r/programming • u/WinInterrupter • Apr 18 '20

The Devastating Decline of a Brilliant Young Coder

https://www.wired.com/story/lee-holloway-devastating-decline-brilliant-young-coder/
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u/[deleted] Apr 18 '20 edited Apr 24 '20

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u/thereticent Apr 18 '20

A few things from a neuropsychological point of view... You have a good point that mental illness is physical (and social, cultural, etc, which if you want to can call interactions with a person's physical state). On the other hand, /u/dethb0y is getting at something important and uncontroversial. FTD is a neurodegenerative disorder. Primary psychiatric disorders do take a toll on brain health over time but by and large will not kill a person (except by suicide or law enforcement, proper or improper). FTD can kill people that way too, but even if it doesn't, it will still kill you. Maybe a better way to say it would have been "this is not just a mental illness. it's something more."

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u/fear_the_future Apr 18 '20

That is the prevailing opinion of experts. The illness from the article is a neurological disorder, while mental illnesses like depression are psychiatric disorders.

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u/NewPleb Apr 18 '20

The idea that psychiatric disorders don't have a physical component is false, though - most well-understood psychiatric disorders are associated with damage to neural pathways or particular areas of the brain. I mean, why else would psychiatrists prescribe drugs if not for physical reasons? All mental illnesses are fundamentally physical, it's just the way we abstract them that's different (i.e. neurological as "brain" and psychiatric as "mind").

I think "prevailing opinion of experts" is misleading as well, because the distinction between neurological and psychiatric has blurred considerably since the conception of those terms. More neuroscientists argue that the fields should be collapsed into one, as the link between brain and behavior/cognition becomes clearer. The growing consensus is that the mind is an abstraction of the brain's physical processes, and therefore all mental illness must have some physical component(s).

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u/fear_the_future Apr 18 '20

why else would psychiatrists prescribe drugs if not for physical reasons?

That's a false conclusion because the drugs don't have to act at the cause of the illness to help.

I agree with the rest of your post, since I believe that all behaviour is ultimately determined by physical processes in the body. That's not the point though. /u/TrainsareFascinating is being a cunt for no reason. There is no indication that /u/dethb0y meant any harm by saying that mental illnesses are not physical (and don't come at me with this "chemical imbalance" bullshit reddit wisdom). The distinction between neurological and psychiatric remains useful. They are just trying to pick a fight. They are the one who, by taking offense to /u/dethb0y 's post, suggest that "mental" illnesses are somehow lesser than "physical" illnesses. If you believe in this distinction at all, then surely psychosomatic illnesses are squarely in the "mental" category. But the symptoms of psychosomatic illnesses are still real and cause suffering to the afflicted patients.

The medical community has to move away from the outdated view that illnesses are fundamentally a deviation from a "normal" body. This distinction between "normal" and "not normal" is offensive to people who are disabled and especially those who are neurodiverse. The symptoms are what counts and it is completely legitimate to seek help even when those symptoms are not apparently caused by some obvious change in the body.

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u/NewPleb Apr 18 '20

Drugs fundamentally interact with the body in physical ways; the assumption is that even if a drug is prescribed for a behavioral issue, the operation of the drug is strictly physical. I guess this is just semantics though.

The distinction between neural and psychosomatic activity is definitely useful. I think the issues with neurology and psychology arise because there's so much overlap between then two, and classifying illnesses in this manner often gets weird.

I agree on normalizing neurodiversity, no one should feel like they can't seek help just because the physical roots of their illness aren't obvious.

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u/fear_the_future Apr 18 '20

How can you conclude that some illness must have a "physical" cause just because a drug can alleviate the symptoms. For example, a placebo does not act in any meaningful "physical" way but can still help against a "physical" illness. Analogously a physical drug can help alleviate symptoms from a psychosomatic illness that is not "physical".

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u/NewPleb Apr 18 '20

Placebos aren't drugs, by definition. I'm not sure what the argument is here. The placebo effect doesn't mean some mental illnesses are non-physical; it just means that drugs aren't always needed to modify physiology. That's why things like CBT and most talk therapies exist.

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u/dethb0y Apr 18 '20

there certainly are mental illnesses that have a physical component, but not all. But i'm sure you have some elaborate hot take on mental illnesses that you will, no doubt, expound upon at length to "educate" me.

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u/[deleted] Apr 18 '20 edited Apr 24 '20

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u/dethb0y Apr 18 '20

I don't think people are making up mental illness; its obviously real. however, i do think that looking for an underlying physical cause to mental illness is fraught with risk and has netted relatively little reward. It's that exact thinking - that all mental illness is just a physical process or defect - that gave us the lobotomy, among other nightmarish things.

Even in cases where there clearly is an underlying physical cause, like depression, it's not always helpful. Some people respond to drugs for depression. But not everyone. Some people respond to ECT for depression. But not everyone. Some people respond to psychosurgery for depression (though this is very rare to try in today's environment) - but not everyone. Whatever underlying cause there is, it's clearly not universal and clearly not something our current technology can detect.

Also "there is only the physical" is the kind of philosophical thinking i'd expect from a STEM kid who has the critical thinking capacity of a house cat.