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0 pointsDomenic_S10y ago0 comments

I'm sorry to hear that story. I hope this doesn't come off cruel because it isn't meant to be, but there are always outliers -- people for whom the gold standard, or any standard, just doesn't work. It's not a good idea to dismiss a well-studied treatment universally shown to be effective because we don't know if it'll work in a specific case. It's important not to anchor a patient -- already living on the edge -- with thoughts that 'maybe this isn't going to work for me'. On average, most people are average.

What we do know is that CBT is exceptionally good at handling most cases. No single treatment (for any disorder) works equally well/at all for all patients, but of course medicine is concerned with helping the largest population efficiently.

I hope one day we understand the brain better, to the point that people like your relative don't have to suffer anymore.

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graycat10y ago

> I'm sorry to hear that story. I hope this doesn't come off cruel because it isn't meant to be, but there are always outliers -- people for whom the gold standard, or any standard, just doesn't work.

I urge caution. The Chief 20+ years ago was darned well informed. Talk therapy and anxiety disease had been going for most of the 20th century. I don't know when cognitive approaches started, but, since they are an obvious approach, gotta guess that they have been understood for a long time.

> It's not a good idea to dismiss a well-studied treatment universally shown to be effective because we don't know if it'll work in a specific case.

Right, "dismiss" would be wrong. Trying it as a first step, if only since it's relatively easy and just a mild intervention, sure.

If you and the NLM, etc. link are correct, then it's news in the last 20 or so years.

From the Sheehan data, the Chief, and some more evidence, I have to guess that often, not just for an outlier, genetics can be an important cause. Sure, even then, maybe something cognitive can help one compensate.

My main point here is simple -- IMHO, the OP looks too simplistic.

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