Comments URL: https://news.ycombinator.com/item?id=32741975

Points: 2

# Comments: 0

Both of which I enjoy, but that's hardly cause for lavish praise.

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.

Plus the case reports are only supplemental to the larger and more empirical lines of evidence for it.

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.

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.

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.

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.

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.

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?

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?

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.

This is particularly noticeable in anything having to do with quality of life or lifestyle questions, including the current front page question about anti-depressants. Indeed that relatively upvoted post goes so far as to ask purely for anecdotes - neatly dismissing nearly a century of evidence on the placebo effect, the known wide variance of reactions to any intervention and a million other documented factors that render anecdotes useless. Indeed, as far as HN is concerned, we may as well be in the dark ages, taking a poll on how HNers respond to leeches.

On a site users often describe as a kind of oasis from the nonsense perpetuated on the rest of social media, this seems rather baffling and suggests a need for - at minimum - some self-reflection.

Comments URL: https://news.ycombinator.com/item?id=30927396

Points: 7

# Comments: 15

"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.

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....

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.