The Little Hiatus

Sorry for the long silence, brain enthusiasts. Neurontic went on a brief expedition to California for a face-to-face with the brain detective-cum-neurologist V.S. Ramachandran. (More on this later . . .) We should be back on schedule very soon, in case you're jonesing for some silly science.

In the mean time, I'm pleased to announce that Neurontic has been featured in the latest edition of Encephalon, the blog carnival for the unapologetic brain geek. Other features include Mind Hacks take on Philip K. Dick's peculiarly appealing vision of psychosis in A Scanner Darkly, and Neurophilosopher's musings on what nanotechnology might mean for brain modeling.


Dear Neurontic

I have some experience with depression, mostly mild although I have had a couple periods that could be described as major depressions. I know that my thoughts are intimately connected to my brain chemistry and that paying attention to how I'm thinking can alter my mood. For example, if I catch myself starting to feel depressed, I can pay attention to the conversations I'm having with myself and interrupt the thoughts that go something like "You worthless, useless, lazy slob". That, along with taking care of chores and projects I've been letting slide, and getting some exercise, usually help. But not always. Neurontic, can you explain what's going on when these remedial activities aren't working? Why am I sometimes powerless over depressive thoughts?

Got the Blues

Dear Got the Blues,

First off, I think we need to make a clear distinction between a perfectly healthy dip in mood and clinical depression (major depressive disorder). We don’t want to make the mistake of pathologizing sadness. Dark times are, after all, a normal part of life.

That said, if you are experiencing clinical depression, it’s important to identify it, and here’s link to the checklist psychiatrists use to diagnose depression: Symptoms of Depression.

If you find yourself experiencing some combination of these symptoms for longer than two weeks, I’d urge you to consult a doctor, not only because clinical depression can be so debilitating and painful, but also because it does a number on your brain.

Research has shown that prolonged clinical depression interrupts neurogenisis (the birth of new brain cells) in the hippocampus, a key player in memory storage. When depression goes untreated it can lead to shrinkage in the hippocampus, which causes memory impairment. Severe depression can also reduce activity in the frontal cortex (the logical/decision-making mind).

Put simply, chronic depression causes brain damage. But before you panic, know that Prozac has been shown to stimulate the growth of new brain cells in the hippocampus, and antidepressants as a whole, appear to restore normal functioning in the frontal cortex. In short, much of the damage caused by clinical depression is reversible if the illness is properly treated.

If you do find that you’re suffering from clinical depression and are uncomfortable with the idea of artificially altering your brain chemistry, I’d suggest looking into cognitive behavioral therapy. To date, CBT is the only form of talk therapy to be clinically tested (although Nobel Laureate Eric Kandel and the Ellison Medical Foundation are in the process of studying the physical impact of other forms of talk therapy).

Studies have shown that, when effective, CBT also works to reverse the damage done by clinical depression. Emory University’s Helen Mayberg (Much Ado About Area 25) conducted a study that showed that “cognitive behavior therapy is associated with a characteristic pattern of metabolic changes in the frontal cortex, cingulate, and hippocampus.” (NeuroPsychiatryReviews) Put simply, this means CBT has the same results as antidepressants, though it works far more slowly.

All of which is a really round about way of getting to your central question: Why are there times when I can’t talk myself out of depression?

The simple answer is that clinical depression hijacks your logical mind. If negative thoughts predominate for too long a feedback loop is established between the thinking mind (or frontal cortex) and your fear center (the limbic system). Negative thoughts continually trigger a flood of stress chemicals in the limbic system; these chemicals, in turn, trigger more negative thoughts. Ultimately, the thinking mind becomes so overwhelmed with trying to process painful feelings, it can do little else--hence reduced activity in the frontal cortex.

Helen Mayberg thinks she has identified the brain malfunction that keeps depressives stuck in this self-perpetuating cycle: area 25. (Much Ado About Area 25) Mayberg suspects that area 25 is the highway connecting the logical mind with the “feeling” mind. Area 25 has been shown to be hyperactive when people are in the grips of clinical depression. What does this mean? Essentially it means that during a major depressive episode, the emotional floodgates are left open for too long. Depressives are continually assaulted by painful feelings even when there appears to be no rational explanation for them.

Thankfully, this process can be interrupted. Antidepressants seem to work by catalyzing the production of the chemicals associated with “good feelings.” This eventually results in an upsurge of “good thoughts,” effectively restoring normal functioning in the frontal cortex (and the hippocampus). CBT appears to cause similar changes.

Deciding whether to use drugs or talk therapy (or some combination thereof) to treat your depression is a very personal choice. Obviously, if the depression was catalyzed by external events it’s imperative that they be dealt with, and talk therapy is undoubtedly one of the most effective ways to do that. That said, severe depression can compromise our vision of ourselves and our lives, and using medication in conjunction with therapy has been shown to improve the odds of recovery.

Have a question for Neurontic? Email orlivan [at] gmail [dot] com.

Sunday's Silly Science Roundup

A collection of scientific findings that make you go "duh"--or simply "huh?"

It's been a banner week for sociologists people:

Penn State's Beth Montemurro, assistant professor of sociology, has accomplished something no one thought possible: she's turned watching stupid television into a respectable profession. After extensive "research," Montemurro has established beyond a shadow of a doubt that 'Bachelorette' viewers aren't seeking reality.

In other news, Sociologist Scott Yabiku of Arizona State University has "discovered" that "Lawns Make People Chatty." (Someone needs to check and see if this guy has ties to the landscaping industry.)

And, finally, Thomas Baker, of York University (in what I imagine must be a prime example of the old axiom "research is me-search") tells us that:

An ability to be open to new situations may predict intelligence earlier in life, but disagreeableness may predict intelligence later in life.
(From Personality Predictors Of Intelligence Change From Younger To Older Adulthood)


Much Ado About Area 25

An estimated 16 percent of the American population will suffer from major depressive disorder at some point during life. The disease strikes down nearly 19 million Americans each year, and it’s likely to happen more than once. A whopping 50 percent will experience an encore performance within two years of their initial depressive “episode,” and the stats get even worse after the second recurrence.

What does this mean? It means that if you’re wired for depression, you’ll likely spend most of your adult life on some form of antidepressant—a fate that many do not relish given the side effects and philosophical ramifications. And that’s discounting entirely the 30 percent of depression sufferers who get no relief from the current crop of antidepressants. All of which explains why breakthroughs in our understanding of depression make for such good headlines. Millions of Americans are waiting for a quick fix for depression and the media wants to give them good news.

The current superstar of depression research is area 25. (See The New York Times, Scientific American Mind, NPR—the list goes on and on.)Yes, I know. It doesn’t sound very sexy. But trust me, it is. Here’s why: if current findings prove correct, area 25 may one day be the key to curing depression. Not managing depression, or blunting depression, or masking depression – as many argue the current crops of drugs do – but curing it.

For those who don’t spend their time geeking out over breakthroughs in mental health, allow me to explain. After years of researching the mechanics of depression, Emory University Neurologist Helen Mayberg noticed something unusual. If you looked at fMRI scans of depressive’s brains next to scans of healthy people’s brains, the depressed people’s showed two things: reduced activity in the frontal cortex, and hyperactivity in an obscure section of the brain known as area 25. Mayberg grew curious, so she did some scans of depressed people pre- and post-treatment. As she predicted, once the patient’s medications took effect, normal frontal cortex activity was restored, and area 25 showed decreased activity.

Mayberg’s began to suspect that area 25 served as gateway of sorts--the bridge between the part of the brain responsible for negative rumination (the frontal cortex) and the seat of anxiety and fear (the limbic system). She wondered whether psychiatric drugs worked because they unintentionally reduced activity in area 25. To test her thesis, she decided to perform an experiment on 12 subjects whose chronic depression had stubbornly withstood drugs, talk therapy, and frequent bouts of electroconvulsive therapy.

The only way to test her theory was to bore two holes into the skulls of her subjects and insert electrodes directly into their brains—a stark reminder that neuroscience is still in its infancy. Yes, it sounds barbaric, but Mayberg’s hope was that delivering a small jolt of electricity to this site would effectively reboot it. And it looks like she was right. Eight of her 12 subjects experienced relief, some instantaneously. Their melancholy evaporated as if by magic and it has yet to return. A quick shock to area 25 appears to lower the gateway between negative thoughts and painful feelings, effectively eliminating both the emotional and physiological components of depression.

All of this is good news and certainly worthy of note. If area 25 proves to be the conductor of depressive thoughts, learning how to regulate it could eventually render SSRIs and the like obsolete. But when The New York Times Magazine runs a cover story called the "The Depression Switch?" people are likely to jump to the conclusion that a cure for depression is just around the corner. And this is patently untrue. Even if Mayberg’s theory is born out in future studies, the average depression sufferer will have to wait years to reap the benefits.

Why? Because, at present, the only way to target area 25 is through invasive brain surgery. And, let’s face it, few among us would be willing to let a neurologist drill a hole in our heads and feed wires directly into our brains. Even if you were game, the odds of being admitted into one of Mayberg’s studies are very, very slight. So, the vast majority of depression sufferers will have to bide their time and wait for a drug capable of:

1) Overcoming the blood brain barrier, and
2) Effectively regulating activity in area 25.

To say that this is a Herculean task is a huge understatement. Right now, the only way scientists have found to breech the blood brain barrier (the barricade between the blood stream and the brain) is to design drugs that act like carpet bombs. SSRIs, for example, work by bathing the brain in serotonin. This has proven effective in alleviating depression in many people, but it also impacts the functioning of systems better left untouched (i.e., the dopamine pathways that control libido).

A drug capable of making a beeline for area 25 is going to be a long time coming. So while Mayberg’s findings offer hope to many, they won’t deliver relief for years to come.

**Virtual Endnote: I don’t mean to be a Gloomy Gus. Here’s some good news. There are more than 40 new antidepressants/anti-anxiety medications in development, a few of which are scheduled for release over the next 2-3 years. Many of these appear to have fewer sexual and physiological side effects than SSRIs. Neurontic will run a short piece on some of the most promising candidates at a future date.


How We Rate Phantom Spaghetti

Okay, clearly Neurontic does not attract the carb-averse. Spaghetti was pretty high up on everyone's list. Answers ranged from a respectable '6' to a lip-smacking '10.'

I contacted a few of you to get the specs on your dinners and here's what I learned:

Yez, a reader after my own heart, gave the meal a perfect '10' and described it as follows:

I'm in a small family style restaurant in Italy. The pasta is something like linguini, and it is absolutely fresh. There is a really simple sauce that goes perfectly with the pasta, delicious veggies on the side and the heavenly Italian bread.
Jen R., Neurontic's favorite culinary student, felt her phantom spaghetti warranted a solid '8,' and said:

It would be marinara w/ fresh basil, onions and mushrooms, plus meatballs - topped with fresh grated Parm. The pasta would be bucatini - which is basically a hollow spaghetti. Ciabatta garlic bread, salad, wine; something simple for dessert. I'm at home, with friends coming over and we would probably eat around 8pm.
Geoff, who apparently isn't quite as noodle-obsessed as the rest of us, rated his dinner at '6,' and said:

"It would be a nice, hearty bolognese, with lamb and pork, mushrooms and lots of garlic."
Okay, so I think we can all agree that those three options sound scrumptious. Neurontic would personally be happy to join you for any or all of the above. But here's the thing, science is cruel. And for the purposes of this experiment, the spaghetti dinner would be somewhat less pleasant.

Your spaghetti would, in fact, be served cold -- in a tin can -- on the curb of dilapidated car park under an overpass in industrial Brooklyn. No sauce or condiments would be provided and several men with a penchant for cardboard box houses and screw-top wine would be your dinner companions. It would also be extremely soggy.

Now, I'd be willing to bet good money that you'd adjust your rating to about a '-1', given the chance. But it's too late. You can't, which is Gilbert's whole point: We make predictions about the level of satisfaction future events will give us based on very little information--and, more often than not, we're wrong.

Why? Because our imaginations are constantly in overdrive. We hear the word spaghetti and our mind's instantaneously sort through a vast storehouse of data about pasta and conjure up a scene that is likely to result in satisfaction. But this fantasy is assembled based on our past pasta experiences, not on our future pasta reality. When you rated your spaghetti dinner, you assumed two things:

a) That it would look a lot like previously enjoyed pasta dinners, and
b) That it would be fantastic.
The thrust of Gilbert's argument is that by investing too much faith in our imaginations we often overestimate the level of satisfaction that the future will bring. Conversely, when we paint a mental picture of something that evokes negative associations, like a public speaking engagment, our imagination lures us into assuming the worst. If public speaking has been filed in the "avoid" category, our brains will manufacture images of humiliation and mute panic.

In reality, our spaghetti dinner will likely be marginally less satisfying than expected (though likely not as awful as the one I described) and our speech will be less cringe worthy. The moral of the story: Don't confuse the future with the past.

I love this exercise because it reminds me just what a powerful tool the imagination is. As Gilbert says of his phantom spaghetti experiment:

Whatever you imagined, it's a pretty good bet that when I said spaghetti, you didn't have an unrequited urge to interrogate me about the nuances of sauce and locale before envisioning a single noodle. Instead, your brain behaved like a portrait artist commissioned to produce a full-color oil from a rough charcoal sketch, filling in all the details that were absent from my question and serving you a particular heaping helping of imaginary pasta.
(Stumbling on Happiness, 90)

The imagination may mislead us on occasion, but that makes it no less miraculous. Scientists are in the habit of saying the thing that separates human beings from the "lower" animals is langauge. If I were the one in charge of making grand proclamations, I'd say the truly singular thing about human beings is the ability to imagine.


Thought Experiment

I'd like to replicate an experiment I recently read about in Harvard Psychologist Daniel Gilbert's new book Stumbling On Happiness, a philosophical tract masquerading as a self-help book.

Despite residing in the nose bleed section of the ivory tower, Gilbert is a lucid, common-sense thinker with some truly worthwhile insights regarding the human temperament. We'll delve into some of them at a later date. In the meantime, I wanted to give you a taste of the kind of "AHA" moments the book delivers.

Here's what you have to do:
1) Imagine you're going to have a spaghetti dinner tomorrow night.
2) Now try to predict how much satisfaction you'll get from this dinner and rate it on a scale of 1-10.
3) Post your answers in the comment box.

I'll be contacting posters over the next couple of days with a follow up question.

Unless no one posts--in which case,you will be left entirely in the dark with your phantom spaghetti.


Sunday’s Silly Science Roundup

A new Neurontic feature, Sunday’s Silly Science Roundup showcases scientific findings that make you go “duh."

After spending a great deal of time and money, a group of researchers at University College London are willing to go out on a limb and say "Irrational Decisions are Based on Emotion."

Hellbent on convincing the two remaining skeptics in the developed world, scientists from Dana-Farber Cancer Institute conducted a long-term study proving that “TV Watching Lowers Physical Activity.”

This just in from the great minds at the Montreal Neurological Institute: “Anticipation Heightens Smoker’s Desire.” Man! Next they’ll be telling us that dieting makes you crave fatty foods.

Did I miss your favorite? Send it to orlivan@gmail.com.