23

I used to date someone that had BPD, and I had it in my head that if I could help her be more positive, then it would somehow be illeviated. After over a year of doing my best I finally understood that I am not the person to try and help her. I am a psychology enthusiast, but I learned that to try and give advice or guidance to someone with mental problems might cause more harm than good.

Is this proposal perhaps the same thing: Lots of people that are NOT professional psychiatrists giving bad advice? It kind of reminds me of the story at http://hyperboleandahalf.blogspot.co.uk/2013/05/depression-part-two.html, where someone with genuine depression is told by the world to just cheer up, not being able to understand the condition well enough to really help.

If someone gives a bad answer on most topics here the result is an error in code, or a bad habit in your art, but when dealing with mental health there could be a genuine risk to somebody's life. and if it kicks off it's likely that friends of users with mental problems may be referred here. Is it right to take on that responsibility and allow anyone to answer a question?

Proposal: Mental Fitness

  • 4
    I don't think thats the intent of this proposal, but it is definately a risk that would need to be adressed. – Textmode Sep 3 '13 at 3:49
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    I think that now is the time to shift the wording and/or focus of the proposal so that we don't get people thinking it's a place to cure their depression! – Alexander Troup Sep 3 '13 at 8:40
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    That's why stack exchange is meant for professionals. – Kenshin Sep 5 '13 at 8:55
  • Who it's meant for and who has the ability to answer are different things. Literally anyone with the internet can give someone advice on dealing with depression, but it doesn't mean they should. – Alexander Troup Sep 5 '13 at 22:40
  • This is why we set a high bar for scientific answers and no self-help questions on Cognitive Sciences... – Josh Sep 9 '13 at 20:28
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    @josh I never even knew that SE existed, thanks! It does beg the question though, can the focus on positive mentality hold water against a cog science board, and is it the right scope? I'd suggest motivation but that's also already covered in productivity.stackexchange.com – Alexander Troup Sep 10 '13 at 7:55
  • Many people don't know we exist! Trying to spread the word. Psychology is on-topic and questions about causes of/lack of positive mentality would be on topic but they have to me framed scientifically and not be "self help", so "How can I improve my positive mentality" will be closed, but "What are the psychological factors influencing a positive mentality" would be acceptable. See this Meta question. – Josh Sep 10 '13 at 11:37
  • People with bipolar already have experts. They are called a psychiatrist or counsellor. – desbest Oct 3 '13 at 20:13
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    And why should we be poking our opinions in with those of a professional? – Alexander Troup Oct 4 '13 at 14:54
  • Mental Health issues should be treated by professionals. But since very many of them can be wrong, we should not exclude or prevent others from joining in. The worst advice I've ever been given in life was from a "Professional". If an answer is obviously bad, regardless of who it came from, down-vote it. If it's bad enough to warrant a 'Close', then close it. Common sense, people. – user95569 Feb 7 '14 at 13:59
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    @Mew I strongly disagree that StackExchange is meant for professionals. E.g. amateur radio, parenting, expatriates, etc. At most, some sites in SE are. – ANeves Mar 14 '14 at 12:19
  • Related SE questions about liability: Liability of Ac.SE for defaming and Any legal exposure from answering questions – Mast Dec 2 '14 at 11:44
12

Counter question 1: How many people on StackOverflow are not professional software developers and how bad do you believe their impact is on the usefulness of the site?

The answer to this question does not depend on the importance of the subject or the potential danger to people seeking information.

Counter question 2: How much bad advice is given by professional psychologists and psychiatrists themselves?

From the style of your question one can infer that you think those are merely a few - but I'm not that optimistic. Research about mental health is not nearly as easy to validate than programming or mathematics and the young history of psychology is full of ideas that were once in fashion but are no longer. Also, questions about mental health have a political dimension that makes this field of research more prone to bias than, for example, physics, which is hardly political at all.

This brings me to:

Counter question 3: Do you believe open dialog and access to information for everyone - rather than (licensed) professionals - improves or damages psychology and psychiatry as a science?

Personally, I'm in always in favor of open information - even bad one. It might turn out to be a dissenting good one later.

  • 4
    1: It absolutely does depend on the subject. The consequence of bad programming advice in 99.9% of cases is not health or life dependant. Bad mental health advice however has a higher chance to lead to a genuine negative health impact. 2. Professionals have spent years training and gaining certification, and are accountable for malpractice. On here, you and I are neither professional, nor accountable. But that aside, professionals work face-to-face for the most part. They have far more than a few paragraphs to make an informed decision on. – Alexander Troup Dec 12 '13 at 13:44
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    3. You neglect that the source of the information is the important factor in this question. I don't believe SE is the format that can promote consistently accurate, and appropriate information in the area of mental health. – Alexander Troup Dec 12 '13 at 13:48
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    When you put professionals on the same level as someone like me, it's easy for me to answer in a graspable way and potentially gain more rep than the pro through consistent use. – Alexander Troup Dec 12 '13 at 13:50
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    Your arguments are the classical appeal to authority. It's an argument that is as old as mankind and turned out to serve the bad ideals time and time again. It is the antithesis of what science stands for. You believe that in order to have/voice an opinion on a subject, one should need a license first. – John Dec 12 '13 at 14:40
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    It is an appeal to authority, and a justified one I feel. Science has also been used to serve bad ideals time and again, but it doesn't mean the idea itself is wrong or evil. I'm open for the argument that there's benefit without a professional, but going against the whole concept of authority feels too broad a scope for convincing me on the specific application here. – Alexander Troup Dec 13 '13 at 12:04
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    An important related question I feel needs answering here is "does on-line health advice add or detract to health as a whole?" If you can show me how stack exchange can help with physical illness, You will convince me that it can help with mental illness, and you'll have a stringent moderator! :) – Alexander Troup Dec 13 '13 at 12:08
  • I wasn't aware that "health as a whole" was the goal, nor am I sure that this goal even makes sense. A meaningful goal would be to provide useful answers (and given the controversial nature of mental health, probably multiple mutually exclusive answers) to questions about mental health. To make that more clear: Even if the site would lead to an unprecedented wave of suicides I'd still be in favor of it as long as it also provides answers that are useful, because that's the only standard that makes any sense to me. – John Dec 13 '13 at 12:41
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    @AlexanderTroup I also have to admit that I doubt the scientific status of health care professionals by quite a margin and that to some extent I even question their motivation. I think it's a field where - as you probably also fear - are a lot of quacks, but in contrast to you I also fear that a lot of them have a licence and count as professionals. I believe that trusting titles in this case will lower, not raise, the bar of that in principle very useful and important field of research. – John Dec 13 '13 at 12:50
  • I think health as a whole is absolutely a goal. If this proposal can benefit people with mental health issues in the short or long term I'm in, but if it is worse for them than better, it shouldn't even be started. – Alexander Troup Dec 13 '13 at 13:24
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    An argument you could go with is that mentally ill people seeking help may look on the internet anyway, and at least on this site answers are peer-reviewed and obvious bad advice will be shot down. So then, can the SE format result in a place better than other sources on the internet? – Alexander Troup Dec 13 '13 at 13:36
  • @AlexanderTroup As I said, I don't care about the absence of bad answers, only the presence of good ones. It's the old question of control vs. liberty with the one side arguing to protect people from themselves and the other side trusting on the freedom of information. I'm in the latter camp. – John Dec 13 '13 at 13:44
  • let us continue this discussion in chat – Alexander Troup Dec 13 '13 at 16:00
6

I think it's better than nothing


If someone has a genuine mental illness and is not seeking help, then feedback from those on this site may provide something useful — especially in the context of (potential) anonymity, which alleviates social pressures and allows for more honest questions and receptivity.

Some who needs professional treat could even be more likely to choose professional help, once they 'have the taste' of real support.

The danger always exists that someone relationship to their condition worsens, but I don't think this is any more or less likely from advice or stimulus they receive in daily life.

3

You concerns are serious, but I disagree with your premises:

  1. The stereotype that everything that is free is of bad quality. Free legal advice worse than highly paid one. Free medical/psychological advice worse that commercial one. Financial advice from Usenet worse than those given by consultant hired by bank. Wikipedia worse than Brittanica. Do you actually have any number to support your claims?

  2. Assumption that everyone has access to professional psychological/psychiatric help. There are still countries where psychiatric clinics are worse than prisons.

  3. Assumption, that everyone can afford professional advice. There are countries in this world where there's no free health service, or it's range is strongly limited.

  • now THAT's an argument :D let me think a moment. – Alexander Troup Mar 5 '14 at 22:48
  • points 2 and 3 are really the same, that many people do not have the means to access professional, quality services. A very, very good point which I hadn't considered. Just for that I think the site would be more valuable than detrimental. Reminds me of travel.stackexchange.com/questions/24540/… – Alexander Troup Mar 5 '14 at 22:54
  • On point 1 though, I don't think the convincing should be done on the paid side, I think it should be on the free side. By that I mean why is free medical advice better than commercial. Why is Wikipedia better than Britanica. On the bank point, if the advice giver is commercially vested in your decision then yes, they may give bad advice, but whether free is better should be on a case by case basis. – Alexander Troup Mar 5 '14 at 22:58
  • I'm not trying to paint free as bad and paid as good, I'm trying to ascertain if free is better in the case of mental health or not, and being answered by people who are mostly hobbyists over professionals – Alexander Troup Mar 5 '14 at 23:00
  • So on point one I see what you're saying, but my concern is more if the format of SE is suited to such social and personal problems. There's no-one to hold to account in the case of bad advice, and the community will likely not hear the effects of the bad advice, so how can it learn what works and what doesn't? – Alexander Troup Mar 5 '14 at 23:07
3

Good question. Being a man with Bipolar Disorder, I remember a time during High School where I was overwhelmed with advice. Everyone expected me to take their advice because they knew it worked for them. They specifically advised me about sleeping, not staying angry, and getting along with others. Hopefully by seeking advice from a stranger in this manner the advice will not be imposed, but rather a solution to a common problem will be stated in detail, and they will have some to choose from.

The truth was I couldn't sleep because I lacked Serotonin. A very small dose put me out like a rock. Exercising myself to exhaustion, standing on my head, closing my eyes and laying down did not work, and I became very drowsy and did not like to wake up.

As far as staying angry, my mind was fixed on issues of little importance. Calling people up and letting them know how I felt while being cordial and polite actually helped. Good advice from the Proverbs. The being fixed on these issues was alleviated by Lithium, though. It was not healthy to concentrate on the little injustices in life or to expect absolute justice from people with limited perspectives. When I could accept that it helped.

Getting along with others: what if the few others that you are friends with are not sympathetic and hard for anyone to get along with, and you were in a condition were you required extra sympathy? Sometimes it takes an official diagnosis or hospitalization to get the sympathy and forgiveness you need.

There are three things that I didn't like about the bad advice: 1) The advisor did not listen to the full problem. 2) The advisor did not research for a solution. 3) The advisor did not seek a solution from people that had a difficult and serious case like mine.
4) The advisors did not collaborate, but just blurted out their opinions. 5) The advisor sometimes expected you to take their advice and refused discussion, or disagreement. 6) The advisor did not realize how important a good solution was to me.

It is impossible to keep people with BPD from getting advice, but we can give recognition to the people that give the best advice and present some cases and solutions. Just like stackoverflow has some ground rules, this group needs some also.

Maybe this: Listen, research, collaborate, and encourage without insisting or minimizing the problem.

With a cause like this we need to make it work.

1

One of two things will happen:

  • Everyone who gives any sort of advice for how to not need a medication will be showered upvotes. Especially if they write about how they suffer from a <severe mental health disorder> and therefore didn't need a medication often associated with a less severe disorder.
  • Everyone who gives any sort of advice for how taking a medication is okay will be showered upvotes. The groupthink mentality will become that "normalizing medication use is a Good Thing" and the possibility of promoting therapy will diminish.

... which, by the way, is precisely because you can't prescribe mental health therapy over a paragraph of text. Does the OP have a problem that is more receptive to therapy if only they make a medication change to a drug that's only been on the market for 2 years? Hell if I know, I was treated for this stuff in aughts!

0

If we don't give advice, they will look for advice elsewhere. That advice may be good advice, or it may be really bad advice from random blogs.

As said before, professionals often can and do give bad advice. Many universities also offer improper training... who is to say that certification makes someone qualified? Throughout most of human history, professional doctors have given outright bad advice and opposed the truth. Mental health is even less mature than physical health.

Anyone who is untrained can also give good advice. A casual learner might be able to quote from psychology journals or books. A person who has personally experienced and overcome depression and anxiety may be more knowledgeable than a professional psychiatrist with decades of experience.

The SE system is great in that it helps people counter potentially dangerous advice with downvotes. Here, content is judged, not certifications. If someone gives harmful advice (e.g. suck it up and ignore your depression), someone should be able to comment and downvote it. The person looking for advice will be able to evaluate both good and bad advice or at least see why the intuitive/common knowledge bad advice is bad.

  • 2
    Nope. I'm going to outright say you're wrong on the point that Anyone who is untrained can also give good advice. Just because you've scanned the Wikipedia page on BPA, or read a self-help book about how to improve your life it does not give you license nor credibility to help someone with a genuine mental problem. – Alexander Troup Mar 5 '14 at 22:41
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    Broad strokes about how universities offer improper training and certification means nothing is missing the point which is that most of the time they do. Beyond that I believe it's 4 years minimum where your subject is the human mind. Yes there have been cases where doctors get it wrong, but they are the exception, not the rule. in the last 100 years we have cured many, many diseases because of the professionals, not the hobbyist. – Alexander Troup Mar 5 '14 at 22:43
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    And as for the public opinion of mental health, just take a look at the massive industry self help is. The problem is that most of it sounds quite intuitive and helpful, and when it sounds right, it gets upvotes. That is my biggest worry about this endeavour. – Alexander Troup Mar 5 '14 at 22:46
  • Something is really fallacious about saying that if someone gets bad advice elsewhere anyway, they should just get it from us. And if you do want to take that seriously then it follows that the bad advice given here taints the whole SE premise and brand. – djechlin Jan 15 '17 at 16:27
  • "someone should be able to comment and downvote it." Right, so now "someone" whose main qualification is 1) getting 3 upvotes on this site after an association bonus and 2) happens to have opinions on mental health is in charge of mental health treatment. This isn't good. – djechlin Jan 15 '17 at 16:29
-2

I would like to ask if anyone has had any deltoid ligament damage. How long it took for them to heal, and what the doctor told them. This wasn't going to be my main source of health advice, but it would be nice to know other stories so I can get a better idea of how long this ankle will take to heal. If they went to a physical therapist etc... There are most definitely people out there that might use this as fact for a final decision, but they were going to find a way to make a bad decision anyways. Don't hold that against me... I want this.

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