I take your point, and agree, but it's become deeply untenable to share a NYTimes article to prove any contested political point. That place has well and truly set fire to its reputation as an impartial reporter.
Hey, can you please stop using HN for political battle? You're a good user otherwise but you've been posting a lot of that, and it's not what this site is for.
I'm a bit confused about how this compares to non-COVID-19 patients. The Mayo clinic [1] shows the same number, one in five, for the general population in a given year.
I think that's the important bit. The article (at least) didn't indicate that the same standard applies at the 180, 270, or 360 day mark, so I don't think we can just say COVID patients roll the dice on mental illness 4x as often as the general population. If that's actually being implied, it's horrible.
In a back-of-the-napkin, spherical-cow, way, it's not too hard.
20% chance it happens in a year means an 80% chance it doesn't. Let's assume (this is the spherical cow) each day has the same chance. We can find it by looking at the chance an adult doesn't get a mental illness in a year. Then, because that's the chance they won't get it every day, it's easier to figure out the daily chance of not getting one.
0.8 = x^365
x = 0.8^(1/365)
x = 0.9993888346422956
1 - x = 0.0006111653577044462
So, overall, adults have roughly a 0.061% chance each day of getting a mental illness.
Compared to the daily risk for this 90-day period
0.8 = x^90
x = 0.8^(1/90)
x = 0.9993888346422956
1 - x = 0.0024763016863216247
So about 0.248% each day for the COVID patients. That's more than four times as high as for all adults.
Remember, this is spherical cow stuff. Numbers to use in other calculations need a more experienced statistical approach, I'm sure. But this at least tells us something's different.
> About 1 in 5 adults has a mental illness in any given year
This talks about people who may already have mental illness -
> Mental illness can begin at any age, from childhood through later adult years, but most cases begin earlier in life.
The OP is about new cases...
Take out a sketchpad, draw an exponential representing the # of COVID cases everyday, over 90 days. The area under that curve / 5 is the number of new mental illness patients added every 90 days. Now extrapolate that over the year, and add it to the 1/5 (Total population) number, and that's where it starts to sound alarming.
Even the 1/5 general population has to develop it at some point. Sounds like covid patients are converging towards the normal after recovery, so I don't really see an issue here.
1/5 of the general population do not develop mental illnesses within 90 days of an arbitrary starting point, unless the mental illness is extremely short-lived.
Think of the difference this way:
If 1/100 people are currently experiencing a headache, then it's also reasonable to think that 1/100 people will experience a headache tomorrow.
But if 1/100 people have an amputation, it does not follow that 1/100 people will get an amputation tomorrow, or even in the next 90 days. If 1/100 people were always getting an amputation within 90 days of any arbitrary starting point, there would be many, many more amputees around.
Mental illness being something that may lasts months to years, this certainly seems to be closer to the amputation case than the headache case. That implies that getting Covid can, indeed, be said to increase your chance of developing mental illness.
It's e.g. not uncommon for people to go into some form of denial of their (new/worsens) mental illness, it they are simple not aware that a mental illness can have given effects.
This makes it super hard to differentiate between something causing mental illness and that something in some way making people being diagnosed with it.
E.g. the current works situation makes it much simpler for people to get depression and anxiety without being infected by Covid-19, but due to the circumstances if someone got a new (or worsens) mental illness and covid in 2020 it's likely that they will diagnosed the illness after having had covid even if it came from the world situation not the covid virus directly.
Example Unrelated to covid: I got diagnosed ~3years after it (slowly) started to mess up my life, but that was when it started to noticably affect my life. As far as I can tell before that I had it in a mild version for like and addition 7-10 years.
So the time where sunshine is diagnosed as mentally ill isn't necessary at all related to when that person got mentally ill.
Commenters are mostly overlooking the bidirectional element in the study.
A psychiatric diagnosis in the previous year was associated with a higher incidence of COVID-19 diagnosis (relative risk 1·65, 95% CI 1·59–1·71; p<0·0001)
Now THAT's interesting. Speculations about why? Are more anxious people more likely to get tested for covid? Depressed people more likely to not care about exposure?
My wife developed hypochondria after her bout with COVID, but I seriously doubt it had to do with the virus itself, and instead had more to do with the uncertainty and fear over the pandemic in general. She was told at the hospital that this type of thing was becoming more and more common, regardless of whether people actually first contracted the virus.
I think it would be unusual _not_ to develop hypochondria at some point this year. The levels of existential threat, perceived or otherwise, have been sky high.
Everyone had some form of hypochondria this year I think. In march I had the fever thermometer on my office desk, because it was used every day. Those days are gone.
I had chills nonstop all through March and April, likely due to stress. I literally wore 2 jackets and wrapped myself in a blanket, only to still be freezing cold (and drenched in sweat). But I have 2 rare immune-mediated neurological diseases affecting my peripheral nervous system. So, undoubtedly my immune system is messed up.
I still get chills off and on but it has been better after moving from the US to Croatia (I am a dual citizen of both countries). I think the stress of Trump (as a disabled person) and the coronavirus situation in the US really messed up my health overall and eventually caused these chills. Coronavirus pandemic did totally change my medical care situation in the US for the worst too.
I still wear a continuous temperature monitor (using a zero heat flux sensor—it’s used in critically ill patients) to help pick up on these events. The device I use was recently cleared as a medical device under emergency use authorization by the FDA in the US: https://corebodytemp.com/
You are spot on, complete self fulfilling prophecy. This pandemic will go down in history as psychological terrorism. I feel terrible for people who are already diagnosed with depression/anxiety. Covid has created more collateral damage than damage pertaining to the virus.
Yea, I think in 2040, historians, doctors and psychologists will look back at this era as the largest case of mass hysteria.
I do not deny a lot of people have died from this, but it's mostly the elderly that could have been protected. I also think the death counts are over-estimates, while everyone else thinks they're under-estimates.
The lockdowns do little to nothing and need to end. Human beings are not machines that can be places in low power mode or gears that can be stopped.
They appear to count any death that was tested positive for coronavirus as a Covid death. Coincidentally these countries are all near the top of the list when sorting by deaths per million.
Clinical Depression is not to be confused with "feeling depressed".
Statistics are around 6.7% in the US for Major Depressive Disorder and 1.5% for Persistent depressive disorder (before Covid era, I suspect this is on the raise).
"Anxiety, depression and insomnia" all the hallmarks of the beginning of ME/CFS or PVS or whatever you want to call this horrific condition. 20% is lower than the 35% that get lasting effects in the Irish nurses study but its also higher than the long term likely to suffer ME/CFS for many years to the rest of their life which is estimated to be around 7% based on the papers that China produced on SARS.
As far as we understand its due to a reduction in the 5-HTP path way which leads to a reduction in Serotonin. There is also a further effect on Gaba as well with a bit more time. Ron Davis and other researchers have done some work to understanding the genetic switch or mechanism but alas they aren't there yet with an affirmation as to the root cause.
Alas the depression and sleep problems are just the beginning, the condition gets much worse and more debilitating than Multiple sclerosis as it progresses and the chronic fatigue and exertion intolerance kicks in. Its excruciatingly painful and poorly treated by Doctors. The news all points to very bad for Covid19 and ME/CFS results unfortunately, it could be a much bigger contributor to loss of people from the workplace than death itself as most sufferers don't ever work again.
>"Anxiety, depression and insomnia" all the hallmarks of the beginning of ME/CFS or PVS or whatever you want to call this horrific condition.
It's also the hallmark of lockdowns since March, political uncertainty and hostility with peers, economic uncertainty, and pandemic threats and uncertainty. All with a hysterical media, an all-or-nothing us-and-them type of conversation on just about any topic, and continual uncertainties.
The viral threat is real, but so are mental health considerations that seem to be completely overlooked by popular discourse.
Given that anxiety and stress related disorders seem to be the main mental health result, I think that this boils down to, "Scary and stressful pandemic is scary and stressful."
Stressful events trigger all kinds of mental illness. Who wouldn't be traumatized after spending weeks in quarantine, or worse, in a hospital without any visitors -- with your life in the hands of strangers that are separated from by a layer of plastic at all times.
throw in a sprinkle of getting checked out medically normalises being checked out medically so you're more likely to go back for other things I reckon.
It wasn't till I needed to go to the hospital for a physical injury (plus the times popping back for physio) that I started going to the GP for mental issues too
People who have COVID-19 have health problems and get screened for all sorts of things. Dementia that had been there all along are therefore is more likely to get diagnosed.
Layman hypothesis: anxious person gets Covid, goes to her doctor 3 months after because she thinks she is experiencing long term effects, and gets diagnosed for her anxiety instead
look at various health forums. Autoimmune in particular.
This is such a common pattern. People are dismissed for years before getting proper treatment.
Some conditions the time to diagnosis is seven years.
Entire time people are being told it’s in their head.
And some people really do have anxiety (And just because its "all in your head" doesn't make it any less "real").
In particular, I think its pretty reasonable to assume the pandemic and other ongoing issues of 2020, will cause severe anxiety issues in a bunch of the population. Its been a hell of a year.
The brain is just another organ, and also vulnerable to inflammation and immune effects. And it can in turn cause or worsen them too in the rest of the body. Medicine truly must stop making psychiatric diagnoses without looking for systemic causes, and vice versa. And I think good doctors understand this. However, like any profession, there are plenty of not so good doctors who lazily throw people away with vague anxiety or pain syndrome diagnoses.
Covid-19 seems to produce very high numbers of Post viral sufferers, but its definitely not unique to this virus. SARS was worse at this point in that epidemic outbreak but only by about 20%. Those SARS studies are a good indicator for the sort of percentages of disabled we can expect from Covid-19.
No mention I can see of what's the rate for general population living under lockdown, and those suffering from the flu or other similarly draining diseases.
Interesting, didn't know that. This makes it a bit more likely that the 13% -> 18% increase is related to general societal impacts of Covid rather than Covid being worse in itself.
Given lockdown and absolute hysteria in the media over covid, I wouldn't be surprised if this applies to the whole population. Are there any numbers for comparison?
I totally get what he is trying to say. It is becoming so obvious after 8 months of social isolation, lockdowns and a ton of toxicity in the community. The aftermath of this "lets lock down everything to protect a few" strategy is going to be horrible. Not just economically. Lockdown lovers seem to think people are machines that you can turn off and on whenever you like. Thats not the case.
So can thousands of people dying all around you. Lockdowns are much, much better than seeing grandparents or parents die in over-exerted hospitals, seeing already sick children or young people who were managing their diabetes, congenital heart conditions, cancers, HIV infections etc. suddenly taken by this horrible, preventable disease.
That we live in a stressful time, which we are being reminded of constantly, and lockdown (With its restricted social interaction) is hard on mental health.
I don't think anyone disagrees that lockdown is hard on people. The cost of lockdown is worth it, but lets not pretend that its free.
Sweden, without COVID lockdowns, is on track for fewer deaths in 2020 than 2018.
The country also has a lower COVID deathtoll per capita than Belgium, Italy, USA.
Lockdown is not a solution. Dealing with air pollution (ending the burning of coal and oil) and obesity (banning and taxing added sugar) would yield significantly greater benefits and require much less cost and effort.
It's obvious what is being conveyed here, and I question the intellectual honesty of your statement. I posit that by "playing dumb," you hoped to be able to convey the notion that there's no "obvious" message here.
Being on lockdown is making people ill and driving them crazy. This is being compounded by the cognitive dissonance embraced by half of the media-consuming world, which is telling them that their attacker is a respiratory virus, and not their local, state, and national governments.
Many people live in a society today where, saying this to the wrong person could get you injured, ostracized, or even killed - or, you may even get branded with the worst noun of all: racist. Anxiety is clearly through the roof everywhere you turn - now, I wonder why this is?
Are we actually going to go around thinking that these high-anxiety times haven't contributed to peoples' illnesses?
I hope you are not so cocksure in every part of your life. It helps sometimes to understand what the other person is saying in more details than jumping to conclusions and then responding with emotions.
I take it that you are challenging my intellectual honesty, I am unsure about your intellectual curiosity.
There was nothing more that had to be said by the parent. You were - quite clearly - trying to discredit the parent poster for making a very reasonable statement.
I am not moved at all by your "hopes." I am quite certain that I am right. I would not have written anything, otherwise. But of course, that's none of your business - my words are more than enough to convey the meaning I intend, as are yours, and as were the parent poster's.
My intellectual curiosity is what allowed me to land on both of my feet and look at the COVID situation for what it really is. It wasn't hard and it only takes some "distancing" from corporate media sources to see what's going on.
You're being downvoted, but I think that's a reasonable point... I don't live in the USA, but given everything that's going on there, I would be pretty stressed if I did.
Native Americans have access to a full blown government hospital system not unlike UK's NHS.
In fact, the US has three times as many government-run hospital systems than most countries, and several times the number of government insurance programs. That's part of the problem. :)
It would also be interesting to see what it's like in countries with different news coverage styles. Fear is a tactic used in the US to keep eyes glued to new media.
>> To be clear, this does not demonstrate that Covid infection causes mental illness from a neurological perspective.
> It would also be interesting to see what it's like in countries with different news coverage styles. Fear is a tactic used in the US to keep eyes glued to new media.
I think that's likely a non-significant part of it. As the saying goes, "Perception is reality" (which is demonstrated in phenomena like the placebo effect, or widespread beliefs in theories like QAnon or RussiaGate) - if so, it shouldn't be terribly surprising that a person who subjects their mind to large quantities of subjective "Coronavirus!!!!!!!" "journalism" would have a genuinely different reaction than that of someone who only exposed their mind to objective statistics.
> “Equally, it’s not at all implausible that Covid-19 might have some direct effect on your brain and your mental health. But I think that, again, remains to be positively demonstrated,” said Harrison.
> A particularly concerning finding was the doubling of the diagnosis of dementia – which is typically irreversible – three months after testing positive for Covid-19, versus the other health conditions.
COVID-19 is primarily a respiratory disease but the number of gastrointestinal infections is still significant. There appears to be a causal link between various dementias and the Gut-Brain Axis [1] so it is plausible that some of the long-hauler symptoms are specific to gastrointestinal changes/damage. It might be useful to compare the incidence of dementia in people suffering from chronic gastritis in addition to injuries and other respiratory infections.
Do you have more information on gastrointestinal COVID-19? I haven't really heard this before and I'm super interested if it has different symptoms/different long term consequences. I've heard of stuff like brain fog; could that be a result?
> Approximately half of patients reported one or more GI symptoms; among these, diarrhea was reported most frequently (38%) and vomiting least frequently (13%). [1]
The original 2003 SARS-1 outbreak in Hong Kong infamously spread via sewage in a single building with faulty plumbing floor traps [2]. Wastewater surveillance has also been proposed and/or implemented in many jurisdictions [3].
I think poor sleep due to discomfort and/or anxiety is just as likely to cause brain fog in the short-term and mental illness over the long-term but irreversible dementia seems to require an additional explanation, in my opinion.
Gastrointestinal issues are always present in ME/CFS which is what long covid looks almost identical too. Long covid has the additonal issue of lung and other organ damage but I wouldn't be surprised to find out ME/CFS is largely driven by gut issues that we don't know how to treat yet.
> A particularly concerning finding was the doubling of the diagnosis of dementia – which is typically irreversible – three months after testing positive for Covid-19, versus the other health conditions.
Unless they controlled for age when calculating that ratio (they didn't, as far as I can see), this is questionable. Covid-19 is disproportionately more likely to be diagnosed in the elderly (because most of the severe cases are in the elderly). Dementia is disproportionately more likely to occur in the elderly.
According to the Lancet paper that Infinitesimus linked to, the researchers divided the patients into cohorts for statistical analysis based on a number of variables:
> We identified a set of established and suspected risk factors for COVID-19, as follows: age, sex, race, obesity, hypertension, diabetes, chronic kidney disease, asthma, chronic lower respiratory diseases, nicotine dependence, ischaemic heart disease, and other forms of heart disease... We also identified an additional set of established risk factors for death due to COVID-19 (which we take to be risk factors for severe forms of COVID-19 illness), as follows: cancer (particularly haematological cancer), chronic liver disease, stroke, dementia, organ transplantation, rheumatoid arthritis, lupus, psoriasis, and other immunosuppression.
Yes, I read the paper. They controlled for these factors in assembling the cohorts.
Beyond this, it is ambiguous. They say the following:
"For analysis of psychiatric sequelae, propensity score matching was directly applied to each cohort pair. For analysis of psychiatric antecedents, given their much larger sample sizes (which exceeded the maximum number of 1·5 million patients possible per matched cohort), cohorts were first stratified by sex and age (18–30 years, 31–45 years, 46–60 years, 61–75 years, and ≥76 years) and propensity score matching (including for age) was achieved within each stratum separately."
First, I'm not sure exactly what this means: did they assemble the marginals as you would to calculate p(psych_symptom|illness), then perform propensity score matching on those? Or did they perform propensity score matching on the subsets of the data that are "people who had covid" vs. "people who had influenza"? It makes a big difference.
Second, propensity score matching is, essentially, regression followed by clustering. The details of the regression therefore matter: they are defining cluster cutoffs in terms of standard deviations, which tells you nothing without knowing the size of a standard deviation in the context of the split.
In short, I don't know if this method of matching will control for age properly in the analysis in question. You would need to see a plot of the age distributions of the data for the groups in question to be sure.
EDIT: Also, Figure 3 quite clearly shows that the relative risk for all psychological illnesses increases with age. This would seem to rebut the idea that they have controlled for this factor.
EDIT 2: The supplementary materials show tables for characteristics of Covid vs. X for all of the control illnesses, which makes me believe that they have applied cohort matching on the marginals. However, they do not show age in these tables, making me doubt that they properly controlled by age (see supp. table 1):
EDIT 3: Not directly relevant to the question, but it hints at it -- per supp. table 8, Cholelithiasis (gallstones) show the strongest association with psychiatric illness (i.e. the weakest Hazard Ratio relative to Covid). In other words: of all of the control diseases, having Covid-19 only makes you 1.58x more likely to have psychiatric illness than having gallstones.
Gallstones are strongly associated with age and gender.
EDIT 4: definitely not related, but supp. fig. 8-9 shows that if you require a confirmed Covid-19 test, the differences between Covid and the controls decreases dramatically. THEY DIDN'T CONTROL FOR ACTUALLY HAVING THE DISEASE!!
Just for example, Figure 2 from the text shows a gap of ~10% between covid and flu for all psychiatric illness. The corresponding plot in supp. fig. 9 shows a gap of less than 2% when you require a confirmed Covid test! This paper is falling apart.
What is with that automatic assumption on HN that whatever scientific paper is under discussion, they surely did ignored <insert completely obvious possibility that they actually did dealt with>?
I'm being equivocal in my wording, because that's what you do when you're being polite, and you're giving the authors the benefit of the doubt. Maybe I missed something, but I didn't see them control for this in a way that satisfies me that the issue was addressed.
Covid attacks brain, through the olfactory system, which is why it screws you sense of smell. It may go further into the CNS and cause more damage. Or cause microclots.
If the process has been working for years and you just had a release and now it's crashing, you're gonna blame the release.
(But to continue the analogy, a reason to be scrutinize this paper is, because the process has been working fine for years no one has looked at the logs in an age, and when they do, oh my .... there are many things going wrong might not related to the release at all.)
This makes me curious.. As a sysadmin, the firewall is almost always blamed (or some imaginary change in the "system"). But often, simple things like DNS are the actual cause. I wonder what the equivalent most common blame and actual cause are in the medical world.
I think it depends on what field you're in within medicine. I think I would be willing to bet strokes would be high up on that list. There's a lot of neurologic conditions that strokes can mimic depending on severity. One that gets missed a lot of the time is vision related strokes (like a central retinal artery occlusion or a branch retinal artery occlusion), since a lot of doctors aren't super confident in their ophthalmology training. Or mimickers like migraines.
A firewall is easy enough to test with pings, telnets, etc. but the LB rarely seems to make much sense and it seems like there's only one guy who knows how it works and they never explain what they changed.
I sometimes blame the compiler. Having said this, I do occasionally find bugs ib g++ and clang (most often, it does not behave like it should - copy g++ behavior).
You now have impostor syndrome (because you don't feel pain, and your exhaustion and other symptoms are really not that bad, but you have some problems)
[Edit: I really meant to ask, how do you know it's an 8 rather than a 7 or a 9? Isn't this very highly subjective? What does the number even tell us? Have you read https://xkcd.com/883/?]
Something different for every person, which is why I hate the 1-10 pain score. Some people will declare a stubbed toe a 10; others will self-amputate an arm and deem it a 6 because they weren't on fire while doing it. Medical staff don't really help by describing a 10 as "the worst pain you can imagine", given variance in imaginations.
I absolutely refuse to give a numerical answer unless they first give me an objective calibration for the numbers. I recently got into a minor argument with a nurse before a minor surgery. "If you won't tell me a number, how will I know if I need to give you a painkiller?" "If I'm in enough pain to need a painkiller, I will tell you."
The number scale attempts to turn a subjective interpretation into an "objective" value. Instead of having to actually listen to people and apply training and experience to judge which treatments are needed, the number system de facto pushes that decision onto the patient so the doctor/nurse/etc only needs to follow a simple set of treatment rules. Similar to black box "AI" used in e.g. criminal sentencing and employee evaluations, the numeric pain scale is yet another example of a fundamentally subjective situation being laundered into a supposedly "objective" value.
There can be some utility in comparing over time. If the patient indicates a 9 before intervention, and a 5 afterwards, that means something's helping. The relative weight of a 9 versus someone else's 9 is irrelevant in this usage.
"The patient indicates" is still based on their completely subjective process of turning a mental state into a number. If they indicate a 9 before intervention, they did so by comparing the feeling of this this trauma to the fuzzy memory of breaking a bone as a child and the more recent but less painful memory of burning their finger in the kitchen a couple weeks ago. Then they sit and suffer from this trauma at approximately that same level of pain for the next 2 weeks, they'll have a new baseline to compare against.
It really sucks that we have no objective measure of pain; a tricorder that you could aim at someone and get a number back would be infinitely better than what we have now.
Not really because people have a terrible memory for pain. It can be worse afterward and still be a 5 (vs 9) just because they have got used to the pain.
There's various pain scales, but all the good ones aren't different for every person.
They're the same because they don't quantify how much it hurts, but instead how the pain affects you.
A 10 would be pain so severe you are unable to perceive anything besides your pain or do anything except writhe.
An 8 on such a scale would be pain that makes it difficult to focus on anything else, let alone listen calmly to a person and give a coherent answer.
A 5, while being distracting, would still allow you to function on some level.
A 3 would be pain that is somewhat easy to ignore.
You see how this is a scale that can actually be measured by an outside observer and is much more useful in figuring out what medication to give. Because while two people may have the same injury, one of them may be able to completely ignore the pain even
without medication - so giving medication would only do harm - while the second person may need medication in order to function.
Assuming such a scale was used, it would make sense for the nurse to say "it isn't an 8" - because if it was an eight you wouldn't have been able to listen calmly and explain that to her, by definition.
> one of them may be able to completely ignore the pain even without medication - so giving medication would only do harm
Well, it won't only do harm though, right? It will still get rid of that person's pain.
If I fracture my ankle, but I learn to compensate by constantly shifting my weight onto my good leg as I limp so that I can still do my job -- in that scenario, I still want my ankle fixed. I don't want a doctor saying, "ah, but you have the special limp, so a cast and crutches would only do you harm." I want the cast, because the cast is probably easier, more comfortable, and in the long term less dangerous than what I'm currently doing.
Why would pain be different? Should someone not be able to get relief from suffering just because they've gotten good at mentally focusing through it?
It seems like the result of approaching pain from the perspective you're advocating for would just be to discourage people from trying to take any practical and/or psychological steps to manage their own pain, because every minor success they have will make it harder for them to get any additional help.
It is completely different. Your analogy isn't great.
A fractured ankle is a bad thing. A cast certainly won't do harm. Pain is a response of your body to a bad thing. Suppressing it can do harm in itself.
Some pain can often be desirable because it prevents a patient from further injuring themselves by, for instance, putting weight on an injured ankle. Pain is a warning system.
Add to that all the possible side-effects of painkillers.
On top of that there's context for everything. You should probably give a patient that experiences pain which can't be avoided painkillers earlier than a patient who experiences pain when they put weight on something they shouldn't.
> You should probably give a patient that experiences pain which can't be avoided painkillers earlier than a patient who experiences pain when they put weight on something they shouldn't.
You're describing someone with chronic pain. So... we should prioritize giving painkillers to someone with chronic pain over someone someone with temporary pain that will quickly go away if they don't do something dangerous? I agree with that.
If someone has chronic pain, that pain isn't helping them avoid doing something bad to their body. It's just pointless pain with no benefit. And even if I can force myself to function with chronic pain, I can still have long-term damage from stress, lack of sleep, damage to relationships, even just damage in terms of pure suffering. It's dangerous for a doctor to say, "you can hold a conversation with me, so medication would only do you harm." I don't think that's an objective scale, and I don't think it actually captures the risks of long-term damage and suffering.
If you want something with more downside than a cast, sub out something like surgery in my analogy instead. Either way, the point is that just being able to function in society is not an adequate measure by itself of whether or not someone needs medical help.
Talk to a chronic pain patient and they'll likely tell you they have to suppress reactions to the pain in order to not be dismissed as "playing it up" and thus drug seeking. That they are used to dealing with pain does not mean the pain is not there.
People who are regularly in great pain would read this comment as saying "you are being mauled by a bear, but if you have ripped your own vocal cords out so that you're not constantly screaming, we judge that preventing the bear from mauling you won't affect the environment much (since the screaming level will not change), so we will not prevent the bear from mauling you".
The thing with chronic pain is that it's very difficult to quantify.
I have small fibre neuropathy (nerve damage) in my arms and legs, and when it first started I thought I was going to go crazy - I just couldn't stand that amount of pain, constantly. I cried a lot, I begged doctors to make it go away, I went to the ER.
The fact is you can't stay like that forever - you either kill yourself, or you somehow learn to live with it.
You don't get used to chronic pain, but you adjust to a new "normal" level of pain. You develop coping mechanisms and learn to "bury it", get on with it as best you can. If you're lucky, you find some medication that actually helps somewhat. You research your condition and possible remedies, a lot. All of this isn't to say it gets easy, believe me it fecking well does not.
A lot of people (doctors included) don't seem to believe that you can be in severe pain, while sitting and conversing with them - "he seems fine to me!".
I'll add as well that I'm one of the "lucky" ones for whom a diagnostic test (skin biopsy) has shown concrete evidence that doctors believe in - without that, you'll get nothing but platitudes and shown the door. You'll probably also get told you have fibromyalgia, even if you don't remotely fit the criteria. I know this firsthand, because I have had to research and guide clueless doctors and insist on tests, and insist on re-tests when they've messed up.
> A lot of people (doctors included) don't seem to believe that you can be in severe pain, while sitting and conversing with them - "he seems fine to me!".
That's very familiar. "I feel like I'm being stabbed in the eye" "But you seen fine" "It's been doing that for the last two years; at some point I just stopped reacting to it"
> I'll add as well that I'm one of the "lucky" ones for whom a diagnostic test (skin biopsy) has shown concrete evidence that doctors believe in
Having visible evidence definitely seems to help - my dermatologist seemed to be sceptical that my dermatographic urticaria[1] was as bad as I was saying given the dose of antihistamines I was on. She did a challenge test, and her first comment was words to the effect of "Huh, that _is_ severe". She ended up doubling the does of antihistamines. The "hidden" symptoms are much more of an uphill battle.
I used to live with a paramedic who explained it like this: "It's difficult to quantify anything but the most extreme pain, so an easy benchmark is a 10. If your pain is a 10, then if the paramedic rushing you to the ER lights you on fire and throws you out the back of the ambulance, your pain would not increase."
It's supposed to be subjective; they aren't measuring pain against some objective measure or even against other patients, just how you're feeling personally.
This number will be used to determine if a more in depth tool is needed (like if you say 7-10). What type of treatment is needed (pain tolerance is different from person to person, so even if two people have the same injury or disease, one might say 8 and need pain killers and the other might say 3 and not). It will be used to gauge if a treatment is working (when you first came in you were at a baseline of 6, but after taking this treatment, you're at a 2), and so on.
Does anyone know if people have made serious attempts to do objective pain quantification? Of the ideas that come to mind, strategy 1 would be: let the patient press buttons that give her electrical shocks and let the patient say "This shock is worse than my pain, that shock is less bad, therefore my pain is between these two levels". (I once read about an early electrical scientist who would measure voltage by shocking himself and comparing the pain with known quantities. Googling, I find that "Kenneth Catania" has done this very recently to measure eels' output...) Strategy 2 would be to somehow observe pain nerves and/or the brain directly; I don't know if this is possible. Strategy 3 would be to describe hypothetical sources of pain and ask what the patient would prefer, though even a patient trying her best may not be able to correctly compare felt pain vs. imagined pain.
Wikipedia isn't much help[1]. It lists 30+ "pain measurement scales", but clicking a few of them doesn't tell me any specifics about how they work.
Looks like someone has in fact tried strategy 1. https://www.hindawi.com/journals/js/2018/6205896/ mentions: "Recently, a quantitative pain-assessing method using electrical stimulation was introduced [12–15]. PainVision™ devices measure perception threshold and pain produced by an electrical current. This system quantifies pain intensity by comparing the experienced pain with the intensity of electrical perceptions. The perception threshold indicates the minimal electric current sensed by the individual, and the pain produced is defined as the maximal electric current sensed by the individual. However, the skin resistance of an individual may affect the electrical measurement result [16–20]."
Their refinement continues: "our system measures from the patient’s skin resistance before measuring the pain." "In this work, we developed a pain measurement device that has two analysis methods, electrical stimulation and applying pressure, for more accurate cross-validation assessment. During electrical stimulation, electrical stress is applied on a nonpain site and then the observed stress can be compared to pain. ... During the pressure evaluation, pain was assessed by applying pressure on the pain site. Inflammation was induced on the rat’s hind paw by carrageenan, and then the inflamed hind paw was stimulated by a hand-type pressure stimulator. The pressure site was then compared with the inflammation levels." Seems like it might be workable.
If you're trying to describe pain to a healthcare professional it's useful to either compare it to some other pain that you've had (childbirth, ear infection, dental abscess), or describe it's effects: "it hurts when I think about it", "it hurts when I move", "it distracts me from my day to day activities" "it's always there, it intrudes into my thoughts and I can't distract myself from it, it hurts even if I'm not moving", "it wakes me up at night, it's always painful, I'm struggling to have this conversation, it makes me think about ending my life".
Talk about the things you used to do that you are not able to do now because of the pain.
For short term pain number 8 is supposed to be able to read or converse but only with effort; dizzy and / or nauseous; limited physical activity; difficulty in functioning; and strong painkillers are not so effective.
Number 9 is unable to speak; crying out or moaning uncontrollably.
Number 7 is interference with sleep, difficulty concentrating.
"pill seeker" Jesus Christ, just punch me in the face, why don't you. I hate people who just go "oh you just want drugs". No, I want the pain to go away and not to be treated like I'm pretending.
This really hits home for me. I have a genetic disease (no specifics to remain somewhat anonymous) that generally causes me to be in pain 24/7. Sometimes it's worse, sometimes it's better - but it's always there. As such I've learned to live with it the best that I can.
The last time I went to the ER (a few years ago now) for something unrelated, I was in extreme pain. I'm used to pain. I can tolerate constant pain pretty well. This pain was way above what I could tolerate.
Instead of help from the nurse I got a lecture about lying about drug use and lying about pain. Eventually I got the help I needed but the whole experience was just so degrading at a time I would have preferred to die rather than continue the pain I felt.
Should have asked her what are you supposed to do? Jump off a building?
Chronic pain sucks...but people fail to understand that some people suffer from high level of pain and that doctors often fail to manage it. I have tried many things to manage my pain, it is at a point where I for the most part get on with my life with some "take it easy" days. Unfortunately, the only thing that helps is opiates, and currently nobody wants to prescribe those. My primary does and 30 pills of low dose last me months. Still when I switched doctors they refused giving me opiates, even though all the other meds lyrica, cymbalata, gabapentin did nothing. A pain doctor offered ketamine treatments at $500....like that is reasonable on monthly basis.
Oof. Been dealing with this for over 3 months now. Thank you for your post. I'm very sorry this has affected you. FWIW, it's somewhat comforting to me to know someone else understands what I am going through.
Oh, and also even though we don't know why you're ill we also know for certain you'll also never get better, so here's some chemo drugs to take for the rest of your life.
In my case I got great help with medical cannabis, but access was only possible this year. All the suffering I endured during these years just because suits didn't want big pharma to lose money... I am bitter about this that justice won't be done. I hope one day karma will reach those people who block access to medicine. I am not saying cannabis is a miracle, but it has changed my life for better.
I'm glad that substances like cannabis are enjoying wider legal access, but you're right that they aren't always miracles. I was recently diagnosed with bipolar disorder, and in the months since I've completely stopped all cannabis-related products, my mental health has improved considerably without having to take prescribed medication.
I got a taste of this from a severe case of pneumonia. I always took my health granted, but never realized how much I took other people’s health for granted too. It’s hard to imagine a lack of ability or capacity when you’ve been healthy your entire life.
Its interesting I have chronic kidney failure and I was asked to fill in a questionnaire about broadly mental issues it was a densely packed two page one.
The only one I had was feeling a bit upset about how it effected my skin some horrible looking scabs.
This is a horrible part of COVID that no one seems to get. Chronic conditions are life changing, and no part of it is good.
It's different, but as an example, I injured my back (i don't really even know how) and was in intense pain for approximately 8 months. You know that feeling when you burn your hand on something? It normally last 5-15 minutes, well it was like that, but inside my lower spine all the time, for a solid 4 months...and then in duller state for another 4. I am still struggling with pain from time to time, but i'm once again able to sleep a full night (something i couldn't do for around 5-6 months), do physical things and not regret every movement. At the start of the injury, i was probably the fittest I've ever been, but now i'm probably the least fit i've ever been. It's seriously sucked. Who am I kidding, it still sucks...coughing hurts...but its improving and that gives me hope that one day it'll be 'normal' again.
Until you've had a long term injury, you have no idea how to sympathize. Right in the middle of this i had a close friend get upset with me that I came over when I knew he was painting, and didn't offer to help. I was frustrated he even considered it a possibility, i was struggling to sit in a car for more than an hour, how was I going to paint a wall or ceiling? People just don't understand.
To everyone suffering with something that inhibits their ability to enjoy life, i'm sorry but wish you the best. To everyone looking in from the outside, assume its 10x worse than what you see and reconsider your next move.
I hear you. Blew a disk in high school. Set me back decades.
A few years ago I got serous on stretching videos, finally found the ones that “fix” it. Doctors and chiropractors were helpful, but it never lasted
Not sure about the original poster specifically, but when I had a herniated disk the two movements that helped the most (and I still perform along with others to this day) were:
- Banded Hamstring Stretches (https://www.youtube.com/watch?v=msxQR56U7sI): You can use a belt for this if you don't have the bands, but properly and consistently stretching my hamstrings was the biggest thing I did to relieve (and 'cure') my back pain after the herniation.
I used this to get rid of my back pain from sitting all day. Now I prevent it altogether, by getting up once per hour, and walking around for five minutes, so I haven't had to do these stretches in a while.
I find that well-executed strength training (i.e. with proper form) eliminates all kinds of back-related issues for me. This talk has been really eye opening for me:
+1 on this, for me deadlifting has single-handedly fixed my back. I tried PT for it, with mixed results, but once I started lifting it completely went away. YMMV, but it's worth considering for sure.
I'm clearly doing something wrong, but lifting has driven every time I've injured my back in the past 5 years. I've had trainers coach me on form, and _most_ of the time I'm fine. But if I have bad form p% of the time (e.g. 0.5-3%), and working out becomes a ~daily thing, then I have a handful of opportunities per year to injure myself.
You kind of provide recipe how to avoid it yourself. One suggestion that might or might not be relevant - don't do weightlifting at your proper max, and don't push your limits that way. Its a way to grow fast but also sure way to injury. There is no way to be at your limit and keep the proper perfect form, every time. You can always add more repetitions to workout.
For me weightlifting is about staying in shape for things like mountain adventures, feeling great, looking good. But Arnold-look is a silly goal for long term wellness, and so are the methods to get there. Once I stopped pushing the numbers and focused on more repetitions, I never had any injury. That's worth much more than some momentary number of kilos/pounds you did today - nobody will care about that tomorrow, but injuries remain, sometimes forever.
YMMV, but I found the following articles quite useful to 1) help self-manage symptoms brought on during strength training, and 2) to stop obsessing about my using "bad" form during training:
My anecdote: I tweaked my back 3 times in 18 months (like bedridden/WFH/swearing like a sailor for a week). Then I started going to a 1hour yoga class 1-2 times a week, and it's now been another 18 months without any issues. (Since covid I've been using DownDog app and doing 10-15 min sessions)
They described the mental hardships that come along with a chronic condition. Is it possible that quarantine is worsening those hardships? Sure. But when you claim that COVID related hardships are due exclusively to quarantine you are basically invalidating their experience by saying that a chronic condition alone wouldn't cause these issues.
Your comment would have been totally fine as a top level comment. It is a believable theory that quarantine is worsening mental illness. Your problem was the context in which your comment existed and the way you were effectively dismissing OPs experience out of hand.
My point was Chronic conditions / isolation. can cause/worsen mental illness. Covid or otherwise
Personally I’ve had the best year in a long time, because I found the right treatments. Only one month before things locked down.
I don't disagree with your point. I simply got the impression from throwaway0a5e's comment that they were saying that these issues weren't worsened by quarantine but they originated from quarantine.
>They described the mental hardships that come along with a chronic condition. It it possible that quarantine is worsening those hardships? Sure. But when you claim that COVID related hardships are due exclusively to quarantine you are basically invalidating their experience by saying that a chronic condition alone wouldn't cause these issues.
I didn't claim that but I don't think that matters to you. All I said was that it's hard to tease out the difference between covid caused hardships and covid treament caused hardships. Cancer doesn't make your hair fall out on its own.
>Your comment would have been totally fine as a top level comment. It is a believable theory that quarantine is worsening mental illness. Your problem was the context in which your comment existed and the way you were effectively dismissing OPs experience out of hand.
I didn't dismiss his hardships. I didn't even dispute them. Stop putting words in my mouth. I only pointed out that (similar symptoms in other people who have had covid) might be caused by how we're treating it (quarantining people and so on) not the disease itself.
There is no point in continuing this conversation. You deleted your comment so it is both no longer relevant and can't be referred back to for further critique. Although the fact you deleted it after already posting it from a throwaway account would seemingly show that it was a comment that you weren't willing to stand behind.
This account is how old and has how many comments? Maybe it's not a throwaway anymore. Clearly I stand behind my comment enough to still be discussing it here.
You didn't stand behind your original comment or you wouldn't have deleted it. You are only standing behind what you claim your comment said. However now no one can actually judge whether those are the same or not.
Either way, the end result is that both of us look like idiots continuing to argue over this. That is why it is pointless to continue.
I've seen this exact thing happen with a facebook acquaintance. She already posted a lot about every problem she has on social media even before she got Covid, but with covid it was another beast. She tested positive before she got symptoms but before the symptoms even really began she was reading anything and everything in full blown hypochrondia-mode and getting more and more depressed and anxious about it (from what I could surmise from the editorializing she added to every covid related article or study she shared). Within one week of testing positive she was deep into the articles about chronic issues, so it was well before quarantining period was even over. It was pretty wild to observe and she's still posting stuff these days. It's hard to distinguish what is legitimate and what's for attention. While there may be legitimate issues, I can't help but think that it would be hard to separate legitimate issues from psychosomatic ones brought about by the way she dealt with it (and how it has become part of her facebook identity). She may be an extreme case, but I could totally see the same happening with other people to a lesser degree.
Oh it can be both.
She could have a chronic issue, and be an attention seeker.
Hypochondria is a major problem.
Part of me finding out what was wrong to make a list of every symptom, every condition that a subset of symptoms, keep track of every test and what conditions it eliminated as possibilities.
The sets of possibilities are enormous.
At every step you get called a hypochondriac.
I didn’t directly find it, but when I showed table of symptoms, and what medications had been tried and failed and what tests had been run a doctor realized it was a rare autoimmune condition.
It’s such an odd thing to be given a terrible diagnosis. But feel immense relief that it’s not “in your head”
From support group, this is Apparently a common reaction.
Yeah, totally agree it can be both, but of all the people I know that have had it, she's the only one exhibiting both hypochondria and posting comments suggestive of anxiety/depression. Certainly anecdotal, but enough to merit further investigation.
> separate legitimate issues from psychosomatic ones
I know what you are trying to say, but phrasing it like this is harmful. Psychosomatic issues are absolutely legitimate. Knowing it's psychosomatic means there may be other avenues of addressing it than if it wasn't, but calling the issues "not legitimate" is very problematic, akin to telling someone with depression "just think happy thoughts".
Yeah, that was poor word choice. I guess I was going for issues actually caused by the disease and not issues that are self inflicted or inflicted by society's response to the disease.
Regarding your back pain, try to start walking barefoot using a forefoot technique, as opposed to heel striking as most people do. I suffered a lot with back pain (for years, despite the fact I was very active), tried everything to fix it to no avail, eventually switched to barefoot/forefoot running and walking (with all my shoes being zero drop and minimalistic), my back problems went away completely.
I can imagine trying to run by placing the toes/front foot first, but I find it difficult to imagine walking like that since it seems awkward. Do you have any links that depict this well?
Buy a pair of Vibrams. Walking in toe shoes that have little to no heel support will naturally change over your gait in a week or two. I used to run 3-5 miles most days on concrete in running shoes and had knee and hip pain afterwards each day. Switching to toe shoes and by extension forefoot running eliminated the pain completely.
The impact of walking and running is dissipated into your calves instead of your joints, and the nice thing about muscle is that it grows back. Take it slow as you ramp up, I promise your calves aren't ready for it yet.
There are plenty of great "barefoot" walking shoes in the market nowadays.
I like to run on Vibrams and sandals (I generally use a Shamma Warriors during the summer), and a have a bunch of other shoes for walking (Lems, Freet, Vivobarefoot, etc.)
A good all-around barefoot shoe that is suitable for both running and walking that I'd recommend is the Lems Primal 2.
Also: use toe socks (Injinji is the only brand I'd recommend) and, if you can, use toe spacers for a while (1-2 years minimum) to correct some potential issues with your toes placement (unfortunately the only brand that seems to be decent enough in the market is Correct Toes, but it's rather expensive; the cheaper ones you can find everywhere are no good in my experience)
Let's take it case by case. All sorts of things could happen, so let's not react until we have some signal. Otherwise we run the risk of overreacting and creating more harm than the thing we've reacted to.
Many folks have a hard time understanding chronic pain. I did too until I suffered from it for a period of 6 months. I injured my neck and my right arm went numb. The pain from my neck down to my finger tips was a constant 10 out of 10, 24/7, even in my sleep. There was no amount of pain killers that would help.
I freaked out my whole family telling them that if it doesn't go away I don't think I can make it. There was a point where I got an axe and asked my wife to hack my arm off at the shoulder. Miraculously, it finally healed somehow and I just remember thinking how wonderful it felt to have a second chance at life.
I understand now why people with chronic pain want to end their lives. For some poor souls it seems like the only way to get rest/peace from the constant and exhausting pain.
People put way to much trust in doctors. I have family members we are clearly suffering exact same issues I have. I keep telling them to go ask for X,Y & Z test.
Everyone of them as assured me their doctors don’t see any reason to run those tests. Then they complain about how hard life is.
Trusting "Experts" is a pandemic. We see it everywhere. They ubiquitous "They say..."
Trust economists that we can print trillions and its fine.
Trust military the war is "almost over".
Trust politicians that they will fix our problems.
Trust teachers to teach our kids (Teachers need parents support at home!).
Trust Coaches to teach our players (you gotta play catch at home to be good at baseball!).
Trust doctors...
trust priests...
trust police...
You have a good point, blind trust is never good. Should not be downvoted imho.
Sadly, it seems that the majority of people who start researching things on their own often arrive to completely wrong conclusions. And that's dangerous, for them and for everyone else.
An economist, for example, would have years of information and training in the field. And that forms a knowledge base in their brain that's (mostly) accurate, so anything they research and learn will be more correct than what an electrician/programmer/politician by trade would find.
To put it simply, they have more information and experience.
Of course, there are exceptions, some people are smart and can run circles around experts, but as I said, the majority of people are likely to arrive at the wrong conclusions.
I don't know how this could be fixed, perhaps more oversight and checks over the experts (many cases where people are just winging it or are complete frauds). But going off on your own and not trusting experts at all is a bad idea.
It could be that a lot of other professions don't have the same reflection rate as scientific areas.
In science and engineering, we are constantly being forced into realization that we were wrong, and we constantly try to fix things where the fix is just yet another problem we created.
I mean, even if you can code for 20 years, if anybody asks you whether you can program or not, you'll probably answer "nope I don't know anything about programming"... and that's a sign for an experienced person in that profession.
On the other hand, a lot of professions can get lucky with social camouflage, where they can blame others and it doesn't stick out for a controlling person. A lot of people that made it this way never were forced into reflecting on their bad decisions.
An ENT doctor recently told me antibiotics don't cause tinnitus.
The doctor at the covid plasma donation center sent my wife home because her clearly labeled "positive" (1.4 threshold, my wife's result was 4.9, but the doctor wanted a minimum of "80") test was too low for plasma donation -- it was not, the doctor was talking about a different quantitative test. After 8 months of people donating covid plasma, this doctor had no clue. It makes my blood boil thinking how many other people didn't donate plasma because of this idiot-- I sent my wife back and told her to make a big fuss and ask for another doctor, who actually explained the idiot doctor my wife can absolutely donate plasma, they just ran different kind of tests, and my wife's test result was more than likely meeting their own required antibody levels.
This was not a medical issue, it was a common sense issue -- if her test had a positive threshold level of 1.4 and she had a 4.9 result, how could this doctor not realize something was wrong with her requiring a value of "80". Did she actually think that only Chuck Norris can donate covid plasma?
My psychiatrist bullshitted me about the mechanism of action of some meds she was prescribing (I knew because I looked them up as treatment options beforehand) -- she did prescribe the "correct" medicine as far as I remember, but she just did not know the correct mechanism of action.
The infectious dissease specialist in my hospital stay for COVID-19 told me the hydroxychloroquine she was giving me was a proven anti-viral medication that worked really well in their national acclaimed hospital. Again, she was really clueless, she was just following protocol, she could at least have shut her mouth if she was clueless.
They only gave hydroxychloroquine to otherwise healthy individuals because or cardiac issues the medicine was known to cause, OF COURSE those patients had really good outcomes, they were otherwise healthy, young individuals.
My wife is a dentist, she really likes her surgeon boss and his approach of telling patients the true odds of success of certain procedures and what to realistically expect out of them. But a lot of patients don't like that. They want to hear the doctor has a 100% success rate with every procedure and that all his dental implants last a lifetime.
So part of the problem is the public that will choose a lying, perhaps clueless doctor with a god complex above an honest doctor that really knows his stuff and is honest and upfront with his patients.
Had similar, had a severe reaction to the newer class blood thinners.
Nurse at hematologists swore up and down that no one has reactions to it. Studies all prove that. Called me a liar.
Well started dealing with other specialist because I was having severe problems due to this medication.
Vascular and others all gave me warnings as they had been seeing a lot of problems.
I found out the studies were done mostly in China, and were suspect.
Hematologist let me know I wasn’t allowed to come in because I wanted to switch. Mocked me for looking things up.
I had not taken it in 3 days and was already losing vision. So waiting months for another practice was a death sentence.
That was my breaking point. Stopped being Mr. polite.
First time I ever screamed and threatened a lawsuit.
Got my new medication. Life got better.
Also yeah antibiotics definitely can have a powerful effect.
Oddly I was diagnosed correctly due to how I responded to certain antibiotics.
It does reach a point that living is worse than death.
Had a similar final. Intentionally became a lunatic at ER.
Refused to take prescribed blood thinner, which is a quick death for me.
They finally listened and gave me a different one.
Life drastically improved after that’s.
I absolutely do not want to minimize your experience, but I also want to point out that pain doesn't have to be excruciating to be life changing. Even 1 out of 10 pain can make it harder to concentrate or sleep, and, without proper management, can be debilitating. Chronic excruciating pain is, of course, oh so much worse. But even mild pain, when it extends out across months and years and decades, is not something you can appropriately manage by just rubbing some tough on it.
I do not want to minimize your experience either, as somebody suffering from chronic pain for the past two years myself.
Chronic pain sensitizes you further, having this awareness helps you deal with your condition better. I highly recommend reading the following article.
I know a girl, my 'Viking friend' that landed upside down with a tractor on top of her. Just about everything that could be broken was broken. She ended up a thrill seeker because anything that would have killed her was also a blessing in disguise. Constant chronic pain at the maximum of what you are able to endure and live. The choice: painkillers and zoned out, unable to do much of anything or no painkillers, continuously in pain but at least conscious. She eventually learned how to deal with it, found a job that took her all over the world and is now happily married. One very impressive person.
Highly relatable. I've never considered taking my own life, but there were certainly moments where I thought "i need to get this fixed, i cannot live this way for the rest of my life".
I'm sure you've seen drs. so I'm not going to get into too much detail about how I fixed my back pain, but I understand where you are coming from. I couldn't stand up straight for months. Laying in the MRI machine long enough to get a good image was excruciating. Just getting comfortable each night to sleep was an exercise in frustration. Narcotic painkillers didn't really help me, but a pain that never goes away helped me understand how people do get addicted to pills.
Finally, I had one of those injections directly on my spine and it was like magic. I walked into the appointment and couldn't stand up straight and walked out like I had never been hurt. For weeks, I would wake up each morning and dread getting out of bed because I wondered would this be the morning the pain came back.
It's been years now, and knock on wood, I hope to never have a problem again. I was always a weight lifter, but stopped powerlifting (maxing things like DLs), and stopped playing basketball. I still exercise a lot, but my entire focus now is on longevity. Strength is still a key component, but so is flexibility and learning proper movement.
I had a similar experience 20 years ago. I had a herniated disc triggered by heavy lifting. Spent about 10 months in pain (enough that it was a problem but not so much that it was debilitating). Finally had an epidural after months of PT that was going nowhere and was 100% fine the next day! I was lucky, the epidural broke the cycle of inflammation that in all likelihood the PT was actually aggravating.
BUT....
Last year I had another herniated disc triggered by axing down a tree. This time it was really bad. I spent two months in debilitating pain unable to move or really do much of anything. Couldn't stand, couldn't walk, couldn't sit, couldn't lay down. All I could do was dope myself up on narcotics and try to sleep the time away.
I had two epidurals. The first one took the edge off the pain away but I was till unable to move. The second epidural I actually regressed.
So I went and had a microdiscectomy done. Turns out my nerve had slipped into a canal that had no room for it and was pinched inside. A week or two of recovery and I felt great again.
BUT....
I didn't change my habits, covid-19 hit, I started working from home where I did not have anything close to an ergonomic setup and my back started to ache again. This time it was the original disc. I was doing ok, but it was enough that I knew I should talk to my doctor. A couple weeks later, at the pool, I decided to go off the diving board while my back was slightly bothering, and that slight bother became nearly debilitating pain again and two months of physical therapy.
I feel great again, the PT worked this time.
What's my point? The injection doesn't always work. PT doesn't always work. There's lots of ways things can go wrong. Take care of yourself and be careful, next time you might not be so lucky!
I completely understand. I'm fairly certain my original issue was caused by playing basketball. The running and jumping really does put a lot of strain on the body. I have never played ball again since the injury.
As I mentioned, I also changed my entire workout regime. While strength is super important, 500+ pound DLs maybe not so much at my age. Both basketball and powerlifting I love, so it was definitely a mental shift. But, now I'm probably in the best complete shape I have ever been in. My cardio, strength and flexibility are balanced and good. COVID has actually been a good thing since I can jump up at any point in the day and take a 15 minute yoga class.
Good luck, I hope neither of us have to deal with back pain again :)
I get that exact burning sensation in the bottom of my spine! Weak core muscles; specifically wrong muscles trying to support the core. I had zero lower abdominals. Pilate's helps a lot.
I have to consciously engage muscles, even after practicing for years (can't afford Pilate's sessions which would make it go faster). Now I very rarely get the burning sensation and corresponding days, weeks, or months or not being able to sit or do much of anything.
Damn you really hit the nail on the head. "Invisibile illness" is how I've heard and referred to it.
Losing your mind now and then is absolutely okay.
--- I'm paraphrasing someone close to me ---
God is giving me only what I can handle. Making me stronger in the process. Something even worse is coming down the line so get ready.
Well I suffered from that for more than a decade but in the end in turned out in was indeed "anxiety". Your thoughts can make you sick. It took me a long time to realize that idea, to admit that psychosomatic effects are real and strong, that it's not craziness, and yes doctors are usually not very useful with that.
Simple test: what were your thoughts and emotions 5 minutes ago? 1 hour ago? since this morning? and how were you breathing (slowly with good posture or rapidly)? If your brain is constantly circling thoughts with no cool-down with bad posture it's guaranteed you will have physical problems.
For me the cure was a combination of:
- Slow breathing exercises
- Mindfulness (to learn to listen to the body and emotions, an to be aware and able to "control" thoughts). No mysticism bullshit, just having a brain and body at rest and present.
- Stoic philosophy : not worrying with things not in my control, not being affected by outcomes (e.g. objectively did my best and the boss/client is not happy? That's fine for me)
- Strength training
- Nutrition
- Financial security (I know I'm lucky but that doesn't change the point)
- Edit: "reconnecting with nature": again no mysticism, just outdoor walks, gardening, and taking the time to observe and appreciate while being fine doing nothing
The best I could describe my default state now is as being relatively at peace, with no negative thoughts circling, slowly breathing with good posture (that I can maintain while coding long hours for example). I'm still of anxious nature and still worry about the future, but only on the time period I will allow it (and not as a the permanent background noise). YMMV obviously.
Sorry if that’s what you got, my intention was only to bring my experience that these symptoms can indeed come from « anxiety », not that it’s the exclusive cause.
I identify a lot with parent comment. Had a lot of chronic pain resulting in very intense and sharp pain near the nose, I really thought it was linked to sinus cavities being inflamed.
At the end it was very linked to my mental state, it took me half a decade to figure it. As parent comment is suggesting, slow breathing to remove tensions near your rib cage can help.
The most useful tool for me is to smoke cannabis, I then identify pain points in my body and massaging them with my hand vigorously is effective. Hope it can help people having « the same kind » of chronic pain.
Your almost describing TMJ. There is a spot between nose and ear that gets crazy tight for me. First time I Painfully massaged it out I had a 75% decrease in migraines.
The type that comes from anxiety is real and debilitating too, and I wouldn't dismiss that either. I lived with that for years before it became clear I had symptoms that boiled down to me stressing myself out enough that they occurred (tremors, pain, IBD, sleep disturbances, cardiac, etc). Psychosomatic doesn't mean "imaginary"--rather, it means being a disorder of both psychological and somatic (physical) nature. That's one of the very first humps I had to get over to accept it was happening to me: the symptoms are every bit as real as in a fully somatic condition.
So I took the comment's point as that there are multiple potential causes for a given manifestation, and chronic conditions in particular are confusing because they invariably end up with physical -and- mental symptoms. There's something to be said for exploring easing the one you can do by yourself, at least to some extent. Mindfulness, slow breathing, and some of those other techniques helped me too. No matter which aspect is primary and which aspect is secondary, easing the mental stress some can still help.
Not specifically. Everyone's different, but for me self-awareness was the key. Mindfulness and breathing exercises (very close to the same thing unless you get deep into MM) are both about processing your various physical and mental reactions. That makes them especially applicable towards breaking vicious cycles like the one I'd gotten in, where I was freaked out in part because of the symptoms so it became self-perpetuating.
I don't want to paint these as silver bullets. I still deal with my anxiety disorder on a regular basis. I just feel more able to look at it in third person a little to defuse some of the worst bits.
Edit: I'm always hesitant when someone uses the word advice, so I gave a vaguer reply than I needed to. I won't give advice but will give a little more detail.
Looking at the original list, the specific ones there I also have tried to improve with varying success are stoic philosophy, nutrition and fitness. But I'll also add sleep, since of them, sleep has had the most immediate effect that I've noticed. However, there's a chicken/egg thing there if you're too uncomfortable to sleep. I used a short course of sleep meds, but those have their own risks so YMMV.
Stoic philosophy is good to aspire to, but it's more end goal than technique IMO. It's a good thought yardstick, though, for what you "should" be feeling if you can step outside yourself a little.
At the risk of being flippant, saying that all illness is chronic illness is dismissing other people's very real and debilitating experiences of continual anxiety.
There's a balance. The two sides of anxiety and chronic illness aren't at war. You can say it could be one thing without dismissing the other.
I find this too. I have several series of books I’ve gone through enough times to not need to be fully engaged or worry if I miss bits. I always have one playing when I go to sleep and it gives me something to hold just enough focus to not get lost in my thoughts.
You developed what I like to call my toolkit for fixing the variety of things doctors have no solutions for.
Crazy facebook/twitter people love to talk about their cure-all (why is always essential oils??). But the reality is there is never a simple solution to solve the issues.
Think of it as a holistic solution. Things to examine:
- Nutrition | Are you eating regularly or too much?
- Sleep | Is your sleeping regular
- Movement | I hate the word exercise! Just walking, stretching, or being outside is helpful
- Meditation | Learning how to use this to reduce anxiety and activates your parasympathetic nervous system
All of these can be very low/no cost
As for things that cost some money
- Therapy | Learning to understand yourself!
- Acupuncture | This varies for each person, but has helped my anxiety
Funny enough - I suffered for 6 years a pain condition. Luckily it was acute enough at times that it was hard for me to believe it was all mental. But that still didn’t stop the sheer force of multiple doctors claiming psychosomatic origins, even flipping my own parents partially in believing that. By the end of it all, I was just about convinced it was mental. I did have a ton of anxiety, it was impossible to figure out the causality.
Ultimately, a genetic test revealed it was a rare autoimmune disorder that causes a wide variety of hard to pin down inflammation-related pain.
I had already come up with a ton of coping mechanisms, and was halfway to accepting it was “just me” or “anxiety”. I’m so glad I finally found what it was, because it would have been devastating to have convinced myself all that was my fault without even any clear genesis.
Not to say yours isn’t. But it makes me wonder: we have no idea the complexity and incidence of smaller phenotypical irregularities that lead to any number of “minor pains” that get ultimately interpreted as “anxiety disorders”. You may even be anxious - who wouldn’t, with an unresolved medical issue spanning years - but you may also have some imbalances driving it that are hard to pin down.
Yes you are right to point that it can juste be coping mechanism and that there can still be an underlying unknown medical condition, responsible for parts or all the symptoms. In my case the stomach burns and acidic reflux part were not « stress » but a kind of food allergy (kind of like ulcers were « stress » until it was discovered it was a bacteria).
Do you know the name of it and the affected genes? My wife has had autoimmune symptoms for years and the doctors keep saying it's anxiety as well. We've had a genetic test done for the common disorders but didn't find anything
Dont have the genes on hand but it’s Familial Mediterranean Fever, more commonly shows when youngish. Idk if there’s anything that’s come to replace it but if you’re ok with putting data in hands of big med, promethease is what helped me find it (was before they sold out), likely still worth trying.
Cancer survivor of 20 years here. You sir seem to understand exactly how things are. This is how it is, not bad, not good, just the nature of life i guess.
This is such a millennial take on the article, just needs a couple of suicidal jokes.
From the article: "Anxiety, depression and insomnia were most common among recovered COVID-19 patients in the study who developed mental health problems". It isn't about long COVID.
We're living in a uncertain, stressful time. Even people who haven't got COVID-19 have some degree of anxiety, of course getting it and not knowing if you will end up in a ventilator will have a bigger impact on your mental health.
Covid reporting is rife with statistical murder for the sake of hyperbole. If someone paid attention to the first week of a statistics course they'd learn about sample bias, false causality, cherry picking, Simpson's paradox, etc. Ahem, publication bias. Small wonder mental illness is up with a constant news cycle abusing fallacy to monopolize the public's attention and a status quo of blaming whomever strikes convenience for the disease. Let's just pull some data from this cohort of people who had Covid... and there we have it - Covid causes mental illness.
In my state deaths from child abuse outstripped deaths from Covid until a recent outbreak in a couple of nursing homes. Guess we can conclude it causes deaths by child abuse. What's the tragedy reported in the newspapers? School closures forcing children from broken homes out of the only place people cared about their safety and success are now dying from abuse? The generation of poor and minority illiterate 3rd graders who will never catch up? Nope. People literally waiting to die in a nursing home are dying. A tragedy.
> People literally waiting to die in a nursing home are dying.
This is why I've said from the beginning that impact to life expectancy should be the metric which guides public policy. It accounts for lives of children being worth more than the lives of the elderly, because the elderly have less life to lose.
This! This. This. Thank you so much. Some days you can feel so depressed about the recovery process. Hang in there. The cold weather made me relapse on postCovid and I feel like shit rn
Dad? For real, this may be satire but it's 100% on message with how we treat those who are suffering from an invisible-externally disease. I wish this wasn't true. Heart goes out to all those suffering from an illness the world thinks they should "suck it up".
I'm definitely aware of some cognitive impairment since dealing with COVID, with me it seems to center on some fine motor skills leading to trouble with typing faultlessly, which I could do without a problem before and now I need to review what I type three times before I'm confident I didn't mess up.
Besides that, the tiredness is mostly gone now (it had better be after a good 8 months), though every now and then it can still recur and then I'm 'down' for a bit.
As for planning, I updated my will a week ago with all this at the back of my mind.
So while I recognize some of it I am happy that I apparently had a 'mild' case of this, and I feel very sorry for anybody that had it worse (and their families as well).
B vitamins are water soluble, so they are easy to become deficient in under any kind of duress. They are known to be important to neurological function.
A quick google of "b vitamin deficiency fine motor impairment" brings up B 12 repeatedly in references. Some B vitamin or other was one of the supplements medically recommended for children with autism that I gave to one of my sons when he was about eight years old and his handwriting issues improved. (I would have to try to dig up old notes, if they still exist, to say exactly which b vitamin.)
(I am not a doctor. This is not medical advice for anyone, much less for the OP. This is just a general observation for anyone interested.)
Edit:
Yep, my old notes still exist and B 12 is one of the three B vitamins listed (I never found DMG but gave the three B vitamins and magnesium to my son and after a few months saw improvement in social issues and handwriting). Excerpt from an old blog post:
"In 1996, I found some information on the Internet about a vitamin therapy that doctors sometimes prescribe for autistic spectrum children. Recently, I found the crumpled, pathetic slip of paper that I originally wrote my notes on. My original note has the following bullet points written willie-nillie, all over the place:
(DMG) Dimethylglycine
125mg tablets or capsules
take 2 - 3 weeks ("then add"),
vitamins B6, B5 then add B12/magnesium
Okay, I take that to mean that all the doses are supposed to be 125 milligrams. They did suggest you start things either one at a time or in pairs (and I take my notes to mean that the pairs are 'B6 with B5' and 'B12 with Magnesium') and observe if there were behavior changes with the addition of each thing. I think 2-3 weeks is how long you should have the child on each supplement before adding the next one."
Got Covid 4 weeks ago, got better two weeks later. This weekend I went out for my first walk, about an hour. Although I didn't have any lung issues during the really-ill period, I definitly can't walk as fast or long as I used to, one hour felt more like two or three. I really had to pace myself. I broke out into heavy sweating going up a small hill. When I got home, I laid down in bed and dozed the rest of the day. Pure exhaustion.
After I got 'better' I thought it was comparable in severity to a bad flu. It's becoming rapidly apparent that the real impact shows itself after sickbed. I'm 33. I feel like I've aged a few decades in the past month. I really hope this will pass.
Yes, I know and I'm counting on that. But the odds are some of the worst I've seen in my life so far, and there is no cure in case I do need it. I never felt before that hope is all I have.
Did I miss something? Everyone is discussing their anecdotal chronic condition stories, but the article is not about chronic conditions. We know the following from the article:
- 1 in 5 people will have a first time diagnosis of a mental illness (including but not limited to anxiety) within the first 90 days of being infected.
This does not mean the diagnosis is chronic or even lasts beyond the duration of the disease. There have been studies done showing that about 2% of people still have symptoms resulting from coronavirus after 12 weeks [1].
We should not be conflating people getting anxiety from having coronavirus, with people developing chronic mental illness.
This has been the past 5 years for me. It's amazing how accurate all of those are and how each point is a major problem on its own, let alone all of them!
-20 to my trust and confidence in the healthcare establishment
Another click bait article. Sad to see psychological terrorism so prominent throughout the United States let alone globally. I'm genuinely surprised hacker news hasn't built a feature to filter out this junk, but of course disinformation is more profitable than real credible studies. This is a great example of the same psychological exploit used with push notifications just in click bait form... Anyone else tired of the internet being abused in this form?
For anyone wondering my entire family has passed COVID, 0 out of 5 of us have developed mental health issues. TLDR; People get paid more monies to scare you and lure in your attention by exploiting that vector of your psychology. Don't be afraid of COVID, do be afraid of countries locking you in your house to "protect you".
Do you understand what statistics and populations are and that they go beyond your family?
I have a connection to Bergamo, Italy and seeing them do triage (selecting who gets treated and who is rejected) last March/April was brutal.
Your comment is disrespectful to all of those who died, are currently dying or who lost one. And to those who suffer long term consequences that will affect them all of their life.
It's incredible that after nearly 1 year of constant information bombardment you are still too ignorant to understand that even 15% problematic cases will overwhelm the system and cause issues that you are completely incapable of understanding. Yes, 80% of infected will be just fine but the other 15-20% are what brings our healthcare system to its knees. Just be happy you were in the 80% and shut up.
You probably even think of yourself as a smart person (you are not), why else would you come to THIS forum and post this breathtaking bullshit?
It's incredible that you don't question information WHEN IT IS FED TO YOU and DISINFORMATION IS MORE PROFITABLE THAN FACTUAL INFORMATION- this is the current business model. I am by no means discrediting anyone who has suffered, I am simply stating that BY EXPERIENCE of contracting the virus alongside my own family, nobody has developed mental illnesses. I understand that this is an insufficient sample size, I am simply making a statement based on real experience in combating the virus.
I don't question my intelligence and I will not be censored while using a public good.
You may want to question your own intelligence level for taking my comments to the utmost extreme, and making emotionally irrational hatred comments back at me.
Jog on, I hope you don't continue to succumb to the psychological terrorism that is living in your head rent free.
People have different opinions. I am pretty sure you are not qualified to assess how smart someone is via the Internet. You just believe your opinion is more worthy or more accepted then the one you are attacking.
And I couldn't agree more with the parent you are replying to.
Cases are popping up. These days, we dont have to wait for the media to tell us how harsh covid really is. I know a number of people who have got it, and everyone of these is fine again. There was one case of a hospitalisation, but that person went to hospital with a lung problem last year as well, so they are what we call a risk patient I guess.
Waving the triaging situation around like you are jesus doesnt help either I'm afraid. Citizens are well aware that the triaging is due to politicians NOT putting extra money into the health care system. No, instead they were busy pouring tons of money into airlines and other industries which managed to cry wolf. I am convinced that if we instead had put only a fraction of that money into the health system, triaging would be way off in the future. But hey, it is easier to sell the measures if you can point at the health system breaking down.
Hey Nueronic, I am not dismissing this medical study as "junk" I am dismissing the click bait headline as "Junk". I agree with Infinitesimus's comment. Nowhere does this article demonstrate that Covid infection causes mental illness from a neurological perspective..
"People like you" is a very dangerous statement. You don't know my background, who I work for, or TBF anything about me.
Correlation does not imply causation, and there is no such mechanism for which this respiratory virus can alter your brain chemistry.. It’s not a fucking prion virus from an infected cow.
I'm actually gonna upvote this, even though I think your phrasing itself has the very problem you accuse the article of, which is being unnecessarily intense/emotional.
But at the heart of it I think you're asking "What is the emotional cost, of all of us on HN reading and worrying about these things? Is the emotional burden worth the marginal information gain of getting scary, unverified news (something that happens all too much: remember fear of terrorism after 9/11)?"
so glad to see more folks speaking out against the mediopolitical coercion happening around the pandemic. it's both fascinating and horrifying to watch the machinations work their way into our brains and out of our hearts and mouths.
masks and lockdown, and spinning our wheels over who're doing those things right and who're not, aren't going to save us and is full-on, simplistic media and political performance (biden is still unhelpfully screaming "wear a mask!") distracting us from the weightier subtleties.
the policy that minimizes spread is to not breathe strangers' direct exhaust (not just air) for a prolonged period of time. we need to hone in on that one behavior, not its poor proxies, like masks and lockdowns.
distancing for instance is a much better primary mitigation for the populace, rather than getting lost in the fear-based political weeds of masks and essential businesses. with that singular focus, we'd have had greater agreement, cooperation, and effectiveness (rather than performativeness), and less uncertainty, anxiety, and fear.
To put this in perspective (and at least trying to approach the data critically), according to another research¹, the "% diagnosed with a first psychiatric disorder within 14-90 days of a health event" is 5.8% for Covid-19, and 2.5% for fracture (!).
My first question, after reading the abstract, would be, "Did they control for the effect of job type on stress level?" Some jobs require COVID-19 testing every week, and some don't require it at all. It makes sense intuitively that those people whose jobs require them to take a COVID-19 test would be over-represented in the case count, and that those jobs would be comparably high-stress.
They did not mention job or career choice in the study, nor did they mention stress except in the context of PTSD. They hint that they did not look at socioeconomic factors at all.
This is how the bureaucratic elite will eventually try to explain the severe mental health crisis unfolding before us as a biological effect of the novel coronavirus, when in fact, it was caused by their own choices to impose restrictive lockdowns.
Exactly. I'll have to read the study to find out, but three axes I'm immediately curious about:
1) Are we seeing a side-effect of bothering to look for mental illness in a generally-underdiagnosed population? Maybe most people have a bit, and scrutinizing people that ended up in the hospital is finding things that most mental health research participants aren't screened for.
2) I don't have a mechanism in mind, but it's always important to filter for correlation without causation, or even for reverse-causation; is there something about predisposition for mental illness that makes one more susceptible to COVID?
3) COVID hits an elderly population harder, and age is already correlated with mental illness. How did they control for age?
From the article: “In the three months following testing positive for COVID-19, 1 in 5 survivors were recorded as having a first time diagnosis of anxiety, depression or insomnia. This was about twice as likely as for other groups of patients in the same period, the researchers said.”
I wonder if that means twice as likely as for some other groups of patients, or twice as likely as all other groups of patients.
I remember reading the Spanish flu caused cognitive impairment in some patients, too.
Could the fact that the entire society has been shut down and your normal ways interrupted also be a major factor in this ?
“This is likely due to a combination of the psychological stressors associated with this particular pandemic and the physical effects of the illness” certainly seems to support that notion.
Sounds like a study without any useful conclusion.
>The study, published in The Lancet Psychiatry journal, analysed electronic health records of 69 million people in the United States, including more than 62,000 cases of COVID-19. The findings are likely to be the same for those afflicted by COVID-19 worldwide, the researchers said
>In the three months following testing positive for COVID-19, 1 in 5 survivors were recorded as having a first time diagnosis of anxiety, depression or insomnia. This was about twice as likely as for other groups of patients in the same period, the researchers said.
So still a doubling when compared to other people living in a pandemic society.
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[ 3.0 ms ] story [ 322 ms ] threadhttps://www.nytimes.com/2020/11/09/health/pfizer-covid-19-va...
https://news.ycombinator.com/newsguidelines.html
https://www.mayoclinic.org/diseases-conditions/mental-illnes...
And 1-in-5 every 90 days equals 4-in-5 over a year. If the risk doesn't change over time (if the covid effect is persistent for a year)
I think that's the important bit. The article (at least) didn't indicate that the same standard applies at the 180, 270, or 360 day mark, so I don't think we can just say COVID patients roll the dice on mental illness 4x as often as the general population. If that's actually being implied, it's horrible.
20% chance it happens in a year means an 80% chance it doesn't. Let's assume (this is the spherical cow) each day has the same chance. We can find it by looking at the chance an adult doesn't get a mental illness in a year. Then, because that's the chance they won't get it every day, it's easier to figure out the daily chance of not getting one.
So, overall, adults have roughly a 0.061% chance each day of getting a mental illness.Compared to the daily risk for this 90-day period
So about 0.248% each day for the COVID patients. That's more than four times as high as for all adults.Remember, this is spherical cow stuff. Numbers to use in other calculations need a more experienced statistical approach, I'm sure. But this at least tells us something's different.
edit: scratch my mistaken numbers - but people would normally (without covid) get many mental illnesses per lifetime?
> About 1 in 5 adults has a mental illness in any given year
This talks about people who may already have mental illness -
> Mental illness can begin at any age, from childhood through later adult years, but most cases begin earlier in life.
The OP is about new cases...
Take out a sketchpad, draw an exponential representing the # of COVID cases everyday, over 90 days. The area under that curve / 5 is the number of new mental illness patients added every 90 days. Now extrapolate that over the year, and add it to the 1/5 (Total population) number, and that's where it starts to sound alarming.
Think of the difference this way:
If 1/100 people are currently experiencing a headache, then it's also reasonable to think that 1/100 people will experience a headache tomorrow.
But if 1/100 people have an amputation, it does not follow that 1/100 people will get an amputation tomorrow, or even in the next 90 days. If 1/100 people were always getting an amputation within 90 days of any arbitrary starting point, there would be many, many more amputees around.
Mental illness being something that may lasts months to years, this certainly seems to be closer to the amputation case than the headache case. That implies that getting Covid can, indeed, be said to increase your chance of developing mental illness.
This is a major difference!
This makes it super hard to differentiate between something causing mental illness and that something in some way making people being diagnosed with it.
E.g. the current works situation makes it much simpler for people to get depression and anxiety without being infected by Covid-19, but due to the circumstances if someone got a new (or worsens) mental illness and covid in 2020 it's likely that they will diagnosed the illness after having had covid even if it came from the world situation not the covid virus directly.
Example Unrelated to covid: I got diagnosed ~3years after it (slowly) started to mess up my life, but that was when it started to noticably affect my life. As far as I can tell before that I had it in a mild version for like and addition 7-10 years.
So the time where sunshine is diagnosed as mentally ill isn't necessary at all related to when that person got mentally ill.
A psychiatric diagnosis in the previous year was associated with a higher incidence of COVID-19 diagnosis (relative risk 1·65, 95% CI 1·59–1·71; p<0·0001)
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
The research is on "anxiety and depression" which is increasing in non-COVID-19 patients this year.
I still get chills off and on but it has been better after moving from the US to Croatia (I am a dual citizen of both countries). I think the stress of Trump (as a disabled person) and the coronavirus situation in the US really messed up my health overall and eventually caused these chills. Coronavirus pandemic did totally change my medical care situation in the US for the worst too.
I still wear a continuous temperature monitor (using a zero heat flux sensor—it’s used in critically ill patients) to help pick up on these events. The device I use was recently cleared as a medical device under emergency use authorization by the FDA in the US: https://corebodytemp.com/
This headline will be a self full filling prophecy.
I do not deny a lot of people have died from this, but it's mostly the elderly that could have been protected. I also think the death counts are over-estimates, while everyone else thinks they're under-estimates.
The lockdowns do little to nothing and need to end. Human beings are not machines that can be places in low power mode or gears that can be stopped.
They appear to count any death that was tested positive for coronavirus as a Covid death. Coincidentally these countries are all near the top of the list when sorting by deaths per million.
Statistics are around 6.7% in the US for Major Depressive Disorder and 1.5% for Persistent depressive disorder (before Covid era, I suspect this is on the raise).
As far as we understand its due to a reduction in the 5-HTP path way which leads to a reduction in Serotonin. There is also a further effect on Gaba as well with a bit more time. Ron Davis and other researchers have done some work to understanding the genetic switch or mechanism but alas they aren't there yet with an affirmation as to the root cause.
Alas the depression and sleep problems are just the beginning, the condition gets much worse and more debilitating than Multiple sclerosis as it progresses and the chronic fatigue and exertion intolerance kicks in. Its excruciatingly painful and poorly treated by Doctors. The news all points to very bad for Covid19 and ME/CFS results unfortunately, it could be a much bigger contributor to loss of people from the workplace than death itself as most sufferers don't ever work again.
It's also the hallmark of lockdowns since March, political uncertainty and hostility with peers, economic uncertainty, and pandemic threats and uncertainty. All with a hysterical media, an all-or-nothing us-and-them type of conversation on just about any topic, and continual uncertainties.
The viral threat is real, but so are mental health considerations that seem to be completely overlooked by popular discourse.
It wasn't till I needed to go to the hospital for a physical injury (plus the times popping back for physio) that I started going to the GP for mental issues too
This is such a common pattern. People are dismissed for years before getting proper treatment. Some conditions the time to diagnosis is seven years. Entire time people are being told it’s in their head.
In particular, I think its pretty reasonable to assume the pandemic and other ongoing issues of 2020, will cause severe anxiety issues in a bunch of the population. Its been a hell of a year.
There is a feedback loop to anxiety and stress and illness.
Some illnesses cause minor problems for decades, but you remain mostly fine.
Add in a huge dose of stress hormones, and that minor condition can go crazy. You now have more things to stress about.
Inflammation can cause inflammation. Sometimes breaking the cycle is enough.
It's a cop out for doctors, I'd say at least 2/3 of the time.
Interestingly enough, previous viral infections are really often at the foundation of these issues. Post-viral syndrome isn't limited to COVID.
https://twitter.com/GidMK/status/1326041350404415489
> socioeconomic status (SES)
https://www.jstor.org/stable/23363545?seq=1
Eg. Italy
Additionally, there's is also a big difference to those that say masks are stupid and live in a rural area vs. In a city with a lot more people.
You are already being helped by those who stay at home ever day. Be grateful for those taking responsibility, instead of whatever this is.
I don't think anyone disagrees that lockdown is hard on people. The cost of lockdown is worth it, but lets not pretend that its free.
Sweden, without COVID lockdowns, is on track for fewer deaths in 2020 than 2018.
The country also has a lower COVID deathtoll per capita than Belgium, Italy, USA.
Lockdown is not a solution. Dealing with air pollution (ending the burning of coal and oil) and obesity (banning and taxing added sugar) would yield significantly greater benefits and require much less cost and effort.
Being on lockdown is making people ill and driving them crazy. This is being compounded by the cognitive dissonance embraced by half of the media-consuming world, which is telling them that their attacker is a respiratory virus, and not their local, state, and national governments.
Many people live in a society today where, saying this to the wrong person could get you injured, ostracized, or even killed - or, you may even get branded with the worst noun of all: racist. Anxiety is clearly through the roof everywhere you turn - now, I wonder why this is?
Are we actually going to go around thinking that these high-anxiety times haven't contributed to peoples' illnesses?
I take it that you are challenging my intellectual honesty, I am unsure about your intellectual curiosity.
I am not moved at all by your "hopes." I am quite certain that I am right. I would not have written anything, otherwise. But of course, that's none of your business - my words are more than enough to convey the meaning I intend, as are yours, and as were the parent poster's.
My intellectual curiosity is what allowed me to land on both of my feet and look at the COVID situation for what it really is. It wasn't hard and it only takes some "distancing" from corporate media sources to see what's going on.
https://www.theguardian.com/world/2020/nov/10/nearly-one-in-...
Looks like the data is from: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
To be clear, this does not demonstrate that Covid infection causes mental illness from a neurological perspective.
This data is from the USA, it would be interesting to compare to countries with free healthcare.
As a note I'm not against healthcare reform, but it's against the HN rules.
Native Americans have access to a full blown government hospital system not unlike UK's NHS.
In fact, the US has three times as many government-run hospital systems than most countries, and several times the number of government insurance programs. That's part of the problem. :)
> It would also be interesting to see what it's like in countries with different news coverage styles. Fear is a tactic used in the US to keep eyes glued to new media.
I think that's likely a non-significant part of it. As the saying goes, "Perception is reality" (which is demonstrated in phenomena like the placebo effect, or widespread beliefs in theories like QAnon or RussiaGate) - if so, it shouldn't be terribly surprising that a person who subjects their mind to large quantities of subjective "Coronavirus!!!!!!!" "journalism" would have a genuinely different reaction than that of someone who only exposed their mind to objective statistics.
> “Equally, it’s not at all implausible that Covid-19 might have some direct effect on your brain and your mental health. But I think that, again, remains to be positively demonstrated,” said Harrison.
> A particularly concerning finding was the doubling of the diagnosis of dementia – which is typically irreversible – three months after testing positive for Covid-19, versus the other health conditions.
COVID-19 is primarily a respiratory disease but the number of gastrointestinal infections is still significant. There appears to be a causal link between various dementias and the Gut-Brain Axis [1] so it is plausible that some of the long-hauler symptoms are specific to gastrointestinal changes/damage. It might be useful to compare the incidence of dementia in people suffering from chronic gastritis in addition to injuries and other respiratory infections.
[1] https://en.wikipedia.org/wiki/Gut–brain_axis
The original 2003 SARS-1 outbreak in Hong Kong infamously spread via sewage in a single building with faulty plumbing floor traps [2]. Wastewater surveillance has also been proposed and/or implemented in many jurisdictions [3].
I think poor sleep due to discomfort and/or anxiety is just as likely to cause brain fog in the short-term and mental illness over the long-term but irreversible dementia seems to require an additional explanation, in my opinion.
[1] https://www.cdc.gov/mmwr/volumes/69/wr/mm6928a2.htm
[2] https://en.wikipedia.org/wiki/Amoy_Gardens#SARS_outbreak
[3] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/wast...
Unless they controlled for age when calculating that ratio (they didn't, as far as I can see), this is questionable. Covid-19 is disproportionately more likely to be diagnosed in the elderly (because most of the severe cases are in the elderly). Dementia is disproportionately more likely to occur in the elderly.
> We identified a set of established and suspected risk factors for COVID-19, as follows: age, sex, race, obesity, hypertension, diabetes, chronic kidney disease, asthma, chronic lower respiratory diseases, nicotine dependence, ischaemic heart disease, and other forms of heart disease... We also identified an additional set of established risk factors for death due to COVID-19 (which we take to be risk factors for severe forms of COVID-19 illness), as follows: cancer (particularly haematological cancer), chronic liver disease, stroke, dementia, organ transplantation, rheumatoid arthritis, lupus, psoriasis, and other immunosuppression.
Beyond this, it is ambiguous. They say the following:
"For analysis of psychiatric sequelae, propensity score matching was directly applied to each cohort pair. For analysis of psychiatric antecedents, given their much larger sample sizes (which exceeded the maximum number of 1·5 million patients possible per matched cohort), cohorts were first stratified by sex and age (18–30 years, 31–45 years, 46–60 years, 61–75 years, and ≥76 years) and propensity score matching (including for age) was achieved within each stratum separately."
First, I'm not sure exactly what this means: did they assemble the marginals as you would to calculate p(psych_symptom|illness), then perform propensity score matching on those? Or did they perform propensity score matching on the subsets of the data that are "people who had covid" vs. "people who had influenza"? It makes a big difference.
Second, propensity score matching is, essentially, regression followed by clustering. The details of the regression therefore matter: they are defining cluster cutoffs in terms of standard deviations, which tells you nothing without knowing the size of a standard deviation in the context of the split.
In short, I don't know if this method of matching will control for age properly in the analysis in question. You would need to see a plot of the age distributions of the data for the groups in question to be sure.
EDIT: Also, Figure 3 quite clearly shows that the relative risk for all psychological illnesses increases with age. This would seem to rebut the idea that they have controlled for this factor.
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
EDIT 2: The supplementary materials show tables for characteristics of Covid vs. X for all of the control illnesses, which makes me believe that they have applied cohort matching on the marginals. However, they do not show age in these tables, making me doubt that they properly controlled by age (see supp. table 1):
https://www.thelancet.com/cms/10.1016/S2215-0366(20)30462-4/...
EDIT 3: Not directly relevant to the question, but it hints at it -- per supp. table 8, Cholelithiasis (gallstones) show the strongest association with psychiatric illness (i.e. the weakest Hazard Ratio relative to Covid). In other words: of all of the control diseases, having Covid-19 only makes you 1.58x more likely to have psychiatric illness than having gallstones.
Gallstones are strongly associated with age and gender.
EDIT 4: definitely not related, but supp. fig. 8-9 shows that if you require a confirmed Covid-19 test, the differences between Covid and the controls decreases dramatically. THEY DIDN'T CONTROL FOR ACTUALLY HAVING THE DISEASE!!
Just for example, Figure 2 from the text shows a gap of ~10% between covid and flu for all psychiatric illness. The corresponding plot in supp. fig. 9 shows a gap of less than 2% when you require a confirmed Covid test! This paper is falling apart.
I'm being equivocal in my wording, because that's what you do when you're being polite, and you're giving the authors the benefit of the doubt. Maybe I missed something, but I didn't see them control for this in a way that satisfies me that the issue was addressed.
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
Your rewards are as follows.
You have max exhaustion at all hours of the day!
Exercise recovery is bumped from next day to 2 weeks!
Your pain level is now on par with dying cancer patients!
Everyone now considers you lazy and incompetent!
Doctors now blame all symptoms on anxiety!
You gain +1 to medical research ability. But -20 to Reputation.
You now get spontaneous and useless medical advise from people that believe in essential oil.
You are now on timer with your job until sympathy runs out!
Disability now can mock you openly as clearly your faking and don’t have a real condition!
You are now a burden to your family!
+10 sneak score; you quickly learn to hide your suffering!
+20 to loneliness!
-20 to persuasion! Asking for help gets little from doctor's.
+10 Planning! Your kids may be orphans soon, make sure they get taken care of. Read fine print on death benefits. ——-
Staying positive when you have a chronic condition is incredibly difficult.
Your not going to get through it without losing your mind now and then.
Had some really bad years before figuring out what was wrong. Found support groups. All of those points are sadly the norm.
Basically everything in body was inflamed or damaged and I was having weekly minor strokes.
Also extremely hypersensitive to most meds.
> Doctors now blame all symptoms on anxiety!
hits hard.
Now a part of every health care provider conversation.
Doctors are sometimes like developers, when they don't find the root cause of an issue they blame it on the network or the OS
(But to continue the analogy, a reason to be scrutinize this paper is, because the process has been working fine for years no one has looked at the logs in an age, and when they do, oh my .... there are many things going wrong might not related to the release at all.)
There is a no way it’s DNS
It was DNS
A firewall is easy enough to test with pings, telnets, etc. but the LB rarely seems to make much sense and it seems like there's only one guy who knows how it works and they never explain what they changed.
I wonder what the developer equivalent of steroids would be.
Nurse once asked me pain level, I said 8. She lectured me that’s ER level of pain, not to use it anymore, I must be a pill seeker.
It was an 8.
[Edit: I really meant to ask, how do you know it's an 8 rather than a 7 or a 9? Isn't this very highly subjective? What does the number even tell us? Have you read https://xkcd.com/883/?]
I much prefer the "Hyperbole and a Half" author's pain scale. http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-does...
I absolutely refuse to give a numerical answer unless they first give me an objective calibration for the numbers. I recently got into a minor argument with a nurse before a minor surgery. "If you won't tell me a number, how will I know if I need to give you a painkiller?" "If I'm in enough pain to need a painkiller, I will tell you."
The number scale attempts to turn a subjective interpretation into an "objective" value. Instead of having to actually listen to people and apply training and experience to judge which treatments are needed, the number system de facto pushes that decision onto the patient so the doctor/nurse/etc only needs to follow a simple set of treatment rules. Similar to black box "AI" used in e.g. criminal sentencing and employee evaluations, the numeric pain scale is yet another example of a fundamentally subjective situation being laundered into a supposedly "objective" value.
It really sucks that we have no objective measure of pain; a tricorder that you could aim at someone and get a number back would be infinitely better than what we have now.
They're the same because they don't quantify how much it hurts, but instead how the pain affects you.
A 10 would be pain so severe you are unable to perceive anything besides your pain or do anything except writhe.
An 8 on such a scale would be pain that makes it difficult to focus on anything else, let alone listen calmly to a person and give a coherent answer.
A 5, while being distracting, would still allow you to function on some level.
A 3 would be pain that is somewhat easy to ignore.
You see how this is a scale that can actually be measured by an outside observer and is much more useful in figuring out what medication to give. Because while two people may have the same injury, one of them may be able to completely ignore the pain even without medication - so giving medication would only do harm - while the second person may need medication in order to function.
Assuming such a scale was used, it would make sense for the nurse to say "it isn't an 8" - because if it was an eight you wouldn't have been able to listen calmly and explain that to her, by definition.
Well, it won't only do harm though, right? It will still get rid of that person's pain.
If I fracture my ankle, but I learn to compensate by constantly shifting my weight onto my good leg as I limp so that I can still do my job -- in that scenario, I still want my ankle fixed. I don't want a doctor saying, "ah, but you have the special limp, so a cast and crutches would only do you harm." I want the cast, because the cast is probably easier, more comfortable, and in the long term less dangerous than what I'm currently doing.
Why would pain be different? Should someone not be able to get relief from suffering just because they've gotten good at mentally focusing through it?
It seems like the result of approaching pain from the perspective you're advocating for would just be to discourage people from trying to take any practical and/or psychological steps to manage their own pain, because every minor success they have will make it harder for them to get any additional help.
It is completely different. Your analogy isn't great.
A fractured ankle is a bad thing. A cast certainly won't do harm. Pain is a response of your body to a bad thing. Suppressing it can do harm in itself.
Some pain can often be desirable because it prevents a patient from further injuring themselves by, for instance, putting weight on an injured ankle. Pain is a warning system.
Add to that all the possible side-effects of painkillers.
On top of that there's context for everything. You should probably give a patient that experiences pain which can't be avoided painkillers earlier than a patient who experiences pain when they put weight on something they shouldn't.
You're describing someone with chronic pain. So... we should prioritize giving painkillers to someone with chronic pain over someone someone with temporary pain that will quickly go away if they don't do something dangerous? I agree with that.
If someone has chronic pain, that pain isn't helping them avoid doing something bad to their body. It's just pointless pain with no benefit. And even if I can force myself to function with chronic pain, I can still have long-term damage from stress, lack of sleep, damage to relationships, even just damage in terms of pure suffering. It's dangerous for a doctor to say, "you can hold a conversation with me, so medication would only do you harm." I don't think that's an objective scale, and I don't think it actually captures the risks of long-term damage and suffering.
If you want something with more downside than a cast, sub out something like surgery in my analogy instead. Either way, the point is that just being able to function in society is not an adequate measure by itself of whether or not someone needs medical help.
Talk to a chronic pain patient and they'll likely tell you they have to suppress reactions to the pain in order to not be dismissed as "playing it up" and thus drug seeking. That they are used to dealing with pain does not mean the pain is not there.
Add in myths like "black people can handle more pain", too. https://www.aamc.org/news-insights/how-we-fail-black-patient...
People who are regularly in great pain would read this comment as saying "you are being mauled by a bear, but if you have ripped your own vocal cords out so that you're not constantly screaming, we judge that preventing the bear from mauling you won't affect the environment much (since the screaming level will not change), so we will not prevent the bear from mauling you".
But if it goes on more than a few hours I will jump off a cliff to end suffering.
I stayed away from the really strong pain killers. But man it was hard. I did not want end up with an addiction on top of everything else.
I have small fibre neuropathy (nerve damage) in my arms and legs, and when it first started I thought I was going to go crazy - I just couldn't stand that amount of pain, constantly. I cried a lot, I begged doctors to make it go away, I went to the ER.
The fact is you can't stay like that forever - you either kill yourself, or you somehow learn to live with it.
You don't get used to chronic pain, but you adjust to a new "normal" level of pain. You develop coping mechanisms and learn to "bury it", get on with it as best you can. If you're lucky, you find some medication that actually helps somewhat. You research your condition and possible remedies, a lot. All of this isn't to say it gets easy, believe me it fecking well does not.
A lot of people (doctors included) don't seem to believe that you can be in severe pain, while sitting and conversing with them - "he seems fine to me!".
I'll add as well that I'm one of the "lucky" ones for whom a diagnostic test (skin biopsy) has shown concrete evidence that doctors believe in - without that, you'll get nothing but platitudes and shown the door. You'll probably also get told you have fibromyalgia, even if you don't remotely fit the criteria. I know this firsthand, because I have had to research and guide clueless doctors and insist on tests, and insist on re-tests when they've messed up.
That's very familiar. "I feel like I'm being stabbed in the eye" "But you seen fine" "It's been doing that for the last two years; at some point I just stopped reacting to it"
> I'll add as well that I'm one of the "lucky" ones for whom a diagnostic test (skin biopsy) has shown concrete evidence that doctors believe in
Having visible evidence definitely seems to help - my dermatologist seemed to be sceptical that my dermatographic urticaria[1] was as bad as I was saying given the dose of antihistamines I was on. She did a challenge test, and her first comment was words to the effect of "Huh, that _is_ severe". She ended up doubling the does of antihistamines. The "hidden" symptoms are much more of an uphill battle.
[1] https://en.wikipedia.org/wiki/Dermatographic_urticaria
This number will be used to determine if a more in depth tool is needed (like if you say 7-10). What type of treatment is needed (pain tolerance is different from person to person, so even if two people have the same injury or disease, one might say 8 and need pain killers and the other might say 3 and not). It will be used to gauge if a treatment is working (when you first came in you were at a baseline of 6, but after taking this treatment, you're at a 2), and so on.
Thus, a personal scale makes sense.
Wikipedia isn't much help[1]. It lists 30+ "pain measurement scales", but clicking a few of them doesn't tell me any specifics about how they work.
Looks like someone has in fact tried strategy 1. https://www.hindawi.com/journals/js/2018/6205896/ mentions: "Recently, a quantitative pain-assessing method using electrical stimulation was introduced [12–15]. PainVision™ devices measure perception threshold and pain produced by an electrical current. This system quantifies pain intensity by comparing the experienced pain with the intensity of electrical perceptions. The perception threshold indicates the minimal electric current sensed by the individual, and the pain produced is defined as the maximal electric current sensed by the individual. However, the skin resistance of an individual may affect the electrical measurement result [16–20]."
Their refinement continues: "our system measures from the patient’s skin resistance before measuring the pain." "In this work, we developed a pain measurement device that has two analysis methods, electrical stimulation and applying pressure, for more accurate cross-validation assessment. During electrical stimulation, electrical stress is applied on a nonpain site and then the observed stress can be compared to pain. ... During the pressure evaluation, pain was assessed by applying pressure on the pain site. Inflammation was induced on the rat’s hind paw by carrageenan, and then the inflamed hind paw was stimulated by a hand-type pressure stimulator. The pressure site was then compared with the inflammation levels." Seems like it might be workable.
[1] https://en.wikipedia.org/wiki/Pain_scale
Talk about the things you used to do that you are not able to do now because of the pain.
For short term pain number 8 is supposed to be able to read or converse but only with effort; dizzy and / or nauseous; limited physical activity; difficulty in functioning; and strong painkillers are not so effective.
Number 9 is unable to speak; crying out or moaning uncontrollably.
Number 7 is interference with sleep, difficulty concentrating.
The last time I went to the ER (a few years ago now) for something unrelated, I was in extreme pain. I'm used to pain. I can tolerate constant pain pretty well. This pain was way above what I could tolerate.
Instead of help from the nurse I got a lecture about lying about drug use and lying about pain. Eventually I got the help I needed but the whole experience was just so degrading at a time I would have preferred to die rather than continue the pain I felt.
Chronic pain sucks...but people fail to understand that some people suffer from high level of pain and that doctors often fail to manage it. I have tried many things to manage my pain, it is at a point where I for the most part get on with my life with some "take it easy" days. Unfortunately, the only thing that helps is opiates, and currently nobody wants to prescribe those. My primary does and 30 pills of low dose last me months. Still when I switched doctors they refused giving me opiates, even though all the other meds lyrica, cymbalata, gabapentin did nothing. A pain doctor offered ketamine treatments at $500....like that is reasonable on monthly basis.
Your mystery illness has now been correctly diagnosed. It’s somewhat treatable. You are given access to a support group that knows your pain.
The only one I had was feeling a bit upset about how it effected my skin some horrible looking scabs.
edited for spelling
It's different, but as an example, I injured my back (i don't really even know how) and was in intense pain for approximately 8 months. You know that feeling when you burn your hand on something? It normally last 5-15 minutes, well it was like that, but inside my lower spine all the time, for a solid 4 months...and then in duller state for another 4. I am still struggling with pain from time to time, but i'm once again able to sleep a full night (something i couldn't do for around 5-6 months), do physical things and not regret every movement. At the start of the injury, i was probably the fittest I've ever been, but now i'm probably the least fit i've ever been. It's seriously sucked. Who am I kidding, it still sucks...coughing hurts...but its improving and that gives me hope that one day it'll be 'normal' again.
Until you've had a long term injury, you have no idea how to sympathize. Right in the middle of this i had a close friend get upset with me that I came over when I knew he was painting, and didn't offer to help. I was frustrated he even considered it a possibility, i was struggling to sit in a car for more than an hour, how was I going to paint a wall or ceiling? People just don't understand.
To everyone suffering with something that inhibits their ability to enjoy life, i'm sorry but wish you the best. To everyone looking in from the outside, assume its 10x worse than what you see and reconsider your next move.
https://youtu.be/PJJO9PmXm90
These are the two stretches that help me the most.
Highly recommend going through bob and Brad, and Dr Jo on YouTube. I try stuff all the time and have regained much of my mobility.
- Prone Press Up (https://www.youtube.com/watch?v=Sws_GwrlYO0): Relieves tension in lower back, pressing discs back towards their natural position.
- Banded Hamstring Stretches (https://www.youtube.com/watch?v=msxQR56U7sI): You can use a belt for this if you don't have the bands, but properly and consistently stretching my hamstrings was the biggest thing I did to relieve (and 'cure') my back pain after the herniation.
https://www.youtube.com/watch?v=4BOTvaRaDjI
He runs through them pretty fast, but someone in the comments recommended playing it at 0.75x speed and that works great.
https://www.youtube.com/watch?v=XNN3K2qj-L0
https://www.youtube.com/watch?v=l9poXGU11ms
For me weightlifting is about staying in shape for things like mountain adventures, feeling great, looking good. But Arnold-look is a silly goal for long term wellness, and so are the methods to get there. Once I stopped pushing the numbers and focused on more repetitions, I never had any injury. That's worth much more than some momentary number of kilos/pounds you did today - nobody will care about that tomorrow, but injuries remain, sometimes forever.
https://www.barbellmedicine.com/blog/pain-in-training-what-d...
https://www.barbellmedicine.com/blog/movement-variability-sh...
Your comment would have been totally fine as a top level comment. It is a believable theory that quarantine is worsening mental illness. Your problem was the context in which your comment existed and the way you were effectively dismissing OPs experience out of hand.
I didn't claim that but I don't think that matters to you. All I said was that it's hard to tease out the difference between covid caused hardships and covid treament caused hardships. Cancer doesn't make your hair fall out on its own.
>Your comment would have been totally fine as a top level comment. It is a believable theory that quarantine is worsening mental illness. Your problem was the context in which your comment existed and the way you were effectively dismissing OPs experience out of hand.
I didn't dismiss his hardships. I didn't even dispute them. Stop putting words in my mouth. I only pointed out that (similar symptoms in other people who have had covid) might be caused by how we're treating it (quarantining people and so on) not the disease itself.
Either way, the end result is that both of us look like idiots continuing to argue over this. That is why it is pointless to continue.
Hypochondria is a major problem. Part of me finding out what was wrong to make a list of every symptom, every condition that a subset of symptoms, keep track of every test and what conditions it eliminated as possibilities. The sets of possibilities are enormous. At every step you get called a hypochondriac.
I didn’t directly find it, but when I showed table of symptoms, and what medications had been tried and failed and what tests had been run a doctor realized it was a rare autoimmune condition.
It’s such an odd thing to be given a terrible diagnosis. But feel immense relief that it’s not “in your head”
From support group, this is Apparently a common reaction.
I know what you are trying to say, but phrasing it like this is harmful. Psychosomatic issues are absolutely legitimate. Knowing it's psychosomatic means there may be other avenues of addressing it than if it wasn't, but calling the issues "not legitimate" is very problematic, akin to telling someone with depression "just think happy thoughts".
The impact of walking and running is dissipated into your calves instead of your joints, and the nice thing about muscle is that it grows back. Take it slow as you ramp up, I promise your calves aren't ready for it yet.
I like to run on Vibrams and sandals (I generally use a Shamma Warriors during the summer), and a have a bunch of other shoes for walking (Lems, Freet, Vivobarefoot, etc.)
A good all-around barefoot shoe that is suitable for both running and walking that I'd recommend is the Lems Primal 2.
Also: use toe socks (Injinji is the only brand I'd recommend) and, if you can, use toe spacers for a while (1-2 years minimum) to correct some potential issues with your toes placement (unfortunately the only brand that seems to be decent enough in the market is Correct Toes, but it's rather expensive; the cheaper ones you can find everywhere are no good in my experience)
Yes? You walk like that. Shorter steps, kind of gliding a little bit.
No? Buy some Vibrams. You'll get one soon enough.
https://www.youtube.com/watch?v=bGST6h3yhJE
As for the running technique, a good reference is this website:
http://runforefoot.com/
You can help the economy and get immunity at the same time! What do you have to lose?
1. Economics[2]
2. You not having friends was a prepandemic and a you problem
I freaked out my whole family telling them that if it doesn't go away I don't think I can make it. There was a point where I got an axe and asked my wife to hack my arm off at the shoulder. Miraculously, it finally healed somehow and I just remember thinking how wonderful it felt to have a second chance at life.
I understand now why people with chronic pain want to end their lives. For some poor souls it seems like the only way to get rest/peace from the constant and exhausting pain.
If it was a machine with problems, I'd just set it to generate a report/warning once in a while and not waste energy probing the sensors every second.
Remind me once every few hours that yes, my back and knees are still fucked (doctors' advice: just live with it...oook).
I don't need it 24/7 (OK subtract a few hours when sleeping without waking up because of it), it's literally pointless.
Down to 1-3 most of the time. But took years of trial and error, and so many mistakes to get here.
Blows my mind.
Trust economists that we can print trillions and its fine. Trust military the war is "almost over". Trust politicians that they will fix our problems. Trust teachers to teach our kids (Teachers need parents support at home!). Trust Coaches to teach our players (you gotta play catch at home to be good at baseball!). Trust doctors... trust priests... trust police...
The list goes on...
Sadly, it seems that the majority of people who start researching things on their own often arrive to completely wrong conclusions. And that's dangerous, for them and for everyone else.
An economist, for example, would have years of information and training in the field. And that forms a knowledge base in their brain that's (mostly) accurate, so anything they research and learn will be more correct than what an electrician/programmer/politician by trade would find.
To put it simply, they have more information and experience.
Of course, there are exceptions, some people are smart and can run circles around experts, but as I said, the majority of people are likely to arrive at the wrong conclusions.
I don't know how this could be fixed, perhaps more oversight and checks over the experts (many cases where people are just winging it or are complete frauds). But going off on your own and not trusting experts at all is a bad idea.
In science and engineering, we are constantly being forced into realization that we were wrong, and we constantly try to fix things where the fix is just yet another problem we created.
I mean, even if you can code for 20 years, if anybody asks you whether you can program or not, you'll probably answer "nope I don't know anything about programming"... and that's a sign for an experienced person in that profession.
On the other hand, a lot of professions can get lucky with social camouflage, where they can blame others and it doesn't stick out for a controlling person. A lot of people that made it this way never were forced into reflecting on their bad decisions.
The doctor at the covid plasma donation center sent my wife home because her clearly labeled "positive" (1.4 threshold, my wife's result was 4.9, but the doctor wanted a minimum of "80") test was too low for plasma donation -- it was not, the doctor was talking about a different quantitative test. After 8 months of people donating covid plasma, this doctor had no clue. It makes my blood boil thinking how many other people didn't donate plasma because of this idiot-- I sent my wife back and told her to make a big fuss and ask for another doctor, who actually explained the idiot doctor my wife can absolutely donate plasma, they just ran different kind of tests, and my wife's test result was more than likely meeting their own required antibody levels.
This was not a medical issue, it was a common sense issue -- if her test had a positive threshold level of 1.4 and she had a 4.9 result, how could this doctor not realize something was wrong with her requiring a value of "80". Did she actually think that only Chuck Norris can donate covid plasma?
My psychiatrist bullshitted me about the mechanism of action of some meds she was prescribing (I knew because I looked them up as treatment options beforehand) -- she did prescribe the "correct" medicine as far as I remember, but she just did not know the correct mechanism of action.
The infectious dissease specialist in my hospital stay for COVID-19 told me the hydroxychloroquine she was giving me was a proven anti-viral medication that worked really well in their national acclaimed hospital. Again, she was really clueless, she was just following protocol, she could at least have shut her mouth if she was clueless. They only gave hydroxychloroquine to otherwise healthy individuals because or cardiac issues the medicine was known to cause, OF COURSE those patients had really good outcomes, they were otherwise healthy, young individuals.
My wife is a dentist, she really likes her surgeon boss and his approach of telling patients the true odds of success of certain procedures and what to realistically expect out of them. But a lot of patients don't like that. They want to hear the doctor has a 100% success rate with every procedure and that all his dental implants last a lifetime.
So part of the problem is the public that will choose a lying, perhaps clueless doctor with a god complex above an honest doctor that really knows his stuff and is honest and upfront with his patients.
Well started dealing with other specialist because I was having severe problems due to this medication.
Vascular and others all gave me warnings as they had been seeing a lot of problems. I found out the studies were done mostly in China, and were suspect.
Hematologist let me know I wasn’t allowed to come in because I wanted to switch. Mocked me for looking things up.
I had not taken it in 3 days and was already losing vision. So waiting months for another practice was a death sentence.
That was my breaking point. Stopped being Mr. polite.
First time I ever screamed and threatened a lawsuit.
Got my new medication. Life got better.
Also yeah antibiotics definitely can have a powerful effect.
Oddly I was diagnosed correctly due to how I responded to certain antibiotics.
Had a similar final. Intentionally became a lunatic at ER. Refused to take prescribed blood thinner, which is a quick death for me. They finally listened and gave me a different one. Life drastically improved after that’s.
https://www.painscience.com/articles/pain-is-weird.php
And as Dave Chappelle says -
Got to find a way to find joy in your existence in spite of that feeling.
Finally, I had one of those injections directly on my spine and it was like magic. I walked into the appointment and couldn't stand up straight and walked out like I had never been hurt. For weeks, I would wake up each morning and dread getting out of bed because I wondered would this be the morning the pain came back.
It's been years now, and knock on wood, I hope to never have a problem again. I was always a weight lifter, but stopped powerlifting (maxing things like DLs), and stopped playing basketball. I still exercise a lot, but my entire focus now is on longevity. Strength is still a key component, but so is flexibility and learning proper movement.
BUT....
Last year I had another herniated disc triggered by axing down a tree. This time it was really bad. I spent two months in debilitating pain unable to move or really do much of anything. Couldn't stand, couldn't walk, couldn't sit, couldn't lay down. All I could do was dope myself up on narcotics and try to sleep the time away.
I had two epidurals. The first one took the edge off the pain away but I was till unable to move. The second epidural I actually regressed.
So I went and had a microdiscectomy done. Turns out my nerve had slipped into a canal that had no room for it and was pinched inside. A week or two of recovery and I felt great again.
BUT....
I didn't change my habits, covid-19 hit, I started working from home where I did not have anything close to an ergonomic setup and my back started to ache again. This time it was the original disc. I was doing ok, but it was enough that I knew I should talk to my doctor. A couple weeks later, at the pool, I decided to go off the diving board while my back was slightly bothering, and that slight bother became nearly debilitating pain again and two months of physical therapy.
I feel great again, the PT worked this time.
What's my point? The injection doesn't always work. PT doesn't always work. There's lots of ways things can go wrong. Take care of yourself and be careful, next time you might not be so lucky!
As I mentioned, I also changed my entire workout regime. While strength is super important, 500+ pound DLs maybe not so much at my age. Both basketball and powerlifting I love, so it was definitely a mental shift. But, now I'm probably in the best complete shape I have ever been in. My cardio, strength and flexibility are balanced and good. COVID has actually been a good thing since I can jump up at any point in the day and take a 15 minute yoga class.
Good luck, I hope neither of us have to deal with back pain again :)
I have to consciously engage muscles, even after practicing for years (can't afford Pilate's sessions which would make it go faster). Now I very rarely get the burning sensation and corresponding days, weeks, or months or not being able to sit or do much of anything.
Losing your mind now and then is absolutely okay.
--- I'm paraphrasing someone close to me --- God is giving me only what I can handle. Making me stronger in the process. Something even worse is coming down the line so get ready.
This life is a test for what comes next.
Pretty sure a pile of gold doesn’t win points.> You're not going to get through it without losing your mind now and then.
Why does this read like a Mountain Goats song?
https://youtu.be/JE37e1eK2mY
Looks like Mountain Goats is a successor though.
Simple test: what were your thoughts and emotions 5 minutes ago? 1 hour ago? since this morning? and how were you breathing (slowly with good posture or rapidly)? If your brain is constantly circling thoughts with no cool-down with bad posture it's guaranteed you will have physical problems.
For me the cure was a combination of:
- Slow breathing exercises
- Mindfulness (to learn to listen to the body and emotions, an to be aware and able to "control" thoughts). No mysticism bullshit, just having a brain and body at rest and present.
- Stoic philosophy : not worrying with things not in my control, not being affected by outcomes (e.g. objectively did my best and the boss/client is not happy? That's fine for me)
- Strength training
- Nutrition
- Financial security (I know I'm lucky but that doesn't change the point)
- Edit: "reconnecting with nature": again no mysticism, just outdoor walks, gardening, and taking the time to observe and appreciate while being fine doing nothing
The best I could describe my default state now is as being relatively at peace, with no negative thoughts circling, slowly breathing with good posture (that I can maintain while coding long hours for example). I'm still of anxious nature and still worry about the future, but only on the time period I will allow it (and not as a the permanent background noise). YMMV obviously.
At the end it was very linked to my mental state, it took me half a decade to figure it. As parent comment is suggesting, slow breathing to remove tensions near your rib cage can help.
The most useful tool for me is to smoke cannabis, I then identify pain points in my body and massaging them with my hand vigorously is effective. Hope it can help people having « the same kind » of chronic pain.
So I took the comment's point as that there are multiple potential causes for a given manifestation, and chronic conditions in particular are confusing because they invariably end up with physical -and- mental symptoms. There's something to be said for exploring easing the one you can do by yourself, at least to some extent. Mindfulness, slow breathing, and some of those other techniques helped me too. No matter which aspect is primary and which aspect is secondary, easing the mental stress some can still help.
Any other advice for what helped you?
I don't want to paint these as silver bullets. I still deal with my anxiety disorder on a regular basis. I just feel more able to look at it in third person a little to defuse some of the worst bits.
Edit: I'm always hesitant when someone uses the word advice, so I gave a vaguer reply than I needed to. I won't give advice but will give a little more detail.
Looking at the original list, the specific ones there I also have tried to improve with varying success are stoic philosophy, nutrition and fitness. But I'll also add sleep, since of them, sleep has had the most immediate effect that I've noticed. However, there's a chicken/egg thing there if you're too uncomfortable to sleep. I used a short course of sleep meds, but those have their own risks so YMMV.
Stoic philosophy is good to aspire to, but it's more end goal than technique IMO. It's a good thought yardstick, though, for what you "should" be feeling if you can step outside yourself a little.
There's a balance. The two sides of anxiety and chronic illness aren't at war. You can say it could be one thing without dismissing the other.
Crazy facebook/twitter people love to talk about their cure-all (why is always essential oils??). But the reality is there is never a simple solution to solve the issues.
Think of it as a holistic solution. Things to examine:
- Nutrition | Are you eating regularly or too much?
- Sleep | Is your sleeping regular
- Movement | I hate the word exercise! Just walking, stretching, or being outside is helpful
- Meditation | Learning how to use this to reduce anxiety and activates your parasympathetic nervous system
All of these can be very low/no cost
As for things that cost some money
- Therapy | Learning to understand yourself!
- Acupuncture | This varies for each person, but has helped my anxiety
Nutrition is the biggest. I’ve read so many people that come up with some crazy diet. Usually eliminating toxins nonsense.
But then you realize they are circling around an autoimmune protocol diet.
The person has inflammation problems, but doesn’t know it. They are slowly finding what really works.
Supplements is another one. People go crazy about them.
Turns out most people have a magnesium deficiency. Number one supplement that helped me out.
Ultimately, a genetic test revealed it was a rare autoimmune disorder that causes a wide variety of hard to pin down inflammation-related pain.
I had already come up with a ton of coping mechanisms, and was halfway to accepting it was “just me” or “anxiety”. I’m so glad I finally found what it was, because it would have been devastating to have convinced myself all that was my fault without even any clear genesis.
Not to say yours isn’t. But it makes me wonder: we have no idea the complexity and incidence of smaller phenotypical irregularities that lead to any number of “minor pains” that get ultimately interpreted as “anxiety disorders”. You may even be anxious - who wouldn’t, with an unresolved medical issue spanning years - but you may also have some imbalances driving it that are hard to pin down.
Your last paragraph sums it up perfectly.
Lot of doctors run out of date tests. False negatives are also a big issue.
Sjogrens is really bad for that, 30% show negative on the standard test.
there is an “Early Sjo” that catches what other tests miss.
From the article: "Anxiety, depression and insomnia were most common among recovered COVID-19 patients in the study who developed mental health problems". It isn't about long COVID.
We're living in a uncertain, stressful time. Even people who haven't got COVID-19 have some degree of anxiety, of course getting it and not knowing if you will end up in a ventilator will have a bigger impact on your mental health.
Small wonder mental illness is up indeed...
This is why I've said from the beginning that impact to life expectancy should be the metric which guides public policy. It accounts for lives of children being worth more than the lives of the elderly, because the elderly have less life to lose.
Besides that, the tiredness is mostly gone now (it had better be after a good 8 months), though every now and then it can still recur and then I'm 'down' for a bit.
As for planning, I updated my will a week ago with all this at the back of my mind.
So while I recognize some of it I am happy that I apparently had a 'mild' case of this, and I feel very sorry for anybody that had it worse (and their families as well).
A quick google of "b vitamin deficiency fine motor impairment" brings up B 12 repeatedly in references. Some B vitamin or other was one of the supplements medically recommended for children with autism that I gave to one of my sons when he was about eight years old and his handwriting issues improved. (I would have to try to dig up old notes, if they still exist, to say exactly which b vitamin.)
https://neuromuscular.wustl.edu/nother/vitamin.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476750/
https://www.symptoma.com/en/ddx/fine-motor-coordination-prob...
https://www.b12deficiency.info/blog/tag/poor-motor-skills/
https://en.wikipedia.org/wiki/Vitamin_B12_deficiency
(I am not a doctor. This is not medical advice for anyone, much less for the OP. This is just a general observation for anyone interested.)
Edit:
Yep, my old notes still exist and B 12 is one of the three B vitamins listed (I never found DMG but gave the three B vitamins and magnesium to my son and after a few months saw improvement in social issues and handwriting). Excerpt from an old blog post:
"In 1996, I found some information on the Internet about a vitamin therapy that doctors sometimes prescribe for autistic spectrum children. Recently, I found the crumpled, pathetic slip of paper that I originally wrote my notes on. My original note has the following bullet points written willie-nillie, all over the place:
(DMG) Dimethylglycine
125mg tablets or capsules
take 2 - 3 weeks ("then add"),
vitamins B6, B5 then add B12/magnesium
Okay, I take that to mean that all the doses are supposed to be 125 milligrams. They did suggest you start things either one at a time or in pairs (and I take my notes to mean that the pairs are 'B6 with B5' and 'B12 with Magnesium') and observe if there were behavior changes with the addition of each thing. I think 2-3 weeks is how long you should have the child on each supplement before adding the next one."
After I got 'better' I thought it was comparable in severity to a bad flu. It's becoming rapidly apparent that the real impact shows itself after sickbed. I'm 33. I feel like I've aged a few decades in the past month. I really hope this will pass.
- 1 in 5 people will have a first time diagnosis of a mental illness (including but not limited to anxiety) within the first 90 days of being infected.
This does not mean the diagnosis is chronic or even lasts beyond the duration of the disease. There have been studies done showing that about 2% of people still have symptoms resulting from coronavirus after 12 weeks [1].
We should not be conflating people getting anxiety from having coronavirus, with people developing chronic mental illness.
[1] https://covid.joinzoe.com/us-post/long-covid
The fear of such a condition or death can also create tremendous amount of anxiety.
-20 to my trust and confidence in the healthcare establishment
I have a connection to Bergamo, Italy and seeing them do triage (selecting who gets treated and who is rejected) last March/April was brutal.
Your comment is disrespectful to all of those who died, are currently dying or who lost one. And to those who suffer long term consequences that will affect them all of their life.
It's incredible that after nearly 1 year of constant information bombardment you are still too ignorant to understand that even 15% problematic cases will overwhelm the system and cause issues that you are completely incapable of understanding. Yes, 80% of infected will be just fine but the other 15-20% are what brings our healthcare system to its knees. Just be happy you were in the 80% and shut up.
You probably even think of yourself as a smart person (you are not), why else would you come to THIS forum and post this breathtaking bullshit?
I don't question my intelligence and I will not be censored while using a public good.
You may want to question your own intelligence level for taking my comments to the utmost extreme, and making emotionally irrational hatred comments back at me.
Jog on, I hope you don't continue to succumb to the psychological terrorism that is living in your head rent free.
And I couldn't agree more with the parent you are replying to.
Cases are popping up. These days, we dont have to wait for the media to tell us how harsh covid really is. I know a number of people who have got it, and everyone of these is fine again. There was one case of a hospitalisation, but that person went to hospital with a lung problem last year as well, so they are what we call a risk patient I guess. Waving the triaging situation around like you are jesus doesnt help either I'm afraid. Citizens are well aware that the triaging is due to politicians NOT putting extra money into the health care system. No, instead they were busy pouring tons of money into airlines and other industries which managed to cry wolf. I am convinced that if we instead had put only a fraction of that money into the health system, triaging would be way off in the future. But hey, it is easier to sell the measures if you can point at the health system breaking down.
People like you are the biggest problem in this pandemic, far outweighing the actual virus and its consequences.
"People like you" is a very dangerous statement. You don't know my background, who I work for, or TBF anything about me.
Correlation does not imply causation, and there is no such mechanism for which this respiratory virus can alter your brain chemistry.. It’s not a fucking prion virus from an infected cow.
But at the heart of it I think you're asking "What is the emotional cost, of all of us on HN reading and worrying about these things? Is the emotional burden worth the marginal information gain of getting scary, unverified news (something that happens all too much: remember fear of terrorism after 9/11)?"
I wrote about this a bit here: https://blog.alexrohde.com/archives/703
Also, if you find these articles a burden, it looks like you could probably do something like https://news.ycombinator.com/item?id=22522076
masks and lockdown, and spinning our wheels over who're doing those things right and who're not, aren't going to save us and is full-on, simplistic media and political performance (biden is still unhelpfully screaming "wear a mask!") distracting us from the weightier subtleties.
the policy that minimizes spread is to not breathe strangers' direct exhaust (not just air) for a prolonged period of time. we need to hone in on that one behavior, not its poor proxies, like masks and lockdowns.
distancing for instance is a much better primary mitigation for the populace, rather than getting lost in the fear-based political weeds of masks and essential businesses. with that singular focus, we'd have had greater agreement, cooperation, and effectiveness (rather than performativeness), and less uncertainty, anxiety, and fear.
https://battlepenguin.com/philosophy/covid-19-is-two-disease...
You can't escape it. Covid panic stories are on EVERY channel. It's inescapable. And it's intentional.
Joe Biden, Kamala Harris Got a Big Social Media Boost from Indian Troll Farms
https://www.newsweek.com/joe-biden-kamala-harris-got-big-soc...
¹=https://www.theguardian.com/world/2020/nov/10/nearly-one-in-...
Go figure.
They did not mention job or career choice in the study, nor did they mention stress except in the context of PTSD. They hint that they did not look at socioeconomic factors at all.
This is how the bureaucratic elite will eventually try to explain the severe mental health crisis unfolding before us as a biological effect of the novel coronavirus, when in fact, it was caused by their own choices to impose restrictive lockdowns.
I had 4 friends tell me about their mental health collapsing since the April lockdowns. 2 have started taking lots of drugs.
Heck before I started this new job, I might be technically depressed. I had never felt like that before.
1) Are we seeing a side-effect of bothering to look for mental illness in a generally-underdiagnosed population? Maybe most people have a bit, and scrutinizing people that ended up in the hospital is finding things that most mental health research participants aren't screened for.
2) I don't have a mechanism in mind, but it's always important to filter for correlation without causation, or even for reverse-causation; is there something about predisposition for mental illness that makes one more susceptible to COVID?
3) COVID hits an elderly population harder, and age is already correlated with mental illness. How did they control for age?
I wonder if that means twice as likely as for some other groups of patients, or twice as likely as all other groups of patients.
I remember reading the Spanish flu caused cognitive impairment in some patients, too.
“This is likely due to a combination of the psychological stressors associated with this particular pandemic and the physical effects of the illness” certainly seems to support that notion.
Sounds like a study without any useful conclusion.
>The study, published in The Lancet Psychiatry journal, analysed electronic health records of 69 million people in the United States, including more than 62,000 cases of COVID-19. The findings are likely to be the same for those afflicted by COVID-19 worldwide, the researchers said
>In the three months following testing positive for COVID-19, 1 in 5 survivors were recorded as having a first time diagnosis of anxiety, depression or insomnia. This was about twice as likely as for other groups of patients in the same period, the researchers said.
So still a doubling when compared to other people living in a pandemic society.
Global Plandemic and Hoaxdown with 170 nations in league with Big Phama, Goverment and ' mainstream media '
---------
Also if anyone gets the China Convid 'infection' (aka flu)
This is the actual Cure without a magic needle:
* Hrdroxy chloroquine (HCQ) and Azithromycin
for 6 days cures a person
Take 2 200mg HCQ chloroquine pills per day,
along with Azithromycin 500g once a day,
+ Zinc Supplments 200mg once a day
Also supplment that with Vit C+D
My money is more on "psychological stressors" aka media hysteria/social ostracization/etc. than "physical effects"