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Why stop there? They haven’t even factored in the cost of developing agriculture from a hunter-gatherer society, or the cost of human evolution or or or


There's inherent baseline - things you've learned and can use culturally at no cost, as you're drawing on _ideas_ - and then there's economic baseline, which is drawn from the larger culture and economy around the commune. Basically, it's not as isolated or insulated as it might purport itself to be.


> since you have to inspect all cells to decide the order in which to evaluate them

I don’t think this is true; evaluation order of a cell with no dependencies or whose dependencies are already resolved shouldn’t matter


> Oxford or Cambridge in England may not be too expensive

They’re really not far off London prices, and because they’re in the UK, the weather sucks


People in Aberdeen might well get upset if you collapsed Doric into just being Scots.



Autistic people were never thought to lack emotions, in fact many complain about feeling too intense emotions. The article is garbage.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518049/

https://www.frontiersin.org/articles/10.3389/fnhum.2010.0022...


Read the article, not the parent poster's mischaracterization of it. The very first paragraph explains the autism+emotion issue.

Also your own sources contradict the claim "Autistic people were never thought to lack emotions".


>Also your own sources contradict the claim "Autistic people were never thought to lack emotions".

Where?


The only thing that seems to be universally true about mental health is that we’re all different, and someone else’s experiences rarely apply perfectly to your own.

I put off getting on the meds for at least 15 years longer than I should have done because of stories like this. They have been life changing lot positive for me with almost no downsides.

In addition, I’ve read more than one story like this where the person eventually decides it’s time to get back on the SSRIs after a year or two off.

Experiment, find what works for you, but these articles that are angry at big pharma and describe pills as primarily bad need to be seen very much as just localised experiences.


I am also a bit skeptical when strong anti-Pharma opinions are expressed, based on personal experience only. Meta-analyses have shown that for severe depression, antidepressants are a first line of attack, only seconded or aided by CBT, but not interchangeable in terms of efficacy. It's kind of stupid to counterargue with yet another personal story, but for me not being able to take SSRIs has proven to be a real problem. I developed a somewhat rare side-effect with both SSRIs and SNRIs, I basically covered up in unexplanable bruises and given the increased risk of internal bleeding, am cut off from this medicine class completely. The only time in my life where I was not crippled by anxiety was on these meds. I continually try relaxation, CBT, DBT and whatnot, but unfortunately I am one of those who does not respond as well to therapy as I do to medication. To be really honest, I am on the other side of the fence: I hope big pharma comes up with something else than benzos and SSRIs for anxiety, so that I can be relieved from the task of living my life spiting anxiety 70% of the day.


Have you considered meditation? It's been somewhat of a godsend for me after more than a decade of horrible side effects from anti-depressants. I'd highly recommend the eastern variety since I got no benefit from the watered-down "mindfulness" variety peddled by my psychologist and didn't have that "aha" moment until my first 10-day retreat.


I'm a legal medical cannabis patient in my state, and it has been HUGE in helping me use CBT in controlling my anxiety. Far better than Benzos.


Legal Medical Cannabis mixed with mindfulness anxiety techniques from my therapist has worked wonders for my panic disorder. I am completely free of Benzos and Antidepressants and have been for 2 years now.


> I hope big pharma comes up with something else than benzos and SSRIs for anxiety, so that I can be relieved from the task of living my life spiting anxiety 70% of the day.

Have you tried psilocybin mushrooms or DMT? I'd been on meds for years treating depression and anxiety. A few mushroom and DMT experiences have basically cured my depression and anxiety and opened up a whole new way of looking at things.


Yeah, I have used psilocybin mushrooms, DMT, and MDMA (and marihuana as well) before I went to seek professional help (or, rather, after I was disappointed with a previous professional endeavour and discredited the psych scientific community as a whole). After that, I tried the psychiatrist route (got a prescription) and eventually tried chronic gaming and alcoholism. None of that helped. Until I once more went via the professional route, and they found out I have ASD. Now I have SSRIs to cut off the sharp edges related to being oversensitive.

The great thing about the SSRI I use is verified content (I'm sensitive to drugs..), its standardised (I'm still sensitive to drugs) and it has a high half-life (again, I am very sensitive to drugs and if I forget to take a dose in the morning I will notice it in the afternoon even with a half-life of a few days). With the stuff you're suggesting though, you either don't know what you get, you don't know how strong it is, or you're otherwise experimenting.

An accurate diagnosis was all it took. Its hindsight 20/20 but I wish I never went with the routes which didn't work. I recommend to follow conventional science first, and only if that is fully exhausted follow the path of unconventional science (full with pseudoscience, charlatans, illegal drugs, and what have you -- btw I used psilocybin and DMT when they were legal in my country, and the amount of marihuana and MDMA was well within the decriminalised amount).

TL;DR my advice, follow the scientific route, get professional help, get second opinions. If its costing you your savings even though you don't get immediate effect I have been there as well. I know that sucks, but it'll get you further than the dark route I sketched above.

With regards to those drugs parent mentioned lets wait till there's scientific consensus on these.


It's sometimes not enough to simply use psychedelics. A lot has to do with the way you use them, with what intention, in what context, with whom, and how you follow up on and integrate your experience.

Plenty (most?) people take psychedelics without any kind of therapeutic or constructive intention -- they take them to party, to escape, as an antidote for boredom, etc. It's not surprising that such use of these powerful substances could have undesirable or even very negative effects -- though sometimes even such arguably reckless use still produces positive results.

Use of psychedelics in therapeutic and healing contexts tends to be very different. The intention tends to be very different, with a focus on healing or on a specific illness, symptom, or problem that the individual suffers from. There is often serious preparation for the journey, ranging from ways of purifying oneself (for psychedelic use in shamanic or other sacred contexts), to sessions of therapy (when this has been done in Western medical contexts).

The actual trips themselves also tend to be handled quite differently in healing/therapeutic contexts from recreational ones. In recreational contexts, people often do it at parties, with the lights on, or maybe watching movies, or maybe sometimes outside in nature. In therapeutic/healing context, the lights tend to be very low or off, sometimes blindfolds are used, and the focus internal. Music is often carefully selected to guide the journey. Sometimes people are asked to look at photos of loved one they've brought with them for this purpose. If things go wrong, trained support is available, and instructions are given on how to the experience in a constructive way, while in recreational settings the support is minimal and usually untrained, if it exists at all.

After the experience, the recreational user is usually on their own in terms of integrating and making sense of the experience, while in medical contexts there are often followup therapy sessions with trained professionals who can help in making sense of and constructively using whatever was uncovered during the trip, and perhaps the scheduling of further experiences with modified dosage, if needed.

I have no idea how your own psychedelic experiences were, but if they were more of the recreational kind, I am not very surprised that you didn't get much out of them.


The problem wasn't that I didn't get much out of them (I got a whole lot out of these experiences else I would've quit after doing it once) the problem is that it didn't gave me the ASD diagnosis or the long-term benefits of stable SSRI usage together with education and work. If I knew back then that I had ASD, I'd have benefited from that knowledge back then. In the meantime, I was stuck with the notion that I have a (different) diagnosis but I cannot work out how to apply that with my real-life. Sure, the circumstances were different as well, and it is anecdotal.

The usage of drugs (recreational or not) without them being prescribed and without a trained, licensed professional guiding you is indeed something different than recreational usage for which the drugs I mentioned (psilocybin, MDMA, marihuana, DMT) and A.muscaria are not licensed for anywhere AFAIK.

The recreational drug usage of psilocybin was, for me, almost exclusively done in a safe, private setting though without bright light and with a careful choice of music. Because otherwise it hurts. For DMT and A.muscaria, it was exclusively done in such setting as well. I can guarantee you my focus was inward however it cannot be compared to a licensed, educated babysitter who's getting paid.


Fair enough, it sounds like you've found something that works well for you. Prescriptions worked pretty well for me for a while, but psychedelics have been a game changer for me. The mind and living life with it is a tricky thing.


While psilocybin and DMT are being actively researched, I would shy away from recommending people try and use schedule I drugs until they're legalised or at least scheduled differently.


Speak for yourself, I have no regrets about curing myself and can only share what worked for me after years of struggles. In my opinion, it is a crime against public health that these drugs aren't already legalized and widely available. Of course everybody takes a different experience from them, but when used therapeutically in a safe environment, they are extremely powerful and safe.


[flagged]


Personal attacks and name-calling will get you banned here. Please don't do this again.

https://news.ycombinator.com/newsguidelines.html


Psilocybin and MDMA are currently being studied for treating e.g. veterans and victims of sexual assault with PTSD. It is demonstrating some pretty amazing results. Not too unexpected if you've done either of those things before, though.


I have been curious about this as well especially since Michael Pollan's book "How to change your mind" came out. How did your experience go? I am not by any means a recreational drug user so have no idea where I can get DMT or mushrooms.


The legality of mushrooms is fairly varied around the world. If you're willing to travel you've got some options. However, if you have no prior experience, I'd recommend bringing a friend to be your sober sitter, ideally somebody who has their own prior experience.

https://thethirdwave.co/legality-psilocybin-mushrooms/


How'd you get access to the psilocybin mushrooms?


Just go outside, they’re pretty much everywhere. Join your local mycological association, there’s a list on that NAMA website:

https://www.namyco.org/clubs.php


This! is what I believe not only in mental illness perspective but in every way. I'm bipolar type 2 and I have been on and off on medications for a long time and suffered a lot. For the past 4 years I've been continuously taking meds and my life, my work and my relationship with other people has improved and I'm quite stable.

Like you said, people are different, the thing that works for one person doesn't necessarily need to be working for others. Antidepressants and other meds saved my life!


Hey! I'm wondering how long it took you to get diagnosed as bipolar 2, and who diagnosed it - GP, psych? This last year I've been suffering depressive episodes that have really affected my capacity to function properly. They're always interspersed with really good days, maybe too good -- heaps of planning and ideas, unbridled optimism etc. It's hard to know what's considered to be the baseline for normal mood fluctuations.


It took me about 15 years to get my BPD2 diagnosis. I was diagnosed with unipolar depression in college. I don't remember how many different depression meds I tried. SSRIs, SNRIs, tricyclics, etc. I was often noncompliant for all the standard reasons, but mostly because I was an independent contractor prior to Obamacare. Insurance was a luxury then.

I was off medication for about 5 years before another bad depressive episode occurred. I was given Zoloft and that sent me into a noticeable hypomanic episode (3 days of being awake, productive and partially agitated). I was seeing a nurse practitioner who was fantastic. Eventually we settled on lamotrigine, which I've been on for about 4-5 years with no real issues. I've had 2 minor bouts of depression in the winter since starting on it. No manic episodes. It's really a bitch of a condition to treat.


Hey, hi! Sorry to hear that. I can understand what you are expressing. I'll try to comment on what you've written. Just read it and don't take anything seriously that you should follow that in your life :) If there is one thing, I wanted to say then it is, find help my friend!

> I'm wondering how long it took you to get diagnosed as bipolar 2, and who diagnosed it - GP, psych?

I think I can remember, that I've been experiencing these mood fluctuations since I was 12 years old (7th grade in school). I have never been consulted a psychiatrist or psychologist or any form of therapy till when I was 17 years old when it went quite severe, I went psychotic with anxiety and depression when I was in high school. My parents had figured out somehow and took me to a psychiatrist. So, coming to the point, I consulted him for some 2 years and he diagnosed me as bipolar 2. And I've been on and off on medications for the next 5 years then somehow I started taking the meds continuously for the last 4 years due to too much suffering. Now I'm 27, though I wouldn't say I'm too optimistic about life and people, somehow I'm moving on with day-to-day activities and finding my joy in it now and then.

I said, medications saved my life, because through that I can be able to function on day-to-day activities. People helped and some are still helping me absolutely!

> They're always interspersed with really good days, maybe too good -- heaps of planning and ideas, unbridled optimism etc. It's hard to know what's considered to be the baseline for normal mood fluctuations.

Oh, my friend! This is the hardest part for me to understand really which is the emotional threshold and where will it lead me to. I really don't know, sorry!


In all fairness, though, these aren't isolated incidents. There seems to be some subgroup of the general population that suffers from SSRIs. That's what's interesting here -- what binds these people together as a group.

In other words, brushing this aside as "just a bunch of individuals" isn't useful, nor is it satisfying anyone's intellectual curiosity.


They aren't isolated incidents, just as the testimonials from people who were really helped by the exact same drug aren't isolated incidents, and the testimonials from people who have experienced side-effects that were not discovered by the original qualification study are not isolated incidents.

Psychiatric medications, in many cases, do genuinely affect different people differently. This has been well known for a long time. It also contributes to the contrast between anecdotal clinical experience and what are often dismal statistical performances.

The difficulty is with people who feel that they have a grievance with the pharmaceutical companies and the medications themselves, when they actually have a grievance with the doctors who directed their care.


> brushing this aside as "just a bunch of individuals" isn't useful

If it gets one person like me who was under the impression that SSRIs make you a zombie, to try them, then it’s useful.


Not if they do make you a zombie (either in general or as an individual exception that's not covered for)


Yes, it does. Some individuals react differently. Some individuals cannot take aspirin daily for heart benefits, some cannot take ibuprofen for pain relief. Both these drugs can have reactions with other medications. It isn't an insignificant portion of the population, but we shouldn't allow those individuals create a dialogue that scares others away from trying the drug.

If anything, we just need to spend a bit more time talking to folks about the possible side effects of the medications.


It's my understanding that with any particular drug used to treat depression the proportion of sufferers who can't take it is high - certainly IME the proportions are not at all insignificant.

Aside: my understanding is that aspirin is no longer recommended (in mainstream medecine [in the UK]) to be used in a preventative way.


Yes that's very much my point.


Keep in mind that for many people taking drugs is:

a) not a choice they personally made (coercion by the school system or authorities or parents).

b) they were lied to about the effects and side effects.

c) they were prescribed 'off-label' which means essentially with no proven efficacy.

When you say "Experiment, find what works for you" keep in mind how offensive that is to people who feel they were lied/coerced into a taking drugs that in some cases ruined their lives.


I have strong feelings about your response.

There are people who were either medicated at a young age or forced to take medication through legal proceedings. Of those, most will have experienced the same hit-or-miss phenomenon with psychiatric medication. In some cases, however, this means that they were forced to take medications that had debilitating side-effects or didn't particularly work, and experienced serious stress trauma due to their ongoing helplessness in the situation.

I do not expect them to be any less capable than anyone else, as a result, of understanding that other people are not them. I do not expect them to be offended when other people describe experiences that are not theirs.

You're responding to the advice of someone who has taken medications voluntarily and had control over the process; this person is writing in response to an article by a man who, for all his bad experiences, was ALSO taking medications voluntarily.

The statement that you single out as objectionable is actually nearly universal advice, and reflects my own experience with medications and mental health problems.

If your comments about "how offensive that is" are based in your own experience as someone who was coercively medicated, I would be interested in hearing an explanation of why you find them objectionable. If they are not, however, I seriously question the value of your interjection into the conversation.

I am attempting to be gentle and moderate in my response and I apologize if it seems harsh to you.


"Off-label" does not mean "no proven efficacy."

Some off label uses have little to no research behind them, but some are well studied.


> When you say "Experiment, find what works for you" keep in mind how offensive that is to people who feel they were lied/coerced into a taking drugs that in some cases ruined their lives.

Right, like suggesting people find employment is offensive to people who have experienced slavery.


Hey if we’re offering sample sizes of one, SSRIs make me sleepy and unmotivated—nearly the opposite of a helpful effect. I’ve also heard quite a few complaints from women friends about weight gain. Sexual side effects are common. For me, at least, SSRI medication was and remains to be a distraction from mental health treatment.

I also have plenty of rage at big pharma, but that’s more around enabling bad therapists to prescribe medicine without providing the appropriate support. They obviously have every incentive to make sure that anyone who sees a psychiatrist has some medicine that could apply.


Huh. SSRIs made my life way better, but I also get sexual side effects. For me, at least, SSRI medication was and remains to be a critical link in mental health treatment.


I struggled with the decision to stop taking it because it’s very hard to nail down how it even affects you. Talk therapy proved enormously successful.

This is kind of my point, though—if in my case I do NOT have a treatable chemical imbalance, if the medication is certainly not successful, is there any good way to tell?


Hey if we’re offering sample sizes of one, SSRIs make me sleepy and unmotivated—nearly the opposite of a helpful effect. [...]Bad therapists...prescribe medicine without providing the appropriate support

Consider the possibility that you have had bad doctors diagnosing and prescribing for you. Also, there are a lot of therapists that don't (can't) prescribe, maybe it's a good idea to seek help in that direction?


It's just human nature, I guess. There's people from whom antidepressants don't work, and there's people from whom therapy doesn't work (unfortunately, those are not mutually exclusive). However, it seems to me that the individuals with the combination (antidepressants dont't work, therapy works) have a much easier time making an impacting narrative given our current intrinsic and social biases.

My advice to those suffering from depression/anxiety would be to do their research and decide which treatment method they prefer, and to reevaluate once in a while how it is working, keeping in mind that it's very easy to get into a 'bubble' and discard or discredit potential treatment options. No one, no matter how smart, is able to overcome biased thinking.

In my opinion, there are only a few options that have substantial evidence going for them (by the so-called mainstream science): various SSRIs, combinations and uncommon antidepressants, cognitive-behavior therapy and mindfulness-based therapy. One should balance exploitation (taking whatever one thinks works better at a given moment) and exploration (taking one option that one hasn't tried yet) to maximize the chances of successful treatment.


I don't know if I'd call them localised experiences per say, as I feel it minimizes what patients experience. I've probably done that to commenters here in the past regarding depression and pharmaceuticals.

However, I largely agree with what you are saying, everyone is going to have different reactions to these medicines. They're all "dirty" (note that SSRIs are far more specific in effects than previous generations of antidepressants) in terms of the vast number of effects neurotransmitters have in our brain, so it's understandable that they wouldn't work the same for everyone.


Out of interest, how long have you been taking them for? I've heard lots of stories of fantastic short-term benefits, but not very many (in fact, not any that I can think of) where they continued to work long term. I'm not saying they can't work long term, in fact I guess that's why I'm asking, to see whether you are or know of examples where they have worked out long term.


I took them for about 15 years (with a couple of little breaks), and they helped significantly the whole time. I went off them when I got pregnant (did CBT), and am still off 3 years later. I would love to go back on because the anxiety has come back (though not the panic) and I know I don't have to feel like this. However, the stigma keeps me off. Kinda sad.


You know Banksy made a film about exactly what you’re describing called “Exit Through The Gift Shop” right?


What good was that film if it made us "think", but not act?

I believe OP is putting the lessons in that film into action in his life, and those actions are present in the thoughts expressed in his words, and happily not the other way around like the people in and outside the art world giving lip service to Banksy.


Loved this album, but took my many many listens to get into it. It’s the entry point to Rolling Stone magazine’s top 500 albums if you ever decide to work your way through it


I find that most, if not all of my favorite albums, took many listens to get into. It may be just that my brain is resistant to new things, but I almost never like good music on a first listen. It is not like I dislike good music upon first listen, but it doesn't have the easy to listen catchiness of pop music. It often makes you work for it.


> The internet was doing fine for decades with minimal involvement from governments - why change things?

Because the threat landscape — both malware and privacy-related — have seen a sea-change.


Kinda wondering why the geniuses who surround him haven’t just made endless tapes of interesting discussions and then had him ghost-written up


The article states he's perfectionist. He probably wouldn't be OK with that.


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