[HN Gopher] Too many people take too many pills
       ___________________________________________________________________
        
       Too many people take too many pills
        
       Author : mfiguiere
       Score  : 98 points
       Date   : 2023-04-28 11:28 UTC (1 days ago)
        
 (HTM) web link (www.economist.com)
 (TXT) w3m dump (www.economist.com)
        
       | hnburnsy wrote:
       | I believe the headline is a play on the line from Shoot to Thrill
       | by AC/DC...
       | 
       | > Shoot to thrill, play to kill, Too many women with too many
       | pills
        
         | hnburnsy wrote:
         | Note the song was recorded in 1980.
        
           | bluefirebrand wrote:
           | And was probably referencing recreational drug use, not over-
           | prescribed drug use.
        
       | irsagent wrote:
       | https://archive.is/fi1L1
        
       | Semonto wrote:
       | Very prominent are also homeopathy.
       | 
       | They if you need to go to a doctor regularly and you don't have a
       | proper diagnosis you might just like going to a doctor
        
         | WirelessGigabit wrote:
         | The fact that Homeopathy is even considered normal treatments
         | is appalling.
        
           | shrimp_emoji wrote:
           | Having a subpar education system is expensive.
           | 
           | https://www.thinkimpact.com/literacy-statistics/
        
       | poulpy123 wrote:
       | Yes I take too many pills for my liking but I don't do that for
       | the pleasure of swallowing pills, I do that to not end at the
       | hospital
        
       | fastaguy88 wrote:
       | This article would be much more informative if it told us more
       | about categories of pills (or diseases), how frequently they are
       | taken, and the ages of the people who take them. Almost half the
       | US population has hypertension [0], and 19 million have stage 2
       | hypertension -- those people should be on drugs. Each year,
       | 800,000 Americans have a stroke, and another 800,000 have a heart
       | attack -- these people should be on drugs. My doctor's office has
       | me on more than 5 drugs, but I only take 2 regularly -- the
       | others are for specific short term conditions (e.g. poison ivy).
       | In general, statins, aspirin, and anti-hypertension drugs cost
       | effectively save lives.
       | 
       | I have no doubt that there are too many people who take too many
       | pills, but there are also too many people who should be taking
       | medication and are not. The article does not make a strong case
       | that, for a given age group, we are being over medicated.
       | 
       | [0] https://www.cdc.gov/bloodpressure/facts.htm
        
       | JohnFen wrote:
       | I had surgery last year, and had to give a list of the
       | medications I currently take. My list had a single item, OTC
       | allergy medication.
       | 
       | The surgeon and intake nurse both independently double-checked
       | that my list was complete. They told me that it's almost unheard
       | of for someone of my age to have no ongoing prescriptions and
       | they wanted to be sure a mistake wasn't made.
       | 
       | I was very surprised by this. I was even more surprised when I
       | surveyed my friends and discovered that every single one of them
       | has at least one ongoing prescription.
       | 
       | I had no idea!
        
         | aschearer wrote:
         | Nice going, John! Role model material. What is your secret?
        
           | JohnFen wrote:
           | I have no idea. This whole thing surprised me -- I just
           | assumed that I was "normal" in this respect. I don't have a
           | secret, as far as I can tell. I am moderately physically
           | active, and I do eat moderately healthy, but not
           | exceptionally so on either count.
           | 
           | I suspect that, rather than being a role model, I just drew a
           | lucky number in the genetic lottery.
        
             | seanmcdirmid wrote:
             | Luck definitely has something to do with it. It took me a
             | while to get that given that I thought my mom was a
             | hypochondriac. It turned out she was just sick her whole
             | life. I'm 48 now and don't have any prescriptions yet, I
             | hope I can maintain that.
        
       | chickenpotpie wrote:
       | As someone who takes a pill daily that fixes my brain chemistry,
       | I would like to clarify that it is simultaneously possible that
       | many people are taking pills they don't need and many people are
       | not talking pills they do need.
       | 
       | I despise generalized statements like "xyz medication is over
       | prescribed" because it is also in some ways probably
       | underprescribed. I didn't seek treatment for a dibilitating
       | illness for many years because I was repeatedly told that the
       | medication was abused and all I needed were lifestyle changes.
       | For me, the medication was underprescribed.
        
       | manuel_w wrote:
       | Slightly related: https://news.ycombinator.com/item?id=16252372
       | 
       | I noticed that taking pain-killers is a very common thing in
       | american TV shows. The main protagonist (male hero) gets hurt,
       | goes to the bathroom, hastily pours a handful of pills into his
       | hand and pops them into the mouth. Not one, but a hand full of
       | pills, cleary too many. I've seen it so much, I'm starting to
       | wonder if it's a TV trope.
       | 
       | I'm wondering if pharmaceutical companies are sponsoring this.
       | It's akin to product placement.
        
         | blacksmith_tb wrote:
         | Hmm, well I wouldn't recommend taking a whole handful of
         | ibuprofen, but it probably shouldn't kill you (unlike a handful
         | of acetaminophen/paracetamol, or opioids), it would be hell on
         | your stomach, but I suppose fast-paced drama doesn't have time
         | for realism.
        
         | slowmovintarget wrote:
         | With the toxin they put in Tylenol (to prevent abuse), you'd
         | blow out your liver if you did that.
         | 
         | In books, you get "chewing asprin without the water." So yes,
         | it's dramatic, but not realistic. It's just a way of conveying
         | through action "Ouch, that _really_ freaking hurts. "
        
           | fire wrote:
           | > With the toxin they put in Tylenol (to prevent abuse)
           | 
           | ...acetaminophen itself is what kills your liver in an
           | overdose, there is no "toxin they put in tylenol"
        
             | [deleted]
        
             | anjel wrote:
             | Got it upside down. Acetaminophen is added to opioids to
             | prevent rec use and abuse.
        
         | [deleted]
        
         | ploxiln wrote:
         | It's a dramatic trope. I'm an american, born and raised as they
         | say, and I've never seen that. It probably happens sometimes in
         | places I'm not familiar with, but ... come on, it's absurd,
         | anyone would be incapacitated by that many pills.
         | 
         | I was thinking about this when watching The Shape of Water,
         | Michael Shannon's character is in his car, arms shaking,
         | pouring the whole pill bottle on his face ...
         | 
         | It's a dramatic trope.
        
         | saltcured wrote:
         | I think this can be one of several subvariants.
         | 
         | A version of the drug habit/self abuse trope that used to be
         | demonstrated with late nights alone with booze bottles in some
         | depressing living room.
         | 
         | A blazing modern signal that the protagonist is hurt but
         | continues anyway, to distinguish him from some impervious
         | Superman or unfeeling Terminator clone.
         | 
         | The writers are mildly concerned about the plot discontinuity
         | and rushing him to the next scene. See also the bullet wound
         | self-care with improvised extraction and bandage from ripped
         | clothing, which leads to miraculous physical rebound. No
         | debilitating blood loss, nerve damage, or torn connective
         | tissue in this plot!
        
           | [deleted]
        
         | shalmanese wrote:
         | I think it's video game logic imported into films. Pills are a
         | common health pack symbol so more pills = more health regained
         | = more return to normal stats.
        
         | SturgeonsLaw wrote:
         | Like the way toothpaste ads show them squirting 3x as much
         | paste as you actually need onto the toothbrush
        
           | quintushoratius wrote:
           | That's just like how shampoo companies advise you to "lather,
           | rinse, repeat". It's a great way to boost sales, but besides
           | being unnecessary it's terrible for your hair, your water
           | bill, fish living downstream, and your wallet.
        
             | gs17 wrote:
             | Personally, I've had much better results with repeating,
             | but I haven't bothered to experiment enough to see if it's
             | from "rinse, lather, rinse" or the full "lather, rinse,
             | lather, rinse".
        
             | [deleted]
        
       | aschearer wrote:
       | People want pills or miracle diets. People don't want lifestyle
       | changes. They're busy, stressed, strapped for cash, and anyway
       | they like the standard American diet. Collectively, we could
       | shape our environment so healthy decisions are easier and
       | unhealthy choices are harder, but we can't even agree to tax
       | sugar. So we won't make policy changes anytime soon, and
       | individually many of us will fail to make healthier choices. What
       | more is there to say?
        
         | [deleted]
        
         | escapedmoose wrote:
         | I used this same reply elsewhere, but it's relevant here as
         | well:
         | 
         | Diet/sleep/exercise/sunlight are always the first step, and if
         | you don't at least get those, you'll be hard-pressed to feel
         | decent no matter what else you do, regardless of whether you
         | have other medication-dependent conditions.
         | 
         | That said, there are way too many people out there who have no
         | experience with conditions which require medication, who seem
         | to think that those things are a substitute for medication
         | rather than a baseline that must be kept up alongside
         | medication.
         | 
         | I'm no psychologist, but I tend to assume that a driver to
         | thinking this way might be the sense of safety that comes with
         | self-righteousness. Similar to victim-blaming in crimes, where
         | people pick at the personal faults of crime victims (however
         | slight) in order to reassure themselves that a similar thing
         | couldn't happen to them. Imo it's a coping mechanism for a
         | world where long-term suffering can be brought on totally at
         | random.
        
         | asdfman123 wrote:
         | As a doctor it's your job to give your patient something that
         | will treat them. You can't tell someone "if you exercise an
         | hour a day, your problem will go away" because at least 9/10
         | people won't do it.
        
           | omginternets wrote:
           | If they don't take the pills, are you also supposed not to
           | prescribe them?
           | 
           | Patients refuse treatment all the time. I'm not so sure it
           | ought to be a doctor's job to cater to the patient's every
           | whim.
        
             | dismantlethesun wrote:
             | Actually yes. If the patient refuses treatment you do not
             | give them a prescription they is useless but rather tell
             | them of an alternative if one exists. If none exists then
             | tell them that.
             | 
             | In the end, it's the patients right to have the treatment
             | they want and can afford so long as it's efficacious.
        
             | [deleted]
        
           | JohnFen wrote:
           | I expect my doctor to give me the best medical care. If
           | that's telling me to make a lifestyle change, that's what I
           | want (whether I follow his advice is an independent issue). I
           | 100% don't want a doctor to give me medication that isn't
           | necessary.
        
             | asdfman123 wrote:
             | I'll tell you what your doctor might not be telling you:
             | 
             | - 30 minutes of cardio, 3x a week is a bare minimum. The
             | more cardio the better, so consider endurance sports.
             | 
             | - Resistance training is necessary too, and can be done at
             | home with no equipment
             | 
             | - Get at least 10 minutes of sunlight right after you get
             | up or right after the sun comes rises, even if it's cloudy,
             | if possible
             | 
             | - Don't drink more than 2 drinks in a day
             | 
             | - Try to reduce stress as much as possible
             | 
             | - Get plenty of sleep
             | 
             | - Cut out digital distractions
             | 
             | - In general try to eat as many natural foods as you can,
             | especially more fruits and vegetables. Avoid eating
             | chemicals if you can, hydrogenated oils, etc.
             | 
             | Now you've heard it, as well as everyone else reading this
             | thread. It's up to you to do it. But odds are, for the most
             | part, you've heard it before and don't need reminding.
             | 
             | If you're confused about any of the details on this list,
             | you are all people who are in the top quartile (at least)
             | in learning things on the internet, and can figure the rest
             | out yourselves.
        
               | [deleted]
        
               | 0zemp2c wrote:
               | I don't think 30 mins, 3 times a week of exercise is
               | remotely close
               | 
               | only stretching back a few decades, my grandfather was
               | working his own land as a subsistence farmer without much
               | "automation"...probably doing the equivalent of three
               | hours of CrossFit a day, basically every day. looking
               | back at pics of him now...he was strapped, even in his
               | late 70s (what was also known as "normal").
               | 
               | my genetics probably come from hundreds of generations of
               | people who led similar lives, yours too
               | 
               | I achieved my "normal" body weight with a minimum of two+
               | hours per day, every day, of exercise...just like all of
               | my ancestors who shaped my genes
               | 
               | 90 mins a week is probably not enough to even slow down
               | weight gain, we are dramatically underestimating how much
               | exercise we need, and dramatically underestimating how
               | much we need to clean up our diets...in 1880 basically
               | anyone doing subsistence farming (most people) was the
               | equivalent of a CrossFit nut with a "clean"
               | diet...everyone
        
               | comfypotato wrote:
               | 5 hours per week of 3 METs (a 2.5mph walk is 3 METs)
               | reduces your risk of Cardiac disease by 70%. This is from
               | one of the bigger meta analyses I've ever read. The US's
               | exercise guidelines are based on it.
               | 
               | In general more is better, but it's diminishing returns,
               | and you could argue that more time than this could be
               | better spent doing other healthy tasks.
        
               | escapedmoose wrote:
               | I don't have the energy to refute these claims one by
               | one, but I would recommend you do some more research into
               | the lifestyles and health conditions of previous
               | generations.
               | 
               | Glad you've found something that works for you though
        
               | omginternets wrote:
               | > The more cardio the better, so consider endurance
               | sports.
               | 
               | The research vehemently disagrees with you, especially if
               | you're a woman.
        
               | amanaplanacanal wrote:
               | I've never heard anyone claim that less exercise is
               | better. Can you point to the research that "vehemently
               | disagrees"?
        
               | comfypotato wrote:
               | It's one of the most researched topics in science.
               | 
               | 5 hours at 3 MET (a 2.5 mph walk is 3 MET) a week lowers
               | your risk of cardiac disease by 70%. It's not affected by
               | gender for the basic numbers. This is from one of the
               | bigger meta analyses I've ever read. The US's exercise
               | guidelines are based on it.
               | 
               | Can't speak for the recommendation of endurance sports.
               | Definitely not a requirement. The research does show
               | that, in general, the more cardio the better.
        
               | Moissanite wrote:
               | > Don't drink more than 2 drinks in a day
               | 
               | Just to clarify, because this one tripped me up: you
               | specifically mean alcohol, right?
        
               | eastof wrote:
               | In american english "drinks" is a common colloquialism
               | for alcoholic drinks. You should definitely drink more
               | water than that with your cardio haha.
        
               | Moissanite wrote:
               | Good; I was worried I'd stumbled into some some paleo-
               | esque "only drink from puddles at dawn and dusk to
               | maximize your gut flora development" nonsense.
        
               | JohnFen wrote:
               | Of course I've heard it. As you said, the odds are
               | excellent that everyone reading this has heard it too.
               | 
               | And I actually do all of that. Not because anyone told me
               | to, or because I should, but because that's just how my
               | life ended up being arranged.
               | 
               | Not sure how that's related to my point, though.
        
               | asdfman123 wrote:
               | Just that everyone's heard it, so the doctor isn't going
               | to repeat it to you with every visit.
               | 
               | I think a doctor absolutely should gently remind people
               | that those things improve a variety of conditions, and
               | occasionally push a little harder in certain situations
               | (you need to start doing X now or your condition is going
               | to be a big problem). Many of them already do, of course.
        
               | JohnFen wrote:
               | Sure, a doctor isn't necessarily going to give generic
               | health advice on every visit. That wasn't what I was
               | saying.
               | 
               | What I was saying is that if I go see a doctor for a
               | condition, and the proper way to resolve that condition
               | is to make a lifestyle change, then that is what I want
               | the doctor to tell me.
               | 
               | What I don't want the doctor to do is to just give me a
               | prescription if the actual treatment is to behave
               | differently in some way.
        
               | asdfman123 wrote:
               | But difficult to treat chronic conditions aren't that
               | straightforward, and virtually all of them respond to
               | general good health as outlined on that list.
               | 
               | Everything else is either a straightforward treatment, is
               | untreatable, or has a lifestyle change that the doctor
               | _will_ tell you about (like with IBS and a low FODMAP
               | diet for instance).
        
               | JohnFen wrote:
               | I agree. That isn't counter to what I was saying at all.
        
               | rufus_foreman wrote:
               | I'll tell you what your doctor might not be telling you,
               | doctors have the highest suicide rates of any profession.
               | Should I trust them to tell me what is healthy?
               | 
               | Retail managers have the lowest suicide rates.
               | 
               | I don't trust them either.
        
               | kzrdude wrote:
               | I have some struggles, and this is basically the plan
               | that I try to follow. I can notice how it really helps
               | with mood, energy, everything, and how a single day of
               | falling off it leaves a big mark the next few days.
               | Cheers.
        
         | eli_gottlieb wrote:
         | >People want pills or miracle diets. People don't want
         | lifestyle changes.
         | 
         | How you gonna make lifestyle changes without permission from
         | your lords and masters who write your paychecks?
        
           | aschearer wrote:
           | LOL what? Where did all this "lords and peasant" nonsense
           | come from? Come back to reality, Eli.
        
             | eli_gottlieb wrote:
             | I'm being real. Lots of people work 10-12 hours a day. How
             | are they supposed to shop and cook for only fresh and
             | healthy food, as well as do 30 minutes of rigorous cardio
             | per day, in the remaining four hours a day when they're not
             | asleep? What if they have family obligations?
        
               | brnaftr361 wrote:
               | My experience was that I was _scheduled_ 12 hours a day,
               | the reality is that we all commuted 1h both ways and
               | turnover often took 30-45 minutes. We were bussed in, and
               | we arrived 15-20 minutes early. To put the final little
               | bit in, we also had to commute to the bus depot. Whatever
               | extraneous time I had was spent in the shower.
               | 
               | While I did manage to eat decently I also had the benefit
               | of years of working in kitchens and I opted for
               | vegetarianism years prior so I had to delve into a novel
               | culinary discipline which served to broaden my horizons
               | both in what I considered a meal, and what I was willing
               | to eat, and how I was willing to eat. Looking at the rest
               | of the cohort: yeah, it was bad. A lot of industries we
               | interfaced with had a lot of very evident cases of poor
               | diet. I expect among the whole the chronically single and
               | childless were the few that could manage their health in
               | the context of that schedule or any modern American
               | regime, really.
               | 
               | Beyond diet it's physically taxing, especially
               | considering that my industry, and every industry touching
               | it worked some variation of swing shifts and if not that,
               | 24/7 on-call. That alone is extremely taxing and has
               | prolific long-term implications. Alcohol and drug abuse
               | are commonplace, whether licit or illicit substances. And
               | there's a huge emotional layer to it as well, if that
               | isn't obvious. Mind you these are the people paid by the
               | companies that keep your lights and heat on, transport
               | all your food and fuel...
               | 
               | But even outside of that extreme edge case the other jobs
               | I've had can have their own sets of challenges. It's not
               | always overeating that gets you, but undereating is a
               | hazard as well. And workplace injuries are _not_ so
               | avoidable as the institutions like to profess. If you 're
               | pressured, your peers are pressured, your customers are
               | pressured, etc... the culture itself becomes go fast or
               | die trying -- they'll tell you to work safe but God
               | forbid if you do you'll be punished for it, ask me how I
               | know. And that's without factoring in RSIs, which in some
               | occupations are virtually inextricable.
        
               | badpun wrote:
               | Most people don't work on weekends. You can do shopping
               | and cook for entire week then. This is not a theoretical
               | proposition, I've done that a lot.
        
               | omginternets wrote:
               | Most people do not work 10-12 hours a day.
               | 
               | Those who do have far bigger problems than regular
               | exercise.
        
               | etempleton wrote:
               | In the US it is fairly common.
        
               | clnq wrote:
               | It is admired. "First in, last out" and sleeping in the
               | office are virtues to be signalled!
        
               | inglor_cz wrote:
               | In the developing world, where highly processed food is
               | usually too expensive for a normal family to live on,
               | people cook regularly. Like, every day.
               | 
               | How come? They certainly don't work any fewer hours than
               | Westerners do.
        
               | amanaplanacanal wrote:
               | I bet most families have an unemployed adult that cooks.
               | Grandma or older child or some such.
        
               | badpun wrote:
               | In communist Poland, both of my parents worked, and yet
               | my mother cooked every day after work. Work + commute
               | took her around 9 - 9.5 hours per day. On top of that,
               | there were long queues to buy anything at the stores, so
               | you were spending easily an extra hour shopping per day
               | (not to mention spending time bartering with family and
               | neighbors the goods you managed to buy, but didn't need
               | for stuff you actually do need).
        
               | escapedmoose wrote:
               | Often those tasks are left for their children who are
               | forced to cut their education short to care for the
               | family.
        
         | badpun wrote:
         | > They're busy, stressed, strapped for cash, and anyway they
         | like the standard American diet.
         | 
         | Most of all, they're lazy. When people retire, all these
         | problems (no time, stress, money problems) usually go away and
         | people have oceans of stress-free free time to fill. And yet, a
         | lot of them don't drop their unhealthy habits like overeating,
         | no excercise etc.
        
           | aschearer wrote:
           | How puritanical. Do you look down on everyone or just
           | unhealthy people?
        
             | badpun wrote:
             | I'm the same. It's just human nature to not want to expend
             | effort. We love excuses, like - I'm too stressed, to busy
             | etc. - but quite often, they're just that - convenient
             | excuses.
        
               | ElevenLathe wrote:
               | All humans in environment A get fat, develop heart
               | disease, and are depressed. All humans in environment B
               | are lean, live long lives without medication, and are
               | happy. The only logical conclusion: everyone in
               | environment A is lazy or otherwise morally deficient.
        
               | [deleted]
        
               | tintedfireglass wrote:
               | everyone in environment A is lazy and morally deficient
               | because environment A promotes laziness and is in itself
               | morally deficient.
        
               | glitchc wrote:
               | Or environments A and B have specific differences in
               | factors operating on the humans existing within them.
        
               | badpun wrote:
               | > All humans in environment A get fat, develop heart
               | disease, and are depressed
               | 
               | There's plenty of non-obese people in the world.
        
               | LightBug1 wrote:
               | [flagged]
        
               | 11235813213455 wrote:
               | > There's plenty of non-obese people in the world
               | 
               | yes, over 9000
               | 
               | but more than half people are overweight in developed
               | countries, so this has become the norm
        
               | badpun wrote:
               | What's with the denial? A significant portion of
               | population of developed countries is not obese. It's easy
               | to look that up. This proves that we don't live in an
               | environment that makes everyone obese.
        
               | SturgeonsLaw wrote:
               | Maybe it's all the beef from those spherical cows they're
               | eating
        
           | mydogcanpurr wrote:
           | There's a huge confounder missing in your analysis which is
           | that they're also typically quite old by the time they
           | retire. People don't change their habits easily at that age.
        
         | dantheman wrote:
         | Sugar is taxed, it's why we have hi-fructose corn-syrup.
        
           | robotnikman wrote:
           | Which is arguably even worse than sugar for you
        
           | amanaplanacanal wrote:
           | Sugar is taxed only in a few localities, but is subsidized
           | federally.
        
       | WarOnPrivacy wrote:
       | Too many people also don't take enough pills - because they can't
       | afford them.
       | 
       | Myself, friends and family all have untreated conditions and
       | aren't getting preventative care because the out-of-pocket cost
       | of meds and treatments are more than their total earnings. Due
       | for Shingles vaccine? $400. Need an inpatient visit to resolve
       | something before it becomes serious? $2800.
       | 
       | Five hundred here, $5000 there and pretty soon healthcare becomes
       | an alternative to housing.
        
       | harha_ wrote:
       | I'm just so glad I didn't start taking SSRI's, my doctor almost
       | forced them down my throat but I didn't take them because I felt
       | like I don't need them. And I didn't need them.
        
       | michelb wrote:
       | Interesting to see which countries have these problems. Reads to
       | me like it's very much a political problem. In my country I
       | practically have to fight my doctor to get pills or an xray if
       | they deem it unnecessary. Which is great in the end, as it saves
       | our society a lot of healthcare costs.
        
       | thenerdhead wrote:
       | Who exactly is responsible for the patient's wellbeing long term?
       | The old idea of doctors and pharmacists should be putting
       | themselves out of a job doesn't seem to be reflected in many
       | healthcare systems. It is also not morally responsible for
       | patients who may not be self reliant to do so for a number of
       | reasons(I.e. not in right health or mind).
       | 
       | On the reverse, how many doctors or pharmacists actually
       | recommend lifestyle and supplementation changes before resorting
       | to a prescription through observation? My experience has been
       | quite disappointing and I lose faith every time I get a checkup.
       | 
       | For what it is worth, I'm not on any prescriptions and actively
       | refuse recommended prescriptions when only seen for 30 minutes
       | every half year. It always feels like an up sell when all you
       | want is to be sent on your way with an acknowledgment that you're
       | healthy.
        
       | local_crmdgeon wrote:
       | I hate these articles. While yes, this is true, it's also true
       | that _many_ people have severe, untreated illness that they're
       | just "toughing it out." My friend with BPD ruined his life
       | because he's "stronger than the disorder, I don't need to take my
       | meds"
       | 
       | Spent millions foolishly, genius engineer - horrible story.
       | Easily fixed.
        
         | [deleted]
        
         | asdfman123 wrote:
         | There is a fine and very important distinction to be made here.
         | 
         | If you have a health problem, you should do your best to get
         | exercise, eat healthy, etc. However, that _doesn 't_ mean
         | medicines are wasteful or pointless. People often greatly
         | benefit from them.
         | 
         | I've struggled with ADHD, depression, and anxiety my whole
         | life. And indeed, yes, the best treatment I've found is diet,
         | weight training, and long-duration cardio. Which I do.
         | 
         | But people who are "in the hole" need medicines to dig them
         | out. And also, people with kids/multiple jobs don't have as
         | much time as I do. And these habits take years to finally
         | stick. And I still need ADHD medication.
         | 
         | And the best treatment for things like this is to try _every_
         | treatment you can together, but don 't overwhelm yourself in
         | the process (and it takes wisdom to not overwhelm yourself).
         | 
         | People on Twitter opine about this kind of stuff piss me off.
         | They think their vague notions about what is right for society
         | --that they have no experience with--should take precedence
         | over my decades of (informal) research and lived experience.
         | It's okay to have opinions and discuss things, but don't try to
         | bully the people who actually know what they're talking about.
        
           | escapedmoose wrote:
           | Diet/sleep/exercise/sunlight are always the first step, and
           | if you don't at least get those, you'll be hard-pressed to
           | feel decent no matter what else you do, regardless of whether
           | you have other medication-dependent conditions.
           | 
           | That said, there are way too many people out there who have
           | no experience with conditions which require medication, who
           | seem to think that those things are a substitute for
           | medication rather than a baseline that must be kept up
           | alongside medication.
           | 
           | I'm no psychologist, but I tend to assume that a driver to
           | thinking this way might be the sense of safety that comes
           | with self-righteousness. Similar to victim-blaming in crimes,
           | where people pick at the personal faults of crime victims
           | (however slight) in order to reassure themselves that a
           | similar thing couldn't happen to them. Imo it's a coping
           | mechanism for a world where long-term suffering can be
           | brought on totally at random.
        
           | gms7777 wrote:
           | Yeah, as someone with ADHD, good diet, exercise, sleep, etc.
           | are critical for managing symptoms. They're also effectively
           | impossible to maintain consistently without medication.
        
         | birdyrooster wrote:
         | Who are you to say that spending your millions is foolish this
         | way or that way? We all end up as dirt. Why not live
         | eccentrically and take risks? It makes for a good story which
         | you have conveniently cast as horrible. I bet that story is
         | plenty interesting and worthwhile as is yours.
        
           | doodlesdev wrote:
           | You clearly never met anyone with BPD.
        
             | Zircom wrote:
             | When you say BPD are you referring to borderline or
             | bipolar? Because borderline is usually treated with therapy
             | as the first-line treatment, while meds are definitely the
             | norm and most effective for bipolar.
             | 
             | OPs description of his friend ruining his life by not
             | taking his meds seems more like bipolar.
        
               | throwaway743 wrote:
               | Eh, could be either really
        
           | trollthrowaway4 wrote:
           | Good fellow, perhaps you've wandered in here from another
           | time? Maybe in 2011 this would've been a level-headed take on
           | this platform -- but not now! Spontaneity, eclecticism,
           | originality? No no, we're all Big Corp workers here, and we
           | must all fall in line into our predefined paths. Hackers and
           | rogues, best ye not speak; lest the hounds of conformity
           | catch a whiff.
           | 
           | Money should only be spent _reasonably._ That is, put into a
           | retirement fund, into savings, and other well-regarded
           | things. Your life must be lived _reasonably_ -- else we will
           | tell you otherwise!
           | 
           | I.e. many other people only see one "good" way to live a
           | life; only one "good" form of morality; only one "good"
           | mindset.
           | 
           | And as much as I've enjoyed the originality of your posts,
           | may I recommend ceasing? Share these morsels of a not-yet-
           | snuffed-out humanity with your intimates, rather than
           | strangers who don't care about the consequences of their
           | words on others?
        
           | quintushoratius wrote:
           | > Why not live eccentrically and take risks?
           | 
           | Maybe because there are dependents that needed that money for
           | school, shelter, clothing, or food.
           | 
           | There was a story in the news recently about a guy who
           | spontaneously gave away $200k by throwing bills out of his
           | car window. Seemed like a feel-good story, at first. It turns
           | out that he gave away his family's life-savings and they're
           | now destitute.[1]
           | 
           | Money can absolutely be wasted and spent foolishly.
           | 
           | [1] https://www.nbc15.com/2023/04/13/man-throws-200k-cash-
           | out-ca...
        
             | birdyrooster wrote:
             | That was exactly what I'm talking about. What an
             | interesting story and we have only heard it from a single
             | perspective. Imagine the stories of the people it affected,
             | I'm sure it made someone better off.
        
       | fear_and_coffee wrote:
       | [dead]
        
       | neonate wrote:
       | http://web.archive.org/web/20230429132941/https://www.econom...
        
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