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I think the big problem is that all those fields are still very new and the thing they're studying is extremely complex and hard to directly study.

I'd argue that chemistry really began with Lavoisier in the late 1700s. Physics? Late 1600s with Galileo and Newton. What about psychiatry? I'd argue that it really got going in the latter half of the 20th century. Freud and lobotomies? They were the equivalent of alchemy. Other fields have been around in a recognizably modern fashion for hundreds of years. The same cannot be said of psychiatry and psychology.

And that's not surprising. The brain and mind are incredibly difficult to study directly. Until the advent of EEC, fMRI, and other modern tools, the only real way to do it was by studying behavior. Similarly, the brain is very complex. We didn't have, what could be considered, a modern picture of the atom until the early 1900s and that was after several major discoveries spread over a few decades. It's not surprising that we're still struggling with the brain.

>Back in highschool we had a massively depressed friend. They tried it all with her: cognitive behavioral therapy, drugs (ALL OF THEM), weed, religion. Tough love. Exercise. Diet. Nothing cured her and her depression killed her via suicide. What's the psych tell me after? Sometimes there's nothing we can do? That sucks. Human genome, done. Prevent HIV from killing someone. Can't do shit about depression sometimes.

That's still the case for a lot of things. You have ALS? On average, you'll be dead in two to four years. 90% of people die within 10 years. Treatment is mainly supportive. Likewise, it's the 1800s and you contract a bacterial disease? Can't do anything about that, antibiotics won't be invented for decades. Drain the pus and hope that you survive.

On ADHD, it turns out that Concerta and Adderall are indistinguishable to me. I take a low dosage and the side effects are basically non-existent and it also gets rid of my anxiety and depression. But it also happens that exercise reduces the intensity of all my symptoms. I only found this out when I stopped going to the gym for two weeks and noticed that my medication doesn't seem to be as effective.

It's quite possible that, if I hadn't been in the habit of exercising regularly, I would've required a higher dosage that would give me severe side effects. It's also possible that I would be fine. How is my psychiatrist supposed to know that? Maybe exercise doesn't work for some people, maybe diet is critical, maybe it's getting enough sunlight. The entire web of interactions is extremely complex and we don't currently have the ability to examine it at a fine level.

Speaking of complex interactions, ADHD is predominantly genetic and there are a number of genes that can contribute to it. For example, a variant of the gene that codes the protein Latrophilin 3 is estimated to be responsible for roughly 10% of ADHD cases. People with this variant are also very responsive to stimulant medication. Given the way that I respond to medication, it wouldn't be surprising if that's responsible for my ADHD.

But other people might have multiple gene variants, each contributing to a portion of the severity of their ADHD. Adequately treating them might require a very specific combination of drugs. The current process is trial and error, but it's possible that you'll never hit that magic combination. Likewise, maybe there is no magic combination in existing drugs or maybe the ideal dose is 6mg, but it only comes in 5mg and 10mg doses.

The medication situation is getting better. There are services that will run a genetic analysis to determine which medications might be most effective. But it's still in its infancy and that's only a portion of the picture.

The brain is complex and our current tools for examining and treating it are still blunt. Don't get me wrong, there are definitely systemic issues in those fields that need to be corrected. But a lot of criticisms seem to boil down to the equivalent of "It's 1819, why haven't chemists invented acrylic to replace the glass in my glasses?"




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