searabbit

I feel for your friend because my mom had acne until (I assume) she hit menopause, and my acne starts back up if I ever take a break from continuous birth control. Doctors are also incredibly dismissive about these things because no one understands female hormones -yay for us!!

I can’t diagnose your friend, but I can point you in some directions to bring up at the doctor:

Starting about 2 years ago her face started getting acne, and any treatments just made it worse. the only thing that helped was antibiotics.

What treatments? (you don’t have to tell me, but have it ready for the doctor) Usually they’ll hand you some benzoyl peroxide and salicylic acid along with the antibiotics as the initial treatment. Maybe tretinoin (retin-A). These are very harsh actives, so they can be very irritating if you use too much or don’t combine them with a skincare routine. They also just don’t work for everyone. She can go back to the dermatologist and try something else.

Some of the spots are very tiny, like pore-sized, and get white heads

This sounds like it could be fungal acne (again not qualified to diagnose, go to a doctor). If it’s itchy and also gets worse with heat/sweat, try some anti-dandruff shampoo with ketoconazole or zinc pyrithione and see if that helps.

Before her period she gets very irritated-hyper, one time she got so pissed off at a pretty mundane thing she threw a mug at the wall.

She should speak to her doctor about PCOS and/or PMDD. They will likely recommend birth control for these conditions if she has them, but that is not the only option if she doesn’t want to go on it.

she says she only looks young because she has big eyes and a small nose

“Looking young,” “big eyes,” and “small nose” could be indicators of various genetic or endocrine conditions, but I wouldn’t bring this up to the doctor since it’s super vague and doesn’t point to anything in particular. She should just stick to symptoms that are bothering her. Presumably the doctor will be able to spot the connection if there is one.

Since 31 is still very young, is this normal for her age?

I don’t think this is a useful question. Acne is a common condition even in adults, but it is still a condition that most people want treated. The point is she wants treatment. If a doctor dismisses her with a “oh it’s normal” or a “it’s just a sign that you have young skin!” (my mom got this line into her 40s…), go to a different doctor.

I love this comment and I’ll look into Wendell Berry since I haven’t heard of him before.

To add on, I’ve met a lot of otherwise smart people (smart as in curious and skeptical to not accept things at face value) who frustratingly have no interest in literature to flesh out their own philosophies about the world.

They’ll go on a rant about this or that and I’ll chime in to say, for example, “oh are you talking about prisoners dilemma?” or “you’re basically describing nihilism” or “well, that person likely disagreed with you because you are using different definitions of the same word/concept” and they’ll look at me with an expression of ‘I don’t know what you’re talking about and I don’t care.’ I’d be so happy to explain things or recommend what to research to engage with topics they’re clearly passionate about, but it’s sad to see the curiosity end so soon when so many people have collectively devoted lifetimes on expanding the ideas they think they just invented.

So I won’t comment on what makes someone intelligent (because you’ll never find me calling the people I described unintelligent), but if you want to improve your own, I emphatically agree on reading literature, even fantasy like Tolkien, whatever you enjoy.

Banksy’s lawyer, Mark Stephens, pushed back on the report and said the artist did not accept many parts of the investigation as accurate.

Stephens argued that revealing the artist’s identity would compromise his safety, intrude on his private life, and undermine his ability to work freely.

Reuters said it decided to publish because of what it described as strong public interest in a figure who has had a significant and lasting impact on culture, the art world, and public discourse.

This is why we can’t have superheros nice things smh

People generally hang out with other people of their general socioeconomic class, so it doesn’t take much guesswork. Usually, they just have nothing in common with poorer people (not the literal poors, upper middle class is poor to them), don’t go to the same places that poorer people go to, and unfortunately, poorer people generally tend to be less attractive than rich people due to lack of access to cosmetic care. The cosmetic care includes skincare, dental work, and I’ve even seen growth hormones as soon as elementary school.

One last point, multimillionaire and billionaire circles are extremely small because, as you can imagine, there’s not that many of them! They tend to know way too much about each other, so if you do happen to be poorer and run in their circles, they’ll either know and/or you’re smart enough to be playing their game.

Idk about your pile, but mine is precariously balanced on top of a chair so it’s O(1) until a literal tipping point when everything falls and then it’s O(k*n) where k is the time it takes me to put away a piece of clothing in the closet/laundry (or start a new pile elsewhere).

That’s the most well written account of something similar I experienced, but not to that extent.

You start out doing something because you enjoy it, then you hyperfocus because your brain is built in that way, then the praise and accolades start pouring in (for me it was academic success and getting into MIT), then it becomes your identity and you/others (mainly yourself as he pointed out) start expecting that level of output from you, you try to maintain it to unhealthy levels because your brain was built without the normal guardrails to keep itself safe, and in one way or another you just break.

For me, as my body was breaking down from stress and sleep deprivation in my 20s, I went to doctor after doctor who diagnosed me with one rare incurable diagnosis after another. A lot of young women may relate with the progression: POTS, then EDS, maybe autoimmune diseases or CFS, likely MCAS and gastroparesis, then sleep apnea and narcolepsy, also migraines with severe aura symptoms towards the end. I believed I did have a rare disease because I had Bells Palsy at 15 (from school stress!) and I still have lingering effects from that ever since.

It actually mainly ended up being sleep apnea, but to his point, an earlier diagnosis and treatment would’ve been great, but it wouldn’t have solved my lack of boundaries and identity outside of “MIT grad” either. My breaking point was being so sleep deprived I literally stopped having thoughts and desires. I just…stopped showing up for work because all my brain wanted was sleep at every moment and couldn’t conceptualize any other thought. I’m past that now thankfully, and I’m grateful for the things that part of my life brought me, but yeah, being that “smart and accomplished” has a very dark side. Especially if you don’t come from a privileged background.

I think people who grow up middle class in a first world country are so sheltered from suffering that animal cruelty is the first example of it that they can actually empathize with and understand as a black and white issue (to them). Unfortunately, suffering is just a fact of life for everyone but the most privileged. The logical conclusion to “if you can’t give animals the standard of care that I expect as a global top 1%er of wealth, then you shouldn’t own any pets” is a PETA type policy of killing any pet that is living a suboptimal existence. Which, if they were humans, we would consider that genocide. It’s really just not a reasonable stance at all.