Maggie's Farm

Nobel Psychologist (whose Nobel was in Economics) Donald Kahneman explains why in a podcast interview.

Asylums for the "moral treatment" of the mentally ill emerged in the early 1800s. I put moral treatment in quotes not to disparage their efforts but because Moral Treatment was a new medical movement at the time to treat the mentally ill compassionately, protectively, and respectfully. That movement continues today.

-  Stanford professor who changed America with just one study was also a liar

-  A Cultural Historian Explores an Old Mental Hospital

The giant old state mental hospitals are mostly abandoned now.  

What is life like for people like Kayla Mueller's parents to know that their daughter was abducted, kept as a sex slave by al-Baghdadi until he tired of her, then tortured including having her nails pulled out, and then beheaded?

I have spent many hours with parents whose children have had tragic experiences, catastrophic lives,  or met tragic ends. Life must go on, but the mental images and the agony that accompanies them can never be erased.

A vale of tears. People like me can sometimes offer no relief, only companionship in suffering.

Everybody knows that most of "homelessness" is about dysfunctional people rather than lack of a roof. Given the complexity of humans, and the complexity of modern society, it's remarkable how few there are.

The great reformer Dorothea Dix recognized the need for "humane asylums" for the mentally ill and incapacitated. By the 1970s, the "miracle drugs" were supposed to treat serious mental illnesses. JFK led a movement towards "deinstutionalization". You all know this.

As things turned out, we found excellent treatments for bipolar ailments but really only symptomatic treatments for the Schizophrenic spectrum of low-functional, marginally-functional, and non-functional people. (Addicts are highly-treatable, but addicts do not always want that and it's a free country.)

So, for the chronically mentally ill (mostly Schizophrenic variants who might be as much as 1% of the population), there is either family support, street life, or asylum of some form. "Asylum" should not be a dirty word. It should be a beautiful word, and asylums can be good places. But nobody is building them or coming up with creative ideas about it.

 How The Loss Of U.S. Psychiatric Hospitals Led To A Mental Health Crisis

Seven Reasons Why Most Major Depression is Probably Not a Brain Disorder

Note that they say "most," not all. Bipolar depression sure seems like a brain disorder of sorts, as do depressive symptoms related to peripartum, hypothyroidism, some GI cancers, etc. 

To my mind, it's best to think of "depressive symptoms" rather than of a unitary phenomenon. Many acute depressive events I have seen are, in fact, reactive to events and could be viewed as grief. 

Bell curve chart is from No One Is Born in ‘The Wrong Body’

The terror of medical opioids is on an upswing. I have seen the upswings and downswings during my career. I wish we could find a middle course, because medical opioids are a blessing to suffering people. Yes, I include Oxycontin in that because it is an excellent medicine.

Of course opioids are habit-forming. For refractory pain, they are also life-giving. For people with life-impairing chronic pain, there is something called "pseudoaddiction."  AGAINST AGAINST PSEUDOADDICTION

These days, I have seen people in that category treated like drug addicts. Sooner or later, there will chemicals with the pain effects of opioids but without the habit-forming effects. Not yet.

Every food can be correlated with increased mortality risk!

 Diet Reporting—the Real Fake News

The one thing that is known for sure is that overeating is not helpful for fitness or survival. 

How to make life happy: Scott Adams podcast

Excellent summary on the mental and physical benefits of exertion: The New Science of Exercise:

Doctors, researchers, scientists--even ancient philosophers--have long claimed exercise works like a miracle drug. Now they have proof.

As I have said before, a rigorous exercise program might not extend your life. It will definitely enhance and extend your quality of life even if you begin it at any age. Everybody knows that they ought to do it, but it's hard and it hurts and we're lazy and "busy."  Plus there is that terrible part: delayed gratification. Everybody hates that. As I say, "The flesh is willing but the spirit is weak."

Our quite well-informed recommendations for general fitness and conditioning for the ordinary person who wants to achieve or maintain maximal functionality for life:

1. Nutrition: Don't be visibly overweight - it's the worst thing you can do to yourself besides being an addict, and no exercise can help being fat. Does a demanding exercise program require a specific pattern of nutrition? Yes. We have discussed that in previous posts here. With a serious exercise program, you have to keep up with the protein and fats - approx. 70-90 gms of protein/day.
2. Weight training - as heavy as possible, approx 50 minutes twice a week
3. 1-2 hrs total of calisthenics/wk for mobility, balance, and athleticism
4. 2 or 3 twenty-min sessions of cardio intervals/wk  (HIIT). (For HIIT, I do stairs once, elliptical once, rowing once. Occasionally sprints in the pool.) Can add an hour of endurance cardio.

Under age 35, it can take 12 months to be whipped into decent shape. Over 35-40, depending on your fitness starting point, 18-24 months. Intense sports like basketball can substitute for calisthenics. Yoga is excellent, but does not substitute for any of the above. Many men find Yoga to be quite challenging and helpful. Lots of pro football players do it. If your day job is physical, all of the above recommendations would differ.

She begins:

I never anticipated spending so much of my clinical time in bathrooms. But drug overdose is the leading cause of death among the homeless individuals I take care of at a health center in Boston—and without homes or access to supervised consumption sites, people who are homeless frequently inject drugs behind the closed doors of public bathrooms, including ours...

Not what they were cracked up to be: Meta-analyses were supposed to end scientific debates. Often, they only cause more controversy.

Free Will always seems like a dorm room topic to me. 

Can Neuroscience Understand Free Will?

Science Says Parents of the Most Successful Kids Do These 10 Things

(h/t AVI) 

A Scott Adams intervew with Dr. Drew explains that housing is not the issue.  It's about mental illness, personality disorders, addiction, and mental insufficency and otherwise low-functioning people. That is a lot of people.

It is a tragedy of false compassion. Thousands of people who need help, when help is available, resist it. It's a free country. Freedom often means messy.

Interesting book: The Biology of Desire: Why Addiction Is Not a Disease by Mark Lewis

Of course, it depends on how you want to define "disease" Is a "personality disorder" a disease?

What about overweight and obesity? There has been a big debate about that, but the pressure to term overweight a disease rather than, say, a physical condition, is all about insurance coverage. Otherwise, such questions would matter little.

Speaking of desire, what about those magnetic attractions to one of those of the opposite (or, I suppose, same) sex?  Those can be as powerful as drugs and make people behave just as crazy.

Yes it is. Your waist size is not your belt size or jeans size though, especially if you wear them on your hips which most people do these days. Your waist is above your belly button, the potentially narrow space below your rib cage.

How to Measure Your Waist

How do you measure your waist? Sounds simple enough, but it’s not always obvious where your waist is. Posture and other variables can affect the reading, so here are some basic guidelines to follow:

Position a tape measure at the narrowest point between your lower rib and the top of your hip bone, or at the midpoint in between. It should be snug but not compress the skin. If you can’t find the narrowest point (it may be difficult if you’re very overweight), measure just above your belly button.

Stand straight and breathe out normally; don’t suck in your belly.

Measure your waist first thing in the morning, before breakfast.

Though there’s no magic cutoff point, values over 37 inches for men and 32 inches for women indicate increased health risks, according to the World Health Organization; values over 40 for men and 35 for women represent substantially increased risk.

Many or most people in the US have used opioids whether for surgical or dental procedures, cancer pain, etc.  The number of those people who become addicts is extremely low, but I do not have the numbers.

I know that there is some recreational use too, which seems, intuitively, more likely to lead towards addiction.

The few times I have used opioids (prescribed, of course), I have found them to be sort-of ok for pain relief but generally unpleasant (sleepy, stupid, unsettling) so I switch to NSAIDs or Tylenol as soon as I can.  

Others find opioids to provide a feeling of deep, warm well-being if not euphoria. That sounds appealing, doesn't it?

What are your experiences with opioids?

Here's Dalrymple's take on the topic. 

Association Between Life Purpose and Mortality Among US Adults Older Than 50 Years

Food for thought. What is "life purpose"? 

In The New Yorker, The Troubled History of Psychiatry - Challenges to the legitimacy of the profession have forced it to examine itself, including the fundamental question of what constitutes a mental disorder.

And on the annual American Psychiatric Association's meeting:

 “If you want to model the APA, you could do worse than a giant firehose that takes in pharmaceutical company money at one end, and shoots lectures about social justice out the other.”

A terrible meeting. I never attend.

My experience is that people like to mock or disparage Psychiatry. That is, until they or a family member need one. 

A story about fake science, from Slate Star Codex.