thelettere

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.

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.

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.

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.

Edit: grammar.

"I have ADHD so I'm an expert on autism."

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.

Stikk is a company that specializes in this, and they say their numbers indicate it works.

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):

https://www.latimes.com/opinion/op-ed/la-oe-rauch-happiness-...

https://12ft.io/proxy?q=https%3A%2F%2Fwww.theatlantic.com%2F...

https://www.researchgate.net/publication/327097311_You_Only_... (particularly starting at pg. 37)

Bottom line: this is a natural transitionary period. To make it successful requires embracing that.

Appreciate the FYI. Of course it's on the comment where I lay out my clearest argument - but so it goes.

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.

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.

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.

Thank God for science, am-I-right?

There are no studies on the empiricism of HN comments, in which case anecdotes and personal observations are all we have.

And I'm not making some obtuse argument, but a common sense one which is readily recognizable by anyone who frequents HN. Are you contesting it?

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.

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.

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.

(1) Through antagonism of 5-HT2AR - see the "cognitive flexibility" section of https://www.frontiersin.org/articles/10.3389/fpsyt.2021.6612... - and more generally through inhibiting natural regenerative processes https://www.amazon.com/Myth-Chemical-Cure-Psychiatric-Treatm...

(2) https://www.sciencedirect.com/science/article/abs/pii/S01650... and https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1399-5618....

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...

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:

A 2021 study of 789 professional athletes found that only 5 (0.6%) had heart inflammation. https://jamanetwork.com/journals/jamacardiology/fullarticle/...

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...

2021 review of 12 studies: "Athletes have an overall low risk of SARS-CoV-2 pericardial/myocardial involvement, arrhythmias and SCA/SCD." https://bmjopensem.bmj.com/content/7/4/e001164.abstract

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.

The article is about "one year later" - not "immediately after".

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.

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?

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.

Exactly. All that energy and time and money to "cultivate" gifted individuals only for them to crawl into that black pit. And the irony is that this education only helps them make that choice with self-awareness of how absurd and culturally destructive it is. But it is where the rewards are, and so that's where they go.

To quote Colacho again "Reeducating man will consist of teaching him once again to value objects correctly: that is, to need few." Then perhaps we might have some hope.

Where have you been the last 20 plus years? This is a subject that's been wrestled with in many high profile books and articles over that period and beyond, and how this is not self-evident to anyone who reads is beyond me.

Here's one article on it I have on hand, if for some reason a search brings up nothing: https://scholars-stage.org/a-few-more-notes-on-the-dearth-of...

"The problem of educating the educators is a problem which the democrat forgets in his enthusiasm for educating the pupils."

When's the last time a single person on hn dared to look at the curriculum of the average degree in education? It consists of courses that any person with the slightest degree of intelligence would run from screaming. I'm interested in education but you couldn't pay me to attend one - it's 99% fluff and nonsense.

Because the bigger problem is not the existence or nonexistence of exclusive institutions but of the kind of people that would render such an education educational. Because neither the gifted nor the wise - particularly if male - go into education today.

Perhaps a reason for the poor track record of modern education in producing any geniuses on par with those of the past and the long-standing dry spell of great works. And the larger trend of exclusive education producing little but "really excellent sheep".

"Our system of elite education manufactures young people who are smart and talented and driven, yes, but also anxious, timid, and lost, with little intellectual curiosity and a stunted sense of purpose: trapped in a bubble of privilege, heading meekly in the same direction, great at what they’re doing but with no idea why they’re doing it."

In which case perhaps it's best it's done away with. It appears past fixing, the rot infiltrating to the core of the bureaucratic machinery.

Edit: fixed/clarified/extended ending.

This can't all be explained away by marketing. It matters, but status concerns are an ancient and primal part of human beings and is a central motivator of behavior.

Marketing exacerbates the issue by priming us for status constantly and muddying the values that would pull us in a healthier direction (i.e. marketing that portrays brands and products in relational terms, like the recent Taco Bell commercials where friends are abandoned for a burrito). But it still would be an issue.

More pressing I'd suggest than marketing is the atomization and alienation of society, where the only way to achieve one's relational needs is seen - consciously or not - as through consumption. A more connected and calm people would be less susceptible to marketing bs, and hypertrophied status concerns would be balanced by the values (and reality) of relating and belonging, and of (real world rather than market) achievement and power.

Yes it does mention it - scholar gives you direct quotes in the subheading, which for this one is: "alter one type of pain (eg, Tylenol reduces physical pain) can alter the other as well (eg, Tylenol reduces social pain)."

I did a paper on this subject some years ago, so I know the info is legit. I didn't expend a ton of effort because information on human beings in hacker news is almost always shockingly lacking and so if I bother to write a high quality post it almost always gets either ignored or downvoted - because the "experts" here don't have the knowledge base to recognize what is true.

And as for scholar, if you type in the right terms, 99% of the time it gives good results. So in this case obviously "tylenol" is not a good search term because that's a brand name. What you want is the active ingredient, which in this case is Acetaminophen. If you type "Acetaminophen rejection" into scholar what are the results?

I just did and there's a wealth of highly cited studies backing up OP's claim, including the very first result.

I don't understand - have you never used Google scholar? Type in the relevant terms and there are a million relevant results. I just pasted the top one, which is all about how physical pain and mental pain is basically physiologically identical and specifically mentions Tylenol in relation tto its effect on social pain. Full text shod be on sci-hub.