Kat and Phoebe discuss breast aesthetics, 90s nostalgia, and whether we're all taking too many drugs. Links: Are We Sunsetting Ass and Entering a Golden Age of Boobs? Sydney Sweeney has brought boobs back - The Spectator World Katherine Dee: “I think benzos and SSRIs are overprescribed for the same reason antibiotics and birth control are. Pharmaceuticals are a lucrative industry and being sick is a lifestyle brand.”
I hate this return to "the pill is bad, actually." In 1978 I needed birth control, and the medical provider told me that the pill would interfere with my moon cycles. I am not making this up. Apparently my menstrual cycle was supposed to be linked to the moon and the tides or some such horseshit, and not just in a linguistic way. So I got a diaphragm, leading to chronic urinary tract infections and, eventually, an unwanted pregnancy. In those days, children, abortions were legal, so I was okay. The kind doctor at the clinic suggested the pill would be more effective, and indeed it was.
I also take anti-depressants. Would you like to know how much regular exercise in the sunshine helped my depression? Exactly not at all. Running five miles in the morning and swimming a mile at noon (outdoors! In the sunshine! In the fresh air! So very curative!) still left me crying and feeling worthless every day. Citalopram ended that.
I think Kat's description of her experience, which I have truly deep sympathy for, might show some of the difference between situational depression and capital-D major depressive disorder. The perspective she describes, and the idea that you might someday not feel like this, is really hard to feel or believe. That doesn't mean the experience of situational depression is less-bad, but I think that other aspect is what can make MDD debilitating or even deadly. There is probably a good argument for not jumping to medication for situational depression, but I think there are limits to how much you can generalize from one experience to the other.
Before I started taking SSRIs in my mid-thirties, I had this feeling, like a knot, in my head whenever I got anxious. It's tough to describe but it was something I physically felt if I went any minute distance from my comfort zone, like if ever tried to flirt, but that went away a few days after taking antidepressants and has never come back. I did meet with an ANRP for an hour initially, IIRC, and have 30 minute follow-ups every 3-4 months. I honestly feel 100% more "natural" because I take those meds and would never want to go back to my pre-meds state.
Whether or not SSRIs are over-prescribed may or may not be true but prescribing them for me was absolutely the right decision. I really find it frustrating that experiences like mine seem to be absent in this discussion. I know I'm lucky that the we didn't need to do much experimenting to get the right pills and dosage. I genuinely believe that my brain wasn't getting enough serotonin and the meds changed that. People like Meghan Murphy (worst BARpod guest ever) have no idea what they're talking about and I really wish they'd talk to people who use meds rather than declare we just haven't touched enough grass.
I discovered the birth control debate a few years ago and it has sometimes been a challenge to not let it haunt me, an unmarried 40 year old who has been on it since I was 18 for the express purpose of not getting pregnant. I know I fall into the category of “it’s ok since I’m using it for its intended purpose,” but all the pods out there demonizing it make me feel like a weird anomaly, a bad girl.
In 22 years, I have been off it once for a few months after a move (when I had to search a bit for a dr to prescribe my preferred method), and once in 2021 as a test, after hearing all the fear mongering pods that were in the ethos. The 2021 test was meant to be at least 6 months, the agreed upon time after which one can safely say they have experienced/noticed the differences between birth control and a natural cycle. I made it two months, fraught with anxiety over, what if I go on a date, what if I want to have sex. It was during this period that I used the morning after pill for the first and only time in my life. I couldn’t take it and went back on it before noticing any major differences (except some hot flashes here and there).
I have no idea what my natural cycle would be like, given that prior to being 18, I never had a very regular cycle, and I’ve never been off birth control long enough since then. I worry that I’m a worst case scenario to those who espouse the horrors of birth control, what havoc have I wrecked on my body and mind, will I suddenly find my boyfriend ugly when I have to eventually go off it, how much damage am I doing to things I have no comparison to… When I ask doctors, they all say it’s fine to stay on it as long as I want. Maybe I’m a victim of misinformation, but the universe did not grace me with a man during my prime childbearing years, and I just don’t want to get pregnant.
KR expressed concern about mis-diagnosis for physical and mental health. In mental health, there are a number of error types- of which I present two, below.
(1) Let’s designate Error 1 as a copycat illness that the therapist mistakenly assigns to patient, instead of assigning the correct illness. I suspect that this occurs when therapist takes short cuts. I am not a therapist, but I imagine that Proper therapist pathway would consist of exclusionary yes/no questions, such that similar conditions are excluded at each step leaving therapist at final step, where “Depression” for example is the sole remaining illness candidate for patient. The short-cut in this example would be the therapist asking herself at beginning “Does client meet criteria for depression?” If so, then client is assigned that diagnosis. The difference is In number of steps.
(2) I designate Error 2 as intrusion of outside influence into therapy practice. Outside influence could be that scary movie about a stalker with multiple personalities that the therapist saw last night. Or it could be the uber-wokeness that APA is in love with. In either case, the problem is that behavioral science is replaced with non-science information.
In closing, I recommend a book that I have not yet read on my bookshelf, “Handbook Of Psychological Assessment”; by Groth-Marnat and Wright, 6th Edition. This book may even be the “bible for therapy” with a good road-map to guide therapists.
[Time 44:00]; PMB on “Anti-Contraception” Utopia on the right envisions an ideal society where every pregnancy has full support across all societal systems. (That Utopia has already been achieved at my nephew’s house- he has 8 or 9 kids). Pro-pregnancy Utopia is The Right’s counter to DEI’s “Adequate social services will make crime disappear, so we can abolish police.”
[Time 32:00]; KR book “All In Her Head” and medical field pathologizing normal woman behavior. When the MD places a drug prescription in your hand, that is step 4 (Treatment). Treatment must connect in the reverse direction to step 3 (diagnosis) as ‘fixing something that is broken.” Continuing in the reverse direction, diagnosis is determined only after MD performs enough assessment (investigation) in step 2 (Assessment) so as to capture evidence to validate diagnosis. Step 2 is where the MD enters “Sherlock Holmes” mode. Step 1 is “Patient presentation”, where patient presents problem to the MD.
On KR “emotional pain has value in personal development” (my paraphrase). I agree. A few years ago, I experienced emotional pain because all of my colleagues became crazy, uncooperative and unprofessional. The mental pain pushed me into fight-mode, where I explored ways to fight the problem. I discovered solutions that otherwise would have been beyond my mental grasp.
I'm 100% on board with Kat here: "I don't love the idea that doctors are deciding, independently, just because there's a woman in front of them who is of child-bearing age, that they need to step in and offer her the pill because she might be having sex and she might not want to have a baby" -- specifically if the offering is outside the context of a prior conversation about what the woman wants and needs, and especially if we're talking about someone still in high school or younger.
Unlike Kat, I didn't have a doctor who at 14 offered me the pill on some on grounds having nothing to do with sex. As I recall, my doctor asked me if I was sexually active and asked if I was interested in birth control. This left me with a sense of autonomy in relation to my body and my sexual choices -- a sense that might have taken a big hit had I caught a whiff of the pill being foisted paternalistically upon me.
Ok I laughed at about an hour and 3 minutes in where Phoebe says "rather than try and be coy about it, the doctor just said bluntly, if you don't take the pill and you're 19 years old, there's a good chance you'll get pregnant" as though the pill is a pregnancy vaccine that prevents catching pregnancy, which is just a disease endemic to teenagers.
PS this is not a vague argument against birth control or people using it, I just found that framing amusing
I hate this return to "the pill is bad, actually." In 1978 I needed birth control, and the medical provider told me that the pill would interfere with my moon cycles. I am not making this up. Apparently my menstrual cycle was supposed to be linked to the moon and the tides or some such horseshit, and not just in a linguistic way. So I got a diaphragm, leading to chronic urinary tract infections and, eventually, an unwanted pregnancy. In those days, children, abortions were legal, so I was okay. The kind doctor at the clinic suggested the pill would be more effective, and indeed it was.
I also take anti-depressants. Would you like to know how much regular exercise in the sunshine helped my depression? Exactly not at all. Running five miles in the morning and swimming a mile at noon (outdoors! In the sunshine! In the fresh air! So very curative!) still left me crying and feeling worthless every day. Citalopram ended that.
Medications are good, actually.
I think Kat's description of her experience, which I have truly deep sympathy for, might show some of the difference between situational depression and capital-D major depressive disorder. The perspective she describes, and the idea that you might someday not feel like this, is really hard to feel or believe. That doesn't mean the experience of situational depression is less-bad, but I think that other aspect is what can make MDD debilitating or even deadly. There is probably a good argument for not jumping to medication for situational depression, but I think there are limits to how much you can generalize from one experience to the other.
Before I started taking SSRIs in my mid-thirties, I had this feeling, like a knot, in my head whenever I got anxious. It's tough to describe but it was something I physically felt if I went any minute distance from my comfort zone, like if ever tried to flirt, but that went away a few days after taking antidepressants and has never come back. I did meet with an ANRP for an hour initially, IIRC, and have 30 minute follow-ups every 3-4 months. I honestly feel 100% more "natural" because I take those meds and would never want to go back to my pre-meds state.
Whether or not SSRIs are over-prescribed may or may not be true but prescribing them for me was absolutely the right decision. I really find it frustrating that experiences like mine seem to be absent in this discussion. I know I'm lucky that the we didn't need to do much experimenting to get the right pills and dosage. I genuinely believe that my brain wasn't getting enough serotonin and the meds changed that. People like Meghan Murphy (worst BARpod guest ever) have no idea what they're talking about and I really wish they'd talk to people who use meds rather than declare we just haven't touched enough grass.
Kat's fertility treatment story is heartbreaking.
I discovered the birth control debate a few years ago and it has sometimes been a challenge to not let it haunt me, an unmarried 40 year old who has been on it since I was 18 for the express purpose of not getting pregnant. I know I fall into the category of “it’s ok since I’m using it for its intended purpose,” but all the pods out there demonizing it make me feel like a weird anomaly, a bad girl.
In 22 years, I have been off it once for a few months after a move (when I had to search a bit for a dr to prescribe my preferred method), and once in 2021 as a test, after hearing all the fear mongering pods that were in the ethos. The 2021 test was meant to be at least 6 months, the agreed upon time after which one can safely say they have experienced/noticed the differences between birth control and a natural cycle. I made it two months, fraught with anxiety over, what if I go on a date, what if I want to have sex. It was during this period that I used the morning after pill for the first and only time in my life. I couldn’t take it and went back on it before noticing any major differences (except some hot flashes here and there).
I have no idea what my natural cycle would be like, given that prior to being 18, I never had a very regular cycle, and I’ve never been off birth control long enough since then. I worry that I’m a worst case scenario to those who espouse the horrors of birth control, what havoc have I wrecked on my body and mind, will I suddenly find my boyfriend ugly when I have to eventually go off it, how much damage am I doing to things I have no comparison to… When I ask doctors, they all say it’s fine to stay on it as long as I want. Maybe I’m a victim of misinformation, but the universe did not grace me with a man during my prime childbearing years, and I just don’t want to get pregnant.
KR expressed concern about mis-diagnosis for physical and mental health. In mental health, there are a number of error types- of which I present two, below.
(1) Let’s designate Error 1 as a copycat illness that the therapist mistakenly assigns to patient, instead of assigning the correct illness. I suspect that this occurs when therapist takes short cuts. I am not a therapist, but I imagine that Proper therapist pathway would consist of exclusionary yes/no questions, such that similar conditions are excluded at each step leaving therapist at final step, where “Depression” for example is the sole remaining illness candidate for patient. The short-cut in this example would be the therapist asking herself at beginning “Does client meet criteria for depression?” If so, then client is assigned that diagnosis. The difference is In number of steps.
(2) I designate Error 2 as intrusion of outside influence into therapy practice. Outside influence could be that scary movie about a stalker with multiple personalities that the therapist saw last night. Or it could be the uber-wokeness that APA is in love with. In either case, the problem is that behavioral science is replaced with non-science information.
In closing, I recommend a book that I have not yet read on my bookshelf, “Handbook Of Psychological Assessment”; by Groth-Marnat and Wright, 6th Edition. This book may even be the “bible for therapy” with a good road-map to guide therapists.
[Time 44:00]; PMB on “Anti-Contraception” Utopia on the right envisions an ideal society where every pregnancy has full support across all societal systems. (That Utopia has already been achieved at my nephew’s house- he has 8 or 9 kids). Pro-pregnancy Utopia is The Right’s counter to DEI’s “Adequate social services will make crime disappear, so we can abolish police.”
[Time 32:00]; KR book “All In Her Head” and medical field pathologizing normal woman behavior. When the MD places a drug prescription in your hand, that is step 4 (Treatment). Treatment must connect in the reverse direction to step 3 (diagnosis) as ‘fixing something that is broken.” Continuing in the reverse direction, diagnosis is determined only after MD performs enough assessment (investigation) in step 2 (Assessment) so as to capture evidence to validate diagnosis. Step 2 is where the MD enters “Sherlock Holmes” mode. Step 1 is “Patient presentation”, where patient presents problem to the MD.
On KR “emotional pain has value in personal development” (my paraphrase). I agree. A few years ago, I experienced emotional pain because all of my colleagues became crazy, uncooperative and unprofessional. The mental pain pushed me into fight-mode, where I explored ways to fight the problem. I discovered solutions that otherwise would have been beyond my mental grasp.
I'm 100% on board with Kat here: "I don't love the idea that doctors are deciding, independently, just because there's a woman in front of them who is of child-bearing age, that they need to step in and offer her the pill because she might be having sex and she might not want to have a baby" -- specifically if the offering is outside the context of a prior conversation about what the woman wants and needs, and especially if we're talking about someone still in high school or younger.
Unlike Kat, I didn't have a doctor who at 14 offered me the pill on some on grounds having nothing to do with sex. As I recall, my doctor asked me if I was sexually active and asked if I was interested in birth control. This left me with a sense of autonomy in relation to my body and my sexual choices -- a sense that might have taken a big hit had I caught a whiff of the pill being foisted paternalistically upon me.
As a middle aged dude, I’m noting that where women’s faces on TV and Internet used to look powdered/velvety, but now they’re all shiny plasticky.
Just the cosmetics are doing that. Ring lights literally reflecting off shiny cheeks.
For what it’s worth, /r/instagramreality still shows a lot more bad butt, leg, and waist edits than bad boob edits, but perhaps that will change.
Ok I laughed at about an hour and 3 minutes in where Phoebe says "rather than try and be coy about it, the doctor just said bluntly, if you don't take the pill and you're 19 years old, there's a good chance you'll get pregnant" as though the pill is a pregnancy vaccine that prevents catching pregnancy, which is just a disease endemic to teenagers.
PS this is not a vague argument against birth control or people using it, I just found that framing amusing