Overall I liked this post, and in particular I very strongly endorse the view that it’s worth spending nontrivial time/energy/money to improve your health, energy, productivity etc. I don’t have a strong view about how useful the specific pieces of advice were, my impression is that the literature is fairly poor in many of these areas. Partly because of this, my favourite section was:
One thing people sometimes say when I tell them there is a small chance taking some pill will fix their problems is that this seems somehow like cheating because it doesn’t require any lifestyle changes. As if because it’s easy you don’t really deserve to have it fixed? I don’t get it but suffice to say that if for ~$20 you can trial something with a simply massive expected value (even if it’s unlikely to work) and usually with almost no downside (you can just stop taking it after two weeks if it doesn’t work) you should definitely try that thing. Think of it like buying a lottery ticket but with much better odds and a chance of actually making you consistently happier in the long-run.
It’s noteworthy that the above applies not just to “taking some pill”, but in fact to any low-cost-of-trying intervention which might prove substantially beneficial in the long run.
To that end, I was surprised to see the following at the end (as I think its framing is contradicted by the above).
Less ideal solutions (but still definitely worth considering) include patching over the problem by trying things like nootropics, antidepressants, or other medication.
It seems straightforwardly wrong to characterise medically treating e.g. clinical depression or ADHD as a “less ideal solution” which is merely “patching over the problem”. For many, treatment will be necessary for at least some time even if lifestyle adjustments and therapy are sufficient management in the longer term. For many others, medicine is a necessary part of the long-term solution, and possibly also a sufficient long-term solution.
I really liked this quote from Howie in a recent 80k1 podcast about this.
[1] - I’m linking to this because I think it makes the point well, but should probably disclose that I’ll be working at 80k from September. The opinions above are only intended to represent my views, including the interpretation of what Howie’s saying in the quote.
Oh yeah, I think you’re right on that! I shouldn’t have been so down on symptom-reducing treatment. It does seem clearly better to fix root causes but given they can be so hard to fix it can often be the case that the best solution is to treat symptoms (and in some cases, like mental health, that can help improve root cause as well). I’ll change that language so it’s more positive on those
Fwiw, for mental health I’m not sure whether therapy is more likely to treat the ‘root causes’ than medications. You could have a model where some ‘chemical thingie’ that can be treated by meds is the root cause of mental illness and the actual cognitive thoughts treated by therapy are the symptoms.
In reality, I’m not sure the distinction is even meaningful given all the feedback loops involved.
Hm, I’m a bit unhappy with the framing of symptoms vs. root causes, and am skeptical about whether it captures a real thing (when it comes to mental health and drugs vs. therapy). I’m worried that making the difference between the two contributes to the problems alexrjl pointed out.
Note, I have no clinical expertise and am just spitballing: e.g. I understand the following trajectory as archetypical for what others might call “aha! First a patch and then root causes”:
[Low energy --> takes antidepressants --> then has enough energy to do therapy & changes thought patterns etc. --> becomes long-term better afterwards doesn’t need antidepressants anymore”]
But even if somebody had a trajectory like this, I’m not convinced that the thought patterns should count as root cause and not e.g. physiological imbalances that gave these kind of thought patterns a rich feeding ground in the first place (, which were addressed by antidepressants and perhaps to be addressed first before long-term improvement is possible). This makes me think that even if there is some matter of fact, it’s not particularly meaningful.
(This seems even more true to me for things like ADHD—not even sure what root causes would be here -, but which weren’t central to OP)
I think you might plausibly have a different and coherent conception of the root causes vs. symptoms thing, but I’m worried of using that distinction anyway because root causes is pretty normatively connotated, and people have all kinds of associations to it. (Would still be curious to hear your conceptualisation if you have one)
I care much less/have no particular thoughts on this distinction in non-mental-health cases, which were the focus of OP.
+1 to appreciating the OP, and I’ll probably try out some of the things suggested!
Cool thanks for the feedback everyone! I haven’t done much thinking about root cause vs symptoms but I agree that especially with mental health it does seem right that ‘root cause’ isn’t really a useful term given the complexity.
I changed up that last recommendation a bunch to get rid of symptom/root cause dichotomy:
“[revised] Try a bunch of other things. There are a lot of medications and pills you can take which have relatively low downsides and which can potentially be game-changers. This includes things like antidepressants, various supplements, nootropics, or other medication. Again, it’s probably worth thinking of these as abnormally good lottery tickets. Expect most to fail but eventually something might really work. [see comments section for more on how to think about treating symptoms vs root causes]”
Overall I liked this post, and in particular I very strongly endorse the view that it’s worth spending nontrivial time/energy/money to improve your health, energy, productivity etc. I don’t have a strong view about how useful the specific pieces of advice were, my impression is that the literature is fairly poor in many of these areas. Partly because of this, my favourite section was:
It’s noteworthy that the above applies not just to “taking some pill”, but in fact to any low-cost-of-trying intervention which might prove substantially beneficial in the long run.
To that end, I was surprised to see the following at the end (as I think its framing is contradicted by the above).
It seems straightforwardly wrong to characterise medically treating e.g. clinical depression or ADHD as a “less ideal solution” which is merely “patching over the problem”. For many, treatment will be necessary for at least some time even if lifestyle adjustments and therapy are sufficient management in the longer term. For many others, medicine is a necessary part of the long-term solution, and possibly also a sufficient long-term solution.
I really liked this quote from Howie in a recent 80k1 podcast about this.
[1] - I’m linking to this because I think it makes the point well, but should probably disclose that I’ll be working at 80k from September. The opinions above are only intended to represent my views, including the interpretation of what Howie’s saying in the quote.
Oh yeah, I think you’re right on that! I shouldn’t have been so down on symptom-reducing treatment. It does seem clearly better to fix root causes but given they can be so hard to fix it can often be the case that the best solution is to treat symptoms (and in some cases, like mental health, that can help improve root cause as well). I’ll change that language so it’s more positive on those
Fwiw, for mental health I’m not sure whether therapy is more likely to treat the ‘root causes’ than medications. You could have a model where some ‘chemical thingie’ that can be treated by meds is the root cause of mental illness and the actual cognitive thoughts treated by therapy are the symptoms.
In reality, I’m not sure the distinction is even meaningful given all the feedback loops involved.
Hm, I’m a bit unhappy with the framing of symptoms vs. root causes, and am skeptical about whether it captures a real thing (when it comes to mental health and drugs vs. therapy). I’m worried that making the difference between the two contributes to the problems alexrjl pointed out.
Note, I have no clinical expertise and am just spitballing: e.g. I understand the following trajectory as archetypical for what others might call “aha! First a patch and then root causes”:
[Low energy --> takes antidepressants --> then has enough energy to do therapy & changes thought patterns etc. --> becomes long-term better afterwards doesn’t need antidepressants anymore”]
But even if somebody had a trajectory like this, I’m not convinced that the thought patterns should count as root cause and not e.g. physiological imbalances that gave these kind of thought patterns a rich feeding ground in the first place (, which were addressed by antidepressants and perhaps to be addressed first before long-term improvement is possible). This makes me think that even if there is some matter of fact, it’s not particularly meaningful.
(This seems even more true to me for things like ADHD—not even sure what root causes would be here -, but which weren’t central to OP)
I think you might plausibly have a different and coherent conception of the root causes vs. symptoms thing, but I’m worried of using that distinction anyway because root causes is pretty normatively connotated, and people have all kinds of associations to it. (Would still be curious to hear your conceptualisation if you have one)
I care much less/have no particular thoughts on this distinction in non-mental-health cases, which were the focus of OP.
+1 to appreciating the OP, and I’ll probably try out some of the things suggested!
Cool thanks for the feedback everyone! I haven’t done much thinking about root cause vs symptoms but I agree that especially with mental health it does seem right that ‘root cause’ isn’t really a useful term given the complexity. I changed up that last recommendation a bunch to get rid of symptom/root cause dichotomy:
“[revised] Try a bunch of other things. There are a lot of medications and pills you can take which have relatively low downsides and which can potentially be game-changers. This includes things like antidepressants, various supplements, nootropics, or other medication. Again, it’s probably worth thinking of these as abnormally good lottery tickets. Expect most to fail but eventually something might really work. [see comments section for more on how to think about treating symptoms vs root causes]”