You can also add agriculture to that list, apparently we should give up the wins of the green revolution and go back to living in this idealized world of Permaculture food forests and tree houses (George Monbiot has some great takes on these ideas).
I really wonder why HN goes off the rails when these topics come up. Is it just a weak science education, combined with the relative accessibility (and acceptability) of health/fitness/exercise self experimentation? Though I also see gut microbiome discussions being shoehorned to any discussion in this space aswell.
On the topic of metabolic disturbances in Autism, huge fan of the work Dr. Randy Blakely is doing on the links between Serotonin metabolism and Autism. One of the most surprising, and strongest (25-30% of patients), biomarkers for Autism is actually Platelet Hyperserotonemia (high levels of bound Serotonin in the blood).
For decades it's been without explanation but recently Dr Blakely has described a bunch of cases where it was narrowed down to SERT transporter polymorphisms and inflammation.
I've got a pet hypothesis that differences in Serotonin metabolism (and receptor hypersensitivity) might play a role in why SSRIs aren't generally considered a first line treatment for ASD symptoms, https://www.pnas.org/doi/abs/10.1073/pnas.1112345109
Dr. Blakelys lab has produced knock-in mice with the rare SERT variants described, and they have exhibited the behavioral and biochemical markers of ASD. It's actually a very remarkable finding. They also saw a reduction in ASD symptoms by pharmaceutically blocking the offending inflammatory pathways.
So I think at-least for the tiny fraction of ASD patients with these rare SERT variants there's actually a chance that they are a major driver of the disorder. Regardless it provides a tantalizing look at some of the upstream pathways that could be involved more generally.
I think we're going to find the disorder is very heterogenous and there will be many different subtypes and pathways involved.
Ah but that OCD study suggests the opposite of OCD overdiagnosis.
People who actually have OCD are being misdiagnosed with other more specific disorders due to a poor understanding of the heterogeneity of the condition.
Like everything in the health world it's a spectrum isn't it. Where you draw the cutoff for something being a disorder and needing intervention is super subjective. Probably something where too much talk doesn't necessarily help, as it seems to dilute that threshold over time.
I guess that's just it, it's a spectrum and even "normal" people can be somewhere on it. And decisions about diagnosis or labeling etc should be taken based on degree of impairment to functioning.
Saying that, we really do want to make kids aware of mental health issues (the same as health in general). I really could have benefited from an education about OCD, as it took me more than ten years to understand why I struggled so much.
Absolutely agree on the 'spectrum' point, and I would argue that it's not that case that 'normal' people can be somewhere on it, but everyone is on it, even if they're all the way to the left.
If we take OCD as an example, there's clearly a huge range from 'I like the TV volume to be set to an even number' through to massive impairments to functioning to the point it's impossible to hold down a job, or that it's damaging your personal relationships.
I am a bit less comfortable with saying that it's "super subjective" where you draw the cutoff though. I agree there's some subjectivity there, but the diagnostic cutoff (per DSM-V) is quite clearly defined, and leaves relatively little room for subjective interpretation: "The obsessions or compulsions are time-consuming (e.g. - take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning."
I think it's unhelpful if folks who (for example) like their TV to be set to an even number talk about 'their OCD'. Or people who like things to be neat and tidy. Similarly for ADHD, the verbiage is: 'interferes with functioning or development/there is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.' Or ASD, where it's defined as 'caus[ing] clinically significant impairment in social, occupational, or other important areas of current functioning.'
Yeh I kinda threw that out there and wasn't the clearest but yes I'm 100% in agreement that everyone is somewhere on the spectrum and I guess we need to reach a place as a society where everyone is okay with that and that there are thresholds where intervention and disorder verbiage makes sense and thresholds where perhaps a conservative approach is sufficient (and these can change over an individuals life).
Totally true that the DSM uses concrete cutoff values in an attempt to limit subjectivity, given that, what do you think is driving "overdiagnosis"? Eg. given we have guidelines in place?
> I think it's unhelpful if folks who (for example) like their TV to be set to an even number talk about 'their OCD'.
I guess we can agree that a tiktok mental health awareness is a poor substitute for a proper education (broad, balanced, evidence based etc). The sad thing is tiktok awareness is popular because people just aren't getting good information elsewhere.
At the same time I don't think gatekeeping is particularly good, the folks who struggle the most are often the quietest.
> what do you think is driving "overdiagnosis"? Eg. given we have guidelines in place?
This is a super interesting question, and I don't know the answer.
My personal, completely unsupported opinion is that people now feel more pressure than ever to be perfect, when people are not. It is therefore logical that when people look at themselves and find imperfections, they try to find a 'cause' or a 'reason' that they can blame those imperfections on. I suspect that once you have convinced yourself that your imperfections are caused by something, you have a sort of Baader-Meinhof effect of the mind which causes you to see more and more 'symptoms' and attribute more and more negative things to that 'cause'.
Agree on both the TikTok mental health awareness and gatekeeping points however.
And to top it off, the same pressure to be perfect can also exacerbate underlying risk factors, and cause a legitimate increase in illness.
Agreed, plus the controversial take, some young adults seem to take an odd pride in strongly identifying with their diagnoses, an in-group effect if you will.
Either way back to the original article, talk is cheap, action is harder. If we want to actually improve mental health we're going to talk less and do more, eg. reducing the pressure on young people (housing/education reform anyone?).
Thank you for saying that, it's a bitter pill for a lot of people to swallow. I suspect most folks who struggle with squaring the facts just haven't spent much time around livestock.
I've been on the hunt for possible mechanisms (for further study) as to why last year after trying an SSRI (escitalopram), to treat an anxiety disorder co-morbid to my ASD, that I ended up in the hospital in a hypertensive crisis. Was an all around terrible experience and I hope one day I can figure out WTF happened to me.
Interestingly the BP rise seemed to be mostly diastolic driven and I had crazy excessive urination which made me think about ADH/aldosterone/etc. Seeing ADH is potentially linked to ASD definitely catches my attention! Some of the alternative theories are, I am a MAO-A knockout (unlikely because of lack of intellectual disability), or possess a hyperfunctional SERT (also linked to ASD).
Really excited for the results of the whole genome sequencing I ordered to arrive.
ive been doing my own research for similar reasons (zoloft in my case), although i fortunately did not end up in a hospital. my girlfriend works with autistic children and swears i have ASD but I havent gotten around to being officially diagnosed, nor am i fully convinced of her claim.
if you dont mind sharing, what genome sequencing service did you use? granted i havent looked too far but a lot of services i saw were kinda sketchy. hope u find the answers u seek :)
Oh the popular WGS services are a borderline scam. I fell for their BS unfortunately so are out a few hundred euros. I don't expect to see results for 12 months or more (if ever).
In the end I found a local company that does WGS sequencing and they are a lot more reasonable to deal with, maybe 1.5-2x the price. So perhaps look for smaller providers, they are all just reselling time on the same Illumina machines.
In your case, just confirming, your blood pressure is otherwise normal and you experienced an episode of severe hypertension after starting Sertraline (zoloft)? No other contraindicated medications? No indications of a bipolar/mania or something of that nature? I've talked to maybe 3x other people now who've had similar experiences (after scouring the internet), and the only commonality I've found is ASD.
This is a bit of a pet project of mine, so if you want to chat about ASD shenanigans, please reach out to: asd.shenanigans@mailbox.org
I've seen some behavior on German job sites that blows my mind as an Australian (and from this discussion it's pretty clear Aussie tradies aren't saints).
Zero compliance with hard hats, straddling a 4th story window without fall protection, incredibly sketchy scaffolding, dust everywhere etc. I was half expecting a worker fatality at some point.
Though I'm not sure I'd blame the Germans (other than for very lax oversight) it was an entirely Eastern European work crew. Which seems to be the case for many job sites around here. Bunch of young folks hustling for money to take home with zero regard for health and safety.
There's an interesting cultural element to this, and I think Brother being a Japanese company is not a coincidence. I see the same mindset applied widely here in the German Mittelstand.
The American growth at all costs mindset (particularly quarterly) is excellent during the technology exploration phase. It spurs radical innovation, but as a technology matures it becomes impossible to meet growth expectations. In response to this the spiral of Enshittification kicks off and eventually the company and it's products fade into irrelevance. Stability in such an environment is impossible (the gain knob is cranked to the max).
The German Mittelstand are different, typically they are much slower to innovate during the technology exploration phase (I think mostly due to the German economy not really rewarding early stage innovation). However as a technology matures the Mittelstand's strength in stable, gradual evolution and refinement really shines. They focus on being the best in their niche and grow by expanding to new markets, opening adjacent product lines etc. Enshittification is the last thing on their minds (the system is critically/over damped).
Do you have any further information / links / legal references regarding the IP transfer grace period? As ideally this is what I'd like to do with my current ideas.
Basically work on a bunch of opensource components that would complement a commercial product that I offer / develop under a future GmbH (which I spin up basically as soon as I have an interested party in the hypothetical product).
Trying to reduce the amount of legal and finanzamt shenanigans where possible.
I'm not an accountant or lawyer and I'm not your accountant or lawyer. You should speak to an accountant or lawyer familiar with IP law or software companies.
All I can say is that it's de facto possible to create a GmbH after you already have started building something that will be owned by the GmbH without requiring a formal transfer of the assets. To do so in a way that is legally safe and sound you should speak to a legal expert.
As I understand it, it's less that there's a legally defined period, it's more about the limits of what you can rationalize or to what degree history can be redefined. If all the code you've written is sitting on machines under your control, who's to say that the code you wrote before the company was founded is the same as the code the company ends up owning? Especially when it was just a draft prototype you definitely threw away anyway. If sale of the company or investment ever comes up, they'll do the due diligence to make sure the documented history is up to par anyway.
If any of this was too subtle: legally, history consists of what everyone agrees history is. Founders can be expected to bring in their prior knowledge when founding a company, so any software produced by them for the company while employed by that company is owned by that company, even if it happens to be indistinguishable from software they wrote prior to founding the company, as long as there are no third-party claims to that previous software (which would create liability for the founder anyway). If you're the only person who knows what color your bytes are, well... .
What's interesting about this to me is just how obvious it is that somebody with 99th-percentile verbal skills and the ability to explain difficult topics clearly should be doing what that second guy is doing, not working one-on-one with individual students.
I really wonder why HN goes off the rails when these topics come up. Is it just a weak science education, combined with the relative accessibility (and acceptability) of health/fitness/exercise self experimentation? Though I also see gut microbiome discussions being shoehorned to any discussion in this space aswell.
I guess I just don't get it, probably the 'tism.