Can we talk about mental illness?

There are rationalists talking about mental illness, but mostly offsite. Ozy talks about BPD among others, Kate and theunitofcaring talk about eating disorders among other things, I'm probably forgetting some.

Disclaimer: My opinions are solely my own and not based on psychological science (at least as far as I know).

I've always thought that things like depression and anxiety have some genetic component (the mix of chemicals in your brain) and some environmental 'trigger' component. You may not be able to do much about the genetic component, but if you get rid of the environmental component you can go a long way towards getting better.

I also have anxiety disorder. A lot of happiness has to do with being financially secure, having a fulfilling job/career, having a good social circle, eating well, having a good mix of hobbies, and working out. I've noticed that in my life whenever I was lagging in one or more of these areas, the anxiety and depression started bubbling up again. But whenever I tried taking care of these issues, I was mostly happy.

If someone is depressed, I don't think it will do to just give them some medications or tell them to do yoga, as you say. But maybe giving them meaningful employment or an exercise regimen will make them happy. Of course, people who are depressed get 'stuck' in a cycle where they are unable to 'break out' and obtain these things.

Again, these are solely my own opinions. Some of them might be stupid, others obvious.

May I ask a stupid question? How do people find out they are mentally ill? Obviously, I mean the not too severe cases. Let's take this GAD or tamer panic thing. During your childhood and youth you have reactions that people call "timid", "nervous", high strung" or "cowardly", depending on the situation and on them. I see four possible courses there.

A)One is you don't give a damn, you just accept it. It makes you less than happy but why would you ever expect to be happy? So you just accept some aspect of your life sucks.

There are two possible sub-courses here. As it is hard to put up with suffering in the long run A1) you can end up with self-medicating with drugs or booze A2) you become a "compensation monster", constantly climbing rocks and suchlike to show yourself and others you are not timit or not a coward.

B) You hate yourself for it, because you consider yourself screwed up and less worthy than others, but you don't realize this is something doctors may be able to fix, because you are used to people being very judgemental about this. I.e. instead of seeing someone who needs help, they see a person who is a bad and should feel bad.

C) You realize (or maybe your parents did) that it is fixable by doctors. This is obviously the best solution although A2 is doable too, but how do people get to this?

Just yesterday, I had a little shock, my wife told me that things like me being unable to dance coordinatedly, beat out a simple drum rythm, or draw beyond kindergarten level, or even to write cursive readably, is not simply "ha ha I am clumsy" thing but probably a childhood neurological, neuromotoric (or maybe ADHD) development issue and if my parents paid attention and seeked help it may have been fixable .I am still dealing with this idea that I am not simply clumsy but in a certain sense "ill".

To me the whole thing is a bit confusing. I associate illnesses with people being in bed and having fever. To understand other conditions as not screwed-upness, inadequacies, things other kids point a finger at and laugh because you are worse than them, but as medical conditions, is quite new for me.

Reminder that CBT workbooks for specific problems have been shown to be almost as effective as in person therapies and that you can just buy them on Amazon.

Depression: http://www.amazon.com/Cognitive-Behavioral-Workbook-Depression-Step-/dp/1608823806/ref=sr_1_4?ie=UTF8&qid=1425883773&sr=8-4&keywords=CBT+workbook

Anxiety: http://www.amazon.com/Cognitive-Behavioral-Workbook-Anxiety-Step-/dp/1626250154/ref=sr_1_5?ie=UTF8&qid=1425883773&sr=8-5&keywords=CBT+workbook

referral link is for Slate Star Codex if you're wondering.

On Akrasia:

• Improving the Akrasia Hypothesis
• Akrasia Tactics Review: The Akrasia Strikes Back
• Kicking Akrasia: Now or Never
• Proposal: Anti Akrasia Alliance
• Akrasia and Immunity to Change
• Rationality, Akrasia and Competitiveness

And it goes on and on, with no victory in sight.

I feel like I could fight the rest of my problems effectively with what I have (or at least, quickly learn otherwise) if I wasn't so paralyzed by Akrasia that the only resource I actually have is the ability to type incoherent comments into a small selection of websites.

I couldn't solve all of them (the technology isn't available yet), but with some of that sweet, sweet Executive Function/Conscientiousness/Free Will/Whatever we call it these days, I could at least approximate functional, and--dare I say,--not prodominantly miserable.

I think cognitive delusions often maintain themselves by being non-falsifiable, and an explicit knowledge of epistemology might help people better use logic to compensate.

I managed to get a schizophrenic acquaintance who had anxiety-causing delusional ideas which originated in mind-body dualism to reject mind-body dualism, after carefully explaining why parsimony is a good way to distinguish between the various non-falsifiable hypotheses and how one can roughly approximate what is and is not parsimonious and why the mind instinctively gravitates to mind-body dualism even though it's not necessarily true. After I finished explaining she kind of laughed and admitted there really was no good reason for her to believe those things. I might be imagining it, but she seemed relieved as well as amused.

We unfortunately lost contact, so I'm not sure if it stuck. This is the most extreme example, but I've seen other, less extreme cases where talking people away from odd beliefs was helpful to them. It's important to be convincing in these talks, and appealing to epistemically sound reasoning (as opposed to just dismissing it as most people do) is a good way to be convincing. Healthy people can instinctively tell that a delusion is silly, but for those whose instincts aren't working properly and take delusions seriously it's important to be able to explicitly explain why it's silly.

Very important. I think a lot of us need to pool together one day and write and release a general F.A.Q. that people can recursively apply to help themselves. It's risky but worth it.

If anyone is interested in actually being part of a support group of sorts, let me know- if enough people are interested, I'll see if I can find a good way to do it.

Considering the high correlation between intelligence and mental illness, you'd think it would be a bigger topic.

On what basis are you making that claim? Are there studies that suggest that such a correlation exists?

There's risk involved in giving medical advice over the internet. It's hard to fully understand another person if you just have text and no face to face interaction.

I can debug someone's phobia in a face to face interaction, but it's much harder to do anything productive over the internet.

It's difficult to find anxiety advice that goes beyond "do yoga while watching the sunrise!"

Did you actually do that exercise and tried whether it's helpful for you?

I overcame depression a few years ago and have been meaning to write about how I did it, but honestly, the current me is so different from the old me, that I don't even remember how being depressed felt.

I do remember some of the things that got me out of the depression:

• Coming independently to the insight that I should "Avoid Misinterpreting my Emotions". One day, I was sitting there thinking the same old depressed thoughts I'd usually thought. Something like "what's the purpose of doing anything." But, I realized that when those words went through my head that day, I didn't feel depressed thinking them. Then, I realized that whatever words were going through my head were not the cause of my emotions. In general, it's true that we can unlike our emotions from our thoughts. By doing this we can optimize feeling better and resolving whatever epistemic issue you think is the cause of your emotions separately.

• Discovering LW helped in a lot of ways.

• Doing lots of mind mapping / writing therapy, using GTD for managing stress/productivity, and to a lesser extent CBT.

• EDIT: Also, getting out of high-school.

I have anxiety/depression/ADHD and aspirations in conflict with my abilities and situation in life.

One strategy I have learned to employ which I consider "rational" is to approach maintenance of my mood and mental health as a limited resource allocation problem. One of the big leaps was learning to see my good mood as a limited resource which is spent as I think about potentially difficult or disturbing topics.

It is not "free" for me to consider all the ways I might do better in life, or past mistakes I have made, or ways the world is messed up. My ego is fragile. Dwelling on such topics, even when it may lead to an ultimately productive insight, is draining, and other things I value in life - my sense of motivation, my friendships, my work productivity - all suffer. My values discourage me from deluding myself to feel good, and so my approach is to allow myself to consider such difficult topics only in controlled doses.

If I am feeling particularly stressed out or guilty or ashamed, then I will deprioritize things like work and the needs of friends, and spend time and energy on improving my mood. And my model of the situation as a limited resource allocation problem helps me sidestep the ensuing thoughts of "you're being selfish/lazy/unproductive/ineffective" - such thoughts come from a place in my mind that does not recognize the resource is limited.

The result is, I keep my mood maintained more consistently, and as a result I am more effective overall.

My advice for anyone with any mental illness is to talk to somebody you can feel comfortable around about your problems. Often a therapist is that person, but not always. If you don't think your condition is serious enough to require medication, trying to discern the often minute differences between therapies can be more trouble than it's worth. Even if you discover the optimum therapy, there's no guarantee you'll get optimum implementation, eliminating the difference in value.

It's hard to give good advice on the topic of mental illness without falling into the trap of Other-Optimizing.

There are two battling narratives of mental illness. The first narrative says that mental illness is a disease of the mind, the second that it is a disease of the brain.

The "mind" story is that these illnesses come from bad ways of thinking, whether this be childhood trauma, diseased patterns of thoughts, etc. The treatment is therefore in psychotherapy, CBT, or other such. To the extent that this narrative is true, discussion of mental illness is likely relevant to rationality.

However, the other narrative is that mental illnesses come from chemical imbalances or other defects in the brain. The cure is therefore lithium, SNRIs, etc. To the extent that this narrative is true, rationality doesn't have a lot to say about mental illness.

Your post suggests you like the "mind" narrative. But to the extent that LW is a hive of reductionism, it may be that the "brain" story is considered more appealing here, and this may explain why there is less discussion of mental illness than you find conducive.

On of the best studied interventions for increasing happiness and thus help with issues like depression are gratitude exercises.

With a few friends I just started a group where everyone posts an audio message into a "What's up" before going to sleep about 5 good things that happened to him the last day. I'm just at day one, but I would expect the exercise to be very beneficial for both increasing happiness and creating group cohesion/friendships among LessWrong Meetup participants.

Examine.com seems like a great resource to find supplements to help with different types of mental disorders.

One of the more useful books I've read on the topic of mental illness is Adventures in Psychiatry by Dr. Abram Hoffer, a research scientist and medical doctor. He did the first double-blind studies of using vitamins to treat schizophrenia in the 1950s. He gave LSD to an architect to help the architect understand what patients may experience, so as to make the design of a clinic better. Those are just two examples of interesting things he did in his life.

The book can be hard to find on Amazon, or in brick-and-mortar book stores, but it can be ordered from the International Schizophrenia Foundation http://www.isfmentalhealth.org/resources/booksfilm/

The ISF also has resources on other types of mental illness from an orthomolecular medicine perspective. I realize that the orthomolecular approach is controversial, but I think that it helps at least some of the people who experience mental health problems, and I think it is not just a placebo. That said, I don't think it has a complete picture of what the problems are and how to fix them. No one in the world has that yet, that I am aware of.

I'm not sure if this falls within the type of discussion you want to start, but I thought I'd give the book recommendation, and point out that there is another option for people with mental illness to look into besides talk therapy and prescription drugs.

Why should LW be a mental consuler? No offense intended - but I bet there are people out there who will help more than anyone one LW can.