[HN Gopher] Sergey Brin, David Baszucki, Kent Dauten commit $150...
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       Sergey Brin, David Baszucki, Kent Dauten commit $150M to fight
       Bipolar disorder
        
       Author : vanilla-almond
       Score  : 45 points
       Date   : 2022-09-16 18:20 UTC (4 hours ago)
        
 (HTM) web link (www.forbes.com)
 (TXT) w3m dump (www.forbes.com)
        
       | Eleison23 wrote:
       | I have been through the wringer in the mental health system, and
       | only 3 years ago did I discover the true genesis of my condition.
       | 
       | My parents began shuffling me into therapists when I was about 8
       | years old. It wasn't really effective because we were all
       | resistant to it: admitting problems, wanting to change, sticking
       | to a course of treatment. So it continued and I was put on SSRIs
       | when I was 21. I loathed that development. I was further
       | hospitalized and put on mood stabilizers a few years later.
       | Needless to say, that was even more detrimental: I still didn't
       | know why I was like this.
       | 
       | Receiving a diagnosis of bipolar disorder was weird; they
       | explained the chemical imbalance fairy tale and the way drugs
       | would help, and they explained how many famous people throughout
       | history had also suffered from this scourge, so I suppose I was
       | supposed to feel like I was in good company. But it was
       | unsatisfying, because if I had a mere mood disorder, why was my
       | life so profoundly messed up? Just because I had a few bouts of
       | sleepless nights?
       | 
       | Fast forward to 3 years ago and I had a series of revelations
       | which indicated significant and enduring childhood trauma and
       | abuse. I landed on a diagnosis which isn't in the DSM and can't
       | be medicated. That has been satisfying, because now I was
       | equipped to both reject the drugs and work on the issues at the
       | root of my profound anguish.
       | 
       | "Bipolar disorder" is a silly catch-all description. It's a
       | collection of behaviors and "symptoms" that can't be clinically
       | tested, it's just a label to slap onto people so that they can be
       | drugged and checkboxes can be ticked in a treatment plan by
       | providers and your insurance (if any).
       | 
       | If they're telling you that you're "bipolar" and they're trying
       | to drug you and you're unsatisfied with that prognosis, then
       | good! I encourage you to dig deeper and explore the root causes.
       | You'll need to trust and commit to good therapists.
       | 
       | For me, my faith in Jesus Christ as savior has made all the
       | difference, and that's actually a gift which my adoptive parents
       | gave me alongside everything else, so thank God for that!
        
       | Eddy_Viscosity2 wrote:
       | "fight" bipolar disorder. Odd choice of words there. Sounds like
       | they want to find bipolar people and beat them up.
        
         | pstuart wrote:
         | It fits in with the common trope of "The War on X".
        
         | yamtaddle wrote:
         | Fight heart disease, fight cancer. Common usage in this
         | context.
        
           | Eddy_Viscosity2 wrote:
           | It is common, but still feels out of place for a psychiatric
           | disorder. 'Understanding', or 'treating' seem like better
           | choices. Like you wouldn't say 'we pledge to fight down's
           | syndrome' - it doesn't work.
        
             | yamtaddle wrote:
             | > It is common, but still feels out of place for a
             | psychiatric disorder.
             | 
             | Probably a result of there being a couple conflicting ways
             | of looking at them: there's the "it's part of who you are
             | (or I am)" perspective--so, an identity thing--and the
             | "psychiatric diseases are just diseases like any other (so
             | shouldn't be stigmatized any more than a broken arm would
             | be)" perspective.
             | 
             | Adhering to the latter, this kind of phrasing is exactly
             | what's desired--writing about psychiatric diseases the same
             | way we'd write about any other disease. Favoring the
             | former, it could come off as insulting.
        
             | tdeck wrote:
             | I think this language started because healthcare advocacy
             | organizations are trying to draft in the wake of military
             | propaganda. Many governments of countries with active
             | militaries (e.g. the US) spend a lot of money convincing
             | the populace that fighting wars on the government's behalf
             | is a great thing. Why not try to recapture that free
             | advertising for a war on poverty, a war on drugs, or a war
             | on cancer? IMO it's not a particularly healthy analogy but
             | it's what we're steeped in.
        
       | herf wrote:
       | "Cara Altimus of the Center for Strategic Philanthropy will serve
       | as managing director of BD2."
       | 
       | HN may not know who she is, but Dr. Altimus is an accomplished
       | researcher who has worked with Samer Hattar at Johns Hopkins and
       | has done major work on ipRGCs. Very excited!
        
       | hammock wrote:
       | What are the proposed causes of bipolar disorder?
        
         | monknomo wrote:
         | There are some genetic factors that contribute - it tends to
         | cluster in families. But genetic pre-disposition is just one
         | factor; just because a person has some genes associated with
         | bipolar doesn't mean they will develop it. Genes associated
         | with bipolar have overlap with genes associated with
         | schizophrenia and autism.
         | 
         | Bipolar is also associated with trauma in a person's life,
         | however some people develop bipolar without any particular
         | trauma.
         | 
         | There is also some evidence that it could be a result of viral
         | infection, similar to MS.
         | 
         | There seem to be some difference in calcium channels in cells
         | among people with bipolar, as well as sodium levels within
         | cells.
         | 
         | Bipolar is associated with difference in blood brain barrier
         | permeability.
         | 
         | Bipolar is associate with increased propensity to get eczema.
         | 
         | There are generally some structural difference in people with
         | bipolar's brains, although it's unclear if those are what cause
         | the disease, if the disease causes them or if treatment causes
         | them. Or all of the above.
         | 
         | Basically, there are tons of potential causes, but most studies
         | are limited by size, length and the population willing to
         | participate in them. Study participants are often in an in-
         | patient setting, which is generally people with a more severe
         | form of the disorder, and is also when the disorder is at its
         | worst, and doesn't allow for tracking the overall course of the
         | disorder. Some long term longitudinal studies would be great
        
         | missedthecue wrote:
         | according to the NHS, disruptive or traumatic life events
        
           | samatman wrote:
           | This is clearly neither necessary nor sufficient for the
           | disease to present itself.
           | 
           | Even as a factor, this is about as sophisticated as saying
           | broken legs are caused by downhill skiing.
        
       | mnemonicsloth wrote:
       | > Even so, treatment breakthroughs have lagged and the drug often
       | prescribed for the condition, lithium, was first used nearly 75
       | years ago.
       | 
       | This is false. I don't know what this author was doing. Even
       | reading Wikipedia would give you a better understanding than
       | that.
       | 
       | Initial treatment for patients presenting with acute mania are
       | antipsychotics like Risperdal or Geodon. After that they might
       | try mood stabilizers like lamotrigine or seroquel, or any number
       | of other things that are much more recent than lithium.
       | 
       | If you want to learn more about the wild world of
       | psychopharmaceuticals, I recommend crazymeds.com, which also
       | tells you a lot about how mentally ill people often view
       | themselves. It's fascinating even if you're not crazy.
        
         | metadat wrote:
         | My experience has been that Lithium is still very widely
         | prescribed for bi-polar disorder as well as BPD (borderline
         | personality disorder).
         | 
         | It's not that there aren't alternatives, but they are much more
         | hit-or-miss in terms of efficacy. Lithium tends to be more
         | predictable in terms of keeping things stable, but the side
         | effects are awful.
        
         | frozencell wrote:
         | * http://www.crazy-meds.org/
        
         | crotho wrote:
         | Lithium is still the fallback drug of choice with the best
         | track record. In some countries it's as much as 50% of
         | patients.
         | 
         | I was first put on lamotrogine and it's mental side effects
         | were far more debilitating than lithium's physical side
         | effects. Lamotrogine destroyed my working memory to the point
         | I'd consistently leave food on the stove and just forget about
         | it. Lithium also works better for me. It is also dirt cheap
         | compared to alternatives which don't work as well for many
         | people.
         | 
         | Other forms of Lithium also have potential for future
         | treatments, with Lithium Orotate being considered for trials
         | recently (few side effects, safer, crosses blood brain barrier
         | more effectively, but was mischaracterized in the 70s and
         | largely ignored until now).
        
       | vanilla-almond wrote:
       | An overview of Bipolar disorder: https://www.nhs.uk/mental-
       | health/conditions/bipolar-disorder...
        
         | lo_zamoyski wrote:
         | Quoting the pages linked above:
         | 
         | "Bipolar disorder is widely believed to be the result of
         | chemical imbalances in the brain."
         | 
         | As I understand it, the notion of a "chemical imbalance" as the
         | cause of mental and mood disorders is highly dubious and losing
         | support. It may be attractive within the context of a certain
         | kind of reductive psychiatric paradigm and can sometimes sound
         | a lot like New Age woo. What does it mean for neurotransmitters
         | to be "in balance"? What is the cause of imbalances? If there
         | is a cause, then is it really the imbalance that's at issue, or
         | is the imbalance merely a sign of some underlying problem (like
         | having too much bilirubin in the blood can indicate living
         | failure)? Add to this that what are commonly accepted mental
         | disorders are generally descriptive, collections of symptoms,
         | rather than causes, though in common speech we often reify
         | these descriptions into some cohesive cause to which we
         | attribute causal power (this, too, can be appealing because it
         | allows you to feel like the cause has been identified and this
         | can feel comforting if you are suffering).
         | 
         | Of course, I am not claiming that constitutional factors cannot
         | cause or contribute to mental disorders. However, it is also
         | possible to ascribe too much to constitution. We often speak of
         | mental, constitutional, and moral factors as if they were
         | distinct, but each can influence the other. Just as
         | constitutional factors can contribute to mental disorders, so
         | can moral factors. A habit of lying, for example, can
         | contribute to depression and anxiety. Denial of truths that
         | we'd rather not face can become expressed as obsessive-
         | compulsive disorders. A hedonistic lifestyle can negatively
         | impact cognition and lead to monomania. I think ignoring these
         | other angles and searching solely for constitutional factors is
         | a disservice. We are seeing an increase of mental disorders
         | today and the causes are very unlikely to be solely
         | constitutional.
        
           | kayodelycaon wrote:
           | Bipolar disorder falls so outside the norm of human
           | functioning to exclude "lack of morals" as a cause or as a
           | contributing factor.
           | 
           | For myself, I am a "moral person" in most regards. There is
           | nothing I can do to stop or prevent my episodes without
           | medication.
           | 
           | For most people it is a severely limiting disability.
        
           | PuppyTailWags wrote:
           | > A habit of lying, for example, can contribute to depression
           | and anxiety. Denial of truths that we'd rather not face can
           | become expressed as obsessive-compulsive disorders. A
           | hedonistic lifestyle can negatively impact cognition and lead
           | to monomania.
           | 
           | I don't really know if any of these are true and I don't
           | understand the correlation of these things. I don't know what
           | correlates lying with depression and anxiety, partially
           | because I know liars who aren't depressed or anxious, liars
           | who are depressed or anxious, and don't know how their lying
           | has a causal factor to anything. This also goes on for
           | hedonistic lifestyles- I've seen depressed dropouts drowning
           | in hedonism and I've seen ultra-wealthy hedonistic
           | celebrities and I don't understand the correlation or
           | causation you're trying to make.
           | 
           | Can you please clarify this point? I genuinely don't
           | understand this because it doesn't match my model of reality,
           | which doesn't show any apparent correlations of generic
           | character flaws (such as lying a lot) with specific mood
           | disorders (like generalized anxiety).
        
           | mnemonicsloth wrote:
           | Dude, bipolar disorder can be just about cured in some people
           | by dosing them with ground-up rocks. Lithium is a chemical
           | element. If it isn't inducing some kind of chemical change,
           | what is it doing?
        
             | anm89 wrote:
             | I don't believe anyone including the person you are
             | responding to is suggesting that Lithium works outside of
             | chemical pathways so it looks like you are attacking a
             | strawman.
        
             | samatman wrote:
             | Inducing some chemical change is so broad as to be
             | meaningless. "Chemical imbalance" is at least a claim, and
             | GP was right to question it before going way off the rails.
             | To address that: major mood disorders are caused by
             | something, and it isn't the decisions of the sufferer.
             | Those can make it better or worse, sure, but to even
             | entertain the idea means you've never encountered this in
             | the wild.
             | 
             | Treating something with a chemical doesn't mean what you
             | were treating is a chemical imbalance. If it's vitamin C
             | and scurvy, yes, if it's ulcers and antibiotics, no.
             | 
             | No one thinks bipolar disorder is caused by a lack of
             | lithium. The theory of chemical imbalance is just a theory,
             | one I don't happen to think has much going for it.
        
               | mnemonicsloth wrote:
               | You're being pedantic. I'm with you that "imbalance"
               | sounds a little new-agey and imprecise, but I've talked
               | to a lot of scientific and medical people about BiPD and
               | I haven't met one yet who didn't understand what was
               | actually being said: that bipolar disorder has some kind
               | of physical, correctable cause in the brain. Somewhere in
               | there, all those little lithium ions pummel a misfolded
               | protein into shape or clog up an ion channel or something
               | in such a way that the patient experiences relief.
               | 
               | It isn't precise. But back in the real world, the
               | "chemical imbalance" explanation serves the very
               | important purpose of explaining to a lot of ordinary
               | people who otherwise wouldn't understand that bipolar
               | people who are manic or depressed are not in control of
               | what they do. And that's important, because when they're
               | manic or depressed, bipolar people often act like bad
               | people.
        
               | samatman wrote:
               | I'm not being pedantic at all, my best bet is that
               | bipolar disorder arises from brain connectome structure,
               | not chemical imbalance.
               | 
               | The chemical imbalance theory of various disorders is
               | ascendant but it's by no means universally supported for
               | bipolar disorder. These days "depression is when you
               | don't got serotonin" is likely to get you laughed out of
               | the room.
        
               | [deleted]
        
           | confidantlake wrote:
           | > A habit of lying, for example, can contribute to depression
           | and anxiety. Denial of truths that we'd rather not face can
           | become expressed as obsessive-compulsive disorders. A
           | hedonistic lifestyle can negatively impact cognition and lead
           | to monomania
           | 
           | Is there any evidence of this? Not saying you are wrong but
           | without a cite this just seems hand-wavy conjecture. I could
           | just as easily say lying to yourself about the state of the
           | world leads to happiness and it is the realists that are
           | depressed and anxious.
        
           | jstarfish wrote:
           | > Just as constitutional factors can contribute to mental
           | disorders, so can moral factors.
           | 
           | I agreed with you up to here. It seems like you're replacing
           | chemical imbalances with morality. Mental illness does not
           | abide by morality.
           | 
           | For example:
           | 
           | > A habit of lying, for example, can contribute to depression
           | and anxiety.
           | 
           | Sure. People can be anxious about their lies catching up to
           | them.
           | 
           | Yet there are people that compulsively lie even when they've
           | been outed and presented with material evidence to the
           | contrary. It defies all logic and appears compulsive, like...
           | 
           | > Denial of truths that we'd rather not face can become
           | expressed as obsessive-compulsive disorders.
           | 
           | I agree with this too, but two independent statements being
           | True does not imply a causal relationship between them. This
           | behavior is found in Histrionic and Narcissistic personality
           | disorders too (and maybe Borderline?).
           | 
           | It has been suggested that pathological lying is a symptom of
           | OCD. The internet is divided on this, but in my anecdotal
           | observations, this has held true. The worst liars I know all
           | have OCD, but not everyone with OCD is a liar. I don't claim
           | to understand why this overlap exists.
           | 
           | > A hedonistic lifestyle can negatively impact cognition and
           | lead to monomania.
           | 
           | Sure, but what does one "get" from a Hedonistic lifestyle? I
           | would suggest: dopamine surges.
           | 
           | This might seem like an easy-to-reach response to Depression,
           | but consider that monomania/ADHD (a cognitive disorder) is
           | literally treated with...induced dopamine surges (in the form
           | of amphetamines).
           | 
           | So does the subject drown themselves in sex and drugs because
           | they are a Lazy Glutton, because they are Depressed...or
           | because there was something wrong with their ability to
           | regulate dopamine production in the first place?
           | 
           | My pet theory: the biggest shortcoming of modern psychiatry
           | is that we over-extrapolate observations of small groups of
           | people as though their traits universally apply to all
           | humans. That some people thrived during quarantine while
           | others went berserk should attest to how we are more
           | different than we care to admit, but we don't have a non-
           | eugenic way of cataloguing those differences beyond labeling
           | everyone as having some sort of psychiatric disorder because
           | their behavior deviates from arbitrary baselines (which is in
           | itself a problem).
           | 
           | Some people just can't follow orders, some are born leaders,
           | some can't sit at a desk for 8-12 hours a day, some can live
           | happily underground, some are liars and storytellers, some
           | overeat. There's probably a genetic reason why individuals
           | are wired to do each of these things, but our best guesses to
           | date have been ridiculous and seem to be discredited with
           | each new generation. Two cats of the same species won't
           | behave identically either. Is either one flawed, or are both
           | optimized for purposes we don't recognize?
        
       | yourMaster666 wrote:
        
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