Agreed save for the last line - the character limit means nothing complex can ever be successfully discussed there. Which excludes basically every important subject, leaving quick news and jokes as the only viable uses of the platform for anyone of sense.
Both of which I enjoy, but that's hardly cause for lavish praise.
> the character limit means nothing complex can ever be successfully discussed there. Which excludes basically every important subject, leaving quick news and jokes as the only viable uses of the platform for anyone of sense.
Definitely not my experience, or that of anybody I know who curates their feed carefully. It certainly promotes shallower conversation, and forces irritating kludges like threads. But it's simply not true that it categorically precludes complexity or depth.
Brevity isn't incomposability. If it was, your argument applies to sentences. If it did, humans wouldn't be able to successfully discuss anything complex.
Dude has exactly zero expertise in the field or experience with this population, and yet he makes these kinds of claims. And all based on an article or two he found.
Pathetic. Almost every psychiatric diagnosis is problematic, and articles questioning any's validity can be dug up. Doesn't mean the emotional/cognitive/behavioral cluster does not exist.
The link between trauma and disassociation is incontrovertible, and DID is merely an extreme version of this. Case reports of it across Western, Middle Eastern and Asian societies across the last 2 centuries show a remarkable degree of consistency in their reports of this, so the idea that this is some kind of passing fake fad is absurd.
The only thing the article adds is a critique of a Tik-tok sub-culture. Color me shocked that this is not a particularly enlightened group - but I guess this is the kind of hard-hitting "journalism" popular Substacks were made for.
Tik Tok culture also has a similar fascination with glamourising, well, any mental illness or disability really.
There's a whole subgenre of ADHD Tik Tokers, for example.
And it's also well observed that, monkey see, monkey do, when the monkey is a teenager looking to differentiate themselves. Like the mass German outbreak of "Tourettes". [0]
I feel your outrage might be better aimed at people trying to turn serious disorders into a cute personality quirk for social media.
So I should save my outrage for juveniles acting like juveniles on a juvenile platform rather than a grown man playing psychologist and successfully clickbaiting a moderated adult platform?
One could argue I shouldn't be outraged at either, particularly given HN's track record of dealing with anything complex involving human beings rather than technology. But I haven't entirely given up on adults capable of engaging in extended discourse, for better or worse.
No matter what one might think of Freddie deBoer, it is worth being aware of his own experience with psychosis. While this is not the same thing as DID, it did give him relatively deep personal insight into aspects of serious psychiatric disorder:
There re still plenty of people who have a severe distaste for his writing, his political views and his behavior, and I think that's fine. However I think it's unfair to claim that this article is "all based on an article or two he found."
"I have been treated for ADHD and as a result I understand some of the ways that a lot of psychiatric institutions fail patients with disorders such as ADHD, autism and others."
The article (despite the clickbait-y title) isn't really about the existence of DID.
> so the idea that this is some kind of passing fake fad is absurd
Two things can be true simultaneously. DID is real, however, exceptionally rare...and there is also a passing fake fad where (mostly) teenagers struggling with their identities (extremely common at this age) are self diagnosing this and amplifying whatever confusion they might actually feel into this specific pattern of behaviors.
> The only thing the article adds is a critique of a Tik-tok sub-culture. Color me shocked that this is not a particularly enlightened group - but I guess this is the kind of hard-hitting "journalism" popular Substacks were made for.
there's definitely a _thing_ where certain mental illnesses are - imo - social media gamed for clout/followers. DID is apparently a popular one for that. I've seen it a bit.
guy should have looked more at the literature though.....
> Case reports of it across Western, Middle Eastern and Asian societies across the last 2 centuries show a remarkable degree of consistency in their reports of this
It should go without saying that a rumor is not a case report. Name one physician who published a report based on extensive first person experience with a vampire (and not, say, Renfield's syndrome).
Plus the case reports are only supplemental to the larger and more empirical lines of evidence for it.
Because of that, I don’t think it is problematic for anybody to say its controversial whether this disorder really exists.
This goes a bit further, though, claiming it probably doesn’t exist.
IMO, that isn’t saying the patients are faking having problems. It’s saying we don’t know much of mental illnesses, and that creating this label doesn’t help the world.
I think most in the field will acknowledge the first part of that statement. That’s why this is called a disorder (“a functional abnormality or disturbance”) and not a disease, a term we reserve for cases where we know what causes it.
As to the second part: I think a new label only makes sense if its definition groups people together not only because they have similar abnormalities, but also because they are helped by similar treatment. That’s very hard to judge for disorders, because “doesn’t respond to the standard treatment” can easily lead to a conclusion “diagnosis was incorrect”. That also is what those writing the DSM struggle with.
A problem, though, is that patients prefer hearing “you have foo” to “we don’t know”, even if there is no difference in treatment between the two.
I think that’s why those claiming “most people claiming to have foo don’t” (which I would say currently is true for such things as autism and ADHD), the stronger “foo is rarer than diagnosed” or the even stronger “foo doesn’t exist” are met with much resistance.
But again: I think the last two are statements about the state of psychiatry as a science, not about patients.
Just because it's more often contested doesn't exempt the author from the responsibility to grapple with (or at the very least make himself aware of) the reasons why it's included in the DSM and the ISD and why it's been acknowledged (if grudgingly) since the very beginnings of the discipline and before - including a long section in James "Principles of Psychology" - if he's going to make such a claim. He seems patently unaware of the long list of psychological principles that no one contests that align with the diagnosis - from the existence of discrete states in sleep and infancy, to brain microstates, to state-dependent learning, to extreme state switching in bipolar, periodic catonia and the other disassociative disorders, to the commonality of hypocrisy of which the individuals themselves are blithely unaware, and the trickiness of personality science.
And that's not even addressing the highly detailed and often highly public case studies of DID across time and cultures, the research showing dramatically different brain readings across the spectrum based on the current identity of the DID patient, ect, ect.
But he doesn't even attempt to address any of that because he has no idea what the hell he's taking about. It's a deflationary article with the populist message that psychologists and Tiktokers are the dumb. So I get why it's popular, but it adds all of nothing to the conversation. He's just another panderer milking the public for attention and money.
And as for the label, again one can acknowledge the existence of a biopsychosocial cluster without coming down on either side of the question of whether or not they are symptoms of an underlying disease. There's a long history of scholars doing this, particularly in the sociology of mental health. Additionally the author does not appear to be making any such argument here against the psychiatric nosology as a whole - just this one diagnosis.
No one seems to be talking about this being a normal part of the stage of life you're in. The 40's are typically the most miserable decade in a person's life, and this is well documented. The major caveat to that is "I know I'm depressed and have been for the majority of my life" - which adds a different wrinkle. But that it's getting worse now is to be expected.
Some readings, which have been helpful for me (I'm also in my 40's):
Not "most". Half of the published research in Ioannidis's ground-breaking analysis couldn't be replicated. Which means half could be (edit: numbers which roughly match a more recent analysis: https://elifesciences.org/articles/71601).
Which is why single studies should never be taken seriously - which is nothing new and frankly common sense. Thankfully there are recent reviews and meta-analysis readily available on most subjects, so that shouldn't even be a temptation.
You would need to see a study on the empiricism of HN comments before you cede that these discussions are valuable for the people to choose to engage in them?
You’re holding discussion to the rigor of scientific publication. Have you completely squashed your internal agent of curiosity?
My point was that we don't have to pretend that we're the first sentient beings to have a conversation on these issues, or ignore/dismiss that on many of them there has been progress made. That while there remain many fascinating open questions about them, the shape of others is relatively known.
There is a Sisyphean quality to the never-ending recurrent pop-up of conversations on topics like depression and loneliness. Every few months if not sooner another round of active conversations pops up with hardly any recognition that this has been discussed - here or elsewhere - before, or that it's been examined with greater rigor than personal experience can provide.
So no, I'm not saying that discussion should be held "to the rigor of scientific publication". I'm saying that a century or more of systemic investigation deserves some space - however small - in the conversation. Or better still should serve as the backdrop, so that what we're discussing isn't forever retreading to no avail the same often wrong-headed paths.
If on a post on nuclear energy someone brought up the idea of rubbing sticks together as a viable alternative national energy source he'd be downvoted and laughed out of the room.
But the equivalent - or worse (i.e. not just ludicrous but counter-factual) in conversations on topics having to do with human beings doesn't just get entertained but is often celebrated as the fount of wisdom.
And here's the thing: when we say someone is educated, what do we mean? In the fullest sense, what does it mean to be an educated person? It means to know something of human beings, which is ultimately the most consequential subject.
And so for the conversations on this most consequential subject to be such an un-self-aware dark ages shit-show in a group that largely holds up - at least in word - science and technology, progress and the future, learning and rationality is ludicrous. And that it continues forevermore still more so.
So I am pointing out what I would hope to be a sobering contradiction. And that if the group is so fascinated by these subjects - they seem at times to be the more active discussions on the site - maybe some of that energy could be used to actually learn something about the subject.
So that future discussions could - at least once in a while - touch on the wonders of nuclear energy instead of being forever damned to never-ending masturbatory chats about sticks.
FYI, your downstream comment is "dead", only people with showdead on can see it - I think this is because of the fourth last word you used. Don't ask me how I know, but variations of this word automatically kill posts
Have value how? How is it not in fact the very opposite of valuable (in cases where there is some empirical knowledge)?
I enjoy anecdotes occasionally as well, but here's a thought: if all you have is personal experience (i.e. you have no familiarity with the accumulated knowledge on the subject) - maybe you should listen rather than speak. Speaking then is akin to spitting in the face of the countless individuals who spend their lives investigating these questions, acting as if they and their work basically does not exist. It muddies the waters - particularly in light of our cognitive biases - and often misinforms where it should enlighten.
How is that moving the conversation forward? If this were a literal watercooler, than that's one thing - but this is forever archived material. The written word has always historically had a higher bar than spoken word (a tradition that the internet has undermined, and to our detriment) - and for a reason.
If we're all just here to entertain each other before we pass into oblivion, then that makes some sense. But the dominant narrative here is not of that kind, but of a belief in progress and the future.
If that is in fact an genuine wide-spread belief here, then these kind of threads are in service to the exact opposite of such beliefs. I'm not saying that anecdotes have no place, but only in the context of some conversance with the knowledge base - or in cases where the question has not been tested or is untestable.
Unless of course we want to just drop the pretenses, embrace our irrationality and start regular threads on medicinal leeches, communications with the dead, and phrenology. But somehow I don't see that happening anytime soon.
Personal experience is the medium of life itself. I’m surprised to hear you give it so little space in the discussion. I weigh personal experience (especially multiple anecdotes from credible sources) about as high as I weigh expert opinion.
Just a question: are you a young person? I’ve just seen the experts be pants on head wrong many times, and that has an effect. I’ve also specifically been burned by overconfident doctors, so add that to the important anecdote pile.
If the science doesn’t align with the anecdotes (on any topic that isn’t partisan politics), then that makes me want to investigate the science, not toss out the anecdotes.
You're the one talking like a young person (and I'm firmly in middle age, thank you very much).
You do know what the world looked like when we relied entirely on anecdotes for knowledge? If that's the world you want to live in, then all power to you.
Former counselor here: I think it's important to differentiate between short term anti-depressant use and long term use. Short term use can be effective for motivating you to do all the non-medication things that have evidence of working (particularly together).
Long term use is typically associated with the worst side effects - both the well known things as well as how some may (edit: at least partially) block one's ability to develop and change/grow (1). Further, long term use is not associated with any meaningful enhancement of quality of life (2) and can often be a crutch - because while it alters mood it does nothing about the underlying cognitive patterns which are so ruinous for one's social life.
If there's been such heart damage to athletes that caught it, how come they all are invariably coming back to the same exact performance they had previously? Is there such a thing as damage to the heart that has no effect on performance, particularly the incredibly demanding kinds of performances that sports like professional basketball require?
They haven't all. Look up Asia Durr if you want an anecdote. #2 draft pick for WBNA and hasn't played since her rookie season due to long haul covid effects.
I am not aware of any study on covid in athletes in particular, though.
Huh, you've got to reach to the WNBA to find someone. Kinda proves my point.
Edit: And to all the wonderful people who no doubt checked themselves to make sure they had expertise on the subject before they downvoted my question (!), here's some food for thought:
Another study found that COVID in athletes was rarely serious: "The severity of COVID-19 in elite athletes is predominantly mild and without complications. Athletes can return to sport after two symptom-free weeks and additional heart screening is usually not required." https://www.sciencedirect.com/science/article/pii/S144024402...
2022 editorial review: "Most importantly, to date, there have been no acute adverse cardiac events reported as a direct consequence of COVID-19 infection in the athletes included in these large registries" and noted that the few smaller studies that deviated from these findings were badly designed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8730531/
2022 study: "These data add to the growing body of the literature and agree with larger cohorts that the risk of cardiac involvement post-infection appears to be low among elite athletic and semi-professional athletic populations." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8791243/
2022 letter: "Several elite professional athletes tested positive for SARS-CoV-2. A few reports of persistent and residual symptoms of infections emerged. However, peak athletic performance in elite athletes did not seem to be affected, with some athletes recording historical performances both in the weeks following as well as several months after contracting the novel coronavirus.... These findings raise further awareness about the importance of performing regular physical activity and maintaining a favourable body composition and overall fitness, and emphasise the need for public health initiatives and actions to promote a healthy lifestyle on a population level." https://www.sciencedirect.com/science/article/abs/pii/S14402...
The idea - however appealing to Americans and apparently hackers - that everyone is on an equal playing field of risk is absolute nonsense.
> Edit: And to all the wonderful people who no doubt checked themselves to make sure they had expertise on the subject before they downvoted my question (!), here's some food for thought:
My original comment specifically highlights that the studies are split, but you are cherry-picking articles that support an argument you are trying to make that athletes aren’t suffering from heart inflammation.
Moreover, based on your initial question to my comment, you don’t even seem to be aware that heart inflammation isn’t necessarily going to effect performance, rather it presents potential longterm and acute risks of a negative outcome to the athletes, and you are specifically citing athlete performance as evidence athletes aren’t suffering from heart inflammation.
All things being equal it is probably better to be a young athlete with heart inflammation than to live a sedentary lifestyle and be obese with heart inflammation for purposes of health outcome, but I think you are confounding risk of having heart inflammation with risk of negative outcomes from heart inflammation. As research and studies continue it could very well be the risk of heart inflammation is in fact equal among the populace, while negative outcomes will be unequal, ultimately this is still going to drive up negative outcomes across the board.
How am I cherry-picking when I included several reviews? Find one review that concludes the opposite (or that such studies are "split" as you say) and perhaps you'll have an argument.
"based on your initial question to my comment, you are specifically citing athlete performance as evidence athletes aren’t suffering from heart inflammation"
How did I "cite" that in a question? That WAS my question, the answer to which I found myself.
Some cyclists even survive cancer, and then come back to a higher level of performance than they had previously. Does that mean there is such a thing as a cancer that has a positive effect on athletic performance?
To keep on the topic of cyclists:
Tim DeClerq - out for months after being diagnosed with pericarditis after Covid infection.
Sonny Colbrelli - suffered cardiac arrest yesterday after his race, two months after Covid infection.
Again, the article is not about the immediate aftermath but one year later (i.e. long term effects). And Sonny Colbrelli was a freak incident - "All cardiac tests carried out last night showed no signs of concern or compromised functions." https://www.theguardian.com/sport/2022/mar/22/italian-cyclis...
I think this post lacks an understanding of heart conditions. You can have an enlarged heart or other heart issues and still be a professional athlete. Ask Reggie Lewis. It took Jason Tatum many months to get back to some kind of playing condition after he contracted Covid, etc.
Yeah and he just won eastern conference player of the month. Article makes it sound like he's at risk of any game now dropping down with a heart attack, which on the face of it is ridiculous.
Exceptions do not contradict the rule - athletes in high demanding sports rarely have heart problems, and the idea that they are at equal risk than the gen pop is laughable.
To your second question, yes, heart inflammation doesn’t mean they can’t participate, participate at a high level, or that the athlete even notices any issue. It means they have heart inflammation which carries associated risks both long term and acute. If you are looking for anecdotal evidence, there are plenty of athletes that talk about post covid struggles that include a range of issues impacting performance (i.e. reduced cardio, more labored breathing, brain fog).
Also, being a victim and being privileged are generally seen as mutually exclusive, so it's a way to avoid guilt.
And with the infinite torrent of knowledge (including of the amount of suffering in the world) at our fingertips, guilt is an ever-present temptation for anyone with means.
You see this with public figures, they do something horrible/super-unpopular and then they whine and say "I've been getting death threats" to posture as victims (maybe they are getting threats and maybe they aren't, but the effect is the same -- ie that they are transformed in the public consciousness into moral beings)
Both of which I enjoy, but that's hardly cause for lavish praise.