<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>kyro</author><text>Good riddance. Psychiatry by and large is a sham field. Physicians who practice it love seeing themselves as artists who are experts in identifying the subtleties of human behavior. That&amp;#x27;s their way of saying there&amp;#x27;s very little underlying science guiding their practice.&lt;p&gt;Many of the diagnoses given are pulled out of thin air and made to justify a patient&amp;#x27;s admission, or to appease a patient&amp;#x27;s desire to feel as if they have a treatable illness. I would ask psychiatrists I trained with to explain why a drug worked or why a disease developed. They would do nothing more than give me the same surface-level information we all know: SSRIs block serotonin reuptake, leading to more serotonin in the synaptic cleft that would then cause increased stimulation, and voila, you&amp;#x27;re not depressed. This is information anyone can attain with a google search. The majority of their knowledge dealt with pharmacological dynamics.&lt;p&gt;I sat in on a psychiatry conference one afternoon where the docs discussed the treatment of several patients. Never was a scientific article or concept uttered. It was all &amp;quot;well, let&amp;#x27;s try him on seroquel and olanzapine, let&amp;#x27;s also throw Paxil in there.&amp;quot; It was evident that their treatment protocol was largely one of extremely unsupported trial-and-error based on very, very unique experiences, anecdotes, and preferences each psychiatrist had.&lt;p&gt;Now, I don&amp;#x27;t want to discredit the entire field. I do know friends and family who have benefited from psychiatric medications, although that could entirely be due to placebo effect. What needs to happen first is that we need to attain a much deeper understanding of how the brain works on the low and high levels, mechanically and abstractly. Mechanically so that we may develop effective meds, abstractly so that we may learn how to manipulate cognitive processes, like with what we see with CBT, which has worked wonders for many with depression -- no medication involved.&lt;p&gt;tl;dr: Psychiatry is a very, very loose and abstract field. You can&amp;#x27;t run any diagnostic tests on patients. It&amp;#x27;s mostly a field of educated guessing and confirmation bias. We need better mechanical and abstract understanding of the mind before we douse it in chemicals.</text><parent_chain></parent_chain></comment><story><title>The psychiatric drug crisis</title><url>http://www.newyorker.com/online/blogs/elements/2013/09/psychiatry-prozac-ssri-mental-health-theory-discredited.html</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>md224</author><text>Fun Fact: Selective Serotonin Reuptake Inhibitors, the class of drugs used to treat depression and anxiety disorders by increasing the availability of serotonin, have a mirror opposite: Tianeptine (&lt;a href=&quot;http://en.wikipedia.org/wiki/Tianeptine&quot; rel=&quot;nofollow&quot;&gt;http:&amp;#x2F;&amp;#x2F;en.wikipedia.org&amp;#x2F;wiki&amp;#x2F;Tianeptine&lt;/a&gt;), which acts as a Selective Serotonin Reuptake Enhancer.&lt;p&gt;Incredibly, this drug has &lt;i&gt;also been effective at treating depression&lt;/i&gt;. That&amp;#x27;s right: two classes of drugs with polar opposite first-order effects are used to treat the same disorder, and both of them apparently work.</text><parent_chain></parent_chain></comment><story><title>The psychiatric drug crisis</title><url>http://www.newyorker.com/online/blogs/elements/2013/09/psychiatry-prozac-ssri-mental-health-theory-discredited.html</url></story>