[HN Gopher] Robert Sapolsky on Depression (2009)
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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.
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