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Not a big fan of Heidt. Way too much political, unsubstantiated and handwavy rhetoric from him. And his track record has been entirely unconvincing.

The only reasonable way I can interpret his work is that of a ideologically driven puritan, trying to make the data fit his perception. In doing so, he often misses the forest for the trees.

In particular, this interpretation of teenage mental illness is predicated on data. But the data sucks. Why should we assume we have accurate data on mental illness? It's ridiculous when you consider our society's terrible history in dealing with this stigma. Sexist notions like female hysteria, gross misuse of sedatives and psychoactive drugs by medical charlatans, repression of discussion about mental illness, bias/inexperience/abuse by governmental and health care institutions, horrible conditions at sanitoriums, the list goes on. Give it another 100 years and maybe we can draw some better patterns.

In no particular order, here are some highlights on medical data and institutions in history...

1. The consensus on normal heart rate is still erroneously assumed to be 60-100 bpm. For over 100 years, this myth was predicated on poor data and grossly misinterpreted literature. Our current, best consensus based on better data is 50-90 bpm, though virtually all textbooks and educational programs have failed to update themselves. If we can't even get statistics on heart rates right, how are we supposed to get statistics on mental illness correct?

2. There is no consensus on average breaths per minute. Textbooks often contradict themselves, quoting different fabricated ranges for respiratory rates within the same page. Data in this area is sparse and and lacks adjustment for demographics. The most comprehensive data is from a study done in 1846... We just don't know because we haven't put in the rigorous effort to definitively identify this range. Again, this basic measurement is much easier than mental illness, and we haven't done it yet.

3. The most established field of medicine is considered to be Obstetrics. That is to say, this is the medical field with the oldest depth of knowledge that we consider to be accurate or useful. Which makes sense given the significance of managing childbirth for societies. And yet there are still severe deficiencies in this field. We have a long way to go in the most mature field of medical science, and an even longer way to go in every other field. In comparison, mental health was not even mentioned in writing until 1946.

4. Prior to the gross misuse of opioids perpetuated by the Sackler family, was the gross misuse of benzodiazepines (Xanax, Valium). Prior was of Barbiturates. Prior to that was alcohol. And countless more medications in between those broad categories. Humanity has abused substances to numb itself from crippling anxiety for centuries, and in the modern sense has almost always sought to mass market these drugs before careful consideration of their appropriate use. Each medication was so abused that each generation has their own idioms and memes regarding their misuse.

I'm certain that we can do better. It's just going to take time, and Heidt's work just seems like reading tea leaves and putting people in arbitrary pigeon holes.



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