[HN Gopher] Robert Sapolsky on Depression (2009) ___________________________________________________________________ Robert Sapolsky on Depression (2009) Author : Tomte Score : 50 points Date : 2021-09-01 05:57 UTC (4 hours ago) (HTM) web link (www.robertsapolskyrocks.com) (TXT) w3m dump (www.robertsapolskyrocks.com) | CretinDesAlpes wrote: | This 2018 talk from Dr Yapko, "Keys to unlock depression: Why | skills work better than pills" - | https://www.youtube.com/watch?v=TVgQ_tgWMyU - suggests a | multidimensional viewpoint rather than purely biological. He says | the causes are: | | 1. Biological. He says "Yes, biology matters, but surprisingly | not as much as you would think, that when we look at what's | termed genetic variance, how much do genes play a role in | depression? Is there a depression gene? No. Are there genes that | make people vulnerable to depression? Definitely. So if we look | at biochemistry, yes it's a factor. If we look at disease | processes, there are many diseases where depression is a | predictable consequence. If we look at drugs, there are many | drugs that have depression as a predictable side effect. Biology | matters, but when we look at genetic variance, that figure is | between .3 and .4. That represents a mild, moderate at best, | genetic influence." | | 2. Psychological. In particular what is known as | "Attributional/Explanatory style" | (https://en.wikipedia.org/wiki/Explanatory_style), i.e. the | person's habitual or reflexive way of attaching meaning to life | events. He says "It isn't what happens to people that increases | their risk for depression so much as how they interpret and | respond to what happens to them." | | 3. Social | | At the end, he says "the goal is not to cure depression, the goal | is to learn how to manage your mood. You don't exercise once and | now you're done with the exercise thing." | codetrotter wrote: | > In particular what is known as "Attributional/Explanatory | style" (https://en.wikipedia.org/wiki/Explanatory_style) | | Thanks for the link! I've been thinking quite often about these | things for the past couple of years, having observed similar | differences between people I've interacted with, but never knew | that there was a name for it. Nice to know. | | My own pet theory is that the experiences and our surroundings | affect us a lot more than we may think. | | And it is also a useful reminder for myself, as for years now I | have tended to be rather harsh against myself at times, and to | look negatively on the future and on what is possible, based on | really a small set of bad experiences, some of them recent and | some of them earlier in my life. | | It's difficult a lot of the time, to stay positive. And for the | past couple of months I've been going through what I am pretty | sure qualifies as burnout. And during this time I've also | increasingly thought negatively about myself. | | And I think the end of your comment, where you bring up a quote | "the goal is not to cure depression, the goal is to learn how | to manage your mood. You don't exercise once and now you're | done with the exercise thing." is also probably key. | deskglass wrote: | After enjoying Sapolsky's lectures on YouTube (including this | one) I began reading his book Behave. I was surprised to see that | it refers to theories that fail to replicate (eg priming) as if | they were solid theories. Stuart Richie (a psychologist who wrote | a book on the replication crisis) enumerates other examples in | his review https://www.spectator.co.uk/article/rules-of- | behaviour/ | | Please be wary of this failure to drop unreplicated findings when | reading Sapolsky's works. | aritmo wrote: | I wouldn't give too much importance to Stuart Ritchie. He is | right-wing and conservative, and conservatives hate Sapolsky. | Ritchie's political views are evident in his book. | cung wrote: | The chemicalization, medicalization and commercialization of | depression is a dead end. While the chemical imbalances might be | real, the symptoms are due to actual situations in your life. | Treating the symptoms with drugs is a pretend solution that only | works because it is often the first step people take to actually | better their life. | Broken_Hippo wrote: | " it is often the first step people take to actually better | their life." | | What makes you think this - and what makes you think that so | many folks have so much agency in their life? A lot of folks | don't, and if you have depression, you generally have even less | of it because you wind up with an inability to see options you | do have... if any. | | It isn't like everyone can escape poverty or a bad spouse (it | takes money to divorce someone or even leave if you need to get | your own place). It isn't like anyone can magically make a | disease diagnosis go away nor does changing jobs always fix | things, especially if the reason you stay is because you | desperately need the health insurance or because no where else | pays as much in your area (and moving costs money). | | We don't make sure folks have tools to improve their life. | | Additionally, this really just blames the victim and I really | hope you don't say this to folks actually suffering. | pjerem wrote: | I 100% agree with your post but i'd like to add something | about this : | | > It isn't like everyone can escape poverty or a bad spouse | | You are right and medicalization is useful to overcome this. | But there is a real risk, as a society, that we find it | normal to treat the depression induced by those issues, | rather than the issues themselves. We should treat poverty | and work towards making divorce less painful rather than | thinking medication allows a status-quo. | | But that's another topic on its own and absolutely not a | counter argument of your answer. | bayesian_horse wrote: | Poverty and spousal abuse aren't actually statistically | significant causes for depression. | | You seem to labor under the fallacy to think that anti- | depressants are some kind of lifestyle drugs that generally | improve mood or tolerance of adversity. They don't. | bayesian_horse wrote: | That is a wrong and damaging statement. You are ignoring the | reality of depression as a disease. It has been shown that | depression, in the medical definition, is often not caused by | situations in the patient's life. | | Thus it is equally foolish to believe, the patients could | "better their life" and thereby alleviate depression. Somehow | assuming the symptoms of depression actually allow any of that. | Hard to improve your life if you can barely get out of bed. | | Your comment is the exact kind of stigmatizing, patient-blaming | and "just stop being depressed" bullshit that hasn't worked for | centuries and contributes to the problem. | OJFord wrote: | I don't necessarily agree with GP, but I think your comment | is the worst-possible reading of it, as in taking it in the | worst light. | | > stigmatizing, patient-blaming and "just stop being | depressed" | | is coming from | | > the symptoms are due to actual situations in your life | | ? Isn't that the opposite, GP is saying _yes it is real_ , | but arguing that the drugs are like spraying air freshener in | a room that still contains the source of the stink? | | Again, not saying I agree, I just didn't read it as | stigmatising or 'just stop' at all. | Honga wrote: | Would you have any sources to back this up? Seems like a big | claim to go against standard practice. | | I suffer from chronic episodic depression. But my life is | objectively great and fulfilling. Are you saying that I should | not be at peace with my lifestyle? Or that my depression is a | nurture rather than nature type issue? | | I'm both triggered and curious to hear your thoughts. | pjerem wrote: | I don't agree with you about the << dead end >> of | medicalization. | | Medicalization really help you to break the circle. It | temporarily treats the symptoms and allows you a timeframe | where you can work towards the origin of your issues. And if | for some reason, you can't, it at least helps you live a more | supportable life. | | Here we are in a mental disease but you can easily make an | analogy with any disease. If you need re-education after an | accident that broke something, the first step is generally to | treat the symptoms that could block you to achieve re- | education. | | As an example, my dad completely lost its equilibrium after a | brain stroke. Re-education was long and hard, eventually | succeeded, but would have been totally impossible without | medication against nausea, which you constantly get when your | equilibrium system is failing. | | And I would add that, AFAIK, some forms of depressions are | purely chemical issues. And it isn't surprising. There exists | tons of diseases that are chemical issues. | OJFord wrote: | Is it not contradictory to say it's a 'dead end', and also | (only) 'works because it is often _the first step_ people take | to actually better their life '? (emphasis mine) | | I don't have strong feelings either way (and basically will | just do what a doctor tells me to do as long as I somewhat | understand it seems to make sense) but I've vouched (not voted) | for the parent comment because I think there's already the | beginning of interesting discussion here; people can (have) | disagree(d), but there's not really a reason to flag it IMO. | himinlomax wrote: | This is complete nonsense as well as damaging for people who | suffer from depression and who would believe your nonsense | instead of seeking science-based help. | frereubu wrote: | You can split definitions of depression in a number of ways, | but one that's been around for a _long_ time is exogenous | (external causes) and endogenous (internal causes). The idea | that symptoms are only due to life situations is simplistic and | wrong. | | This feels a bit like the straw man arguments about economics | only treating people as rational actors, whereas economists | have been aware of the issues with that for decades. | gatestone wrote: | The conflict between the external world and your inner self | (psychology, neurology,nurture) is a situational problem, not | so much medical. | | You don't have to seek blame, not from outside or inside in | your self. But you can look for a solution in changing either | or both. | gatestone wrote: | You may be an exceptional character: very dumb or smart; | maybe too sensitive of too unemphatic; on some strange | neurodiversity spectrum; maybe you was raised by a bit too | personal parents; maybe you adopted radical or odd | ideologies etc., ad infinitum | | Or you may live in an exceptional external situation. It | can be good (you are a rock star) or bad (many). | | Either way, either case or a bad mix of internal and | external may wear you out in the long run, and you stop | functioning, you burn out, you become depressed. | haxiomic wrote: | Depression is a symptom that can be the result of a multitude | of physiological causes and not always psychological. One could | induce the effects of serious depression in a person through | gene therapy, specific nutritional deficiency, certain drugs, | for example. | | It can be hard to understand the cause for each person, and I | do believe strongly we currently under-treat and under- | investigate depression and it's sources in people | | The arguments put forward in the article and video are good and | do a better job than I could at explaining what we know about | depression | s5300 wrote: | The entire article is pretty spot on, experience wise at least | (can't comment on the chemistry of it) | | However | | > Inside the body is going through a massive stress response that | is similar to what your body would be doing if you were fleeing | an armed assailant. All the time. | | This right here... is important, and something I don't think most | are aware of. It's also something I don't think one can fully | understand without having experienced it. | | I have been mugged at gunpoint/knifepoint and also had bullets | fired in my direction in an attempted carjacking (thank you | downtown St. Louis) at an earlier time in my life. The fight or | flight reflex was definitely about as strong as you might imagine | it would/should be in that situation, perhaps slighty dampened by | a hobby that required a lot of situational awareness/vigilance. | | Cue coming down with a pretty severe chronic physical illness a | couple years later and no financial means nor support to fully | deal with it (fuck Vascular Ehlers Danlos and Thoracic Outlet | Syndrome) - obviously, some severe depression comes with the | hopelessness of things like this. The fight or flight reflex... | just, came on as symptoms became severe. It was quite noticable | and fluctuated in severity the first month or so, but soon became | an all encompassing baseline normal... now going on for years. | | Simply put, figuratively, I could walk straight up to somebody | shooting at me and touch them on the face without any fear/monkey | brain instinct to save my life. Literally, I would likely be | quickly dead because bullets do that to you and it's not hard to | hit somebody walking straight up to you. I really do not mean | this in a suicidal sense whatsoever, just the fact that there is | absolutely no further stress response from any situation I may | find myself in, no matter how dangerous (well, I haven't been | plastered in easily visible US military gear in the middle of | Afghanistan with people shooting at me, so perhaps I may be | slightly too full of myself). | | But, the stress response one would normally get that invokes the | fear and adrenaline to run away from imminent dangers, it | essentially no longer suddenly happens, as it's just been a part | of daily life for so long. I can't walk down a busy street | without the instant mental registration of where every sound I'm | able to hear is coming from. Basically, extreme hypervigilance. | It is outright extremely exhausting, and once in a blue moon | slightly convenient (like when not having realized the bar you're | coming out of at 2am is less than a block from Skid Row and | you've got quite a walk to get where you're headed). | | I wish more people were aware of this aspect of this mental | illness, and I very much hope that there's not a point of no | return from it. Something makes me think that there has to be | though - whether that's years, or decades of the non-stop fight | or flight stressor, and perhaps dependent on what portion of your | development you experience it in. ___________________________________________________________________ (page generated 2021-09-01 10:00 UTC)