"It's really hard. If you can medicalize your faults, you get legal protection for them. If you can't medicalize them, you're personally responsible for keeping them in control. That creates a huge incentive for medicalization of everything in the human condition. And we're all worried about being left behind in this Red Queen's Race."
From excellent comment from philosophical discussion about Modafinil (the stay-awake-alert-all-night magic drug).
Hacking personality. Welcome to cyberpunk, what made you think it was all fiction?
Eventually the artificial line between "medical" and "I feel like it" will need to be addressed. On the other hand, the world is probably rich enough to support the kind of experimentation described here "in the noise."
Personally, I expect or rather hope for a drug that will truly help me lose weight with minimal danger and minimal side effects. I eat too much, almost enough to qualify for "the biggest loser," but not quite at that level. (If I lost 100 pounds I'd be thin but OK, they routinely lose 100 pounds or more and are still zaftig, plus they are shorter than me.)
I'd say as long as I wait for the right drug to lose weight, I can't fault those who have found it to talk to more girls at parties. Its probably healthier than becoming a rock star or carrying around cocaine all the time anyway.
I'm reminded of the advice from pg's never-delivered high school graduation address (posted here the other day): don't look for excuses to be lazy. Are drugs like Paxil the "lazy" way to avoid dealing with the realities of social interaction? For some surely not, but I think that for a good number of people they are.
Thats why you shouldn't use them lazily, as the author did. Taking Paxil as an alternative to therapy is misguided. Taking Paxil, and then working your ass off in therapy is the way it should work. The Paxil opens you up a bit so you can learn social skills with a professional coach, your therapist/psychologist/psychiatrist.
Its just a tool. You still have to work like hell to get over your social phobia. Then you come off the Paxil.
My personal experience: When I was regularly playing Racquetball and lifting weights, I didn't find everyday problems - tough as they were - to be daunting. Then there was a long gap when I didn't have this protection and the circumstances had much greater impact on my mood. I am starting workouts again.
If you are male, the best "drug" for social anxiety is weightlifting. (No, you don't need to be a huge-ass body-builder-douche, if you don't do 'roids you probably won't be one, you'll look normal and athletic.)
I think probably it's all about testosterone - weightlifting increases the levels of those and thus makes us feel more "manly" and that just blows away the insecurity.
I'm not a scientist, so that testosterone stuff is just a guess, but it was amazing how at the age if 17 it transformed me from a shy, withdrawn, never-look-people-in-the-eyes teenager to a "real man" - relaxed, confident, one who talks to people as a real equal. Much of social interaction has hidden traces of very primitive instincts behind it: the sexual instinct and the fight instinct, and weightlifting gives you confidence in both (even though you would still be beaten to a pulp by any 120 pound Thai Box fighter, but that doesn't matter, you probably don't actually need to fight: it's just the feeling) which transforms into a relaxed and confident social interaction.
Another way to put it is that as an Aspie, I always felt alien from both the world and from my body. My idea of "me" is something in my head who tries to drive my body with a remote control and it just doesn't work well. Weightlifting got me to connect with my body, it made by body a part of the "me", and through the body as a medium, it made me connect with the world and other people. (Probably it's something about strenghtening some under-used neural pathways that connect the "self" parts of the brain with other parts.)
Now at 30 I'm often too lazy to do it, but whenever I do it for a few months, my Aspiehood just goes away.
I always find it strange that when people suggest doing weight training, there's often a disclaimer that you won't become huge and muscular with regular workouts. It's like a disclaimer saying that you won't get all brainy and smart if you study physics or math. I would imagine that if you had the potential to be a world class bodybuilder, it's worth exploring, just as if you had the potential to be a world class physicist, it's worth exploring.
About weight lifting helping cure social anxiety, I think it's more than just testosterone. If you get serious about weights, you start watching your diet. Eating well is a large component of feeling well, and cutting down on junk and processed foods makes a noticeable difference in mood and energy.
Another factor that comes into play is having regular periods of intense focus. We all claim to be focusing when we're doing work, but there are still all those microdistractions that come with the territory. You'll learn very quickly how to maintain focus if you down want to drop a couple hundred pounds on your chest.
There was a period of time when I wasn't working out, but I'd go for a drive late at night when I was stressed. Not a normal drive, mind you; I would blast up and down the side of a nearby mountain. The physical aspect of driving, combined with the focus necessary to not go flying off a cliff, had a very similar effect. I don't recommend this, as it was extremely reckless, but if you happen to live anywhere near a track, or even a karting facility, I'd strongly suggest trying it out.
I would imagine that if you had the potential to be a world class bodybuilder, it's worth exploring ...
For some I'm sure, but not me. At the beginning of this year I began regular weight training sessions, three times a week. I have in fact repeatedly said to my friend that got me into it that I never want to look like those world class guys, the ones with the huge super tanned muscles and massive veins popping out all over the place. It's just not aesthetically how I would ever want to look. In a way I see it as being another expression of the "thin" culture that movies and TV tend to promote (mainly to women). These huge pro body builders have taken it to far in my opinion. The human body cannot reach that level of musculature without the aid of synthetic growth hormones. It's just as artificial (if not more) as a person who starves themselves to meet Hollywood's current ideal. Of course, it's their body and they can do what they want with it, but I'm just talking from my POV.
I think I would have the possibility to be a pretty successful pro body builder if I wanted to be as I have a naturally large frame. Even before I started going to the gym, people sometimes would think that I did. So even though I think there's a good chance that I would excel in this area, to me it's not worth exploring to the furthest extreme. My point being that I believe there must be many like me who do weight train but do not wish to ever look like Arnold in his hay day. Hence the common disclaimers that you mention.
In the 3 months that I have been training I have noticeably gained strength and muscle mass, but will never take steroids and will make sure that I never look unnaturally muscled.
I very much like the meditative nature of the training as it relates to concentrated focus on the specific task at hand, as mentioned by another commenter. And there are health benefits that I have already observed.
But as for the effect of weight training on confidence in social interactions, I can't say I've noticed any change whatsoever for me. My feeling is that those who do notice a positive change in confidence are possibly the guys who are a little on the small side and after training for a while and gaining some strength and mass, it makes a bigger psychological difference to them than it may have for me (as I mentioned, I have always been relatively big and tall). My second point being that - based on my own anecdotal experience - I would think any change in confidence would be more tied into the psychological than the physical.
That sounds like the equivalent reasoning for a study I've heard about, that many girls don't go into science and engineering because they don't want to be like those nerdy and brainy people, which is also an expression of the culture that movies and TV promote. Unfortunately, people's passions and talents don't always line up, and they have to make a choice of which path to follow.
Personally I'm not a fan of antidepressants. For me, Prozac had the side effect of extra-sensory perception: I couldn't do anything without having immediate karmic effects on people I knew who lived hundreds of miles away. I'd be sitting in bed talking to my wife about (essentially unpredictable) events that would happen to take place the next day. People think they might want those kind of powers, but you can count me out. I lasted about a week, but it took most of a month for the metabolites to wash out of my system.
One tablet of lexapro causes my interest in sex to disappear entirely for a week. Personally I think this simplifies my life, but three days of sleeplessness is quite a price to pay.
A friend of mine started taking Effexor, but then we found accounts of how it's impossible to stop taking Effexor: blood-curdling stories about pharmacists who'd dissassemble the pills and reassemble them to titrate the dose down, and who'd still be unable to get the dose to zero. He stopped in three days, before the damage was done.
Anyhow, all of those drugs affect serotonin metabolism, as do the 5-HT2A agonists that some people call psychedelics or entheogens. Alexander Shulgin did a 30-year research program on psychedelic phenethylamines (drugs structurally related to dextroamphetamine, mescaline and ecstacy) and found that certain drugs in that family have a synergism with alcohol much like what the author of that article describes.
After a whole lot of stuff coming down at once (divorce, December holiday season, back taxes due) I was prescribed with Prozac. I took it for maybe 3 months, then stopped. I noticed that I became a plodder for the time being, which worked well for all of the crises. I got over the ex, I got through the holidays, and I set up a repayment plan.
But all in all, I had zero creativity. I do not remember coding anything of significance. Pretty much just a maintenance lifestyle. I behaved the same with alcohol and cannabis, so it is probably my specific make-up.
I really enjoy the creative side, and I choose to remain clear. It makes for better relationships for me, all around. I also love what I do, and I seem to get better enjoyment from it.
Interesting. My father took Prozac for a while some years ago and his creativity shot through the roof. For the whole time he was on it, he became an almost expert woodworker - something he'd shown no interest in before - making some great pieces week after week. Once he came off, within a few weeks he was back to programming again, but no hands-on creative work anymore.
Good post. I think what you just explained is exactly how antidepressants should be thought of for 99% of the population. They are in almost all cases only meant for temporary use. Hell I was suicidal and basically a useless vegetable for a year and surprisingly survived before I got on three different anti-depressants (still on all three right now). But neither my psychiatrist nor I feel like I'll be taking any more than one in a year or two.
So Prozac definitely helped but yeah the creativity thing is a pain. I work like a robot now. I list out a schedule and have to follow it exactly or I get annoyed. I don't like to do anything out of the ordinary now :(
I think I lost you there, can you explain this line for me?
A friend of mine started taking Effexor, but then we found accounts of how it's impossible to stop taking Effexor:
blood-curdling stories about pharmacists who'd dissassemble the pills and reassemble them to titrate the dose down,
and who'd still be unable to get the dose to zero. He stopped in three days, before the damage was done.
For me, stopping Effexor after having taken it for a year was 2-3 weeks of misery. I have heard that for some people the withdrawal is so bad that they can't stay off the drug long enough for their body to finish returning to normal.
I don't know that this is really that irrelevant. Hacking the brain has been an interest of some hackers since at least the 80s, and once you get beyond some over-hyped nootropics, drugs like Paxil are how people are hacking their brains.
Further, there are a lot of shy geeks out there who might want to try something like Paxil. Brain chemistry is a very complicated and sometimes weirdly individual thing, and while there are undoubtedly people who've benefited from Paxil, I think it's useful to have a clearer narrative of what the very possible downsides are beyond some rattled-off disclaimers on a commercial.
One interesting downside to SSRIs in general I heard about recently comes via Helen Fisher's research (http://www.helenfisher.com/) - SSRIs suppress the dopamine systems in the brain, and high levels of dopamine are associated with the 'artisan' personality type (manic, creative, risk-taking, autonomous). High levels of serotonin are associated with the 'builder' type (managerial, traditional, stubborn).
So by taking SSRIs to hack your brain's level of shyness you might actually end up dampening your entrepreneurial vibes and becoming a middle-manager. Crazy, huh.
Irrespective of the actual reason behind the result, I found this, through personal experience, to be true. I spent the greater part of 2 years on several SSRIs, and went from a creative writer/clever programmer/poetry writing (clinically depressed) geek to a quiet, emotionless "normal" person riding an emotional flat line.
Perhaps being depressed makes me more creative. Perhaps the medication suppresses something inadvertantly, who knows (AFAIK, no one does, at least for now). But there was a definite correlation between the SSRI and my creative side.
I know plenty of others, including myself, who back up the anecdote with the same story. When does an anecdote stop becoming an anecdote and start becoming evidence? ;)
I think HN needs to have more discussion on this point. For instance, I used to listen to Art Bell: his callers gave numerous anecdotes about UFOs, but I wouldn't say those anecdotes added up to evidence of any sort. On the other hand, if you know 1000 people, and 20 of them have seen UFOs, that's definitely evidence, all else being equal. (The people you know don't exactly constitute an unbiased sample, but they aren't a meaninglessly biased sample either.)
There is a personality questionnaire called the "Temperament and Character Inventory" which purports to partition personality into a few dimensions of temperament some of which (supposedly) emerge from the independent neurotransmitter systems of the brain. [1] So basically if you trust the test you could use it to gauge your dopaminergic and serotonergic activity level (among other things). I've not researched the test enough to draw my own conclusions about it. Thus I can't say this it is a "good" way to measure anything in particular. I've not taken the test yet as I am loathe to sit through 240 questions only to find out things I already know. But I probably will at some point. You can take it online for $14.50 though a website somehow associated with its designer C. Robert Cloninger, M.D. [2]
I write code for medical devices for a living; if a substance found in the body is therapeutically interesting, then someone, somewhere has built an instrument to measure it :-)
The comment author almost certainly assumed that the measurement would have a meaning - specifically, that it would determine whether he might benefit from a drug.
There is no doubt that we can measure the concentration of dopamine or serotonin in an aqueous solution (and eventually, within a brain.) Whether there can be any clinical point to such a measurement is debatable.
Read the actual arguments in the linked article, and refute them. The source is irrelevant.
Alternatively, ask an honest psychiatrist whether anyone has any solid idea just why the drugs work, when they work. Or why they don't, when they don't.
"How are the chemical imbalances which are the supposed basis for the prescription of "antidepressants" diagnosed? Is exploratory neurosurgery performed, using some technique that allows the surgeon to quantify synaptic transmitter levels? No, the very idea is absurd. Is a spinal tap, then, done to at least measure, on a gross scale, the distribution of neurotransmitter metabolites? Of course not – how many people have undergone spinal taps before receiving a prescription for Effexor®? Is blood at least drawn, to test something? No. This diagnosis – the diagnosis of the most subtle of chemical disorders in the most complex organ in the body – is made on the basis of the patient's report of feeling sad and lethargic. Try to imagine a hematologist diagnosing leukemia this way to get a sense of just how ridiculous this idea is."
"The principal reason for rejecting biopsychiatry (aside from the fact that intellectual honesty demands its rejection) is that it locates the cause of psychic suffering in people's "bad brains," and excludes the conditions of modern life, or anything else, from consideration as the cause of such pain."
Note also that the author defends your right to take any drug, if you wish to. However, he defends it from the personal freedom point of view, and attacks the (popular yet unfounded) notion that these drugs return the individual to some nebulous ideal of "mental health."
One of the issues that has always bugged me about this is the issue of context - medicine has a great track record in treating emergencies, but fares quite poorly with preventative care and chronic illness.
The issue arises when people associate the good track record of emergency care with preventative treatment - so essentially take what's prescribed as gospel.
Would you take investment advice from a great pig farmer? Dental advice from a good banker? Art advice from a physicist?
I would imagine that pharma will have to tread very carefully over the next decade, as the cumulative resuls of drug-trials like these start to create an interesting track record. However, spin-doctoring is everything....
Although PAXIL does not increase the impairment of mental and motor skills caused by alcohol, patients should be advised to avoid alcohol while taking PAXIL...."
There usually a pretty good reason for medical warnings. Sherlock here made that pretty clear. He was warned not to drink alcohol. He drank. The side effects of the medication became more intense when mixed with alcohol just as he was told would happen.
If you are warned by a doctor and/or pharmacist not to mix alcohol with a medication, then don't mix alcohol with that medication.
You can't follow the directions of the medicine you're testing if you're out to villainize an entire class of life-saving medications to support the moral weakness theory.
I hate to say it, but this article is trollish. He isn't depressed. He doesn't have social anxiety disorder, he's just shy. He doesn't get therapy or join toast masters, he just pops the pill and then gets drunk all the time.
And it doesn't work wonders for him. Who woulda thought?
"Bitterness, anger, jealousy, sadness: They all make me happy."
Exactly. Coming full circle to the point you actually derive happiness from what you once eschewed is probably the most important thing you can ever teach yourself to do.
I have never taken a single neuroceutical that did what it was supposed to. Ever. Including caffeine. Eventually I gave up and decided not to try messing with my brain chemistry in any way ever again ever.
I had a similar, but more positive experience on Paxil, and I think my experience is more typical than the author's, which is why it is in widespread use.
I was always very shy, and had problems opening up to others. I was isolated and depressed, so I saw a psychiatrist. I took Paxil and had intensive (and expensive) therapy, and over the course of a year I opened up and learned to enjoy other people. After that I did not require the Paxil, and I am much more outgoing.
The side effects were not much fun: sweating, inability to orgasm or to feel orgasms, insomnia, etc. and yes Paxil made me love alcohol too. The side effects of depression however were much worse, and Paxil addressed those.
In combination with therapy it totally changed my life, and probably saved it. Its not a recreational drug, however, and the author seemed to use it as such.
It's sad that our society values and rewards extroverts so much, that introverts like the author feel the need to alter their minds in order to fit in.
The very existence of the tweeters and facebooks tell something about that need to reward extroverts.
From what I understand (to some extent personal experience), drugs like Paxil can be very helpful for people with certain problems. Unfortunately, there is a significant cost, and the gain may require more than just low-grade $disorder to really be felt.
Very much so. Sometimes you have little choice but to take the drugs.
It was once explained to me that depression is somewhat like a deep pit, with slippery sides that get steeper and steeper....once you are in a certain depth, you need a rope to get out.
Over the last year or two, I have begun to really understand how true that can be, learning to control how deep my moods get, and use the people, world, and experiences around me to keep myself from going beyond that self-salvageable depth.
From 18 to 24 or so I was on tons of various anti depressants. In my experience I found them all to be placebos! I was no different on them or off them. Either way I really could never be myself around people I hung around with; anxiety-ridden & silly OCD stuff(I can laugh at now).
For me talking about anxiety and OCD stuff was the biggest help. So many people go through the same thing but you think your the only one and are afraid to talk about it, because oh no people may think Im crazy. Yet were all the same! Though even after talking about my issues it generally took some years and feeling comfortable in my own skin was the end all cure.
Im not saying anti-depressants don't work, but for me they were pointless. Time and talking about my issues with friends/others was my cure!
By the way, not very well known but benadryl (OTC antihstamine) and Chlortrimeton (OTC antihstamine) are some of the oldest substances, known to have serotonin and norepinephrine reuptake inhibition features. In fact Prozac was synthesised from benadryl, in attempt to make it more potent antidepressant. Chlorpheniramine was researched by swedish scientist, who won Nobel prize (not sure for what exactly), in 1950-s and was found to have SNRI effects. But I beleive these will never be researched again - it hurts potential profits for Pharma.Who needs month of supply of antidepressant for $10, when you can sell it for 200?
its not hacker news, but it is hacker related, since a lot of hackers tend to be shy and social outcasts, who'd probably consider taking Paxil eventually.
And if people wish to downvote, they can downvote this comment(since you can't downvote the actual submission)
I guess I missed what someone said after I left my comment, as it was deleted.
Hacker related or human related I was just detailing my experience in the hopes that anyone going through what I did knows there is hope! Again, talking about it and relating with others was the key that led me to a better life...in time! But, that is my experience and these drugs are helpful to millions, besides myself!
From excellent comment from philosophical discussion about Modafinil (the stay-awake-alert-all-night magic drug).
http://news.ycombinator.com/item?id=389321
http://news.ycombinator.com/item?id=389408