to the previous factor, mental health diagnoses are used to
gatekeep medical care and social support. So, people who need more resources
than they currently have are going to push more for additional mental health
diagnoses, while people who are more okay are going to be fine with the first
one proffered. Eg, a young woman who is extremely anxious and whose mom yells
at her all the time goes in, gets diagnosed with anxiety and prescribed
anxiolytics, things are still bad because her mom keeps yelling, so she goes
back and gets a depression diagnosis and anti-depressants. Or a school can
offer accommodations for ADHD and not autism, or vice versa, so someone with
one goes back and asks the psychologist for the other.

In short, there's a general willingness-to-seek-diagnosis that's an _obvious_
latent variable for mental health diagnoses. I'd be more surprised to _not_
find a positive correlation between two arbitrarily picked mental health
diagnoses. If there's an outright negative correlation, that's something that
would be actually indicative of a biological link of some sort - either the
biochemistry of one complex protects against the other, or they're a pair of
under/over-activity of a system, or the like.

~~~
toomanybeersies
As you said in point 3, mental health diagnostic criteria are a tool for
diagnosing and treating people who experience distress from their cognitive
process. Doctors and psychiatrists exist to give medical advice and treat
people who need help, not to tell them how their brain works out of curiosity.
On that point though, depression and anxiety are two completely different
things, I've experienced both (separately and simultaneously) and they're
distinctly different in how they feel and how one would describe the symptoms
to a doctor or a friend.

I went to the doctor in my mid-20s to get treated for ADHD, as it was causing
me significant problems in my life, having gone through bouts of anxiety,
depression, and suicidal ideation for the year or two prior, which the
manifested itself in an inability to manage the negative traits of my ADHD.
I've had it all my life, but only realised I likely had it a couple of years
prior, but it was never something that caused big enough problems to go to a
doctor about, mostly just report cards stating "easily distracted and
distracters others".

At the same time I was diagnosed with ADHD, the doctor said it was likely I
also had high functioning autism. I guess maybe I have it, but it's not
something that's ever caused me any particular problems in life, so the doctor
basically said not to worry about it and only to seek treatment (therapy or
counselling) if I felt like I needed it. Same story for the ADHD too, he said
there was no need to continue seeking treatment if I felt like I didn't need
it at any point in the future.

On the other hand, being put on medication for ADHD (clonidine and
dexamphetamine) has made a world of difference for me, and I've seen vast
improvements in quality of life. Most importantly though has been recognising
and accounting for the fact that my mind functions in a different way than
most people, and making accomodations (and asking others to accomodate) for
this.

Interestingly enough, he also mentioned the possibility of having bipolar
disorder as well, but said that it was likely the symptoms were actually ADHD
masquerading as bipolar and decided to treat the ADHD first and see if the
symptoms remain. Diagnosing mental health issues is a difficult task, a lot of
people with ADHD are misdiagnosed with bipolar, or people with bipolar
diagnosed with clinical depression. If it wasn't for the fact that I was
fairly certain that I had ADHD when I went to the doctor, I wonder what I
would've been diagnosed with.

I think the language around mental functioning and disorders isn't great.

If you have Asperger's or ADHD and don't experience distress or difficulty in
life from it, then it's not really a mental illness or disorder, it's just a
different way your mind works. ADHD has a particularly bad name, it's not an
attention deficit to begin with, but rather an inability to chose what your
attention is on (you should see me if I'm in a hyperfocus/flow state, it's
definitely not a deficit of attention), and it's not always hyperactive. I
have primarily inattentive-type ADHD, you wouldn't pick me as having it just
from looking at me, I display barely any "typical" traits of ADHD, it's mostly
mental for me (mood swings, inattentiveness, impulsiveness, poor working
memory, no concept of time, rejection sensitivity and a lack of emotional
permanence). I don't think it's intrinsically a disorder either, it's been
hugely beneficial in parts of my life, and I don't really want to be labelled
as disordered or broken for the entirety of my life, it only became a disorder
at a certain point in my life, largely due to external factors at the time.
Often it's helped me function above and ahead of neurotypical people.

I know plenty of people with ADHD who don't take any medication and don't feel
the need to, and get by perfectly fine in life. My father very likely has ADHD
(it's hereditary, and he displays a lot of traits), and has never seeked
treatment for it, and he's a very successful man. Same for people with
bipolar, autism, or other neurodiverse minds.

------
danieltillett
I wonder how much of this correlation between disorders is just an artefact of
inconsistent classification of patients by psychiatrists? What might be being
measured here is not the likelihood of getting a second illness, but the
probability that person with illness X get diagnosed with illness Y despite
the underlying symptoms not changing.

I have always thought that mental disorders are no different to physical
disorders. We all know some people who are robustly healthy while others seem
to get a bewildering array of different diseases. Illness is not randomly
distributed.

~~~
mirimir
That's been my experience. For decades, I was diagnosed with depression.
Eventually, I was prescribed an SSRI. And that became a disaster, over the
course of a few years.

But then I saw a psychiatrist who inquired about my use of psychoactive drugs.
And based on my love of stimulants, he diagnosed me as having bipolar
disorder, manifesting primarily as depression. And so he prescribed modafinil,
with lamotrigine to reduce the risk of mania.

So I wonder if bipolar disorder is actually relatively common. I mean, I was
self medicating primarily with caffeine, and for many years used nicotine to
take the edge off. Maybe that's fundamentally why coffee, tea, etc are so
popular.

Edit: typo

~~~
dodobirdlord
You probably know this, but for the benefit of other readers, bipolar disorder
masquerading as major depression until flushed out into mania by SSRIs is a
common (and dangerous) enough misdiagnosis that psychiatrists avoid
prescribing SSRIs for depression until they're confident that enough time has
passed that they're not dealing with bipolar disorder. It's basically the go
to example of one disorder being mistaken for another.

There's a milder form of bipolar disorder called cyclothymia that is rarely
diagnosed unless a patient seeks psychiatric care for a different reason.
Estimates suggest it's fairly common, potentially up to 1% of the population.

~~~
mirimir
Huh. I didn't know that. It wasn't well enough known in the mid 90s. But
perhaps it was by the mid 00s, which is when I was properly diagnosed.

------
unexaminedlife
Probably 10 or so years ago I had a few episodes that made me think I may be
suffering from some form of mental illness (low on the "spectrum", but
something nonetheless).

Since then I've thought a fair amount about mental illness in general and have
a few theories.

1) Diet. Get the right materials into your body so it can do with them what it
needs to. Especially early in life while brain is still forming.

2) Exercise. Make sure your body can get sufficient blood / oxygen to all
parts of the body so it can function properly.

3) The brain, IMO, should be viewed as a TOOL Sure it is already part of our
body but this is why I think it's so overlooked as a perspective. If I decided
to do some landscaping and needed an excavator, I would need to learn how to
use it, and practice in order to become efficient and effective with my use of
it. I think it's same with the brain. New circumstances come up all the time
and sometimes the people who experience them have not trained their brains to
deal with them in an effective / efficient way. There should be more focus on
this sort of perspective / reflection / learning and perform these generally-
applicable exercises early in life. Not just math, science, english, etc.

\-- There is no doubt in my mind there are going to be SOME genetically
relevant issues. But I would be surprised if, once this stuff gets fleshed out
further, we don't come to realize most of it was preventable.

~~~
james_s_tayler
Im sort of half surprised at the down votes and not surprised at the same
time.

I think you're probably right to a large degree. To paraphrase you're
basically saying yes, there for sure is a very real genetic and environmental
component, however if we simulate a reality where everyone runs their bodies
and minds in an optimal manner we'd be far less likely to see all forms of
disease including mental illness/psychiatric disorders.

The takeaway is if you're struggling with it, they are both important
components that ought to be a part of a wholistic treatment plan.

I was watching something on Health Theory the other day and she psychiatrist
being interviewed said they start with an elimination diet and the
nutritionists have more success than the psychiatrists.

Food for thought.

~~~
DanBC
> Im sort of half surprised at the down votes and not surprised at the same
> time.

Reducing the complexity of the bio-psycho-social model down to "exercise" and
"eat better" isn't great.

~~~
james_s_tayler
That's just not what was said.

~~~
DanBC
It is what was said, and it's something that gets mentioned in every single HN
thread: people who are mentally ill need to get exercise as a treatment for
mental illness.

Parent post is clear: get exercise, eat better, prevent mental illness.

------
lidHanteyk
It is interesting how powerful the meme is which prevents discussion of
psychology and psychiatry amongst the laity. Multiple threads started and died
on the theme of being a layperson and not an expert, despite the fact that any
science should be examinable on its premises, observations, models, and
theories.

Meanwhile, the Dodo Bird theory [0] has yet to be disproven, and there are
good reasons to suspect that humans are merely smart mammals, rather than
special animals who have no peers throughout the rest of the kingdom, which
means that psychology and psychiatry are only the tip of a much bigger
comparative discipline which handles humanity as a special case rather than as
the main system of study.

[0]
[https://en.wikipedia.org/wiki/Dodo_bird_verdict](https://en.wikipedia.org/wiki/Dodo_bird_verdict)

~~~
dodobirdlord
The Dodo Bird theory may, as it states, be relevant to therapy, but it holds
no water for psychiatric treatment. Some mental disorders are known to respond
radically differently to certain psychoactive medications. SSRIs are a
canonical example. They are an effective treatment for major depression, but
in bipolar disorder they cause rapid cycling and increase suicide risk.

~~~
lidHanteyk
Assuming mental disorders exist, sure. But there is also evidence that a
sufficiently technocratic government will use psychoactive drugs
indiscriminately on its population in order to coerce and control them
[0][1][2][3]. We must demonstrate somehow that mental disorders not only
exist, but that their classification is due to science, and not due to bigotry
and a lack of understanding [4][5].

Your example of SSRIs is an especially poor one, as SSRIs are well-understood
to have been developed by the pharmaceutical industry as part of a panpsychic
wellness package which is meant to be sold pill-by-pill to the public [6][7].
SSRIs today are like sugar in the past [8], with a corporate army of
compensated scientists ready to study the noise and find useful results from
harmful chemicals.

[0]
[https://en.wikipedia.org/wiki/Project_MKUltra](https://en.wikipedia.org/wiki/Project_MKUltra)

[1]
[https://en.wikipedia.org/wiki/Edgewood_Arsenal_human_experim...](https://en.wikipedia.org/wiki/Edgewood_Arsenal_human_experiments)

[2]
[https://en.wikipedia.org/wiki/Crack_epidemic_in_the_United_S...](https://en.wikipedia.org/wiki/Crack_epidemic_in_the_United_States)

[3]
[https://en.wikipedia.org/wiki/CIA_involvement_in_Contra_coca...](https://en.wikipedia.org/wiki/CIA_involvement_in_Contra_cocaine_trafficking)

[4]
[https://en.wikipedia.org/wiki/Homosexuality_and_psychology](https://en.wikipedia.org/wiki/Homosexuality_and_psychology)

[5]
[https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Man...](https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-5_critiques)

[6]
[https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i...](https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor#Controversy)

[7]
[https://twitter.com/jcbonthedl/status/1159823784242753537](https://twitter.com/jcbonthedl/status/1159823784242753537)

[8]
[https://en.wikipedia.org/wiki/Sugar_marketing#Influence_on_h...](https://en.wikipedia.org/wiki/Sugar_marketing#Influence_on_health_information_and_guidelines)

~~~
voidpointercast
Ultrabased

------
pharrington
We're going to need some sort of coherent theory of socialization if we want
to properly understand mental illness. I suspect we're currently in a "fish
can't see water" situation regarding that.

~~~
Toine
Mimetic theory

------
TopHand
I've found this article, and the associated comments to be very enlightening
and insightful. I suppose that is because almost every human alive has been
touched by these disorders. What I find most interesting about the discussion
on this page is that no one has chimed in with "leave it to the experts" in a
manner that is usually seen in the comment section of complex social problems
on HN.

------
twomoretime
I think the main issue is that most mental illnesses are vaguely defined
clusters of problems - if you represented a diagnosis as a vector where each
index corresponded to severity of a particular symptom, the diagnosis space
would not properly aligned with the actual disease basis. This introduces
ambiguity - a single disease tends to fall into multiple clusters when your
representational domain is misaligned with the actual data axes.

The solution is ML. Neural networks with appropriate architectures effectively
perform a change of basis, mapping the data basis to an output coordinate
system. When properly trained they can automagically orient their internal
representation with the true data bases.

~~~
ColanR
I agree with your first paragraph. However, a NN can't explain its reasoning.
You start with a set of symptoms, and you end with a vector, and they're two
representations of exactly the same thing. The problem is that NNs are
representational, not explanatory, so they won't help a doctor get to a root
cause any more than just thinking about the collection of symptoms and what
they're associated with.

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dooglius
I think what's implicit in the comment is that the output vector can
correspond to things like dosages of drugs or recommended therapeutic
treatments.

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deathgrips
I'm not sure why but I wouldn't feel comfortable letting some tech bros decide
what drugs people should take.

~~~
9HZZRfNlpR
Psychiatry works as a trial and error of different drugs so it wouldn't be far
too off.

~~~
ColanR
Yeah, but at least a malpracticing psychiatrist can lose their license.

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dr_dshiv
One factor that is under examined is the role of subjective Wellbeing in
mental illness. All disorders are highly correlated with feeling bad...!

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slim
mental disorders come from the genes of cromagnon

