Salemicus comments on Can we talk about mental illness? - Less Wrong

39 Post author: riparianx 08 March 2015 08:24AM

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Comment author: Salemicus 10 March 2015 09:56:43AM 1 point [-]

Coming from a reductionist "mind is brain" viewpoint, therapy actually does help. This is pretty well documented in the fact that 73% of patients who go through it say it helped in the long run. (statistic from my psych 101 textbook)

You have to admit, this is weak tea. What would you think of a pharmacological study that relied on the fact that 73% of patients "say it helped." We don't need no stinkin' effect size or control! As I'm sure you're aware, there is a great deal of controversy about the effectiveness of talking therapies, and it is even controversial whether such therapy really does anything more than "just talking."

Now look, I too am in the reductionist "mind = brain" camp, and I too think therapy can be effective in principle. I am actually very sceptical of the idea that mental problems such as depression, anxiety and OCD result from a generalised "hardware" problem (such as faulty neuroendocrine function). Yet just by mentioning the (very widely held) notion that these problems do have such a basis, I'm apparently espousing dualism. It's very strange.

Saying the brain doesn't follow patterns is, well, wrong.

Who exactly said that?

Comment author: ChristianKl 10 March 2015 05:03:31PM 0 points [-]

Yet just by mentioning the (very widely held) notion that these problems do have such a basis

The issue isn't that you mentioned the notion that the problem might be due to faulty neuroendocrine function but that you assume that talking can't do anything about that.

I'm apparently espousing dualism. It's very strange.

If you limit talk therapy to the goal of changing the mind and ignore hardware than you lose effectiveness.

Granted it's impossible to get good feedback to do targeted interventions on the biochemical level but the body is still vitally important.

But even given SSRI isn't targeted intervention on the biochemical level. According to a recent article:

It is currently impossible to measure exactly how the brain is releasing and using serotonin, the researchers write, because there is no safe way to measure it in a living human brain.

Instead, scientists must rely on measuring evidence about levels of serotonin that the brain has already metabolized, and by extrapolating from studies using animals.

The best available evidence appears to show that there is more serotonin being released and used during depressive episodes, not less, the authors say.

SSRI might also work by reducing inflammation. They also hit targets outside the brain. Depression correlates with inflammatory cytokines. There are efforts underway to focus on diagnosing depression with blood tests and if those tests come the prime measuring stick the official definition of depression might even include inflamation.

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