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Toward a Predictive Theory of Depression

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Re: Toward a Predictive Theory of Depression

#101

Post by girvo »

tcj_phx wrote: post #92
HerrFolgreich wrote: post #88

Earlier quoted context omitted.

Would you mind to elaborate a little bit on your suggestions? That is if it's not too specific.

The only thing that fellow could really do for himself was buy some coconut oil. The brains of alcoholics become insulin-resistant and switch to running on acetate, one of the breakdown products of ethanol. The medium-chain-triglycerides in coconut oil provide brain cells with an alternate source of fuel. (I understand that Coconut fatty acids are short enough to be burned without having to go through another step th…

I was a heroin addict for 6 years, and have been clean for 5. The sweets thing was very true for most addicts I knew as well as myself: in withdrawals I’d crave sugar something fierce. Gummy bears would temporarily make me feel better. It was interesting.

Re: Toward a Predictive Theory of Depression

#102

Post by girvo »

trapperkeeper74 wrote: post #18
Klockan wrote: post #10

Earlier quoted context omitted.

> exercise, acupuncture, aromatherapy, drugs, meditation, float tanks, social interaction, music, intensely flavored foods, cold therapy, saunas, electroshock therapy, etc. None of those are guaranteed to work though, a significant number of depressed people never gets over it and it wouldn't be that way if we knew effective treatment methods.

The current answer is we don’t yet have full functional pathologies of types of depression, noninvasive, specific mood disorders classified down to exact neurological dysfunctions, accurate and precise knowledge of how existing antidepressants work and evidenced-based application of particular therapies based on such scientifically-identified presentations. Clinical psychiatry has been mostly a scattergun, guesswork…

Sublingual ketamine has worked well for my girlfriends depression. Dissolved into water at 30mg/mL, she takes 1mL every three to four weeks. A threshold dose, the dissasociative effects are rather weak there, but the antidepressant effects are rather rapid and work wonders for her.

If you’re in the US, I believe you can go to clinics and have it administered by a doctor which is safer.

Re: Toward a Predictive Theory of Depression

#103

Post by icc97 »

I typically have odd thoughts that are often wrong. But I really like quote from 'The Martian', "let's science the shit out of it".

I don't know if it's possible to science your way out of depression. If in some way the curiosity gives a small enough lift to keep you getting one foot in front of the other and learning about what's causing your depression.

It at least seems relatively risk free way of tackling depression. Learn about the beast and track what you do and what changes your mood.

But is this something you can tell people that are seriously depressed or is it just another useless bit of advice?

Re: Toward a Predictive Theory of Depression

#106

Post by quantumhobbit »

empath75 wrote: post #100
cassowary37 wrote: post #65

Professor of psychiatry here - I've spent the past 20 years trying to help folks with depression, and related illnesses, and trying to study these diseases at a genetic level. I suspect this will get me down-voted as I know the medical/biological perspective is often unwelcome on hn. However: a key error people make here and elsewhere in speculating about depression (and suicide, and ADHD, and...) is either extrapola…

I’ve never been sure why it’s treated as a disease rather than a symptom. It’s like saying someone with a high temperature is suffering from fever. Which is nice and descriptive and treatable with the right medications, but does nothing to describe the underlying cause.

Lots of what we now consider symptoms were thought of as diseases until the underlying problem was better understood. It wasn’t that long ago that your fever example was how people thought. The fever was the disease regardless of the unknown underlying cause.

That depression is considered a disease by itself and not a symptom of many, possibly related, problems suggests how little we understand it.

Re: Toward a Predictive Theory of Depression

#107

Post by quantumhobbit »

roflc0ptic wrote: post #83
cassowary37 wrote: post #68

Earlier quoted context omitted.

Yes. This is one reason I bothered to comment. Psychiatrists who step into the public space bear a particular obligation both to advocate for our patients and to push back against misinformation.

The article is prefaced with: "Epistemic status: wild speculation." It seems like we rather do need more theorizing, because we don't currently have a theoretical description of depression that leads us to solutions. I know I've also seen him write about the possibility that depression is a set of interrelated diseases that look the same, and talked frankly about the inefficacy of treatments. It's a fairly ungenerous…

He highlights the speculative nature of the theory quite frequently within the article. It would take pretty poor reading comprehension or deliberate misreading to conclude that he was presenting established scientific facts.

Re: Toward a Predictive Theory of Depression

#108

Post by throwaway197812 »

eradicatethots wrote: post #91
davymac wrote: post #87

Earlier quoted context omitted.

Fair point. I like this view. Seeing all the anecdotal ways people have gotten themselves out of severe episodes may not work for the person seeking help, but it may give them enough hope to keep looking for the next approach before calling it quits for good.

Don’t really think there are that many. The vast majority are some form of “work out, eat healthy, ...”

I agree. It's clear from this thread (and it fits with my experience as well) that the usual advice only goes so far, and for obvious reasons: if I had enough energy, motivation, and discipline to work out, eat healthy, meditate, whatever -- all the standard advice for lifting my mood -- I wouldn't be depressed!

I've been wondering lately if there isn't a model of care that goes beyond just a psychiatrist (to prescribe the meds) and a therapist (to administer therapy along with the standard advice about exercise and eating well). Something more like a "nanny" or a caretaker who could help the patient with those things: bug the patient daily to make sure they're taking their meds (and/or supplements, if you're going that route); buy and cook that nice healthy food; get you out of the house and into the gym; etc. Something more than just seeing a therapist once a week, but less intensive than any form of institutional care (even on an outpatient basis).

Asking for a friend... :(

Re: Toward a Predictive Theory of Depression

#109

Post by SilasX »

Avshalom wrote: post #94
roflc0ptic wrote: post #83

Earlier quoted context omitted.

The article is prefaced with: "Epistemic status: wild speculation." It seems like we rather do need more theorizing, because we don't currently have a theoretical description of depression that leads us to solutions. I know I've also seen him write about the possibility that depression is a set of interrelated diseases that look the same, and talked frankly about the inefficacy of treatments. It's a fairly ungenerous…

>> Do oncologists need to talk about how bad cancer is every time that they write about it in a public space? Eh. They would if a surprisingly large portion of the public believed cancer didn't actually exist.

"How dare you allow your malignant cells to unboundedly replicate! What would your mother say?"

Re: Toward a Predictive Theory of Depression

#110

Post by defined »

icc97 wrote: post #103

I typically have odd thoughts that are often wrong. But I really like quote from 'The Martian', "let's science the shit out of it". I don't know if it's possible to science your way out of depression. If in some way the curiosity gives a small enough lift to keep you getting one foot in front of the other and learning about what's causing your depression. It at least seems relatively risk free way of tackling depress…

> But is this something you can tell people that are seriously depressed or is it just another useless bit of advice?

From my point of view, it's not useful advice, partly because severe depression utterly saps the motivation to do virtually anything, and partly because depression is highly resistant to rationality.

Mandatory references to "Hyperbole and a Half"[1][2].

[1]: http://hyperboleandahalf.blogspot.com/2011/10/adventures-in-...

[2]: http://hyperboleandahalf.blogspot.com/2013/05/depression-par...

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