Overdiagnosis?

Pepper said:
I don't know if it is increasing, but human malaise has always been with us. Due to mass communication this is more obvious as more & more of us contribute to the dialogue.
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Yes to the "malaise" part, but formerly there was no diagnosis, nor was this even considered appropriate. It was up to the individual to live with it as best they could.

Then the possibility of a diagnosis for conditions that had no measurable identification. It was based solely on the individual's subjective complaint, and compared against recorded observations of cases with similar complaints.

In a sense it was the medical equivalent of finding on case law for legal issues.

So the question is: does this trend seem to be growing?

But let me be fair, because I seem to have ruffled feathers: do you even agree that this practice (diagnoses that may/may not result in medication based on no measurable conditions that vary from the normal ranges) exists?
 
Pepper said:
I've basically given up fixin' after all these years just trying to accept.
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There you go?

That's why I asked the question: at what point is the medical profession tending to medicate conditions--often at the preference of the patient--that formerly people accepted as something you simply lived with?
 
debodun said:
I've been told many times that I over-think things - i.e. analysis paralysis.
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Oh, no paralysis here!

I'm all for declaring martial law and frog-marching both the sufferers and those who treat them off to the salt mines for a spell.

A good way to learn the difference between real and imagined misery...

;)
 
Sawfish said:
a)
Then the possibility of a diagnosis for conditions that had no measurable identification. It was based solely on the individual's subjective complaint, and compared against recorded observations of cases with similar complaints.

In a sense it was the medical equivalent of finding on case law for legal issues.
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Sawfish said:
b) .. does this trend seem to be growing?

c) ... do you even agree that this practice (diagnoses that may/may not result in medication based on no measurable conditions that vary from the normal ranges) exists?
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About 300 years ago someone invented the term "consumption." Some medical scientists hypothesized that consumption referred to cancer, but not all of them agree on that.

a) Doctors can only rely on symptoms their patients describe, test results, and yes, similar cases.
b) I don't see this as a trend. It's how doctors practice medicine.
c) Ok, that threw me off again. Incorrect diagnoses happen. Medical accidents happen. Misinterpretations and over-medicating happen. And indeed, bad doctors and careless treatment exist, and it's reasonable to assume there's more and more of it based on numbers alone.

(I probably still don't get what your asking 100%)
 
Sawfish said:
That's why I asked the question: at what point is the medical profession tending to medicate conditions--often at the preference of the patient--that formerly people accepted as something you simply lived with?
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Ooohhh....ok, yes, doctors are treating conditions we probably could live with (that our grandparents lived with). But if we choose not to live with them, imo, it's great that we don't have to. And I'm emphasizing; patient's choice.
 
Sawfish said:
So the question is: does this trend seem to be growing?

But let me be fair, because I seem to have ruffled feathers: do you even agree that this practice (diagnoses that may/may not result in medication based on no measurable conditions that vary from the normal ranges) exists?
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I think I answered that. I think it (depression & ETC) was always with us and present humanity is the first to have been humongous and literate, and translatable, and inter connected, but yes, I think those ills are part of the human condition; the price we pay for being self aware, and having a bit of leisure time which grows, thank goodness, with each generation.

The diagnosis of mental anything is almost always answered with pharmaceuticals. Your Prozac, Effexor, Xanax, etc., those money makers.
 
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Pepper said:
The diagnosis of mental anything is almost always answered with pharmaceuticals. Your Prozac, Effexor, Xanax, etc., those money makers.
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The only other treatment we know of is psycho therapy and psychiatric counseling. IMO, doctors who Rx psych drugs should always refer the pt to a mental health provider, but I don't know if they do. It's probably protocol.

When science discovers the actual mechanisms in the human brain or nervous system or chemistry, or whatever, that cause and control mental health symptoms, then treatment will improve.
 
it would'nt be instantaneous but it has been my observation that these feelings can be addressed through diet and dynamic coaching. this would be highly dependent on the person's ability to metabolize the necessary nutrients efficiently and the tenacity to follow a rigorous program of reorientation.

the problem with much of the healthy dietary practices is that they don't address antinutritients and the process of preparation lowers the yield of some of the foods we eat. much of the ancient knowledge is either disregarded or long forgotten.

we've have finally come to realize that the microbiome is a determining factor in our general health as well as mental state. knowing this we need to understand that we are not only eating to satiate ourselves but also to nourish the microflora and commensal organisms which converts what we eat into the building blocks of cellular processes.

there is no one stop shop for everyone... each individual has their current state of health, rate of activity, diet preferences and treatment history to be considered.

then the work can really begin. nootropics, such as theobromine, corcin & safranal would greatly assist the transition. anthocyanins, quercetin their related antioxidants, and short chain fatty acids (scfa) play a key roll in targeting metabolic syndrome.

"Phytochemicals derived from natural plants are often used to prevent and/or treat metabolic disorders due to their unique therapeutic properties and safety (Bacanli et al., 2019). Plentiful medicinal and non-medicinal natural plants have been used to treat diseases from time immemorial in the world on account of the accessibility and low cost. Studies have shown that phytochemicals such as akebia saponin D, quercetin, cyanidin-3-O-glucoside, corilagin, notoginsenoside R1, scutellarin, salvianolic acid B, resveratrol and curcumin show protective effects against metabolic diseases..."

https://www.frontiersin.org/articles/10.3389/fcell.2021.686820/full

all that's left is to figure out how to transport the necessary nutrients to be delivered for the most efficiency. it can be best understood as a delivery platform with synergistic relationships adjuvants if you will (as pepper is for turmeric.) it's really quiet simple if one understands the moa, mechanism of action, involved and are aware of the interaction in order to prevent paradoxic developments.

i am not a medical practitioner, nor trained in the any of the related fields. i only come to this understanding through self experimentation. so yes, probably sophomoric by any of the current standards. so don't give me no nevermind... and only with a grain of salt.
 
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multimodAL said:
it would'nt be instantaneous but it has been my observation that these feelings can be addressed through diet and dynamic coaching. this would be highly dependent on the person's ability to metabolize the necessary nutrients efficiently and the tenacity to follow a rigorous program of reorientation
...

i am not a medical practitioner, nor trained in the any of the related fields. i only come to this understanding through self experimentation. so yes, probably sophomoric by any of the current standards. so don't give me no nevermind... and only with a grain of salt.
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I wouldn't call it sophomoric, but I wouldn't call it common, either. Most people just wait for word from the experts.

But I don't think you'd argue that many cases of depression, for example, are the result of emotional trauma; a traumatic event, traumatic childhood, a devastating experience.

I'm certain that sort of trauma causes changes in the body...maybe chemical, maybe physical, maybe both...and that there is a mechanism in our bodies that can control or correct the disturbance, but it sometimes requires intervention or assistance.

That needs more study.
 
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Murrmurr said:
I'm certain that sort of trauma causes changes in the body...maybe chemical, maybe physical, maybe both...and that there is a mechanism in our bodies that can control or correct the disturbance, but it sometimes requires intervention or assistance.

That needs more study.
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absolutely spot on @Murrmurr... not an easy issue to approach, and would need to be considered with kid gloves. this would be approached through dynamic coaching, a self development strategy which would not necessarily be clinician led as the patient devepes their own self-coaching process. nobody else can perform this reorientation process for them. at least that's how i envision it.
 
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multimodAL said:
absolutely spot on @Murrmurr... not an easy issue to approach, and would need to be considered with kid gloves. this would be approached through dynamic coaching, a self development strategy which would not necessarily be clinician led as the patient devepes their own self-coaching process. nobody else can perform this reorientation process for them. at least that's how i envision it.
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I don't think you can trust a traumatized person to develop their own self-coaching process. Trauma happens when the person doesn't have the tools to cope with a devastating event, and they kind of get stuck. Asking this person to develop some sort of strategy is too much stress.

And what if the traumatized person is a teen or a toddler?
 
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A
Murrmurr said:
I don't think you can trust a traumatized person to develop their own self-coaching process. Trauma happens when the person doesn't have the tools to cope with devastating event, and they kind of get stuck. Asking this person to develop some sort of strategy is too much stress.

And what if the traumatized person is a teen or a toddler?
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As Putty said to Elaine, in the old Seinfeld series when she worried about being eternally damned to Hell for the life she's living...

"It'll be rough."
 
Murrmurr said:
I don't think you can trust a traumatized person to develop their own self-coaching process. Trauma happens when the person doesn't have the tools to cope with devastating event, and they kind of get stuck. Asking this person to develop some sort of strategy is too much stress.

And what if the traumatized person is a teen or a toddler?
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some initial guidance and occasional assistance would be advisable, true... but failure would be imminent if those beliefs are held onto. it would be individualistic by approach and not a panacea or for everyone due to differences in chemical (and thereby mental) states.
 
Shalimar said:
I have worked extensively with persons suffering from severe CPTSD, a condition remarkably resistant to drug therapy, and usually chronic. The emotional devastation incurred by this level of trauma precludes the efficacy of a total self care approach. I do agree that therapy should be catered to the needs of the individual, and it is not a brief process.
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It is "brief" if your insurance only covers five or so sessions. Canada probably isn't like that, but here in the U.S., therapy is rationed. And you need to be diagnosed with something listed in the DSM in order to get treatment. The good news is, almost anyone can be diagnosed with something from the DSM! :rolleyes:
 
I would like to see a more holistic approach to medicine generally, where I am not considered and defined in terms of my high BP, high cholesterol, and elevated PSA antigens. I’m a complete package, and not in bad shape for the shape that I’m in! I don’t expect to feel at 70 the way that I did when 20.

I think that the bell-shaped curve of normality is broader and more inclusive than many practitioners assume. Time was when almost every concern was routinely handled by your friendly neighborhood GP, whereas now you’re packed off to a specialist for the equivalent of a hiccup, and that specialist won’t see you as a total person, either…💊
 
Sawfish said:
Do you think that the current societal trend is to try to find a medical/psychological pigeonhole for anything that is not subjectively satisfactory?

And that this results in a lot of questionable diagnoses?
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I think autoimmunity accounts for some of this. It's not well understood though it's widely prevalent. Early symptoms are generalized and vague--chronic fatigue, pain etc.--and are often labeled hypochondria. After years of "feeling unwell" as @Sawfish clarified above and autoimmunity/autoinflammation progresses, organ damage eventually occurs and patients get a clearcut diagnosis.
 
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I gave testimony during a court martial against a fellow Marine because when we did an inspection, we found over 600 pills of Ritalin, which is an intent to deliver. He had an accomplice and the pair of them received 2 years in Federal prison and then released with a dishonorable discharge.

I know that to most people this is no big deal, but in this case, I was upset because I had been kind of a mentor to this kid. He was 20 years old, came through basic training with flying colors and had 2 stripes earlier than most do. I really liked him and helped him anyway that I could. I had high hopes for him. A few months after he was released, he came to me and apologized. I told him how disappointed I was and he actually cried. He told me he was going to do better. He told me all he ever wanted to be was a Marine, but he just got hooked with the wrong guy.

Today, he is married with kids and has a good paying job as an over the road truck driver. His wife is a nurse at a doctor’s office and they live in a nice house. I visited him when I got back to San Diego and congratulated him for turning his life around. He thought my doing that was a big deal and invited me to a cookout for his friends at his house in Julian that weekend. I had to go. We still keep in touch and this all happened back in the mid 90’s.
 
Your original question while interesting is too general to get an answer. "Anythng that is not satisfactory?" What if you decided you really don't like living at the bottom of the sea? The solution would not be a medical one; the solution would be to move.

But what if you have really ugly, crooked teeth, for instance? That does have a "medical" fix, and obviously it isn't to go to a psychiatrist to learn how to live with the problem. It would be to go to the dentist. "Medical" fix, yes, but choose the right kind of practitioner.

If we're talking about kids, it's harder to decide. A kid going through a bratty phase is not a medical problem. Good parenting is the solution. A child who refuses to talk, is always angry or destructive, etc. probably really does have a medical problem.

There are all kinds of problems, and all kinds of fixes. For some, medical is appropriate, for some there are better solutions.
Sawfish said:
Do you think that the current societal trend is to try to find a medical/psychological pigeonhole for anything that is not subjectively satisfactory?

And that this results in a lot of questionable diagnoses?
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Sunny said:
Your original question while interesting is too general to get an answer.
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That's the point.

I'm saying that diagnoses are offered for vaguely reported subjective symptoms.
Sunny said:
"Anythng that is not satisfactory?" What if you decided you really don't like living at the bottom of the sea? The solution would not be a medical one; the solution would be to move.
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Eggz-actly.
Sunny said:
But what if you have really ugly, crooked teeth, for instance? That does have a "medical" fix, and obviously it isn't to go to a psychiatrist to learn how to live with the problem. It would be to go to the dentist. "Medical" fix, yes, but choose the right kind of practitioner.

If we're talking about kids, it's harder to decide. A kid going through a bratty phase is not a medical problem. Good parenting is the solution. A child who refuses to talk, is always angry or destructive, etc. probably really does have a medical problem.
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More-or-less. Could just be attitude.
Sunny said:
There are all kinds of problems, and all kinds of fixes. For some, medical is appropriate, for some there are better solutions.
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I try to just lump through most stuff, or as much as I can.

I find that the body, like a properly ballasted boat, tries to right itself. Or mine does, anyway.

...it's the slow leaks that worry me... ;)
 

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