I’m working on some background data relating to anxiety disorders, in particular phobias, panic and generalized worry. These are generally not thought to cause disability. This is an error. To have a psychiartic disorder your life must be impaired: it is not merely symptoms but lack of function.
From Dutch workers, you looked at disability, diagnosis, and work absenteeism: the Dutch have the best tools and systme in dealing with both presenteeism and absenteeism. [1]
Our results showed that a chronic course, anxiety arousal and depressive mood were strong predictors for long-term work disability while baseline psychiatric status, a chronic course and depressive mood were strong predictors for long-term work absenteeism. When testing the relative effects of baseline clinical status versus the effects of different psychiatric course trajectories, we did not expect to find that baseline psychiatric status seems to be such an important predictor for long-term work absenteeism. This might indicate that subjects with pure depressive disorders remain more absent from work than those with pure anxiety, despite the course of their disorder. It is possible that baseline psychiatric status includes more characteristics which are important but were not measured, for instance age of onset, personality characteristics (such as (low levels of) neuroticism, openness and conscientiousness), help seeking behaviour and treatment.
Hendriks SM, Spijker J, Licht CM, & others. Long-term work disability and absenteeism in anxiety and
depressive disorders. J Affect Disord. 2015 Jun 1;178:121-30.
If you look at other papers the effect size for disability (Cohen’s d) is about 0.8, using the world health organization disability assessment scale (Hendriks SM, Spijker J, Licht CM, and others. Disability in anxiety disorders. J Affect Disord. 2014 Sep;166:227-33.)
Disability hunts with anxiety. As there are far more anxious people than depressed, and far more depressed than psychotic, much of the global burden of disease relates to many people with moderate levels of distress.
However, when you have seen those who are severely distressed from anxiety alone, and crippled by it, you get annoyed by those who think serious mental illness is madness (psychosis) alone.
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1. I am referencing these properly and not relying on links: link rot, unfortunately, is a significant problem in academia.
If you’re stressed or anxious, your nervous system is tired and peripheral control is impacted. At the end of a long day, the anxious or stressed person is far more likely to make mistakes (both mental & physical). Injuries add up and wear down the body.
You see this in professional sports, as well. A player is far more likely to be hurt near the end of a game than the beginning, especially for low or non-contact injuries. Coordination is much more nervous than muscular in nature.
Better: the habits you have mean that you reinforce adaptive or maladaptive neural networks. What we do in our late teenage years is prune our synaptic networks. The neural network is a better metaphor than the brain as a muscle. Look at the most recent work with psychosis: it is the network where the fault is, not the nerves.
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I was going to put this point in the previous thread, but it’s more applicable here. Medicine treats the Brain & Nervous system in the wrong way. They aren’t like the other major organ (or organ groups). The Nervous System needs to be treated like a Muscle, with one major exception (relevant to this discussion). That exception is that you can’t build it up easily. Genetics and early childhood are huge factors in how your nervous system will develop.
And this also points to the recovery aspects for some people. They can absorb some pretty wicked injuries or life events and seemingly recover fairly easily, while others are seemingly crushed by the same event. One person had both the body & the mentality to work through things, while the other party lacked one or both.
A better way to think about this is that fear hunts with worry and being over-fearful and not exposed to risk in childhood means that you cannot manage risk in young adulthood and midlife. This leads to maladaptive habits and a lack of resilience. Some of this is genetic, but a lot less than most people think: even with psychosis, which is the most “neurological” psychiatric condition (along with autism and OCD) you need GWAS (Genome wide Assays) involving 2 -4 M participants to start getting a handle on the genetics. Cardiovascular disease and type II diabetes are far more genetic
The last point is one no one really likes to talk about. I’ll use Autism as the example. It’s very possible Autism rates are actually dropping, but that only makes sense if you understand why we are seeing a sudden “rise” in Autism. Most Autism cases are on the “spectrum” and not the supremely nasty ones. We used to have a phrase for those people: “weak constitution”. Pre-1955 in the West, nearly all of them would be dead by age 5. And most of the rest dead before 20. Vaccines don’t cause Autism, they prevent the Autistic from dying of most deadly diseases while highlighting the issue their body has. (The Vaccine hits their body’s supremely hard due to their stress & 1-carbon metabolism being compromised.)
Sort of correct. One of the spurious reasons why people do better with autism and psychosis in the third world is that the most severe die off. Vaccines are, after all, an old idea, going back to Jenner and cowpox. The population who get into research now are in the community and recruited by Radio and TV advertisement: they are almost all on the spectrum — of anxiety or autism or depression or psychosis. Thirty years ago they were inpatients, and they were more severe. This has led to a secular trend for decreased effect of some of the older treatments and a spurious over estimation of efficacy of placebo / no treatment. Here DSM has not been of service, because the primary criteria for psychiatric disorder must be that you are unwell. If you have a symptom cluster and are well, you don’t need a doctor. And that group are the ones who are getting into studies.
As an aside, the nutritional hypotheses were tested in the late 1990s, but (as far as I know) the results were not published.
I’m running a different webbrowser and it’s having a hard time staying logged in/posting correctly here. Sorry about that.
I’ll fiddle with getting the login working properly tomorrow. (I’ve switched to Vivaldi for this area of the web, but it seems to be having issues with WordPress/other logins at the moment.)
I realize I didn’t put one more paragraph I intended in the first post.
“So we need to be mindful of the possibility that much of what we are seeing is simply the consequences of those surviving whose bodies might otherwise be compromised to the point they would simply not have survived this long otherwise.”
I’m not one that’s big on the HBD stuff, but most of the World is the descendants of those who survive the massively lethal diseases.
On Autism, it’s a little more easy. Nervous System inflammation. Mother’s Homocysteine levels having a massive correlation factor. Most cases are congenital, with some being genetic. The really nasty cases seem to be more often congenital, though since Autism will have an effect on DNA methylation over the course of life, the congenital defect is more easily passed from parents to children.
The child starts life with a nervous system under heavy stress and already at its limit. Their immune system actually “works” properly, but the stress load (via 1-carbon Metabolism) can’t keep up when they get sick. Vaccines also hit the 1-carbon system extremely hard. That’s why changes are first noticed after the heavier vaccine rounds. (Though let’s skip over the vaccine schedule being far too tight now. That’s its own problem.) Their neural networks don’t develop in the same way and settle in over time via adjusted expression of neurons. Growth factors are impacted and development can go badly. It’s like trying to grow up with an anchor running behind the car you’re driving. It’s just rough all around.
It is “treatable” far more than they have now, but the main problem they have now is a lack of understanding to put all of the details together.
I’ve played with Vivaldi at home and it works for me… using gentoo or fedora.
I saw this at a former job where people were fairly routinely abused.