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Medications that change who we are (bbc.com)
419 points by daveytea 39 days ago | hide | past | web | favorite | 274 comments



>"It turns out many ordinary medications don’t just affect our bodies – they affect our brains."

I feel like perpetuating this mindset is the ultimate sin of modern psychiatry and the entire industry of psychiatric pharmaceuticals - your brain is your body. It's not some special thing that sits apart from it. It is an integral part of the whole, no different than your kidneys or liver. People think they can take an antidepressant and it just "works" on their brain somehow. It affects absolutely everything.


> It's not some special thing that sits apart from it. It is an integral part of the whole, no different than your kidneys or liver.

Except it is. The brain is a part of your body and the two are tightly integrated. Yet the brain is also not simply another organ. If you lose half of your liver, your personality might change due to the trauma, but you will still be you. If you lose a kidney, you’ll live on as if little happened (assuming modern medicine stops you from dying of infection). If you lose half your brain, you’re probably dead, and if not, you’ll be drastically impaired the rest of your life. You’ll also likely experience drastic personality changes.

The brain is part of the body but it is also special. To my knowledge it’s the only organ with a dedicated blood barrier. It’s also the only organ that modern medicine can’t keep “you” alive without. If your body is on life support but you are “brain dead”, then “you” are gone. Your heart can be replaced with a pump. Your kidneys can be replaced with dialysis. Your stomach can be replaced by a feeding tube. Yes, all of these are pretty poor alternatives but they affect quality of life. They don’t end life. If modern medicine could replace your brain with a computer, no one would consider this a lifesaving intervention.

No one says they’ve lost a parent to kidney failure while the parent is still alive. Many people have said they’ve lost a parent to dementia while the parent is still alive.


> If you lose half of your liver, your personality might change due to the trauma, but you will still be you.

If your thyroid is damaged, it effects who you are through depression, lethargy, anxiety and significant behavioral changes. If your adrenal glands are overactive, it effects who you are through chronic stress, psychological conditioning and panic. Disorders of the gut effect who you are similarly, as does removal of parts of the lymphatic system. Hormonal changes from disease, consequences of genetics or supplementation can drastically change a person's personality.


Yep. The body is not independent of the brain. Your other organs and especially the hormones they produce absolutely affect it.

But the brain is still not “just another organ”. The brain is special, as evidenced by the fact that the body gives it a special blood barrier. The brain also is you, to a greater extent than any other organ. This is why your thyroid can be removed and with appropriate hormone replacement, you’re mostly unaffected. No amount of hormones will replace the loss of your brain.


Also these psychological changes happen because these hormones ultimately go on to affect the brain


Except that non/under-functioning thyroid can usually easily and cheaply be replaced with levothyroxin. Anyone who feels that they’ve slowly been getting more tired and just can’t stop gaining weight should ask their doctor to get their T3 and T4 levels checked.

Finding out mine was underfunctioning and getting the levothyroxin dosage right made a ton of difference in my energy levels and stopped (but didn’t reverse) my weight gain.


“If you lose half your brain, you’re probably dead, and if not, you’ll be drastically impaired the rest of your life.”

Depends.

Patients who undergo hemispherectomy at a very young age can recover remarkably well; a testament to the incredible plasticity of the developing brain.

https://en.wikipedia.org/wiki/Hemispherectomy

In adult brains, yeah, it’s a very different story. See also: stroke.

Honestly, you’re both right. It is only one of a multitude of highly interconnected interdependent organs; but it can (and usually does) do some truly incredible stuff while running within that system.†

--

† Assuming, of course, that Descartes/Wachowskis aren’t right after all.<g>


This is probably an example of an "exception that proves the rule".


There are a fair few exceptions though:

https://en.wikipedia.org/wiki/Henry_Molaison#See_also

Mind, these are the 'famous' people.

My google-fu isn't super great here, so I've not sources, but I know of a few cases of French postmen that 'suffered' from hydranencephaly, were married, with many children, and otherwise 'normal'. It's not super uncommon that people with otherwise good balance but who cannot ride a bike also 'suffer' from a lack of a cerebellum.

The wiki article on hydranencephaly is SUPER wild. Take a look at that picture of that baby! Though it is typically lethal, there are cases where those affected survive into adulthood

https://en.wikipedia.org/wiki/Hydranencephaly


As an aside there is also the testis-blood-barrier, although this is not quite as tight as the blood brain barrier.


Also, personalities tend to change if the testes are removed.


There's a huge family of "Neurosteroids"[1], which impact various receptors in the brain in lots of super complicated ways that aren't entirely understood. They are synthesized in all kinds of ways naturally, and when it comes to "what they do" in terms of personality... "probably something" is the best we can do.

There is massive complexity in all these things, all kinds of feedback mechanisms, genes and enzymes involved, etc. They do something but it's hard to say what exactly.

I know about this personally; one of the amazing things about transgender medicine is that there is a huge range of responses to the hormones involved, and there's honestly no way to predict what will happen with a given person.

There are tendencies in aggregate - like less testosterone = less libido - but how those come about biologically is unclear and the effect varies tremendously between different people.

It's a joke to pretend like we fully understand or can predict how any of these things actually impact our lived experiences beyond very rough, bulk tendencies.

[1]https://en.wikipedia.org/wiki/Neurosteroid


Sure, but also if you neuter a cat, it'll be less prone to fight with other cats or to mark its "territory" with urine.


[flagged]


I didn't mean to make this about transgender medicine. The evidence is pretty strong that hormone treatment improves wellbeing for transgender patients[1], and of course, they can always stop it if it doesn't. The fact that very few do is a good indicator of satisfaction overall. There is a very strong bias towards safety in the practice of transgender medicine.

I can also personally attest that transgender medicine has vastly improved my life. The changes in appearance reduce awkward interactions (I presented female almost always even before transitioning). The mental changes have all been positive and left me feeling much more in control of myself and my life.

There is a lot more science to be done and things to be discovered especially when it comes to brain impacts. Transgender medicine is a new field where there is much to be discovered. It's still a super important thing I'm glad exists.

In any case, I was using it as an example where these brain interactions become super visible and complicated, not trying to debate it directly.

[1] (simply the first thing I found googling) https://link.springer.com/article/10.1007/s11136-006-0002-3


[flagged]


I don't have statistics on-hand, but as I understand it, bottom surgery (SRS, GRS, whatever you want to call it) has one of the absolute highest patient satisfaction rates of any major surgery (including lifesaving surgeries).

> permanent genital mutilation which results in a potential lifetime of pain from daily dilation of an artificial orifice which is little more than a glorified wound

Pretty much every single word of what you just wrote is not only wrong, but highly offensive. Please don't speak of things you don't understand.


> I don't have statistics on-hand, but as I understand it, bottom surgery (SRS, GRS, whatever you want to call it) has one of the absolute highest patient satisfaction rates of any major surgery (including lifesaving surgeries

I think you really do need to cite these statistics given the controversial nature of the subject matter in hand.


It's actually not controversial at all among the people actually impacted by it. It's only "controversial" in that a lot of people are transphobic and are offended that trans people are allowed access to gender-affirming medical care.

Besides, nobody's asking for statistics on how many people are satisfied with surgery to remove cancer, or other "obviously" good surgeries. Why are we expected to justify the existence of gender-affirming surgeries?


> It's actually not controversial at all among the people actually impacted by it.

Confirmation bias much?

> a lot of people are transphobic and are offended that trans people are allowed access to gender-affirming medical care.

Again, stats please, ideally by country so we might have a proper discussion.

> Besides, nobody's asking for statistics on how many people are satisfied with surgery to remove cancer, or other "obviously" good surgeries.

Sorry, but that does actually happen, they're called survival statistic, most, if not all health care systems record them. People who survive cancer are generally happy they're alive.

> gender-affirming surgeries

There's no such thing as "gender-affirming surgeries", they're called sex changes. Gender is a role unlike biological sex.


https://www.sciencedirect.com/science/article/pii/S115813600...

https://www.ncbi.nlm.nih.gov/pubmed/19040622

https://www.erudit.org/fr/revues/ss/2013-v59-n1-ss0746/10174...

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2265....

https://link.springer.com/article/10.1007%2Fs10508-014-0300-...

https://www.academia.edu/2236936/Trans_Mental_Health_Study_2...

https://link.springer.com/article/10.1023%2FA%3A102408681436...

https://www.cambridge.org/core/journals/psychological-medici...

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1743-6109....

https://whatweknow.inequality.cornell.edu/topics/lgbt-equali...

Hmm maybe that will occupy you for a bit?

I also find it incredibly disingenuous that everyone asking for The Statistics are asking after a very awfully specific surgery and don't seem to care whatsoever about mutilation performed on intersex people, or of metoidioplasty, or reconstructive surgery, or many other procedures in the area that are performed for all kinds of reasons.

Geesh, I'm actually kind of mad about it... as someone that has given birth to a child and about due with another one, I would love for HN commenters to talk about pelvic pain, vulvodynia, 4th degree tears, incontinence, prolapse, and other incredibly common postpartum issues that might require surgical intervention to the same degree that gender affirming surgeries are being questioned.


I've vouched for your comment which was flagged, I think you make some reasonable points, if somewhat clumsy, but are valid for discussion, especially in regards to children. If the parent poster is an adult then I'm fine with what they wish to do to their body.

I don't have an axe to grind regarding top or bottom surgery in adults. But given the current troubling reports about the activities of the Tavistock clinic, especially with regards to children being supplied puberty blockers etc and perhaps regrettable surgeries (offshore by ill informed parents), this warrants more rigorous study by the health profession.


What “other incurable conditions” do doctors not even attempt to treat and simply tell patients to “accept who they are and deal with it”?


Well, helping people cope and find acceptance could be a form of treatment. I am a little scared by the number of my friends who have gone on the medical transgender journey.


[flagged]


If you don’t support gender transitioning, fine, but don’t pretend that your concern is for the person transitioning as if they don’t understand the implications. Your agenda is painfully clear and has nothing to do with the ethics of prescribing hormones when we don’t fully understand them: “I'm saying hormones and plastic surgery do not make a woman”.

The reality is that we don’t understand any medicine particularly well, but we do our best to treat an endless array of diseases and disorders anyway, because it’s more ethical to attempt to ease pain and discomfort than to ignore suffering.

Also people do regularly get plastic surgery to address aesthetic concerns. Would you advocate that people with cleft lips should simply learn to accept who they are and we should consider it unethical to correct the deformity?


You're taking that one line out of context in his post. Yes of course the brain is special because it's the only organ that makes you, you. Just like the heart is special because it's the only major organ that if you removed, blood would stop flowing.

GP's point was that in the context of how medication affects our bodies, the brain and body are more connected than we tend to think. Medication doesn't either only affect our body or our only affect our brain. It affects the entire system.


> If you lose half your brain, you’re probably dead, and if not, you’ll be drastically impaired the rest of your life. You’ll also likely experience drastic personality changes.

That's...not at all what the actual results of a hemispherectomy, in which you literally lose half of your brain, show.


That’s rarely performed on adults because the risks are so high. Even in children it’s a last resort reserved only for the most severe and morphine seizure cases.


What the heck autocorrect? Morphine -> Nonresponsive


I was about to look up morphine induced seizures as it sounded intriguing haha


And yet an unlucky blow to the head can alter you forever. It’s not black and white.


And a change to your gut biome can have drastic effects on your personality, with many leading psychiatrists thinking there may be an inherent link to gut bacteria and clinical depression.


do you mean the brain as in what's contained in our skull or also the central nervous system which would include controlling (both automatically and consciously) everything else, as well as sensing all of what we define as reality?


I don't think there is proof that consciousness originates in the brain, or in anything material for that matter.


well that's ironic. :P


> > It's not some special thing that sits apart from it.

> Except it is

I'd half agree. It is a special thing, but it doesn't sit apart from the rest.


The interesting bit here is that literally everything you do or eat affects this.

For example your diet is going to get broken down into micronutrients and for a lot of these molecules, while they are circulating, there are a lot of receptors that they are going to bind to and modify function on. And then there is exercise (or lack thereof) and all of the even-further away components (personal relationships, sleep etc) work on your brain and state of mind too.

When I was in Med school I came across this joke - apparently the effect size of antidepressants decreases with phase 3 trials, trending back to placebo. So the joke goes that as soon as a new antidepressant comes out, they need to use it before it stops working.

The deeper question here is whether the initial effect size was simply due to chance, and so the effect size of antidepressants is simply placebo and it was poor studies that let them get in the wild in the first place


Certainly, "who" a person is, is a dynamic process. However, I strongly suspect that things like nutrition, social interactions and sleep are things we're adapted to self-modulating, so these are ways we can "consciously shape ourselves", give the old-us the opportunity to create the new-us. But a drug with an unexpected affect on personality seems like the opposite of this.


Even if the brain is not apart from the rest of the body, there is a special thing between the two: the blood-brain barrier, which is actually quite hard to cross with medications, and poses a real challange in curing brain diseases.


Sure but the list of drugs that cross that barrier is long. Everything from antibiotics to statins.

And even if they didn’t, the body is a tightly interconnected system. Taking an antidepressant to “selectively affect serotonin” in the brain? Whoops, turns out your gut has at least as many serotonin receptors as the brain. Taking a statin to reduce cholesterol (which it does very well but with an NNT > 200 for heart attacks and NNT > 300 for stroke)? Whoops, it causes transient global amnesia and personality changes and diabetes in a lot of people. And 40% of the US Adult population we’re on statins in the mid 2000s.


I believe you, but I just wanted to read up about where serotonin receptors are expressed in the human body in what amount, but the Wikipedia page on serotonin receptors didn't write about it.

I'm not in the medical field, but try to keep up just a little bit to have some basic knowledge, but it's quite hard as often I see that Wikipedia is many years behind.

At the same time medical articles take a lot of time to read, as they are much less accessable.


Very interesting claims, please share the citations.


1) NNT meta analysis (one of a very large body of literature): https://www.thennt.com/nnt/statins-persons-low-risk-cardiova...

2) Best I could find in 2 minutes. Will look for the studies. https://www.scientificamerican.com/article/gut-second-brain/


To be fair, there are a lot of blood-XYZ barriers:

https://en.m.wikipedia.org/wiki/Blood%E2%80%93brain_barrier#...


It seemed like the reduced cholesterol was what impacted personality. I don't know if statins cross the blood brain barrier but if cholesterol levels themselves drive behavior changes it doesn't seem like they would need to in order to have an impact. This was the most interesting take away for me because it means that crossing the barrier isn't always necessary as indirect effects can be powerful as well.


I think the problem goes at least as far back as Plato and the allegory of the cave. Plato spread this concept that there was a difference between the body and mind or soul, and Western culture has never really recovered from the stupidity of that idea.

There's really no evidence or justification for it. Your mind and your body are the same thing.


My Python code ultimately runs on a circuit, but it feels lacking to say that my program is the circuitry. The program itself only has meaning inside of my mind, and in fact could exist equally well on paper. It exists conceptually even if it never manifests physically. So where do concepts like this exist, given that they don't exist as matter? What do we mean when we say that something like 1+1=2 is true - that that truth exists - and would exist even if there wasn't any matter to have 1 and 1 of?

The more you look at it, the more it looks like truths and ideas are even realer than the material world. After all, the only thing we know of the material world is what we experience of it in our mind. That was Plato's point, that the material world is a shadow of the real, immaterial world of thoughts, ideas, and truths.

Similar argument patterns permeate most ancient philosophies. The meme is that mind is the ultimate reality, of which the materialistic worldview is a surprisingly fragile inverse.


Google embodied cognition - while it is true semantics can be separated from the physicality of the incarnation of the system for simple software things, it seems likely any digital representation of the mind will include a lot of data about the material facts of wet brains, chemicals, diffusion, weird coincidences between same gene pathways affecting multiple systems and all.


> My Python code ultimately runs on a circuit, but it feels lacking to say that my program is the circuitry. The program itself only has meaning inside of my mind, and in fact could exist equally well on paper. It exists conceptually even if it never manifests physically. So where do concepts like this exist, given that they don't exist as matter? What do we mean when we say that something like 1+1=2 is true - that that truth exists - and would exist even if there wasn't any matter to have 1 and 1 of?

You're claiming that these concepts don't exist as matter, but you've actually described how it exists in matter. Moving the program to paper just changes the matter from silicon and metal to paper and ink. You're saying it never manifests physically while describing its physical manifestation.

Even if the program exists only in your mind, all that means is that the physical manifestation is neurons/synapses instead of silicon/metal or paper/ink.

I won't claim to know completely how the human brain works, and I think it's unlikely that anyone completely understands everything. But it's unreasonable to claim that anything we don't completely understand the physical manifestation of must not have a physical manifestation. That's just the God of the Gaps argument[1] repackaged into a "Mind of the Gaps" argument. If you are defining the mind is every thought and mental process that we don't understand, then the mind is an ever-shrinking phenomena that slowly disappears as we apply the scientific method. In that case, I think we have a better word for that than "the mind": we typically call that "ignorance".

> Similar argument patterns permeate most ancient philosophies. The meme is that mind is the ultimate reality, of which the materialistic worldview is a surprisingly fragile inverse.

This is unsurprising, given that ancient philosophers lacked even basic scientific knowledge. The materialistic worldview seems fragile when you know next-to-nothing of the material world. We might draw the same conclusions as them if we only look at the evidence they had, but it would be foolish to only look at the evidence they had, when we have access to, for example, modern neuroscience. It would be extraordinarily improbable for people who believed fire came from phlogiston to come to the same conclusions about the nature of the mind, as people with access to decades of magnetic resonance imaging of the brain.

[1] https://en.wikipedia.org/wiki/God_of_the_gaps


I like your analogy and do have a similar view in that the total consciousness level of all humans combined, at any given point in time, creates a separate universe of our own. This total consciousness level has its own rules and principles created by us which also evolves over time. It shapes all of our belief systems, actions, behaviors, etc. throughout various human civilizations in history.

It operates almost like a mind of the entire human race just hovering above all of us. This concept is pretty abstract but like you said, at any given point in time this total soul may not exist physically, but it does exist conceptually in our exclusive reality and it too constantly evolves together with us.


How did you come to the conclusion that the phenomenon you are describing is hovering above all of us, instead of resting comfortably inside our brains in the form of neurons?


I was saying that it would be a total level of consciousness from all human individuals combined, and its power is really more than just the sum of each individual. In a sense, this could be considered as the total knowledge that our species has acquired at a given point in time.


Some people feel one’s essence is fundamentally different from one’s body, including the brain as part of the body. Not saying I support this notion, but to brush it aside as stupid or unjustified seems a bit hasty in view of the huge literature behind these issues. Moreover, doesn’t the notion of reincarnation in some parts of the Eastern world show it’s not restricted to Western culture? I’m sure there plenty more such notions outside the West.


> Some people feel one’s essence is fundamentally different from one’s body, including the brain as part of the body. Not saying I support this notion, but to brush it aside as stupid or unjustified seems a bit hasty in view of the huge literature behind these issues.

I don't think it is.

Consider: someone decides to say something without evidence. It's obviously okay to brush this aside and just say "there's no evidence for that". Then hundreds of thousands of people read what that person said, and then decide to propagate the idea by saying it themselves, still without any evidence. You're claiming that at some point, the bulk of literature means we can't say it's a stupid idea any more? I disagree. Ideas are determined valid by the evidence or lack of evidence, not by how popular they are.

In fact, when a stupid idea is popular, that's when it causes the most damage. So when there's a bulk of literature propagating a stupid idea, that's the time when it's important to say that it's a stupid idea.

> Moreover, doesn’t the notion of reincarnation in some parts of the Eastern world show it’s not restricted to Western culture?

You'll note I didn't say it was restricted to Western culture. I think Plato has a large part in spreading the idea in Western culture, but I'd guess he wasn't the first, and other people probably came up with the same idea independently.


What's the evidence that there is a brain or body in the first place, which is a big part of the original discussion? No, I don't mean that just because Plato said it cannot be "stupid", but you have clearly provoked the crowd bringing philosophy to the fore, and broadly speaking philosophy is where you stop having certain evidence for anything, as it precisely challenges anything deemed certain. Once the body is assumed and our senses trusted, if you find solid evidence it'll be about how the brain differs (or not) from the rest of the body, not about the presence or absence of a mind or soul.


> What's the evidence that there is a brain or body in the first place, which is a big part of the original discussion?

I'll sidestep this by saying that for my purposes, reality is just a theorized model of what our senses perceive. If we don't trust our senses, then it's possible none of the things we perceive exist, but who cares? The things we perceive as our brain and body can be modeled to predict what we will perceive in the future.

> broadly speaking philosophy is where you stop having certain evidence for anything

That's not how I define philosophy, but I won't get into a semantic argument about what philosophy is. I also think saying things are "certain" is almost always a mistake. All I'll say is that if that if you define philosophy as eschewing evidence, then I'm happy to dismiss all of what you consider philosophy. If you aren't able to produce evidence (empirical or logical) for the statements you make, then all you're doing is stringing together words into grammatically-correct but meaningless sentences, which is not a skill I care about by itself.

I'm happy to say that I don't think all philosophers share your view that evidence is unnecessary, so there are many people who I would respect who I would also call philosophers.

> Once the body is assumed and our senses trusted,

I don't think we can assume that. Nor should we. Nor is there any value in doing so.

Let's temporarily assume the opposite: let's assume our senses are lying to us. If that's so, I'd argue that our senses lie to us in consistent, predictable manners. I can predict how my senses will lie to me in the future based on how they are lying to me now, and how they have lied to me in the past. If I choose to tell my fake body to let go of a fake ball, my senses will lie to me and tell me that the fake ball falls toward the fake earth. Every fake morning, my senses lie to me and tell me that the fake sun rises.

How would my situation differ if all this were real? If I really dropped a real ball and it really fell toward the real earth, would that be different? If a real sun rose in the real morning, how would that change my experience? In short, a falsehood so complete that it is completely indistinguishable from the truth is not meaningfully different from the truth. If I put my hand on a hot stove and sense pain, does it matter whether that pain is real or fake? I don't think it does.

> if you find solid evidence it'll be about how the brain differs (or not) from the rest of the body, not about the presence or absence of a mind or soul.

That's true, which is why minds and souls should be relegated to the fiction section of the bookstore, with ghosts, werewolves, elves, and all the other fictional things we don't sense with our senses. I'm not saying these things aren't fun to think about, they just shouldn't be considered as existent phenomena on which we base our beliefs and decisions.


First of all, thank you for your thorough replies, and not just to me. I feel you engage in and know philosophy way more than I do, though I know in philosophical circles this is not supposed to be a problem. My main issue is simply that you labeled "stupid" and "unjustified" a position that indisputably has been justified at length (clearly not to your satisfaction), and that (at the risk of sounding stupid myself) makes some sense, like so many incompatible positions in this area. I understand people in philosophy are prone to dismiss other views, either as stupid, stating "we must pass over in silence", or with some remark in between. Interestingly, and I'm sure with plenty of precedent, in Wittgenstein's case he came to dismiss parts of his own dismissal later on.

I won't get into the philosophical issues themselves (as I'm sure it can only hurt my case:), but you must surely be aware that when dealing with philosophical matters, your, my or anybody's agreement or dismissal of a viewpoint will never be universal, not even nearly universal. To wit, philosophers will still in this century go back and forth about the law of non-contradiction [1], one of the pillars of classical logic, and there is no sign of a slowdown. So, before you find "evidence (empirical or logical)" you may have to first wrestle about the very nature and demarcation of logic, with turtles all the way down.

Like you say, these issues can be fun to think about... or not (I'm not sure I can agree, certainly not for the prolonged periods of time that would make a person a philosopher), but in any event I have great appreciation for the people that get involved seriously in this discipline. Precisely for this reason, I take issue with labeling most any position carefully put forth as stupid, moronic, unjustified, etc. Even more so when nobody will ever get nowhere near unanimous consensus on any topic in philosophy, which can easily be contrasted with science or mathematics, where you do find it, at least for some issues, such as the (sigh... nearly) universally dismissed geocentric and flat-Earth models.

[1] https://global.oup.com/academic/product/the-law-of-non-contr...


> Interestingly, and I'm sure with plenty of precedent, in Wittgenstein's case he came to dismiss parts of his own dismissal later on.

Okay, but that doesn't prove that I will reach the same conclusions Wittgenstein did.

> I won't get into the philosophical issues themselves (as I'm sure it can only hurt my case:), but you must surely be aware that when dealing with philosophical matters, your, my or anybody's agreement or dismissal of a viewpoint will never be universal, not even nearly universal.

Whether everyone believes the truth is irrelevant to whether or not it's true. Universality and consensus are not goals I have when seeking the truth.

It will never be the case that everyone believes what's true.

> To wit, philosophers will still in this century go back and forth about the law of non-contradiction [1], one of the pillars of classical logic, and there is no sign of a slowdown. So, before you find "evidence (empirical or logical)" you may have to first wrestle about the very nature and demarcation of logic, with turtles all the way down.

Sure. I won't claim to have a solution to this debate, but this, like "Can we trust our senses?" is another question without implications. If the law of contradiction is false, few people are willing to really put their money where their mouth is and really embrace contradiction, and those who do end up in psych wards. That doesn't help us prove that it's true (or false) but it does make the question fairly uninteresting. I prefer to ask questions where the answer has real-world implications.


Universality and consensus are not goals I have when seeking the truth.

If there is one truth per (willing) mind we might as well call them points of view, no? I won't hide that's a big part of what pulled me to mathematics for my college degree: foundational issues notwithstanding, it is the discipline that, at least on some fundamental notions (such as the number 7 being prime), gets closest to universality and consensus.

I prefer to ask questions where the answer has real-world implications.

You have basically stated that science is more interesting to you than philosophy. We can agree on that, and so can most other people.


I like reading ignorant things like this because it helps show why we really need more classical education in society. If you'd actually read some Plato, as opposed to summaries, I'd be shocked if you could keep the same belief. It's just so damn good for thinking with.

But prior to Plato, the Pythagorean Philolaus wrote that sensation/experience comes from the interaction between the soul (greek: psyche) and the body. Soul, here, is not the experiencing thing but the immaterial forms. (Summary: an example of an immaterial form is the concept of a triangle — a real and meaningful form but separate from any material instance). This Pythagorean view of the soul is compelling and has similarities with the idea of computational logic being fundamentally separable from the media of computation. The same logic can run on silicon or some water pump computer.

So, from this, if mind is what we'd call the experience, then it isn't just the body. It is the material body interacting with the soul (the "computational" forms).


> I like reading ignorant things like this

From the HN guidelines:

"Be kind. Don't be snarky. Comments should get more thoughtful and substantive, not less, as a topic gets more divisive. Have curious conversation; don't cross-examine."


Thank you for appreciating my kind, substantiative and thoughtful disagreement.


> Don't be snarky



> If you'd actually read some Plato, as opposed to summaries, I'd be shocked if you could keep the same belief.

I guess that means you're shocked.


You mean you've read some Plato? That's great. I'm most inspired by Phaedo, Gorgias and Timaeus. I think it's really important to stay attuned to the Pythagorean tradition, which seemed to be Plato's largest philosophical influence.


I've read The Republic. There wasn't anything in there that inspired me to read more of his work.

I think Plato and a lot of other early writers should be studied as historical figures, but we should also recognize that they were products of their time. Plato got it wrong more often than he got it right, not because he was stupid (he wasn't), but because he didn't have the benefits of thousands of years of previous thinkers to refine his ideas against. But we do have that benefit, and we should use it. We have the opportunity to stand on the shoulders of 21st century giants, and we miss that opportunity if we choose to stand on the shoulders of philosophers in the infancy of philosophy.

Even where ancient philosophers got things right in their theories of the mind, it was mostly just lucky guesses, without the benefit of modern neuroscience to validate those guesses. And neuroscience itself is in its infancy: our theory of the mind should be expanding every day as new discoveries are made.


What makes you think Plato didn't have the benefits of thousands of years of previous thinkers to refine his ideas against? I'm not aware we have any evidence that cultures with oral traditions didn't have thousands of years of history of philosophical thought. They would have dressed them up in stories because that's how oral traditions work but they're still very philosophical.


It would not surprise me if Plato did have the benefits of thousands of years of previous thinkers to refine his ideas against. I'm not saying he didn't, I'm saying we have the benefit of thousands of years more than he did.


I definitely see things differently.

1. Plato doesn't get things wrong because the nature of his rhetoric is presenting provocative dialogue for thinking with. The questions he raises are still relevant: what is good, what is virtue, what is beauty. I'm of the opinion (it's disputable) that the purpose of Philosophy isn't finding "the truth" but in living better.

2. Standing on the shoulders of 21st century philosophers... Well, there have been some good ones. But consider this list -- wouldn't you be standing taller on Plato's shoulders than on any of these? https://bigthink.com/scotty-hendricks/10-living-philosophers...

3. Neuroscience can't validate what is good, what is virtue, what is beauty. As a neuroscientist, I find an incredible amount of value in reading the original texts of the oldest philosophers, particularly the Pythagoreans (all is number; Harmonious soul in a harmonious cosmos). Understanding cognition in terms of harmonization processes is, for me, of great value. It is actually an excellent framework for understanding phase-amplitude coupling and other neural dynamics. The notion of harmony passed from Pythagoras to Plato to Plotinus to Ficino to Kepler to Newton... And then largely died. Why? It was the tacit agreement between the church and the scientific establishment to clearly separate science and spirituality.

Today, some seek to deny the existence of science, some the existence of spirituality. The alternative to that rejection is an integration of the two. Yet, modern science simply isn't interested in that task-- and neither is modern philosophy. So, if one cares about that integration (and I'm not the only one), there is a lot of benefit in going back in time to when there wasn't a difference between the two fields. And that's why I love the Pythagorean - Platonic tradition: an empirical investigation of the spiritual mysteries of a mathematical universe. Good luck finding a modern philosopher to take that on!

If you are intrigued, try reading "mathematics useful for understanding Plato" by Theon of Smyrna (c. 100AD)


> 1. Plato doesn't get things wrong because the nature of his rhetoric is presenting provocative dialogue for thinking with. The questions he raises are still relevant: what is good, what is virtue, what is beauty. I'm of the opinion (it's disputable) that the purpose of Philosophy isn't finding "the truth" but in living better.

Plato absolutely gets some things wrong. For one, he favored dictatorship (self-servingly, he thought the dictator should be a philosopher).

Sure, some of what Plato says is relevant, but lots of modern philosophers are saying those things, only more refined. There's not much value in reading Plato if you can read the same thing by a modern author, with all Plato's mistakes ironed out by two and a half millenia of discovery and debate.

In fact, Plato's belief in dictatorship was a great example of where we have the benefit of two and a half millenia of experience that Plato didn't have: we've seen a lot of dictators, and had the benefit of comparing the results of dictatorship to other forms of government.

> 2. Standing on the shoulders of 21st century philosophers... Well, there have been some good ones. But consider this list -- wouldn't you be standing taller on Plato's shoulders than on any of these? https://bigthink.com/scotty-hendricks/10-living-philosophers....

No. You think this is a rhetorical question, but it isn't. I would absolutely rather stand on the shoulders of one of those philosophers, rather than Plato.

It's likely that all of those philosophers have read Plato, and are already standing on his shoulders. So by reading those philosophers instead, you get the parts of Plato that have value, plus the benefit of their having refined Plato's ideas. Plato might have been a giant in his time, but he's a child compared to those who have the benefit of his height in addition to their own.

Incidentally, the argument I'm making in this post is pretty similar to one made by Martha Nussbaum, one of the philosophers on this list.

"Now the fact that Aristotle believes something does not make it true." --Martha Nussbaum

> 3. Neuroscience can't validate what is good, what is virtue, what is beauty.

Nor can Plato.

> As a neuroscientist, I find an incredible amount of value in reading the original texts of the oldest philosophers, particularly the Pythagoreans (all is number; Harmonious soul in a harmonious cosmos). Understanding cognition in terms of harmonization processes is, for me, of great value.

The part that makes this palatable is where you speak for yourself. If you like it, I applaud your enjoyment of it!

> The notion of harmony passed from Pythagoras to Plato to Plotinus to Ficino to Kepler to Newton... And then largely died. Why? It was the tacit agreement between the church and the scientific establishment to clearly separate science and spirituality.

This not only ignorant of history, but it is also ignorant of the present day. If there's a agreement between the church and scientific communities to separate science and spirituality, neither side is holding up their end of the bargain. Did you read the part of the article you linked on Daniel Dennett? If you think Darwin or Einstein weren't spiritual, you can't have read much of their writings.

"The Darwinian Revolution is both a scientific and a philosophical revolution, and neither revolution could have occurred without the other." --Daniel Dennett


To be entirely fair, by reading those philosophers listed, you get the parts of Plato that they believe have value. That's not necessarily the same thing as the parts of Plato that actually have value, I'm sure you agree?

Of course that Aristotle believes something does not make it true, but also that Nussbaum doesn't believe something Aristotle believes doesn't make it false either!


That's true--what I said was intended as an approximation. I should have added some "most"s and "probably"s.

I think we can say that if one or two other philosophers besides Plato think that something Plato says has value, the chances of it actually having value are higher than a random sampling of what Plato says having value.


Why then would historians emphasize the importance of primary sources? If you rely on a progression of secondary sources over and over, you get serious misconceptions. Such as, for instance, your notion of the forms as being indicative of a descartian mind/body split. That simply isn't what Plato wrote.

So, as it turns out, not everyone can or should read primary sources. It's only for the select few. But those that do won't be dumber than those that only read secondary sources.


Plato's allegory of the Cave is about the liberation provided by education, and self-awareness.

How gaining understanding of your environment freed you from the limited reality it presented you.

The initial usage of the story was to illustrate how political indoctrination could present a false reality to ardent followers "the shadows of cave fire for those raised in the cave", and how education could "open the eyes and show them the true light" (the fire in the sky/sun vs the fire in the cave). "...even if one was dragged out of the cave".

This was later extended to demonstrate that if humans learned about their own emotions, they could learn to reason decisions, rather than allow emotions to guide them exclusively.

Tangentially, this rough concept in early western philosophy evolved into the religion of the Sun, and had significant influence on early Christianity.


I would caution you on ever thinking that allegories or analogies "demonstrate" anything. Analogies can be used to explain a model of a system, but they can't be use to prove that that model is accurate.

Consider the analogy "arms are like wings". That's actually true in a lot of ways, but we can't simply assume that arms have all the properties of wings by analogy, otherwise we'd conclude that arms allow us to fly.

That education improves our capabilities is fairly well proven via other means.


Are you saying that two thousand years of nominalism vs. realism are based on a misunderstanding of Plato?

(And, doesn't sun worship predate philosophy by a good bit?)


I believe the mind, or soul, is indeed in the brain. But it's also separate. It's more like software controlling the hardware.

Take self control and attention. How many people struggle with it, procrastinating? You want to do something, you know you have to do it, you like doing it... But you don't.

Because your brain doesn't listen to your mind. Because the brain is mostly a primitive autonomous system and needs to be constantly motivated, coerced, trained to do things that it technically doesn't need to (why do anything besides eat, survive, reproduce?)

Take away what we call the mind/soul, and we're just a basic animal, running reactively on instinct and reflexes.


I think the battle in procrastination is not between the brain and something outside but between different parts of the brain, one favoring a long term perspective and others favoring immediate gratification.


> Take away what we call the mind/soul, and we're just a basic animal, running reactively on instinct and reflexes.

Yes, that's correct, and I really don't understand what you think you've said that proves otherwise.


> Your mind and your body are the same thing.

That is incorrect, but unfortunately a very common misunderstanding.

The mind is highly correlated with the brain but it is not the brain. It’s easy to see this is the case because the brain is made up of a qualitatively different material than the mind. While the brain is composed of biological cells / chemistry / atoms, the mind is composed of things like sense-perceptions (like colours, smells, sounds, etc), emotions, etc.

Which is to say that the mind is composed of material that is fundamentally different from the brain. Of course they’re highly correlated but they are in fact separate entities composed of different materials.

You may say that the fundamental materials of the mind are reducible to the same things as the brain, but that would be confusing correlation for the thing itself.

Take for example the colour red, which is present in the mind but not the brain. Yes the brain enables the perception of red but it is not red itself. Eg a photon with a wavelength of approximately 620-750nm is often confused for red but in fact it’s just a photon which, when it hits the back of our eyes causes a chemical cascade from the relevant cone cells. So it’s abundantly clear this photon in itself is not red because it just causes a specific chemical cascade at back of our eyes. So is this chemical cascade red? No it’s just a chemical cascade that is highly correlated with red appearing in our mind.

The right answer, I believe, is simply that red is highly correlated with specific pathways of chemical cascades in our brain. The point remains that the brain and the mind are separate and distinct entities made up of qualitatively different material.

If you disagree with this assessment, please tell me what is red?


Your argument falls apart where you claim something is abundantly clear, when you can't even clearly describe what you think is abundantly clear.

You're claiming red light isn't the perception of red. I can be on board with those semantics, but they are just semantics. In that case, I'd say the phenomenon described by the terms is that red light is the electromagnetic radiation in the long range of the visible spectrum, and the perception of red is the chemical cascade starting with the stimulation of L-cones and ending with the firing of neurons in the visual cortex.

You keep saying that red light and the perception of red are "highly correlated" with red, but I'm saying, there's no evidence for anything besides red light and the perception of red. You're saying that the brain and the mind are made up of qualitatively different material, but I'm saying, "qualitative" implies "observable", and you've yet to present an observable phenomenon that is clearly the mind.

Either the mind is indistinguishable from the brain, in which case we don't need a second term for it, or it's a distinguishable phenomenon that you've failed to actually demonstrate exists. It's not clear which is the case, because you haven't made it clear what observable phenomena you are calling "the mind".


Do you agree that orange light isn't the same as the perception of orange? After all, the perception of orange can exist without orange light, as demonstrated by the RGB monitor you are most likely using to look at the header at the top of this web page.

The mind is a distinguishable phenomenon from the brain because I can observe other people's brains (although I hope I never actually do) but I can't observe other people's minds.


Is it not abundantly clear that a photon is just a photon? What else could it be?

> the perception of red is the chemical cascade starting with the stimulation of L-cones and ending with the firing of neurons in the visual cortex.

So this quote illustrates the gist of your thinking, but I think you've got some muddled terms. For you there is "red light" and "the perception of red". So for you:

"red light" is the photon & "the perception of red" is the chemical cascade.

Whereas, I would break it down as follows:

"red light" is the photon as well - ie a photon with wavelength between 620-750nm (though I'd caution that despite calling this photon "red light", there is in fact no "red" associated with it - except that it can cause the perception of red if it hits and excites specific cone cells at back our eyes, but it is still just a photon, albiet with a specific energy level but the point is this photon has no quality "red")

Where we differ is I believe:

The chemical cascade is the chemical cascade & "the perception of red" is "the perception of red"

So I think the real problem with your understanding of this is your confusing the chemical cascade caused by a 620-750nm photon to be "the perception of red".

In a sense, you are claiming that this chemical cascade is 2 things: 1: a chemical cascade and 2: the perception of red (i.e. the subjective sensation of looking at red); whereas, I would say the chemical cascade is just a chemical cascade... that's all it is, because of course chemicals can't be chemicals AND sense perceptions - that's the real incorrect leap of faith in your argument.

I believe it makes much more sense to consider sense perceptions to be a separate distinct phenomenon. You say that I have yet to present an observable phenomenon that is clearly in the mind, but just imagine a red triangle, boom there you have it - that red triangle only exists in the mind. Sure, in the brain there's electrochemical activity within the visual cortex, but you won't find a red triangle in there, because the red triangle is made up of fundamentally different material - i.e. the sense-perception of red in the shape of a triangle. Now, I have no idea what red actually is, except that I know it is a qualitatively different material than the brain and is fundamentally irreducible.

If you still disagree with this, tell me where is the red triangle? Because I think it's patently absurd to say the red triangle IS a chemical cascade in your brain. No, it's not. It's highly correlated with a chemical cascade in your brain, but it is an objectively distinct and separate entity/object; it's simply made of qualitatively different material than the brain. Ultimately, as I said before, I believe you're confusing 2 correlated processes/things for a single process/thing: the chemical cascade and the sense-perception.


> Is it not abundantly clear that a photon is just a photon? What else could it be?

Well, light can be modeled as either a wave or a particle[1]. When talking about colors, it makes more sense to talk about light using the wave model of light than the particle model of light--not that either way of talking about it is wrong, it's just that the particle model is way more complicated for modeling this particular phenomena.

> "red light" is the photon as well - ie a photon with wavelength between 620-750nm

No. If you're talking about wavelength you should be using the wave model. It absolutely makes sense to say "red light" when you're talking about a wave.

There's no such thing as a red photon because photons don't have color by themselves--red light is made up of many photons, which have a frequency.

It sounds like your argument is basically that you don't know how to represent color with the particle model of light, so you assume the answer is "the mind". Not only can you go learn how to represent color using the particle model, but even if that weren't possible, assuming that anything you don't understand is "the mind" is pretty premature.

> In a sense, you are claiming that this chemical cascade is 2 things: 1: a chemical cascade and 2: the perception of red (i.e. the subjective sensation of looking at red); whereas, I would say the chemical cascade is just a chemical cascade... that's all it is, because of course chemicals can't be chemicals AND sense perceptions - that's the real incorrect leap of faith in your argument.

People who have the chemical cascade experience red. People who don't, don't--even if red light is there (i.e. if they are colorblind). Do you have any reason for believing these are different phenomena?

> You say that I have yet to present an observable phenomenon that is clearly in the mind, but just imagine a red triangle, boom there you have it - that red triangle only exists in the mind. [...]

> If you still disagree with this, tell me where is the red triangle?

It's also in the brain, because the mind is just the brain.

This isn't hypothetical. We can read (very) fuzzy images from people's brains using neural-imaging[2]. I'm not aware of any experiments that specifically has read a red triangle, but I don't see any reason to believe that this image is uniquely in the mind and not the brain.

Again, it seems like you're just defining "the mind" as anything that happens in the brain where you don't know how it happens. And again I'll say, even if we didn't already know how it happens, concluding that this is "the mind" rather than some physical process we haven't yet discovered, is premature.

> it's simply made of qualitatively different material than the brain.

If it's qualitatively different, what are the qualitative differences?

As for the parts of your post I didn't respond to directly: declaring things irreducible, patently absurd, and declaring that you know things, all ex nihilo, is not a persuasive argument.

[1] https://en.wikipedia.org/wiki/Wave%E2%80%93particle_duality

[2] https://news.berkeley.edu/2011/09/22/brain-movies/


A lot of what you say is irrelevant. I get the feeling you aren't aware of the hard problem of consciousness, so I'll leave this here for you to read up on: https://en.wikipedia.org/wiki/Hard_problem_of_consciousness. Are you familiar with concepts like qualia? I recommend reading that wiki too.

The problem for you is that you still fail to draw a distinction between 2 highly correlated phenomena: the chemical cascade & the perception of red. You even get close to admitting the distinction yourself. E.g.:

> People who have the chemical cascade experience red. People who don't, don't--even if red light is there (i.e. if they are colorblind). Do you have any reason for believing these are different phenomena?

So yes, many reasons - some of which have already been explained and inadequately responded to, but here's another example that should prove it to you: We can put someone under anesthesia, shine red light into their eyes & they will still have the chemical cascade, but will not experience or perceive red. How do you square this circle? I suspect you'll insist they must also experience it and simply not know, but I'll be interested in hearing your mental gymnastics.

> It's also in the brain, because the mind is just the brain.

> This isn't hypothetical. We can read (very) fuzzy images from people's brains using neural-imaging[2]. I'm not aware of any experiments that specifically has read a red triangle, but I don't see any reason to believe that this image is uniquely in the mind and not the brain.

I've looked at brains under the microscope... never once have I seen a red triangle, or green square, or blue circle, yet here they are in my mind. Again your confusing correlation for the thing itself.

Yes I'm sure we'll get to the point where if I imagine a red triangle, then we'll be able to "read" it from my brain, but this doesn't mean that the red triangle is in my brain, just that a certain activity of neurons in the brain is correlated with a red triangle... those neural imaging techniques are all largely about correlation, which is my point exactly.

> If it's qualitatively different, what are the qualitative differences?

The brain is made of traditional matter we're familiar with (e.g. atoms and their constituent parts, amongst others), but the mind is made up of things like sense-perceptions (e.g. the colour red or the smell of lemons, which are fundamentally irreducible - by which I mean you cannot say the perception of a red triangle is made up of traditional matter. Instead a red triangle is simply made up of red; in essence, if a red triangle is made up of atoms, those atoms would have the quality red, which is a property traditional matter does not possess, hence the mind being made up of qualitatively different matter than the brain.

I know it's probably hard for someone who refuses to believe consciousness exists to admit that consciousness does in fact exist as a separate distinct phenomenon, so I won't try too hard to convince you. I'm sure with time you'll make that distinction too.


> I get the feeling you aren't aware of the hard problem of consciousness, so I'll leave this here for you to read up on: https://en.wikipedia.org/wiki/Hard_problem_of_consciousness. Are you familiar with concepts like qualia? I recommend reading that wiki too.

This is, again, saying a problem is hard, and then concluding that since we can't solve it, the solution is mind! Which again remains a premature conclusion.

> The problem for you is that you still fail to draw a distinction between 2 highly correlated phenomena: the chemical cascade & the perception of red.

No, that's not a failure. That's my entire point. There aren't two phenomena: they are the same thing.

> We can put someone under anesthesia, shine red light into their eyes & they will still have the chemical cascade, but will not experience or perceive red. How do you square this circle?

Surely you can see how inserting a chemical into the brain might change or interfere with the chemical cascade? If you assume that the chemical cascade IS the perception of red, then interfering with the chemical cascade preventing the perception of red makes perfect sense.

> I've looked at brains under the microscope... never once have I seen a red triangle, or green square, or blue circle, yet here they are in my mind. Again your confusing correlation for the thing itself.

I must admit I got a chuckle out of this. Is this what you think I'm claiming? This is definitely not what I'm claiming. I'm just going to quote this so you can't retract it.

> those neural imaging techniques are all largely about correlation, which is my point exactly.

Neural imaging is done with physical machines, which can only detect physical phenomena. "Correlating" means to take two things and show them to be related. So if you're correlating two phenomenon with machinery that can only detect physical phenomena, you can only correlate physical phenomena. If you're claiming that neural imaging shows the correlation between a chemical cascade and the processes of the mind, then the processes of the mind must be a physical phenomenon--which is my point.

> I know it's probably hard for someone who refuses to believe consciousness exists to admit that consciousness does in fact exist as a separate distinct phenomenon, so I won't try too hard to convince you.

I don't refuse to believe in consciousness--consciousness certainly exists, as electrical and chemical processes in the brain. And I wouldn't refuse to believe in consciousness as distinct from electrical and chemical reactions in the brain, if you presented any evidence for that assertion, instead of just repeating it and adding new unfounded claims.

> I'm sure with time you'll make that distinction too.

You are sure of a great many things.


From the viewpoint of the mind, red is an illusion or perhaps a conventional way of organizing experiences. From the view point of the body, red is an emergent phenomena. Color is an interesting example because people literally don’t see colors that their languages do not differentiate: https://www.wnycstudios.org/podcasts/radiolab/segments/21121...


"The mind is highly correlated with the brain but it is not the brain."

... in roughly the same way that a process is not a processor. Or a program, for that matter.


Okay, if you're saying that the mind is just the sequence of events occurring inside the brain, I certainly won't argue that the sequence of events doesn't exist.

However, I don't think that's what most people mean when they say "mind", and using the word "mind" brings with it a lot of baggage, so I'd prefer to use a more descriptive term, like "sequence of events".


"Sequence of events", to me, doesn't capture the relationship between subsequent states of either the brain or the mind. Also, "states of mind" have an explanatory power that "states of the brain" don't have, even though the former are theoretically reducable to the latter.


I think it is at this part of the debate where the ship of Theseus becomes interesting.

The sequence of events in the brain are what make up the mind. But, if you replace the brain while keeping the sequence of events continuous, you have a new brain and the same mind.

Or maybe just the same brain. Ship of Theseus and all that.


> The sequence of events in the brain are what make up the mind. But, if you replace the brain while keeping the sequence of events continuous, you have a new brain and the same mind.

Okay, but as far as I know, we've never replaced a brain while keeping the sequence of events continuous--I'm not even sure what actions one would take to do that.


Oh, we definitely haven't yet.

But the fact that we can't currently do so doesn't mean that it isn't relevant to the philosophical discussion of whether the mind is a separate entity from the brain.

It seems likely to me, though, that we'll be able to really make progress on that question in the next century or so for this very reason.


Modern philosophical thought and religion were built on that idea, and they were arguably inextricable from science in it's early stages. This is like someone people never fully recover from adolescence. Correct, it forms an integral part of who you eventually become.


> Modern philosophical thought and religion were built on that idea, and they were arguably inextricable from science in it's early stages.

So were lots of bad ideas. Science is a process of trial and error. This was an error. The hope is that you correct the errors, not make them an integral part of your belief system.


Metabolism. How the chemistry of your body interacts with itself.

I know for sure I have 'episodes' when I've got acid in the wrong parts of the gut. I also 'feel' the stages of stool composition, and there are definitely relics of unhealthy eating in my mood swings.

One thing though, is I never take pharmaceuticals, as I wish my body to be a picture of my life balance, which I believe are two separate realms completely (body/life). Instead I do everything I can to eat well, and give my body the sport it needs. This isn't easy, but everyone's got their own body, and its own needs. If you pay attention, it'll tell you what it needs.

The brain, or at least my brain, is a nice soft spongy joystick for controlling the rest of it. It feels good to throw around a bit, but you gotta take care of what its attached to, as well. A good day in the surf is how I charge my mind up, anyhoo...


“I used to think that the brain was the most important part of the body. Then i realized who was telling me that...”


I used to think the brain was the most important part of the body. Then my arsehole clenched shut for a week...


Hope you tore it a new one!


This joke is also very deep. "You" might tear "it" a new asshole.

Almost as if, in some important and meaningful way, "your ass" was a fundamentally different entity than the "you" that has agency to act


actually a big chunk of this article is about cholesterol-lowering statins being linked to mood disorders, a medication which purportedly has no psychiatric impact at all. The reliance the medical industry has on statin drugs cannot die fast enough for me.


Indeed, Statins seem to be handed out like by doctors as a fix for high colesteral. I recall that the final verdict is they increase life expectancy so they're effectively just a treatment for a disease marker.


To take it further, an even greater sin is perpetuating the idea there is a static "you". "You" are a conglomerate of coordinating and competing systems and are ever changing.


>"I feel like perpetuating this mindset is the ultimate sin of modern psychiatry and the entire industry of psychiatric pharmaceuticals"

Hmm. Modern psychiatry is usually accused of the opposite. Also interesting that leading comment on an article about how many (non-CNS) meds have CNS effects becomes yet another opportunity to criticize antidepressants. HN community's hostility to treating brain diseases (while emphatically supporting people with brain diseases) is perplexing.


I read that as They don't just affect our hardware, but also our software.


Right, but the point being made is that there is no distinction between the two.


True, and the rest of the body (particularly the gut and genitals) produces chemicals that function within your brain.

The brain and body inform eachother.


“perpetuating this mindset is the ultimate sin of modern psychiatry and the entire industry of psychiatric pharmaceuticals”

O-kaaaay.

But, as the science kids all say:

[Citation required]

(Please note Scopie’s Law is now in full effect.)


>Citation required

https://youtu.be/twhvtzd6gXA

>"Depression may be related to an imbalance of natural chemicals between nerve cells in the brain. Prescription Zoloft works to correct this imbalance."


So, sharks selling surboards. Not exactly PubMed though, is it?


At least 70% of the DSM-5 Task Force had financial ties to those sharks selling surf boards

https://en.m.wikipedia.org/wiki/DSM-5#Criticism


I take issue with the idea that we have some intrinsic essentialist self/soul/atman that constitutes "who we are" — such that it could be changed. If taking antidepressants makes one less neurotic, does that mean we have been fundamentally changed? Doubtful.

The illusion of the self is socially useful and pervasive, but there isn't much to support it.


I mean making a distinction between mind/consciousness and body is one thing, and while I wouldn't, those of a religious bent might try to justify it. Making a distinction between brain and body is just sophomoric. The BBC unfortunately seems to have content-farm mistakes like this fairly frequently in their online writing.


Yes. The word "psychosomatic" exists for a reason.


Definitely 100% true, first hand experience here.

I had mild medication prescribed for regulating blood pressure. Supposedly without psychological side effects. I found out a year later that it dramatically affected my personality. More or less like in the article, but in the opposite way.

The frightening thing is, I didn't know !!!

I found out a year later when temporarily stopping the medication, my kids started to make remarks, alluding on my changed behaviour. Only that moment I started to realize what happened.

Also affected my profesional live: I heard years later that people / collegues had noticed (but never mentioned it). I'm pretty sure it impacted my career. All without me knowing. For medication without any known psychological effects.

I took this medication for a year without realizing anything was wrong, that will probably also be the case for other people, and I'm pretty sure in many cases psychological side effects won't show up in clinical trials.

I'm pretty sure if you take anything like anti anxiety / depressants, psycho-pharmaceuticals, or just anything with known side effects, the impact must be dramatic.

When I found out, discussed it with (several) docters : one said "impossible", another "interesting, tell me more". It assume most doctors are clueless here. When you break a leg, they can set it and it heals. When you have a headache, they look in their book to see if there is a pill. But anything out of the ordinary, it may be hard to find good medical help.


> I found out a year later that it dramatically affected my personality. More or less like in the article, but in the opposite way.

So the blood pressure medication made you more calm? You didn’t specify the medication they prescribed, but that’s a common effect of certain types of blood pressure medication. In fact, certain blood pressure medications are prescribed off-label for their calming properties. One blood pressure medication is even approved for also treating ADHD (Guanfacine).

If you find that your doctor doesn’t acknowledge your side effects or dismisses your complaints, it’s time to get a second opinion or rotate doctors. I’ve never had a problem with my doctors not believing me.

> I'm pretty sure if you take anything like anti anxiety / depressants, psycho-pharmaceuticals, or just anything with known side effects, the impact must be dramatic.

In my experience, the good doctors are well aware that all medications come with side effects. The best doctors strive to minimize medication exposure for this reason. Ironically, many patients disapprove of this because it feels like the doctors are withholding treatments, even when it may be the best choice for the patient.

The most common example is people demanding antibiotics for common colds. Doctors know antibiotics won’t help and that they come with significant risks, but they also know that patients might leave a bad review if they leave empty handed.

In the case of psychiatric medications: Yes, the differences can be significant. However, the side effects are worth the tradeoff for alleviating serious psychiatric issues. Being naturally healthy is obviously preferable to being medicated with side effects, but that’s not the choice that patients are making in these cases. Instead, they’re choosing between continuing to be unhealthy without medication or dealing with some side effects in order to relieve some of their pain.

This is also why many people get stuck in cycles of discontinuing their psychiatric medications. Someone who achieves remission from depression with anti-depressant medication might think that they don’t need the medication now that they’re “better”, and when all they can see are the side effects. This leads them to discontinue, which often results in relapse of the underlying disorder if not managed with the help of their doctors.


Blood pressure medicine does make you more calm and this is known anecdotally among the medical community.

I know this because I know of medical students taking it before giving a speech. Literally the medicine is well known for making you perfectly calm.

You know that magic pill that can get rid of your approach anxiety? I hear, this is it, though I never tried. I'm wondering if anyone more in the "know" can comment on it.


Be careful: There are multiple classes of blood pressure medications with different mechanisms of action.

You're referring to beta blockers, which can reduce the stress response in your sympathetic nervous system.

> Literally the medicine is well known for making you perfectly calm.

> You know that magic pill that can get rid of your approach anxiety? I hear, this is it,

They're not magic. They won't make you perfectly calm and they won't magically rid you of different types of anxiety. Beta blockers are used in mild cases to help tip the scales toward calm, but they won't cure major anxiety or make you superhumanly calm.

Like any medication, it's best used as a combination treatment approach with therapy and other interventions. As always, refer to a doctor for a proper treatment plan, never try to self medicate with prescription medications.


I know someone who suffers from anxiety and takes propranolol. She says it helps with the physical symptoms of anxiety (e.g. racing heart), but doesn't help prevent anxiety in the first place. Still, she finds this somewhat useful, as feeling physical symptoms of anxiety can cause a sort of feedback loop, where it leads to more anxiety.

So yes, while beta blockers can help, they are no panacea.


> You know that magic pill that can get rid of your approach anxiety ... wondering if anyone more in the "know" can comment on it.

BLUF (bottom line up front):

Try biofeedback to regulate level of emotional arousal before an anticipated stressor or critical decision or event.

COMMENTARY

You may be referring to “Propranolol”

“Propranolol is occasionally used to treat performance anxiety... benefits appear similar to benzodiazepines in panic disorder with potentially less side effects such as addiction. Experimentation has been conducted in other psychiatric areas... Post-traumatic stress disorder (PTSD) and specific phobias...”

https://en.wikipedia.org/wiki/Propranolol

It is a beta blocker:

”Beta blockers (beta-blockers, β-blockers, etc.) are a class of medications that are predominantly used to manage abnormal heart rhythms... also widely used to treat high blood pressure (hypertension), although they are no longer the first choice...“

https://en.wikipedia.org/wiki/Beta_blocker

HYPOTHESIS

When taken before something like a Ted Talk, perhaps what’s happening is pre-treatment of not anxiety but indicative symptoms of anxiety, damping your biofeedback signals.

Perhaps it’s not doing anything direct for your anxiety, rather damping the racing heartbeat and increased blood pressure you usually experience in anticipation of stress (PTSD style association), and without that biofeedback sensor, your metacognition of anxiety doesn’t ramp up as much.

No citations, pure anecdata from 5 years in hedge fund sector.

CONTRAINDICATIONS

More than a few contra-indications:

https://en.wikipedia.org/wiki/Propranolol#Contraindications

https://en.wikipedia.org/wiki/Beta_blocker#Contraindications

ALTERNATIVE: BIO-FEEDBACK / MINDFULNESS

Bio-feedback mindfulness exercises are likely to be able to have the same effect after practice, not just in general, but in the immediate short term preceding an anticipated stress:

”Financial decision making : Financial traders use biofeedback as a tool for regulating their level of emotional arousal in order to make better financial decisions. The technology company Philips and the Dutch bank ABN AMRO developed a biofeedback device for retail investors based on a galvanic skin response sensor.... financial decision makers can learn how to effectively regulate their emotions using heart rate measurements.”

”Stress reduction : A randomized study by Sutarto et al. assessed the effect of resonant breathing biofeedback (recognize and control involuntary heart rate variability) among manufacturing operators; depression, anxiety and stress significantly decreased.”

https://en.wikipedia.org/wiki/Biofeedback#Financial_decision...


Thank you for all this detailed feedback, this actually helps a lot in understanding.

"I suspect it’s not doing anything direct for your anxiety, rather damping the racing heartbeat and increased blood pressure you usually experience in anticipation of stress (PTSD style association), and without that biofeedback sensor, your metacognition of anxiety doesn’t ramp up as much."

That's it. Heartbeat is gone, anxiety is still there. Also the "adrenaline rush" is gone.


Can you tell us more please? How would a regular person go about using bio-feedback to reduce anxiety and stress?

How have you observed people in the hedge fund industry using Propranolol? How would they acquire it, use it, and was there any talk of negative side effects?


I recall reading a story of some bank robbers taking beta-blockers prior to the "job".


Doctors are not always researchers. The mind of a good researcher is very curious. A good practitioner has to rely on heuristics for troubleshooting due to the high dimensionality of the decision space they deal with.


Usually doctors still operate by the book. All symptoms and deductions have to make sense in the "context" of the "book," if the book doesn't mention it, the doctor doesn't proceed any further.

For example, I slept on my bed with a heater blasting onto my face. Next day I developed sudden onset dry eye. Literally from eyes that had zero issues to dry eye. I think the heater was the causative agent, but the medical literature is blank on this, so the doctor is clueless as well. In fact the doctor literally ignores the fact that I had a heater blasting my eyes all night. I came in to the eye doctor and he assumed that my dry eye developed over a long time when in actually I "caught" it three days ago.

One perspective of this is that the patient is biased and assigning causative attributes to something that only happens to correlate with an outcome. Therefore all patient descriptions must be cut through and ignored if it's not relevant to the problem. It's largely true but I think doctors bias themselves towards this predisposition a little too much and dismiss many things that are actually important.

Either way though, if it's not in "the book" then treatment for it doesn't exist in any scientific form yet, so the doctor can't help you anyway.


Why aren't you calling out the name of the medication given your story of warning?


It's almost certainly propranolol, but it is odd they wouldn't just name it


And I agree 100% with you. Also first hand experience here.

After that period, I started to read everything I could find about the subject, and it is pretty scary. You are spot on when assume that most doctors are clueless. Actually, I think is too complicated to understand for anyone.

Have you seen other people go through the same situation ? Have you tried to help them ? If you ever do, that's when you find out how complicated it is, because they look at you like you are crazy. Many times no one is able to figure out what's really going on. Not their family, not their friends, never mind their doctors, who sometimes just prescribe a stronger medication and all hell brake loose...


Can I ask what medication it was?


I'll wager it was a beta blocker.

https://en.wikipedia.org/wiki/Beta_blocker#Anxiety


Spot on, indeed. However, I wasn't suffering from anxiety, and so the effect was a unexpected. Actually, stress indeed disappeared, but for me stress was never an issue. I used to draw a lot of energy out of my (positive) stress.


Re: blood pressure meds; this is common knowledge. Look at beta blockers; they're commonly used for people with presentation anxiety for e.g. exams. Some people can barely speak without taking them.


Drugs like propranolol, clonidine, nitrates etc that are commonly prescribed for their effects on blood pressure, also exert action on the peripheral and central nervous system.


Do you mind sharing the name of the medication? Was it a beta blocker, which are known to have anti anxiety properties?


> I took this medication for a year without realizing anything was wrong

Looks like you were also maybe not really paying attention to your behavior back in those times, as it looks like you would caught such a behavioral change sooner if you were to take medication again, don't you think?


Indeed, in hindsight it should have been obvious. It's less obvious at the moment itself.

In life, many things are hidden in plain sight.


In what way did your personality change?


It's difficult to go into details, but lets say I became less focused and driven in both work and personal life, but also an easier person to work with. The kids perceived this evolution as very positive.

I'm on different medication now, but some effects appear to be irreversible.


I'm reading your combined posts as you having had mild anxiety that you weren't consciously aware of (aka high strung), and that the medication (partially?) addressed this without your realizing it.

That the effects were lasting (ie continued after you stopped taking the medication) just means the underlying causes were likely mental (ie conditioned or learned) as opposed to an inherent physical condition.

Good news! If you want it back just take stimulants - anxiety is one of the most prominent negative side effects of caffeine. (I'm only half joking here - most people will be familiar with the over-caffeinated and highly productive but difficult to work with coworker.)


Let's also consider the other direction -- how fresh vegetables and fruit, plus whole grains, beans, nuts, seeds, and herbs improve mood, behavior, resilience. Throw in some vigorous exercise, and for most people, drugs can't do better, without the drugs' side effects and cost.

For many people, switching from a standard American diet to largely those ingredients would register as changing who they are.

I just finished reading a chapter on it in Dr. Michael Greger's How Not to Die -- the chapter is "How Not to Die From Suicidal Depression" with plenty of footnotes to primary sources.


Let's also consider the other direction -- how fresh vegetables and fruit, plus whole grains, beans, nuts, seeds, and herbs improve mood, behavior, resilience. Throw in some vigorous exercise, and for most people, drugs can't do better, without the drugs' side effects and cost.

If you look at health outcomes, this is sort of obviously not true. I don't mean the health benefits of the things you mention, I mean the "for most people" part.

Of course I realize that you are engaged in advocacy. I think it probably isn't good advocacy, people should be thinking about (and talking to their doctor about) the best way to approach their current health status, not imagining that they are going to eat well and get lots of vigorous exercise.


Are you really trying to say that promoting a nutritious diet supported by physical activity doesn't work for "most people"? You call that engaged advocacy?

What he claimed is true and backed by multiple studies. Doing a healthy dose of physical activity with a healthy diet can only be beneficial, no downside whatsoever. It's quite underrated I guess. Too many humans wish for a magic pill, they delude themselves into thinking that it must be better than healthy living habits, since it's more modern. People are looking for the lazy fix.


What he said is imagining you will start eating well and exercising is rather far from eating well and exercising. I know of no intentional changes that are less successful than trying to eat healthy for the rest of life. Even smokers have better luck with quitting. (Talking long term here - eating better for six months isn’t that useful).


Yes, that's the point, people don't do the whole good lifestyle thing and in many cases will be better off taking a drug vs not taking it.

I would say my comment is criticism of the advocacy in the other post, not really advocacy itself.


> this is sort of obviously not true... I mean the "for most people" part.

> I think it probably isn't good advocacy

That's pretty strong, can you at least explain why you think that?


> Throw in some vigorous exercise, and for most people, drugs can't do better, without the drugs' side effects and cost.

This is a dangerous generalization. I fully agree that exercise is more beneficial than most people realize for general health, but it's not good to treat exercise vs. drugs as a false dichotomy. They both have their place.

The key is to work with doctors who aren't afraid to recommend exercise and behavior changes when necessary. It's also important to signal to your doctors that you're willing to make lifestyle changes before jumping to drugs, if possible.

In my experience, doctors would always prefer to prescribe exercise, diet, and lifestyle changes before medications, but they're hesitant to do so in this world of patient satisfaction scores and demanding patients who self-diagnose their medication needs before they schedule the appointment.


This sounds more like diet marketing. People have such varying success with different diets that one set of foods simply cannot fit all.

Exercise is a different story. The most likely to bring about the improvements you describe.


It's hard to believe you made such a comment without including more doubts in your claim. I will leave one link, I hope it changes your mind and people mind if they agree with your comment. But there's more science supporting that a good nutrition help the brain: https://www.health.harvard.edu/blog/nutritional-psychiatry-y...


You could argue that any kind of self-improvement, therapy, dealing with depression and other issues, changes who you are.

The big question is: do they change you for the better or for worse? If they make you happier, more balanced, more in control of your behaviour, then I'd argue that's a good think. If they make you angry, uncontrolled, a slave to your impulses, then that's bad.

A lot of the stuff we put in our bodies subtly or not-so-subtly influences our behaviour. I wonder if at some point we'll understand these processes well enough to allow us to influence our own behaviour in the direction we want.


What if you are happier but become a sex pest (phrase I learned from TFA)?


This is a biased conclusion.

The most logical answer is this: Anything we ingest can change our personality. Whether it's for the better or worse is an opinion.

The causative nature of how ingesting A causes a personality change of type B, must be investigated experimentally. You cannot just say eating veggies improves mood. Where is your data and what do you mean by "improve"?


You're advocating between drugs and the alternative you listed.

The problem is the alternative you've listed are usually for prevention not as a cure. At least all the papers I've seen are observational and retrospective. Drugs on the other hand are design experiment, clinical and casual.

You don't cure cancer with exercise and good diet.


As the article mentions, this is a complicated, not-simple type of thing to filter out.

If it were anything other than the BBC reporting it, I would probably have a raised eyebrow.

One of the things that makes it difficult to develop a causative link, is things like someone may suddenly develop symptoms of heart disease or high blood pressure, but they are also going through a personally stressful time, and have taken to exercising less, worrying, and sitting around eating popcorn.

It may seem as if some medication or practice is the cause, but exercising less, and munching salt can throw the curve. Being worried about the future (or our own health -the reason we’re on the meds) can also have a fairly profound effect on things.

Animal testing will usually control for stuff, but real life is messy.

For example, alcohol is known to interact with all kinds of compounds. Rats don’t drink, so, unless the researchers deliberately introduce alcohol (in realistic dosage) in their regimen, they can be quite surprised, when unanticipated things start happening in human trials.

I’ve heard of unanticipated results manifesting, because a symptom only appeared within a certain dosage window, and testing had used extreme dosages.


I take gabapentin for a spinal issue (nerve damage in my spine) and it has a drastic and noticeable effect, I'm naturally quiet and introverted but when I take the higher prescribed dose that changes radically, I become outgoing and talkative, I have more confidence and I seem to be more creative (though that could just be the reduction in pain).

It definitely alters my mood and I can feel it happen.


Gabapentin has an off-label use as a mood stabilizer for those with bipolar disorder and other mood disorders. I've seen it turn manic lives into successful lives.


I was on a large dose of gabapentin for anxiety for a few years. It felt similar to the flow of a beer, before the negative parts of the alcohol kicked in


That's essentially what MDMA does too.


It is quite different than MDMA in practice though I think and even despite its name it does not bind to GABA I would still more liken it to the positive/social feelings of alcohol than mdma (don't mix alcohol and gabapentin though, it can be dangerous).


which is interesting, because the dosage range for gabapentin is, to put it mildly, all over the place: 100-3,600 mg/day

https://slatestarcodex.com/2019/07/18/know-your-gabapentinoi...


I've had trouble falling asleep for a long time, and at some point years ago started taking ambien for it. It took a long time to realize just how strong an impact it was having on me (could write a long blog post about it). Stopping wasn't easy, but now year+ later I'm basically back to normal, and feel like I have superpowers compared to the time when I was still on it.


a) how often and for how long, and what impact?

and

b) yes, you should write a blog post on it


which effects? drowsy in the daytime? walrus in the nightime?


This is basically the story of my mother.

About 15 years ago she was suffering from a panic disorder. Instead of trying to help her, her doctor prescribed a fairly high dose of benzodiazepines and be done with it.

These 'medicine' only made matters worse and changed her behavior radically. She became very closed up, never wanting to do anything, never leaving the house and always finding excuses not having to do anything. The stuff is also terrible for her memory, so she can't really remember anything since she has been taken these pills.

The worst part is that these medicine are highly addictive, and we have now passed to point where we had to accept that my mother will be on these pills for the rest of her life.


Highly recommend not giving up on getting off it. My grandmother thought she needed it to sleep for many years. But finally, after pressure from the family (several who are health care professionals), the doctor took her off it. She became so much better, even her sleep improved! Having worked as a health care professional myself, the rule was maximum 3 weeks, only for temporary treatment, long term need to find other solutions. Always some exceptions but then everything else had (or should have) been tried.


I used the Ashton Manual to get off benzos. https://www.benzoinfo.com/wp-content/uploads/2019/08/Ashton-... It's probably best to find a doctor too who specializes in getting people off the stuff. It's worth trying, and it may take years to do it, but it's worth it in the long term.


I think benzodiazepines can be partially behind my friend, Jerold Haas' death especially the withdrawal from it. These drugs are really strong and it if it is strong in a way that doesn't help it leads to great distortions in thinking. Some drugs can help a lot but if it doesn't help it can hurt pretty bad. I take some drugs that help me tremendously but I won't last long without it because I can't get restful sleep without it anymore. In that case I have a dependency without addiction but I read that benzos can also be addicting.

It is a shame Darry did not get the kind of help I received. I believe he died because of a psychiatric system that doesn't take time to observe patients and make small adjustments. I pleaded that Darry get hospitalized and I think he was but it just didn't work out for him. They got him in and in a few days he was out. I was in for weeks. I've basically been on the same medicine regimen since then 14 years ago.

(Darry was Jerold's nick name)


I’d be curious to hear the experiences of people who take/have taken some of these drugs such as L-dopa. With alcohol, I feel different but I don’t feel like a different person. Is it like that, or is there a larger feeing of difference?


For a lot of folks with epilepsy, this is nothing new. Plenty of medications that treat epilepsy are known to induce changes in mood, mental state, etc.

Probably the biggest one is levetiracetam (also known as Keppra). If you read the warning label, it says it can induce "mood changes", which is a euphemistic way of saying "it can turn you into an uncontrollable rage monster".

I've been there. Whatever you think you know about getting ticked off, you haven't felt angry until you've felt it on Keppra. There is no gradation of anger-- no "subtly annoyed", no "getting ticked off", no "this is really getting me angry". Just "zero" and "Incredible Hulk on a bad day". The stuff that annoys you may not be anything that annoyed you in the past, but now it's something that makes you want to bash somebody's skull against the pavement until it goes soft. And there is no warning, no ramp-up-- you just suddenly find yourself enraged beyond all human comprehension, and you're doing everything you can just to restrict yourself to yelling incoherently instead of resorting to physical violence.

There's even a cute nickname for this whole horror show: "Kepprage".

I'm off levetiracetam now (onto lamotrigine, which is also prescribed as an antidepressant). But it scared me pretty badly. I genuinely fear getting angry now-- because I worry that I'm going to wind up back where I was. I was single when I was on Keppra, but I'm in a relationship now-- it scares me to think what I might do if I ever get back to Kepprage levels of anger, because it could easily cost me my partner.

So, to your question: was I a different person on Keppra? I mean, I still responded to my name and worked the same job and had the same favorite foods and such. But I was a lot angrier, I was getting angry all the time, and there was no off switch. It's a valid philosophical question as to whether that makes me a "a different person". Looking to your example, consider that feeling that you have on alcohol, and its assorted side effects and behavioral changes. Now imagine that you were stuck in that mode, 24/7. Would you be "a different person"?


> I’d be curious to hear the experiences of people who take/have taken some of these drugs such as L-dopa.

L-DOPA's significant side effects and risks are very well known to doctors. No one should be prescribed L-DOPA unless they have severe Parkinson's disease, and even then the L-DOPA dose should be actively minimized.

The impulsive behavior side effect of L-DOPA is so well known that it has its own Wikipedia page: https://en.wikipedia.org/wiki/Dopamine_dysregulation_syndrom...

We should all be aware of potential side effects, but it's also important avoid the false dilemma fallacy. These patients aren't choosing between being healthy or taking L-DOPA. They're forced to choose between suffering from severe Parkinson's disease symptoms or risking the side effects of the medication. When the side effects outweigh the benefits, the medication should be discontinued. When the side effects are less than the underlying disease, the medication should be continued.


I've taken Levodopa, not prescribed, I do not have Parkinson's. Just had access to it and decided to try it as mood enhancement/anti depressant.

It did nothing noticeable. At higher dosages for 1 day I felt somewhat dizzy/nauseous, so I never tried that again (there is some research mentioning it can damage receptors irreparably). At the prescribed dosage, after a month I dropped it, as there was no improvement, no change.

Really, the only things I tried that had an actual effect were alcohol, cannabis, phenylethylamine (with nicotine! Does not work without it. And can probably kill you with alcohol, beware!), cocaine, aniracetam and sulbutiamine.

No wonder they're mostly banned, because they exhibit actual effects, but are not for any specific sickness. Sad, I'd say lack of alertness and a bad mood should be treated as sickness.


I've took various antidepressant (SSRI/SNRI/SARI) medications over the course of my life and some minor & major tranquilizers. Some alone, some in combination. Heck, during some time I even mixed them with psychoactive instances like LSD/amphetamines.

I doubt that it changed who I am, but it changed on how I act. Well, of course it depends on definition of who we are to start with. They certainly affect on how do you feel and how do you think, but when effects wear off, you typically return to your former ways. Maybe with new thoughts or new look at your life. But that's it.

I continue to see those kind of meds as a mere tools, which you can use to alter your thinking for a period of time to get yourself a fresh look at ordinary things. I think that therapeutic effect exists here only if you get some realization about your former ways.

Some meds made me worry less about my life when I've realized that worrying doesn't actual solve anything, it just makes you feel worse.

Some made me more emphatic towards people when I've realized that everyone is exactly as same as me, just with different life story.


the experiences you have make who you are. if a drug changes the way you behave it will change how you experience things. so depending to what you are exposed to, it can definitely change who you are.

an extreme example for environmental factors radically changing people’s behavior is lead poisoning.


My brother was diagnosed with PD in his early 30's (mid 50's now). He was on a bunch of drugs, but the one that really fucked him was Mirapex. Turns out, there are huge numbers of people whose lives have been ruined by it. It is also used for restless leg syndrome and you can find forums on the internet where spouses of people taking Mirapex will recount how their partners lots fortunes to gambling and other addictions.

My brother went from being pretty wealthy to homeless in 7 years.

His personality was greatly changed by the meds or PD. It's not clear, but the side effects of Mirapex are very clear. It is criminal that that drug is handed out like candy, without any discussion of the potential problems it creates.


First of all, not the same level of problems and not sure what I took. Could just be a fantasy.

Anyways, circa 1998, battling a serious fungal infection, an alternative treatments doctor (not homeopathy or something, this was in Seattle) put me on some kind of medication. I realized on my 3rd or 4th rage incident that the medicine triggered something which put me on the edge that even a small discomfort would trigger me. It was not the skin issues, it was just my mind on high. I have never been on (recreational) drugs before or after and barely drink alcohol, so not sure if any drugs cause similar behavior. I did not stop the medication once I realized it but I did try to be conscious of the effect and was able to control the rage better (but still not 100%).

[ Add: As I think more, the doctor was in sports medicine, so maybe he used somethings that he usually tried on athletes. ]


Tangentially (and anecdotally), not long ago I seem to have contracted what seems like a flu (or the like), and I remember feeling very healthy, social and unusually well—almost high—most of the day right until my brain went foggy and fever started.

In hindsight, I did not behave quite like myself that day, especially considering I felt somewhat overworked the preceding week.

This prompted me to first draw the analogy with taking and withdrawing from a substance, and then to imagine a possibility of some future human-made flu-like virus that preserves the incubation stage effects and lacks the “conventional” symptoms. Like a contagious mood boost, contractable for free by air!


> This prompted me to first draw the analogy with taking and withdrawing from a substance

The substance has no goals.

The flu specifically wants you to be social.


The action of taking the former is probably in alignment with some goals (even if potentially short-sighted), while contracting the latter alters your behavior so that it can spread more widely in accordance with the goals of its own DNA.

But yeah, I didn’t think my analogy through further than surface symptoms.


Yeah I always feel fantastic the day before I get sick. I don’t have any sources, but I remember reading that it’s due to your immune system ramping up and getting ready to fight. Not sure how much truth there is to that, but every time I’m sick, I can look back and see I felt great the day before.


I've noticed exactly the same experience in recent years with common colds (which I've had slightly more often than normal thanks to young children). Like the parent post, the day before I feel "unusually well—almost high", and the next day the cold symptoms start, or I get a day of feeling especially unwell without any specific symptoms (the blearghs). Don't think I've read anything supporting this, but in my layperson's mind it is due to my immune system going into overdrive trying to fight the infection.


A month ago I had an especially good workout then a few hours later the dengue fever that was incubating hit.


Similarly, I've learned to avoid running when I begin to feel any symptoms of a sinus infection or head cold.

Time and time again, I wake the next day will the full-blown illness.

Instead, a little rest goes a long way in letting my body heal itself.


Ironic that folks who work in CNS drug discovery spend much of their time worrying about how to get our molecules /into/ the brain... and less energy thinking about keeping non-CNS meds out. For what it's worth, though, these 'off-target' CNS effects have also prompted a lot of enthusiasm for repurposing existing FDA-approved drugs for new indications, since their safety is already established.


I have long wondered about this. In the Asian world, traditional Systems of Medicine focus on "holistic" treatment and the general public often calls Western Medicine, "Allopathy with side-effects". I had intuitively felt that these medicines must have an overall effect on behaviour which may always not be obvious to the observer unless the difference between the before and after were stark and noticeable.

We really need a lot more research on this aspect of all commonly used medicines. A lot of our mood-swings, irritability, anger, anti-social behaviour etc. might be explained by this.


> In the Asian world, traditional Systems of Medicine focus on "holistic" treatment and the general public often calls Western Medicine, "Allopathy with side-effects". I had intuitively felt that these medicines must have an overall effect on behaviour which may always not be obvious to the observer unless the difference between the before and after were stark and noticeable.

Many traditional herbal medications also have significant side effects. It's not accurate or helpful to describe this as Eastern vs. Western medicine. All significant supplements and medications are bound to have side effects to some degree.

Good, evidence-based doctors don't care if the practice is Eastern or Western. If the practice or supplement has reasonable scientific evidence, a good doctor will incorporate it into their recommendations. I've had plenty of "western" doctors prescribe practices like acupuncture, yoga, meditation and traditional TCM supplements like ginger and turmeric.

The real problem with the Eastern vs. Western medicine false dichotomy is when it leads people to choose a side and stick with it. I've known a few people who suffered far too long with ineffective TCM or alternative medicine treatments before accepting proper, evidence-based treatment. The problem isn't limited to Eastern medicine, of course. For example, many depressed patients take Saint John's Wort for its herbal anti-depressant properties and are surprised to experience as many, if not more, side effects than highly targeted SSRI medications. Just because it's natural doesn't mean it's safer or more effective.


You make some good points. However that is not what i meant when i said "holistic".

As an example, in Ayurveda/TCM, "prophylaxis" is given greater importance than symptomatic treatment.

We are what we eat and how we live.

The beauty of Western Medicine is that it is highly targeted and therefore provides immediate relief. However, people go overboard with no thought to other factors, consequences and ramifications. They look at it in isolation. Whereas in Eastern Medicine; controlled diet (with emphasis on stomach/gut cleansing), massage therapy (affecting the circulatory, lymphatic and nervous systems), change in environment(Summer/Winter) etc. are given more prominence. The organism and the environment in which it is embedded are looked at together.

With what we know today, both these approaches need to be harmoniously blended together for the best effect.


I'm asian myself and I am intimately familiar with eastern medicine.

You are largely right on western medicine, it is holistic as far as the scientific evidence is relevant. That means if there is no unbiased experiment on the 20 year effects of some effect of some drug then there is no science behind it and therefore no knowledge and no treatment. Causative treatments are established to a degree as close to absolute as possible using the scientific method. However, because scientific experiments are biased towards things that are easily observable and measurable, treatments are also biased in this direction.

In other words it is very hard to run an experiment on the 10 year side effects of some drug therefore there aren't much treatments of this nature among western medicine.

Eastern medicine is the opposite. It has no basis in science in the sense that none of it's tenants were established in scientific measurement and observation. More it's adhoc trial, error, a lot of bias and a lot of fraud. This kind of treatment can definitely be more "holistic" but this holisticness is based off vague and anecdotal evidence and is very inexact. Some eastern medicine may work and some may not and you may be being lied to.

In fact, the logical theory behind eastern medicine is utter crap. The logic talks about chi flows going through your body of both hot and cold and the logic is to eat medicine to help control balance in the chi flows. These chi flows are a fantasmic concept not observable by scientific experiment.

This does not mean eastern medicine doesn't work. THe reasoning might be off but the effectiveness of the medicine may still be valid because cultural selection would have virtually eliminated this field if it did not actually aid with survival in some form or manner. Just know that every time you ingest some medicine based of of eastern philosophy know that you are making a gamble on evidence that is anecdotal and possibly placebo induced or even fraudulent.


When it comes to the Human Organism and Medicine, in spite of all our advances, things are quite complex, interrelated and not fully understood. While there is a lot of "woo woo" in Traditional Eastern Medicine against which we must guard ourselves, there is still a lot of empirical evidence for it though we may not subscribe to the explanatory models behind them. This is why people/hospitals are trying to introduce the reasonably well understood parts of Yoga, TCM, Ayurveda, Meditation into a more holistic approach towards well being.

The point is not to fixate on some well known negatives but take a deeper look at what has worked over the ages and employ them for good effect regardless of the theoretical models claimed for them.


>When it comes to the Human Organism and Medicine, in spite of all our advances, things are quite complex, interrelated and not fully understood.

And I have said, if you read carefully that some of it still works despite this. This is not the point, the point is the black box test still needs to work despite a garbage theory. ANd my point is, not only is the theory wrong, but there is very little overall scientific evidence for the efficacy of the treatment as well.

>there is still a lot of empirical evidence for it though we may not subscribe to the explanatory models behind them.

There is actually very little scientific and experimental evidence behind it. There is some but compared to the body of experimental work that is western medicine the research on eastern medicine is miniscule.

> This is why people/hospitals are trying to introduce the reasonably well understood parts of Yoga, TCM, Ayurveda, Meditation

The above mentioned things like meditation actually have scientific evidence behind them. You can google it.

>The point is not to fixate on some well known negatives but take a deeper look at what has worked over the ages and employ them for good effect regardless of the theoretical models claimed for them.

That is the problem. There is very little scientific evidence for what has "worked" for eastern medicine. The problem with anecdotal evidence is the placebo effect; people are delusional. Some people believe in scientology and who is it for you to say that a belief in eastern medicine isn't similar? The dividing line is scientific experiment. IF an experiment verifies a hypothesis then it is likely to be real. For efficacy of a treatment to be measured you cannot just ASK people, you have to conduct a massive scientific experiment in a double blind study. This simply has not been done yet for eastern medicine. You do not know the "good" just like you don't know the "negatives" because there is no scientific data.


There IS Scientific Research being done on aspects of Traditional Medicine.

As an example, see the book "Herbal Medicine: Biomolecular and Clinical Aspects".


I never said there wasn't but the definition of western medicine is scientific research meaning that it is the primary method on how such treatments are developed. Scientific research on eastern medicine is not only minuscule in number but backwards in creation.

By backwards I mean that treatments are made up adhoc based off of the faulty chi logic then tried adhoc on people without rigorous double blind experiments. Only in modern times are we actually running true scientific experiments on the treatments to verify them. This is basically like the FDA allowing some random person to distribute drugs touting some miracle cure only to run experimental tests after the drug is released. More than likely most eastern medicine treatments will fail tests as this majority failure rate is already what happens in western medicine during clinical trials.


It is amusing to me the sort of detached love people have for Eastern medicine. It's really a feeling of grass is greener on the other side.

In India and a few other SE Asian countries, the predominant killer disease is heart disease. There is no "Eastern" medicine for that.

"Eastern" methods work really well on innocuous diseases and symptoms because they really aren't medicines nor a treatment. Sure Ayurveda and other "techniques" tackle a few simple problems. But people actively seek such treatment for important medical problems: "a little knowledge is dangerous".

The troubling fact is none of the Ayurveda nor Eastern medicine is based on a deep understanding/exploration of human beings: instead they rely on folklore and guesswork. Very dangerous after seeing the amazing progress vaccines, statins and so on have contributed to the world.

This article talks negatively about "statin" painting it as some sort of a bad word based on one potentially problematic drug: the number of lives saved by the simple Atorvastatin-like medicines is really astonishing. I really hope a nuanced discussion about important life-saving drugs can be had in forums such as this instead of quickly reverting to the tropes of Eastern magic medicines.


There might be side effects to modern medicine, but there's no reason to assume that traditional beliefs re: health and medicine are more correct; The arguments behind them are usually epistemologically unsound, and they are often out-and-out superstitions.


Somewhat True, but "don't throw the baby out with the bathwater".

Much of "traditional medicine" is empirically based. The models they came up with to explain the mechanisms may not be valid in light of today's Scientific Knowledge but they are instructive nevertheless (rungs in a ladder leading to better understanding etc.) As an example we still don't know how exactly Acupuncture works but do know that it works for many cases.


    "don't throw the baby out with the bathwater"
Right, but we don't have any reason to assume it to be true if there's noe evidence to support it - which would be step one in determining whether its a reasonable belief, and integrating it into modern medicine.

As for your example, we do not know that acupuncture works - conclusions are inconsistent in systematic reviews, which would suggest that it's not effective. Most researchers I've heard speak about the subject seem to believe any perceived reduction in pain to be due to placebo.


You’re right, but I’m quite sure the “Asian world” doesn’t use that term, since homeopathy / allopathy / osteopathy are all western invented classifications.


“In the Asian world, traditional Systems of Medicine focus on "holistic" treatment”

[rant on]

I believe the term you’re looking for here is “fabulist bullshit”.

“the general public often calls Western Medicine, "Allopathy with side-effects"”

Aaaand… No, it doesn’t. SCAM calls it that. Which is ironic, as “Allopathy” is a term coined by Hahnemann to mean “Everything BUT Homeopathy”, and that was in a day when “Western Medicine” was itself rank quackery still laboring under Galen’s “Four Humors” nonsense. Thus Chiropracty, Reiki, TCM, Acupuncture, etc are all “Allopathy” too.

Conversely, what you so casually misnomer “Western Medicine” (the term itself is borderline racist) is just “Medicine That Works†”.

(†“Within Limits”, as any sci fule kno.)

I mean, the only really significant difference between Traditional Chinese Medicine’s explanation of disease and Galen’s is that TCM believes in five humors while Galenites believed in only four. [Insert Emo Philips/Picard joke here.]

Otherwise “Chinese/Eastern Medicine” is the same mix of ungrounded herbalism and bloodletting that stalled out western healthcare for 2000 years. Until the Arab/Persian world, during its all-to-brief scientific golden age, came up with the brilliant idea that one should actually test one’s beliefs to find out if they’re bullshit or not… a process that Renaissance Europe finally distilled into modern scientific method 500 years later and determining Galen was full of it shortly after that.

..

Of course, getting the actual institutions to change took a lot longer; it wasn’t until Pasteur gave us a working model of disease that Galen’s bollocks and its attendant “worse than doing nothing at all” so-called treatments were finally buried down a very deep hole.

Germ Theory gave us sanitation, vaccination, and surgical hygene. Untested herbalism was usurped by pharmacognosy, modern chemistry, and reliable mass manufacturing. And so on.

Alas, China was been quite so lucky. Thanks to Mao and his vast “barefoot doctor” scam (which got around the problem of not having enough real doctors or money to provide everyone else with medicine that worked), TCM/Acupuncture is still around, not least as the CPC is now selling it for export as much as for use at home.

Incidentally, Mao himself (like most wealthier Chinese nowadays) had no truck with that homegrown crap and happily availed himself of your “Western Medicine”, thankyouverymuch. (You might want to take note of that.)

Incidentally #2, just as TCM was, and is, badly-tested herbalism marketing often poor-quality and fraudulent product, pre-Mao acupuncture was really just Galenic-style bloodletting sticking bloody great bamboo trocars into people. Worse, it had almost (rightly) died out until Mao reinvented it its modern form using fine steel needles, bad sterile practice, and total Qi bollox. “Distracting the patient while nature all does the work” as Voltaire used to say.

Incidentally #3—and considering that western researchers invested decades in figuring out how to reliably blind acupuncture studies before finally producing results showing it no better than placebo—every acupuncture study out of China is still positively glowing. Someone recently posted a FP link regarding China’s massive ongoing medical research crisis; I’m sure you can dig it up if you want.

..

TL;DR: You can take your “holistic treatment” and “traditional Systems of Medicine” and stick ’em where the pathologist’s light does shine, because that is where they all belong.

[rant off]

--

Real medicine does in fact study and treat the whole person. Unfortunately, it’s also a victim of its own and industrial nations’ success. General practices and hospitals are slammed with demand, increasingly with inevitable diseases of very old age (since so few of us die young now) and diseases of sedentary urban lifestyles.

And while doctors can tell us to eat less and exercise more till they’re blue in the face, they can’t make any of us do it; so it’s not surprising things like statins get widely (over?) prescribed as a workaround for our fat lazy butts.

I’ve no doubt too modern medicine desperately wishes more public would understand that all Medicines (that is, pharmacologically-active compounds) have multiple Effects; and that the only meaningful distinction is between Effects that are advantageous in treating a patient for a particular condition and Effects that are disadvantageous in that same patient. We commonly call the latter “side-effects” [not counting intolerance and allergies], but that’s misleading.

For instance, aspirin (descended from willow bark) is commonly used both as an NSAID and as an anticoagulant; thus what is a “side-effect” in pain patients is the therapy in those with blood disorders. (And vice-versa. And, of course, aspirin’s other common effect of giving you stomach ulcers isn’t a benefit in anyone. Although if you think aspirin is bad, just try original willow bark instead.)

Thus, we should not be surprised that modern pharmaceuticals have multiple effects across a wide range of biochemical and physiological systems; if anything, it’s a minor miracle they don’t have way more unwanted effects. Alas, familiarty does breed laxness, if not contempt, even in scientific and medical professionals; so it can never be re-stated enough that education, awareness, and due dilligence are essential to keeping that system operating as well as it can.

Think of it like this: Medicine [which works] is just a rolling bug-patching process of the most heinously complicated, tightly-coupled, under-documented Big Ball Of Mud known to man, and proceed accordingly. And that even that thing we call “self” is just a synthesized fiction, the product of countless biochemical and electrical interactions constantly occurring in just one[-ish] of numerous intricately interconnected organs, which together make up “Us”.

--

Dear Dog, I really need a drink now. Never been so glad I that crashed out of premed and landed up in software dev instead. :)


WTH ? That is a nice rant but one with some validity :-)

First see my other responses in this thread so i don't have to repeat myself.

>Real medicine does in fact study and treat the whole person.

In Theory; Current practice has all but forgotten this. That is why many Physicians themselves are looking at Yoga, Meditation, TCM, Ayurveda etc. to supplement their treatment.

>Medicine [which works] is just a rolling bug-patching process of the most heinously complicated, tightly-coupled, under-documented Big Ball Of Mud known to man

Somewhat True but there are also multiple models/architectures within it all of which gives us a framework to hang everything else off of i.e. there is a method within the madness.

The point is not to throw away centuries of empirical evidence on what has worked regardless of theoretical models used to explain them. Two different examples, a) The importance of quieting/calming the mind using Meditation independent of any religious connotations. b) The importance attached to Turmeric which has been validated today by identification of the Curcumin active ingredient.


“In Theory; Current practice has all but forgotten this. That is why many Physicians themselves are looking at Yoga, Meditation, TCM, Ayurveda etc. to supplement their treatment.”

Eh, no. If many Physicians are looking at TCM, Ayurveda, etc†, it’s because there’s piles of Money and Ego in it. Shock: some <koff> physicians really do miss the Good Old Days of “Doctor-as-God” Paternalistic Medicine, and are only too delighted to bring it all back for their neurotic wealthy patients who miss it too.

“The point is not to throw away centuries of empirical evidence on what has worked regardless of theoretical models used to explain them.’

Centuries of “empirical evidence”?

Get. Tae. Fuck. And take your Appeals to Antiquity and Special Pleading bollocks, and stick them up your ass with all the other balls that Gwyneth Paltrow and Alex Jones and the CPC are flogging this week too.

Because I wasn’t born yesterday.

Unlike you.

https://sciencebasedmedicine.org/?s=bait+and+switch&category...

https://archive.org/details/thirtyyearsinmo00chrigoog

https://www.independent.co.uk/life-style/health-and-families...

--

†I exclude Yoga and Meditation here because (ignoring any woo-woo gateway bullshit) those are essentially Exercise and Relaxation, which along with Diet are standard mainstream medical advice. Only real difference being that Medicine says “Eat right and exercise, or you will Dieeeee!‡”, whereas AltMed says “Eat right and exercise and stick our super-magical expensive coffee up your ass, and you will have an orgasm in your pants!”

‡Okay, it doesn’t really say “Die”, but that’s what neurotic high-maintenance muppets hear anyway; which is what makes them such suckers for the AltMed con. And I really wouldn’t care about that because that’s their funeral, except that they make others dead too.


Are you just an ass or are you just trying to get a rise out of people? It is hard to have a conversation when your tone is combative rather than rational.

You are trying to employ the "Gish Gallop" and throw all sorts of irrelevant noise to muddy the waters. What do Gwyneth Paltrow, Alex Jones etc. have to do with Medicine?. If you think physicians are looking at Ayurveda/TCM/Yoga etc. only for the money/ego/fad then you really don't know what you are talking about. Don't waste my time with nonsense.

You are also cherry-picking articles with sensational headlines eg. your last link about usage of Turmeric is an article which is very clearly sheer stupidity and nothing to do with the medicine itself.

Here is something for your edification;

Efficacy of Curcumin(Turmeric) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/

Read the book "Herbal Medicine: Biomolecular and Clinical Aspects" for scientific research on a variety of traditional herbs. Centuries of "Empirical Data" is what is being put to test to identify efficacy. This is the proper scientific method and not the offhand dismissal that you seem to embrace.

You are also very wrong about "Yoga and Meditation" being merely "Exercise and Relaxation". Read the following;

* A Physiological Handbook for Teachers of Yogasana

* Zen & the Brain

That should hold you for a while.


[flagged]


Mate I agree with you but people on HN don't appreciate this sort of way of speaking. Just tone it down a bit. You're making a lot of really good points and it'd be a massive pity to see you banned for making them in a way that is so antagonistic.



It's a worrying thought. My dad has become much less empathetic and more bitter over the past decade. I'd assumed it might have been the pain that was at least partially responsible, now I'm wondering if its actually the painkillers


Chronic pain will chip away even the kindest person's ability to care about anything else.


It could also be the pain itself. My dad’s Parkinson’s and congestive heart failure did the same to him long before medicines were involved.


Wow, turns out there's a lot of studies into e.g. paracetamol out there too. e.g. https://www.ncbi.nlm.nih.gov/pubmed/31523834

More here: https://twitter.com/autismepi/status/1214388671752916992/pho...


There were few associations with behavioural or neurocognitive outcomes after age 7-8 years, whether reported by the mother or the teacher.

If paracetamol use in mid-to-late pregnancy has an adverse effect on child neurocognitive outcome, it appears to mainly relate to the pre-school period. It is important that these results be tested using other datasets or methodologies before assuming that they are causal.

translation: "we studied it and no, tylenol doesn't cause autism; calm your pants."


The world is in the midst of a crisis of over-medication, with the US alone buying up 49,000 tonnes of paracetamol every year – equivalent to about 298 paracetamol tablets per person

Shocking, I knew it was bad but this is madness.


I wonder how much of that paracetemol is actually consumed? Maybe a lot of it just sits on a shelf and expires?


That was my first thought. My local Costco sells 1000 tablets of Paracetamol for $8.49.

I've bought several thousand pills of OTC pain relievers in the past year to keep a bottle in my car, my office, at home, and so on. I've only taken maybe 10 pills over the course of a year.

I do agree that the country is over-medicating in general, though. The focus on customer satisfaction and patient review scores for doctors has created bad incentives for doctors to "do something" by prescribing pills instead of pushing for natural interventions (diet changes, exercise, reducing screen time, going to bed earlier)


As another illustration: that is enough paracetamol to reliably kill a quarter of the human population on earth.


This Common Painkiller Does Some Interesting Things To Your Mind - VICE https://www.vice.com/en_us/article/gymgx7/tylenol-can-have-s...


Very good article! Thanks for the link.

Some quotes;

There’s some imaging research that suggests that social and physical pain could have overlapping biological mechanisms, he tells me, so the parts of the brain that Tylenol affects to make your headache go away are the same parts that are involved in these other feelings as well; the same brain networks that allow us to feel and respond to physical pain may have been co-opted to also feel social pain.

He felt like the effects of Tylenol they were seeing were similar to mind wandering. People cared less about social rejection. They didn’t respond as much to existential anxiety; a similar kind of sensitivity reduction to the outside world.

“I think we should absolutely have a scientific concern to recognize the neurocognitive and neuro-affective consequences of substances that we've heretofore thought of as benign,” Handy says.

Ratner says there’s also the intriguing possibility that acetaminophen might be used therapeutically one day for people dealing with minor cases of depression or social anxiety.

The last point is the one which i had observed in my own behaviour and led me to suspect a correlation between acetaminophen/paracetamol and my "feeling good".


When I was younger, I believed that my spirit and thoughts and personality were somehow separate from my body. Like something uniquely me that was put in my body to animate it.

As I get older I began to think the opposite; that our thoughts, personalities, and everything original about us are a product of our physical composition and brain structure.

I began to really notice this after reading Principles where Ray Dalio observes that the way people think and approach and solve problems are largely fixed. I notice this in myself and the people around me.

There was a sort of inflection point for me after getting my first massage. My body was completely relaxed, resulting in my mind being completely relaxed. After the massage I went to a trader joes in columbia maryland during a saturday. This trader joes is a logistic nightmare that always stresses me out, so much so that I would usually avoid going during peak shopping. But this time I was completely unbothered, nothing about the experience was bothering, my thoughts were completely at ease. At that moment I realized that it wasn't stress making me tight, it was tightness making me stressed. The dependency was completely backwards from the way I thought. Being self centered i thought my thoughts informing my physical, but it was actually my physical causing my thoughts.

I have genetically high blood pressure, and I have to consume low sodium in order to keep it under control. While I was learning this and my blood pressure was high, I was literally angry about everything. Road rage, meltdowns at home, being short and explosive with my wife and son. I thought it was stress or affect from work I thought it was thoughts/personality -> body. As soon as I experimented with reducing sodium, getting exercise and my blood pressure dropped, my mood completely rounded out and fixed itself. IT was actually my body -> thoughts.

The same thing happens with hiking spending time outside. I used to feel like a connected, or spiritual relationship with the outdoors. I enjoyed drinking and camping, I thought that there was a spiritual relationship with the outdoors (personality -> body) when, once again, it's actually just physical -> personality, dopamine is released, my blood pressure probably dropped my thoughts became more relaxed, my body was tired and relaxed from hiking.

I think that we really are a lot less conscious than we think we are, and that the way we think, our personalities, and pretty much everything about us is largely predetermined by our physical composition. I think we're just more complicated animals and our personalities are just a response to physical input and reactions.


I think it goes both ways. The physical body affects the thoughts/emotions/personality, and the manifestations of the mind/fallacies/affects affect the physical body.

Regarding spirit, I still believe that that is somehow separate. It's one of the things though that I'm not sure can be proven in the physical realm (e.g., brain) to an undeniable degree.


Everything that happens to us changes who we are. Every conversation we make. Everything we think. We are not the same person in any given moment.

Also, because we are shaped by the things that happen to us, we are literally actually not ourselves but rather "everything else".


yes and this would not be contested. the same way we are not surprised when the drugs we take have the intended effect. this goes wrong is when the side effects are unexpected or undesirable. as a society we are conditioned to be entitled and to believe everything has an easy/quick fix.


"No man ever steps in the same river twice, for it's not the same river and he's not the same man"


> with the US alone buying up 49,000 tonnes of paracetamol every year – equivalent to about 298 paracetamol tablets per person

Commonly sold as the brand Tylenol. How is it possible that the average across the US population is nearly one per day, the entire year? Max dose is 3900mg per day. Tylenol is not recommended for children with fevers as it can have bad side effects (Reye's Syndrome). More popular than aspirin perhaps as less risk of ulcers. Not as safe as Advil/ibuprofen. Even for people regularly taking pain meds, not all will be on paracetamol. Those taking it every day (perhaps 5% of the population?) must be taking 10-20 tablets a day?

> – and the average American consuming $1,200 worth of prescription medications over the same period.

I know there are people taking pills that cost tens or hundreds of thousands, but this is still a pretty amazing average number across the population. This year I spent just over $100 on meds and that was probably one of the most med-intensive years of my life. Most years I have spent perhaps $10 for one round of antibiotics and $2 on advil, which I buy a $6 bottle every 3 years or so. So under $20. I wonder if the numbers are significantly less for most other countries.


Wonder at what rate that stuff gets bought and not used, either by institutions or consumers, but it's probably only a small part.


Hey that's actually a really good point. First aid kits, hospitals, etc. Could half of it simply be trashed?


Reye's Syndrome is for Aspirin, not Tylenol.


I am very curious about how transgender HRT affects personality. In a sense, HRT is supposed to change who one is, but the personality changes people undergo on it seem underappreciated and not really understood or studied clinically. At least I have not been able to find a published study specifically about about how HRT changes personality. I think not all of it can be attributed to decreased gender dysphoria or people "coming out of their shell" and being able to live and socialize as who they want to be after transition.

If I had to make a $100 bet today on what future research will find, I would wager that

1. FtM HRT reduces Big Five neuroticism despite increasing aggression. The effect is permanent and persists after the person's "second puberty" induced by HRT is over. It affects beliefs about how society should function. To a degree of approximation, it makes transmen more conservative or right-wing than they were before the treatment.

2. MtF HRT does not have the opposite effect to the above (but it may, and probably does, have other effects). Edit: The opposite effect on neuroticism and sociopolitical beliefs. It decreases aggression.


It could be but I used to look at studies about roid rage and found back then that there was not that much support for increased aggression, at least not when using testosterone and in moderate dosages for bodybuilding (which are very large dosages compared to replacement therapy).

On the other hand I'm pretty sure when we are talking really strong AAS such trendbolone there is so much anecdotal evidence that people get aggressive that I have no problem buying it in that case.

Never done any AAS but been prescribed corticosteroids (prednisone) which is an anti-inflammatory and that sure as hell changes the mood for me and many others. It is on the side-effects list as well I think and personally can get more irritated on it. Not always but it is noticable.


Are you blaming Trump on the trans? That's a funny new perspective!

But joke aside, why would hormones only work in one way?

And why couldn't you say the same about, say acetaminophen? Without a RCT your guess is as good as mine!


Sorry, not following. I don't have any deep knowledge about the subject more than I historically been interested in fitness and bodybuilding and with that comes some knowledge about hormones.

Not saying "roid rage" is not impossible but the studies I saw was that the idea mainly came from people in criminal circles who often used a multitude of drugs who wanted to be bigger and more intimidating and then drank some alcohol, popped some benzo or did pcp and started fights. Thus "roid rage" became a thing.

But when they looked at people who were just in the fitness industry with normal jobs and families that used testosterone they did not find the connection. This was a time ago and maybe there are newer studies. However there are much stronger anabolic steroids than testosterone and those I suspect can cause real roid rage; some people seem to get odd rages on for example trenbolone.

Hormones do affect how you feel though and like I said I do only have experience with Prednisone for inflammatory bowel disease flares and while I get noticeable more irritated (I can control it, so I know that I'm pissed that my colleague is humming because of the medicine and I can just ignore it) but I've read in forums about the disease that one decided to stop driving when he was on high dose Prednisone just because he got such insane road rage and was afraid that he would do something stupid. That is rarely something doctors tell you.

About your other questions I don't know I'm afraid. I have very little knowledge about the subject more than these specifics.


Fair enough!


> ...Big Five neuroticism...

It's gonna be really hard to deconvolve hormones from environment. Men and women are treated very differently in our culture; men's and women's behaviors are interpreted very differently; the former having a possible causal relationship with neuroticism, the latter having a possible causal relationship with diagnosis. You'd need a fairly large study involving a large number of trans people who aren't on hrt but pass as well as those who are.


I think it’d be hard to isolate factors to test your hypothesis. You’re likely not wrong to some extent given that HRT changes the body (almost always for the betterment of voluntary trans individuals), but there’s so much activity going on in the song and dance of society it’d be hard to isolate.


I think most people don’t have the context to understand half of what’s being said there.


This is a funny comment on HN, where it is very easy, for me at least, to be so far out of my element that I have no clue what is being discussed, such as any post about hardware!


Probably all that's going through the stomach has one effect or another... Ever watched kids behaviour before and after sugary and non-sugary meals?


https://www.livescience.com/55754-does-sugar-make-kids-hyper...

There seem to be a bunch of studies indicating that it is not the sugar that affects the behavior


That link does little to disprove that sugar isn't the culprit.

And anecdotally, both my partner and I can recognize adverse psychological effects in myself after I consume too many high-glycemic carbs (ie, sugar).


I was pretty sure that the kids + sugar behavior change was debunked and all up to expectations from the parents.

Now, this is not a study but covers what I thought was the case since years back:

>The sugar-hyperactivity myth is based on a single study from the mid 1970's in which a doctor removed the sugar from one child's diet and that child's behavior improved. Since then, over a dozen larger studies have been conducted and not one of them has found that sugar causes hyperactivity. Interestingly enough, researchers have found that parents are more likely to say that their kids are overly active when they think they've consumed sugar.

https://www.eatright.org/food/nutrition/dietary-guidelines-a...


As someone who's been on the keto diet, the majority of the past five years, this seems blasphemous.


> Ever watched kids behaviour before and after sugary and non-sugary meals?

Yes, and I've never noticed a difference. I believe that "sugar rushes" are imaginary.


I had never heard of this link between statins and aggression and Tylenol and lack of empathy before. Interesting. Maybe this is why Boomers act so strange now. “Former flower children lost their empathy and caring for the world and the next generation when their doctors put them all on statins and they started gobbling Tylenol” would be quite an interesting story. Both my parents are on statins, it seems every person past a certain age is, the doctors think statins are something everyone should be on. I have my doubts.

>“Should people at low risk of cardiovascular disease take a statin?”

https://www.bmj.com/content/347/bmj.f6123


Have them ask their doctor about the NNT of statins (number needed to treat). Statins reduce cholesterol, and boy do they do a good job. But what are the outcomes? Despite the hypothesis, Lowered cholesterol does not really reduce your chances for a heart attack (NNT 217) or stroke (NNT > 300). Which means 217 have to take the drug for 3 years for 1 person to avoid a non fatal heart attack!

Most of those statin studies were done on men. There is growing evidence for women but for decades it was almost non existent.

One of the problems with the Pharmaceutical industry is how long term effects/safety data are never available until decades later, after the industry has heavily pushed the drug On doctors and patients and made a ton of money. I’m not saying it is necessarily nefarious, just that the incentives are misaligned for positive patient outcomes. All patients should be aware of that.


I take statins and my best self-analysis is that it gives me nightmares. I can't count the number of times I have woken up with bad dreams. However, I think it is my brain trying to regulate heart by causing it to beat harder. When I exercise, I usually do not have these nightmares, or maybe I am too tired to notice them.


I got prescribed Rosuvastatin and got extremely vivid nightmares to the point of waking up unrested. I thought I was the only one because I could find much online. The dreams and nightmares are so intense I have stopped the statin.

Thank you for recommending me exercixe. That might be the answer.


> Both my parents are on statins, it seems every person past a certain age is, the doctors think statins are something everyone should be on.

In my experience, modern doctors are well aware of the risks of statin treatment. I'm sure you can find trigger-happy doctors who over prescribe statins, but that's definitely not the recommended best practices.

According to one of the first studies I found, only about 1 in 4 patients who fit the criteria for statin use are actually prescribed statin medications at followup: https://www.ahajournals.org/doi/full/10.1161/JAHA.118.010241


> only about 1 in 4 patients who fit the criteria for statin use are actually prescribed

That’s not of much help, when the criteria is very close to “everyone”.


Some of these examples given in the article are actually quite known. For example, many anti-asthma drugs available today have a leaflet informing the patient about possible side-effects, such as increased anxiety, nightmares, changes of mood and behavior, and even suicidal thoughts. Knowing this is extremely helpful as it allows the patient to distance oneself from these symptoms in case they occur.


Damn, this really hits home for me. My brother got prescribed statins and one day the family had found out he'd stopped because he didn't believe in it and they didn't feel like they were doing anything.

He's one of the most scientific guys I know but began giving conspiracy theory/anti vaxx sort of answers of how you can't trust medical studies all the time. When asked why he still takes his hypertension meds and trusts the literature there, he couldn't answer and he said it's just a feeling. The family was pretty astounded. Honestly felt as if someone you know suddenly started believing antivax or say flat earth ideas is the closest way I can describe it.

I was explaining how inconsistent his thinking was, bordering on delusional. If the truth was that the statins affected him psychologically, I can see why he'd chose to hide it when his wife and parents are grilling him for it.


I just want to say that there is definitely a lot of misinformation around statins. All I want to say is that the debate among statins isn't settled like the debate about whether vaccines cause autism.

If you do a dive of only published medical research papers and professional opinions, you'll find nuanced arguments about what even causes heart attacks, how effective statins are, what the very real side effects are (eg: cancer), who all should be taking them, and what alternative treatments (eg: diet, exercise) should be tried first.


There's a wee bit of me feels I need to ask the question, is this years later, the Andrew Wakefield effect rearing its head again[0]?

Very small samples of and affected medicated population being used to push an agenda? Sure I realise the brain and body are deeply interconnected, but until we invest time and money in valid studies, how can we possibly know the outcomes of prescribing statins, paracetamol etc in terms of human behaviour.

For the vast majority of the population taking these drugs are generally safe (yes I know about drug allergies, which is a different thing), but I imagine there will be in a minuscule percentage of a population, long term, there may be side effects. I think this should be researched, but this sounds like a scare story.

[0]: https://en.wikipedia.org/wiki/Andrew_Wakefield


> the US alone buying up 49,000 tonnes of paracetamol every year – equivalent to about 298 paracetamol tablets per person

I bet many of those expire and are never consumed. There is very little pricing difference based on quantity so people buy much more than needed.


Yeah, if you trust our "institutions" - still - you are in need of a serious, unsettling wake up. The 60's slogan of "Question authority" is needed more than ever. Our "institutions" are predators and we are all its prey. Your mindset is the most valued, because one they have that they can feed you anything: any foods, any drugs, any laws and any shitty orange politician they want.

I go out of my way to not take any medications, as well as maintain my body with healthy foods and regular exercise. This is a responsibility we need to respect to maintain clear heads in this psychological war period we live.


Well this is our modern “moldy rye bread” situation folks so what to do? Let’s not forget disruption of the basal ganglia is responsible for the formation of delusions which could be in the same ballpark here.


All I can say is when I realized the only thing that prevents me from thinking negative thoughts about people and things around me, being frustrated at everything for petty reasons I end up forgetting shortly after and demolishing my productivity was whether or not I remember to take my medication, it became a major existential crisis for me. I felt powerless to actually change my situation through my own actions rather than chemical rebalancing which I can't just will into existence.

Of course I only have this crisis if I forget to take my medication.


I'm interested that they did not touch on ADD medication there.


Pretty sure everyone knows speed changes your personality!


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