Scientists concluded this in the 1990s, and then had to produce yet another study to unequivocally state it again after every time someone claimed to have found the “cause”.
This is part of the reason it was re-named ASD in the first place; it describes a set of atypical neurological development symptoms, not an identifiable state of being. Kind of like “cancer” describes an atypical cellular reproductive state, not a pathogen attacking your cells. Both can be caused by many different factors or combination of factors.
Of course, with ASD, it doesn’t even mean there’s anything particularly wrong most of the time; just atypical, resulting in a person whose thoughts are weighted differently than historically typical, with less interpretation of social cues and a greater ability to focus.
This seems similar to the phenomenon where antidepressants are only effective for about 15% of patients. The benefit is large for those who benefit. For the rest, they’re no better than placebo, suggesting the drugs treat one of several causes for the syndrome known as depression.
Yeah but we’re not allowed to talk about how that 85% has been prescribed stuff that doesn’t help them, very often has negative, deleterious, harmful mental and physical sideeffects, oh and also often cause dependency/addiction.
Because then when you look at it that way, that would mean basically all currently active, prescribing pscyhiatrists would be open to malpractice lawsuits, and/or drugmakers would be open to gigantic class action lawsuits.
You know, like with opioid pain killers?
But uh nope, nope, that can’t be allowed to be considered, so … just don’t talk about it.
Doctors are generally not subject to malpractice suits for engaging in what was believed to be the best practice at the time. That’s how it should be, because that’s how science works.
Knowing that antidepressants don’t work for most people presents a difficult problem though. There is no test to determine whether they will work other than trying them for months. Never trying them would be unethical because they can be life saving and life changing for those who respond. Using them indiscriminately is also unethical because they have side effects and withdrawal symptoms.
I would at least appreciate it if doctors were permitted to jump ahead to the actually effective stuff (i.e. ketamine, psilocybin therapy) without having to force the patient through the gauntlet of ineffective drugs first. I believe it’s insurance companies to blame for that one. They would rather not pay out for quarterly/yearly/one time ketamine treatments that actually work, because that means their money isn’t flowing in the preferred direction. I guess they prefer us to die buying tainted drugs off the street.
Doctors are generally not subject to malpractice suits for engaging in what was believed to be the best practice at the time. That’s how it should be, because that’s how science works.
We electroshocked and then lobotomized the patient, they’re basically a 4 year old now mentally, but thats all fine because the science at the time said so.
We smoked in our office consults with pregnant women, but thats all fine because science said so at the time.
… Uh, nah, no, at least from a morality perspective.
So, so much tangible quantifiable financial damage done to so many people by sideffects and then meds for those sideffects…
Legally, yeah, maybe not malpractice if … thats the actual legal standard, maybe it falls on the drug mfgrs legally, but uh what ever happened to harm reduction, is it now maybe time to have some kind of actual reckoning with this as a field/industry?
To me, at this point, in the US, psychiatrists are basically very snobby and arrogant drug salesmen, who will confidently tell you they know what they’re doing and then oops turns out they don’t.
Your second paragraph illustrates this perfectly.
Don’t even have a method of assessing how any of this should work.
Just no clue, none, might as well be popping random pills at a rave, nearly the same epistemic level of ‘will this do what the person i got it from said it will’, difference being stuff from a psych is very unlikely to be cut.
This is is mad scientist level shit.
15% chance it works, 85% chance it doesn’t, you’re all experimental test subjects actually who were not informed of that.
I dunno about you but I don’t tend to trust people who tell me to do something and tell me its all very well understood, and then oh haha, no it isn’t.
I had MDD for a while and my psychs ran me through an ever increasing gauntlet of drugs for it that justade everything worse and worse, to the point I now have them all listed as things I am allergic to, turns out I just needed less stress and pressurr in my life and to get away from my abusive family.
Roughly 1 in 10 people in the US are on anti-depressants, … and for 85% of them, that can basically only be neutral to harmful.
Maybe revoke all these things as approved treatments and move them back to the experimental trials phase, stop using about 30 million people as test subjects, and also lying about that?
None of those things are “fine”. They just shouldn’t result in penalties for individual doctors who were following established best practices.
The problem should be addressed at institutional and structural levels. Drug companies shouldn’t be allowed to throw away 30 studies with inconclusive results and get approved based only on the two with positive results. Drugs that work by inducing a structural change like SSRIs shouldn’t be approved for indefinite use, and if that evidence is found after their initial approval, the approval should be amended. Drug companies should never have been allowed to advertise that depression is a “chemical imbalance in the brain” which is corrected by their drugs when there was never evidence for that beyond the drugs having an effect.
Sure, ok, yeah, we need systemic change at a fundamental level, yep, totally agreed.
Anyway, do any psychiatrists have any morals?
Why do we even have medical ethicists when basically the entire system is fundamentally broken, the extent and details of this are well known to experts, but they just content themselves with ‘doing their best’, and require layman to investigate how full of shit all of this is?
How can you work in this field and sleep soundly at night at the same time?
Sorry, right, like, I’m an anarchist, the ‘point’ of a system is what it actually does, not what it claims to do or aspires to do.
Road to hell, good intentions, all that.
This is all provably ludicrous, and imo, the field should be on fire, revolting in droves at how fucked up this situation is and how they won’t participate in a massively harmful and morally dubious system.
Otherwise, I guess the Hippocratic Oath isn’t a thing for psychiatrists, this is just their day job.
with less interpretation of social cues and a greater ability to focus.
“ability to focus” is more accurately described as “tendency to focus”. “ability to focus” connotes control over focus, which… from lived experience and what I’ve read, just isn’t generally true. Autistic inertia – the inability to defocus and then focus on a new context – is very real. Autism is a neurodevelopmental disorder not just because of an ignorance of social cues but because of how rigid, inflexible patterns of behavior often interfere with daily life.
Yeah, describing it as simply ‘greater’ or ‘lesser’ ability to control or maintain focus is… well, too simplistic.
I can, when it comes to task, hyperfocus on something like writing a piece of complex code / software, try to solve a real world engineering problem, do a comprehensive data analysis of some topic, write a chapter of a novel… I can hyperfocus on that for a solid day or week or month, and I have to actively remind myself to do things like eat and sleep regularly, because I know I tend to get obsessively focused on ‘the task’.
Shifting to another task, another very different … realm of thinking, or way of thinking, is often very jarring and exhausting.
But on the flip side, when socializing, people tend to say I am scatter brained, overwhelming, because I just flow all the way through my entire chain of concept associations to end up with a resulting… thing I am trying to say.
Sort of like how modern agentic AI has an ‘explain its thinking process’ mode.
Thats just the default for me, its all an explicit, conscious train of thought.
For me, summarizing that chain of thought into just a resultant ‘thing to say’ is the difficult part, that I get worse at the more mentally exhausted I am.
Also, I would say most, not all, but most autists… its not that we are inattentive to or ignorant of social cues.
Its that neurotypicals tend to process social cues mostly subconsciously, whereas autists tend to process social cues mostly consciously…
… and that most neurotypicals actually all have widely variable, inconsistent and imprecise standards by which they judge and perform social cues, but most of them are unaware of this, to the point that they are overly confident that everyone has the same rubric and understanding of social cues as they do, when this very obviously is not the case.
So, this confuses/overwhelms many/most autists, because they are presented with an inconsistent and variable ruleset, and then also told that this ruleset is consistent and invariable.
Neurotypicals will often get angry/rude/frustrated/overwhelmed when you try to break this down and explain this to them, presumably because they largely are not aware of / do not have this explicit, conscious thought process, and tend to interperet being asked to formulate it in consistent, precise detail just as a rude, unreasonable thing to ask for.
Basically, imo, NTs use a fuzzy, fast, less accurate, mostly unconscious heuristic to evaluate and perform social cues, and they tend to be very confident they are doing this correctly…
… whereas Autists tend to logically and consciously go through an entire evaluation system, which is more robust and thorough in that its basically a discrete series of probabilistic associations, but this is all much slower, much more ‘computationally costly’ to perform.
So, when an Autist is oversocialized, under too much pressure to perform socially, they can get overwhelmed and then either basically shutdown or freak out.
This also works, imo, to explain why Autists tend to take longer to initially learn socialization cues and concepts… because they are having to build a much more conscious, step by step evaluation model of all possible micro/macro expressions, tonal shifts, inflexions, vocab choices, all possibly relevant context, etc, and this can often be much more difficult to establish when Neurotypicals are nearly entirely unaware of or dismissive of their own inconsistencies and variability when it comes to those things.
This also works to explain why Autists are often seen as overly straightforward or blunt: They’re just telling you the result of their attempt to evaluate a social interaction.
And this also explains why almost no NT person I’ve ever met can accurately assess my emotional state / social interaction disposition, yet they almost all are very confident they can do so correctly and precisely.
EDIT
And I will here comment on the meta-irony of all of this, that … any scientist could just ask a ‘high-functioning’ autist to explain how this works, and they could… you know, trust what a person says about how their own thought processes work?
But nope, nope, still we are pathologized as if we are strange, alien, confused and confusing others, not valid sources of information as to how our own minds work, when our whole ‘problem’ is that we are way too aware of how our minds work.
Why do you think PTSD coincides with the later Autism diagnosis group more strongly than the early diagnosis group?
Because we have been saying shit like this our whole lives, and broadly, nobody cares and just makes up whatever explanation or understanding they prefer, which is almost always significantly innacurate/incomplete, so we tend to live lives of constantly being slandered and mocked, rarely being respected as human beings with full agency.
Scientists concluded this in the 1990s, and then had to produce yet another study to unequivocally state it again after every time someone claimed to have found the “cause”.
This is part of the reason it was re-named ASD in the first place; it describes a set of atypical neurological development symptoms, not an identifiable state of being. Kind of like “cancer” describes an atypical cellular reproductive state, not a pathogen attacking your cells. Both can be caused by many different factors or combination of factors.
Of course, with ASD, it doesn’t even mean there’s anything particularly wrong most of the time; just atypical, resulting in a person whose thoughts are weighted differently than historically typical, with less interpretation of social cues and a greater ability to focus.
This seems similar to the phenomenon where antidepressants are only effective for about 15% of patients. The benefit is large for those who benefit. For the rest, they’re no better than placebo, suggesting the drugs treat one of several causes for the syndrome known as depression.
Yeah but we’re not allowed to talk about how that 85% has been prescribed stuff that doesn’t help them, very often has negative, deleterious, harmful mental and physical sideeffects, oh and also often cause dependency/addiction.
Because then when you look at it that way, that would mean basically all currently active, prescribing pscyhiatrists would be open to malpractice lawsuits, and/or drugmakers would be open to gigantic class action lawsuits.
You know, like with opioid pain killers?
But uh nope, nope, that can’t be allowed to be considered, so … just don’t talk about it.
Doctors are generally not subject to malpractice suits for engaging in what was believed to be the best practice at the time. That’s how it should be, because that’s how science works.
Knowing that antidepressants don’t work for most people presents a difficult problem though. There is no test to determine whether they will work other than trying them for months. Never trying them would be unethical because they can be life saving and life changing for those who respond. Using them indiscriminately is also unethical because they have side effects and withdrawal symptoms.
I would at least appreciate it if doctors were permitted to jump ahead to the actually effective stuff (i.e. ketamine, psilocybin therapy) without having to force the patient through the gauntlet of ineffective drugs first. I believe it’s insurance companies to blame for that one. They would rather not pay out for quarterly/yearly/one time ketamine treatments that actually work, because that means their money isn’t flowing in the preferred direction. I guess they prefer us to die buying tainted drugs off the street.
We electroshocked and then lobotomized the patient, they’re basically a 4 year old now mentally, but thats all fine because the science at the time said so.
We smoked in our office consults with pregnant women, but thats all fine because science said so at the time.
… Uh, nah, no, at least from a morality perspective.
So, so much tangible quantifiable financial damage done to so many people by sideffects and then meds for those sideffects…
Legally, yeah, maybe not malpractice if … thats the actual legal standard, maybe it falls on the drug mfgrs legally, but uh what ever happened to harm reduction, is it now maybe time to have some kind of actual reckoning with this as a field/industry?
To me, at this point, in the US, psychiatrists are basically very snobby and arrogant drug salesmen, who will confidently tell you they know what they’re doing and then oops turns out they don’t.
Your second paragraph illustrates this perfectly.
Don’t even have a method of assessing how any of this should work.
Just no clue, none, might as well be popping random pills at a rave, nearly the same epistemic level of ‘will this do what the person i got it from said it will’, difference being stuff from a psych is very unlikely to be cut.
This is is mad scientist level shit.
15% chance it works, 85% chance it doesn’t, you’re all experimental test subjects actually who were not informed of that.
I dunno about you but I don’t tend to trust people who tell me to do something and tell me its all very well understood, and then oh haha, no it isn’t.
I had MDD for a while and my psychs ran me through an ever increasing gauntlet of drugs for it that justade everything worse and worse, to the point I now have them all listed as things I am allergic to, turns out I just needed less stress and pressurr in my life and to get away from my abusive family.
This should be a nationwide scandal.
https://www.cdc.gov/nchs/products/databriefs/db528.htm
Roughly 1 in 10 people in the US are on anti-depressants, … and for 85% of them, that can basically only be neutral to harmful.
Maybe revoke all these things as approved treatments and move them back to the experimental trials phase, stop using about 30 million people as test subjects, and also lying about that?
None of those things are “fine”. They just shouldn’t result in penalties for individual doctors who were following established best practices.
The problem should be addressed at institutional and structural levels. Drug companies shouldn’t be allowed to throw away 30 studies with inconclusive results and get approved based only on the two with positive results. Drugs that work by inducing a structural change like SSRIs shouldn’t be approved for indefinite use, and if that evidence is found after their initial approval, the approval should be amended. Drug companies should never have been allowed to advertise that depression is a “chemical imbalance in the brain” which is corrected by their drugs when there was never evidence for that beyond the drugs having an effect.
Sure, ok, yeah, we need systemic change at a fundamental level, yep, totally agreed.
Anyway, do any psychiatrists have any morals?
Why do we even have medical ethicists when basically the entire system is fundamentally broken, the extent and details of this are well known to experts, but they just content themselves with ‘doing their best’, and require layman to investigate how full of shit all of this is?
How can you work in this field and sleep soundly at night at the same time?
Sorry, right, like, I’m an anarchist, the ‘point’ of a system is what it actually does, not what it claims to do or aspires to do.
Road to hell, good intentions, all that.
This is all provably ludicrous, and imo, the field should be on fire, revolting in droves at how fucked up this situation is and how they won’t participate in a massively harmful and morally dubious system.
Otherwise, I guess the Hippocratic Oath isn’t a thing for psychiatrists, this is just their day job.
“ability to focus” is more accurately described as “tendency to focus”. “ability to focus” connotes control over focus, which… from lived experience and what I’ve read, just isn’t generally true. Autistic inertia – the inability to defocus and then focus on a new context – is very real. Autism is a neurodevelopmental disorder not just because of an ignorance of social cues but because of how rigid, inflexible patterns of behavior often interfere with daily life.
Autist here:
Yeah, describing it as simply ‘greater’ or ‘lesser’ ability to control or maintain focus is… well, too simplistic.
I can, when it comes to task, hyperfocus on something like writing a piece of complex code / software, try to solve a real world engineering problem, do a comprehensive data analysis of some topic, write a chapter of a novel… I can hyperfocus on that for a solid day or week or month, and I have to actively remind myself to do things like eat and sleep regularly, because I know I tend to get obsessively focused on ‘the task’.
Shifting to another task, another very different … realm of thinking, or way of thinking, is often very jarring and exhausting.
But on the flip side, when socializing, people tend to say I am scatter brained, overwhelming, because I just flow all the way through my entire chain of concept associations to end up with a resulting… thing I am trying to say.
Sort of like how modern agentic AI has an ‘explain its thinking process’ mode.
Thats just the default for me, its all an explicit, conscious train of thought.
For me, summarizing that chain of thought into just a resultant ‘thing to say’ is the difficult part, that I get worse at the more mentally exhausted I am.
Also, I would say most, not all, but most autists… its not that we are inattentive to or ignorant of social cues.
Its that neurotypicals tend to process social cues mostly subconsciously, whereas autists tend to process social cues mostly consciously…
… and that most neurotypicals actually all have widely variable, inconsistent and imprecise standards by which they judge and perform social cues, but most of them are unaware of this, to the point that they are overly confident that everyone has the same rubric and understanding of social cues as they do, when this very obviously is not the case.
So, this confuses/overwhelms many/most autists, because they are presented with an inconsistent and variable ruleset, and then also told that this ruleset is consistent and invariable.
Neurotypicals will often get angry/rude/frustrated/overwhelmed when you try to break this down and explain this to them, presumably because they largely are not aware of / do not have this explicit, conscious thought process, and tend to interperet being asked to formulate it in consistent, precise detail just as a rude, unreasonable thing to ask for.
Basically, imo, NTs use a fuzzy, fast, less accurate, mostly unconscious heuristic to evaluate and perform social cues, and they tend to be very confident they are doing this correctly…
… whereas Autists tend to logically and consciously go through an entire evaluation system, which is more robust and thorough in that its basically a discrete series of probabilistic associations, but this is all much slower, much more ‘computationally costly’ to perform.
So, when an Autist is oversocialized, under too much pressure to perform socially, they can get overwhelmed and then either basically shutdown or freak out.
This also works, imo, to explain why Autists tend to take longer to initially learn socialization cues and concepts… because they are having to build a much more conscious, step by step evaluation model of all possible micro/macro expressions, tonal shifts, inflexions, vocab choices, all possibly relevant context, etc, and this can often be much more difficult to establish when Neurotypicals are nearly entirely unaware of or dismissive of their own inconsistencies and variability when it comes to those things.
This also works to explain why Autists are often seen as overly straightforward or blunt: They’re just telling you the result of their attempt to evaluate a social interaction.
And this also explains why almost no NT person I’ve ever met can accurately assess my emotional state / social interaction disposition, yet they almost all are very confident they can do so correctly and precisely.
EDIT
And I will here comment on the meta-irony of all of this, that … any scientist could just ask a ‘high-functioning’ autist to explain how this works, and they could… you know, trust what a person says about how their own thought processes work?
But nope, nope, still we are pathologized as if we are strange, alien, confused and confusing others, not valid sources of information as to how our own minds work, when our whole ‘problem’ is that we are way too aware of how our minds work.
Why do you think PTSD coincides with the later Autism diagnosis group more strongly than the early diagnosis group?
Because we have been saying shit like this our whole lives, and broadly, nobody cares and just makes up whatever explanation or understanding they prefer, which is almost always significantly innacurate/incomplete, so we tend to live lives of constantly being slandered and mocked, rarely being respected as human beings with full agency.