http://www.blog.sethroberts.net/2009/05/25/the-naysayers/ is pretty relevant to my claim.
The point about lithium in particular. It’s implausible that part of the first few percent of the search space explored in all sorts of applications, from treating bipolar disorder to killing insects to making stockings should turn out to be best.
Lithium is being used because it’s practically the only thing that works.
Seriously, everything else that’s been tried has been useless. And lithium is a terrible, terrible treatment—the blood serum levels associated with gross toxicity is only about twice the effective levels. The old sleeping pills were banned for being too dangerous, and they have a much, much greater safety margin. A twofold serum increase can occur just from dehydration. Furthermore, a significant percentage of people who go through lithium overdoses show clear signs of brain damage afterwards—presumably there’re subtler forms of impairment.
Lithium treatment is thus almost certainly exploiting the very early stages of metal poisoning, rather than being a truly beneficial effect. The reason it’s still used despite those disadvantages is that manic depression is so extraordinarily destructive—the mania more than the depression, even. Manic-depressives can ruin their entire lives in a few days if they go through a severe bout. And nothing else works.
The only thing research has really done for mental illnesses is rule out some of the more obvious hypotheses. We know what they aren’t—we really have no more idea of what they are than we ever did. There are a few exceptions, and they belong to neurology rather than psychology.
Lithium is being used because it’s practically the only thing that works.
FFT (Family-focused Therapy), IPSRT (Interpersonal Social Rhythm Therapy), and CBT (Cognitive Behavioral Therapy) have all shown some promise in this area, actually. (Interestingly IPSRT has some crossover with Seth Roberts’ “morning faces” hypotheses; part of IPSRT is regularizing social rhythms—i.e., what faces you see when and for how long.)
I am strongly in favor of non-pharmacological treatments—assuming they work, of course.
I have heard of those strategies before, but frankly if I had manic depression I’d be pursuing them only as adjucts and supplements to lithium. And I think the stuff is literally poison.
http://www.blog.sethroberts.net/2009/05/25/the-naysayers/ is pretty relevant to my claim. The point about lithium in particular.
It’s implausible that part of the first few percent of the search space explored in all sorts of applications, from treating bipolar disorder to killing insects to making stockings should turn out to be best.
Lithium is being used because it’s practically the only thing that works.
Seriously, everything else that’s been tried has been useless. And lithium is a terrible, terrible treatment—the blood serum levels associated with gross toxicity is only about twice the effective levels. The old sleeping pills were banned for being too dangerous, and they have a much, much greater safety margin. A twofold serum increase can occur just from dehydration. Furthermore, a significant percentage of people who go through lithium overdoses show clear signs of brain damage afterwards—presumably there’re subtler forms of impairment.
Lithium treatment is thus almost certainly exploiting the very early stages of metal poisoning, rather than being a truly beneficial effect. The reason it’s still used despite those disadvantages is that manic depression is so extraordinarily destructive—the mania more than the depression, even. Manic-depressives can ruin their entire lives in a few days if they go through a severe bout. And nothing else works.
The only thing research has really done for mental illnesses is rule out some of the more obvious hypotheses. We know what they aren’t—we really have no more idea of what they are than we ever did. There are a few exceptions, and they belong to neurology rather than psychology.
FFT (Family-focused Therapy), IPSRT (Interpersonal Social Rhythm Therapy), and CBT (Cognitive Behavioral Therapy) have all shown some promise in this area, actually. (Interestingly IPSRT has some crossover with Seth Roberts’ “morning faces” hypotheses; part of IPSRT is regularizing social rhythms—i.e., what faces you see when and for how long.)
I am strongly in favor of non-pharmacological treatments—assuming they work, of course.
I have heard of those strategies before, but frankly if I had manic depression I’d be pursuing them only as adjucts and supplements to lithium. And I think the stuff is literally poison.