Drugs and Depression


The most gripping portions of Let Them Eat Prozac [by David Healy] narrate courtroom battles in which Big Pharma’s lawyers, parrying negligence suits by the bereaved, took this line of doubletalk to its limit by explaining SSRI-induced stabbings, shootings, and self-hangings by formerly peaceable individuals as manifestations of not-yet-subdued depression.

Yeah. From an excellent book review. The author of the review, an English professor, doesn’t understand methodology, but the facts are nicely presented. I assigned some of Healy’s book to my students. Healy did experiments that showed that Prozac caused suicidal thinking in a non-trivial fraction of ordinary people.

Blood Donation, Weight Loss, and Humor

At the Shangri-La Diet forums, karky, who has lost 75 pounds on SLD, wrote:

In July I experienced a plateau, and wrestled with the same 5 lbs all month. At the end of July, I donated a pint of blood. WooHoo! Weight loss is back! I think to myself, hmmm… coincidence. In November, another plateau, wrestling with 3 lbs. I donated a pint of blood Monday. Today is Wednesday, I have lost 5 lbs since Monday, 3 lbs Tuesday morning, 2 lbs this morning.

Chrianna replied:

you certainly make a good argument for donating blood!

Which made me chuckle.

I cannot come anywhere near explaining karky’s observation. But maybe I can explain — someday, not right now — why Chrianna’s reply amused me. I once wrote down about 50 laugh-inducing sentences I heard on the the sitcom Cheers, looking for patterns. Several were obvious. For example, many of the laugh-inducing sentences were insults. Maybe I should resume this quest.

It is a good way to pass the time. A few days ago, I heard the following on a Chevrolet radio ad:

Male voice: With Pilates, three kids, and a house full of laundry, Diana is too busy to think about fuel economy.

Female voice: I’m sorry. Did somebody say something?

Funny! I was driving. I turned off the radio and thought about it for the rest of the trip. What’s the rule? What general pattern is it an instance of? I couldn’t figure it out. I’m not the only one interested in this question. In an interview I can no longer find, Robert Mankoff, cartoon editor of The New Yorker, said he wanted to write a scientific paper about the patterns he saw in New Yorker cartoon caption contest submissions. Which reminds me: I have written about patterns in New Yorker cartoon captions and talk-show monologue jokes.

Too Skeptical = ?

Paul Meehl, a famous clinical-psychology researcher, once said that when he was a student he was taught “the general scientific commitment not to be fooled and not to fool anyone else.” Yes, the. I’ve heard a dozen variations of this: “In graduate school I learned to think critically,” for example. How weirdly unbalanced. Isn’t it just as important — or more important — to figure out what can be learned from evidence? Not just what can’t?

The bias shows up in language. Skeptical is good, credulous is bad. There is no word that means too skeptical, no word that means under-credulous, no word that means the right amount of credulous.

When I hear comments like Meehl’s — when someone says “correlation does not equal causation,” for example, and does not stop to wonder what can be learned from the particular correlation being discussed — I think: You’re only using half your brain.

A Better Way to Do SLD?

The most interesting recent posts on the Shangri-La Diet forums have been from Roger Garrett (id Fastneasy), who has come up with what seems to be an especially potent version of the diet: He has a three-hour food window every day that starts when he eats his first meal; the rest of the day, he drinks sugar water and doesn’t eat anything else. He takes weekends off.

He’s 36 years old. Starting weight: 269 pounds. After about a month, he writes, “I’ve lost 24 pounds so far. This has been incredibly easy! No hunger, no struggle, and tons of energy.” He did almost the same thing eight years ago with one difference: no sugar water.

The difference between then and now is [now] I’m shedding the fat at three times the speed and with no anguish and fatigue that’s associated with the fasting. I’m not hungry, my stomach doesn’t growl. I have tons of energy and feel great in the morning. Also the funny thing, after waking in the morning after fasting for 21 hours, I’m not starving. I remember with the fast before I would wake in the night stomach growling and ready to eat. When I would wake up, I could kill to eat.

The David Lawrence Effect

Two days ago I was on the David Lawrence Show, which Mr. Lawrence produces in his own apartment, in Burbank. This was the second time; the first was in June. The show lasts three hours and consists of three interviews. Between my first and second appearances on his show, Mr. Lawrence stopped doing regular shows to concentrate on acting. He now does new shows now and then.

During my second appearance, he told me that radio was going downhill even faster than network television. That may be, I said, but your show had a much bigger impact on interest in my diet than almost any other interview I’d done, TV or radio — and I’d done about 50. He was surprised. Really, I said, I’ll make a graph and send you a copy. Later he asked me to compare his show to the other radio shows I’d been on — what was the percentage difference between the impact of my show and the other shows, he wondered. “2000%” I said. “20 times?” he said. Yeah, I said, maybe even 50 times. He looked surprised.

Here is the data.

graph showing the David Lawrence effect

This shows the maximum number of people reading the Shangri-La Diet forums at any one time for each day. (This is an easy-to-compute proxy for the number of distinct visitors.) The first media to have a big effect was a 35-minute interview on the Dennis Prager Show, which was replayed twice. The next was a Woman’s World article. The third was the first David Lawrence Show interview.

It is stunning that the David Lawrence Effect was of the same order of magnitude the effect of the Woman’s World article. Woman’s World, of course,is a huge operation, with millions of copies sold each week.

After the David Lawrence effect wore off, the function continued its steady climb at roughly the level you would extrapolate from before the DL effect started. My interpretation is this: As persuasive as that show turned out to be, and as large its audience — its effect was small compared to the total effect of word of mouth, which is what is pushing interest up.

Omega-3: What Happens When You Stop?

Anonymous wrote again, with new data:

I started taking two tablespoons of flax seed oil about a month after reading this post by you [about Tyler Cowen’s dental experience] (sometime around the beginning of August, I think). I decided to try it because I have had bleeding gums for about as long as I can remember. This has always confused me, because I don’t have any cavities and have otherwise good dental health. I would always ask my dentists about this, and they would always tell me I didn’t floss enough, but even when I would floss regularly, the bleeding wouldn’t totally stop. After about a week or so of two tablespoons of flax seed oil a day, I had virtually no gum bleeding. I didn’t change anything else.

Then, about two weeks ago, my girlfriend pointed something out to me: I was not taking pain relievers anymore. I train in amateur mixed martial arts (MMA), which is a very intense, full contact combat sport that combines boxing, muay thai, brazilian jiu-jitsu, and wrestling. For as long as I’ve been training in it, I have had to deal with muscle soreness and pain in my joints, and to deal with it, I would take 4-6 ibuprofen before training. But, for about the past three months, I wasn’t in enough pain to need it. I didn’t really think about it at first, just chalking it up to getting tougher. But that doesn’t make sense–I’ve been training in MMA for well over a year, and the only thing I have done differently in the past three months is start taking flax seed oil. I wasn’t 100% sure that the flax seed oil was making the difference, but considering the effect it has on inflammation–which is what ibuprofen is for–it made sense.

That was when I sent you the emails you posted. One of your commenters accused me of falling victim to the placebo effect, so I decided to test it. I stopped taking flaxseed oil on November 5th. At the time, my gums were not bleeding, I had no joint pain or soreness of any significance, and I felt great overall.

As I write this it’s November 15th. My gums have bled heavily when I brushed this week, especially the past few days, and I have intense pain in both shoulders, soreness in my left elbow, and my knees are throbbing. I had intended to go two weeks without taking any flaxseed oil, but I am stopping the experiment now because this is all the proof I need.

One more interesting fact: I took four tablespoons a few hours ago, instead of the regular two, thinking that maybe I could load up and it might help me get back to normal quickly. The pain is pretty much the same, and I just brushed and my gums bled, so obviously the flaxseed oil takes more than a few hours to affect those problems. But–and I haven’t measured this with reaction tests like you do–I feel considerably more mentally alert right now. I don’t know if I felt like this before, and maybe I didn’t notice it because it came on slowly, or maybe I need four tablespoons at once to see a difference, but I really do feel the difference.

My Theory of Human Evolution (Make edition)

The path to human nature, I propose, began with capable hands. No surprise there. In our brains formed a desire for hobbies, to take advantage of what our hands allowed. Hobbies were the first step toward occupational specialization, which led to the full flowering of human nature (trading, language, procrastination, art, holidays, rituals, fine wine, fashion, Veblen’s Instinct of Workmanship, etc.).

The Hobbyist Within Us is especially clear in the pages of Make, a young magazine devoted to higher-tech DIY. Turn your old scanner into a camera. Make a Joule thief. It started as a website, which was so successful that a print version was launched. More recently, Maker Faires have started.

Thanks to Niall Kennedy, who has written for Make.

My Theory of Human Evolution (the Henry Rosenthal Pennant Collection)

Henry Rosenthal, the San-Francisco-based producer of the documentary The Devil and Daniel Johnston (the best movie ever made about mental illness), has a large collection of pennants. No sports teams, no schools, only North America — those are the rules. Hundreds of pennants. Most are for places (Mexico, the Grand Canyon, San Francisco). A few are for events (a Chicago trade show). “I’ve been collecting since early childhood,” Henry told me. “I made two pennants myself years ago, one for Joseph Albers and the other for Robert Rauschenberg.”

For years I wondered why people collect. By collect, I mean collect gift-like objects, such as frog figurines or erasers with pictures or stamps or refrigerator magnets or pennants. I understood it was enjoyable — you derive pleasure from your collection. It was the evolutionary reason I couldn’t figure out. When I eventually thought of my theory of human evolution — it is all about the growth and encouragement of occupational specialization — I realized this was one of the puzzles it solved.

Will Henry pay more than the average person for new and well-made pennants? Very likely. Will he appreciate an especially well-made pennant more than the rest of us? Undoubtedly. Like most collectors, Henry has placed the items of his collection side by side, making it easy to compare them and, I believe, promoting connoisseurship. Studying his collection — covering the walls and hanging from the ceiling of a large room — made me a connoisseur of pennants.

Collections increase the demand for finely-made things, helping their makers make a living and advance the state of their art, whatever it might be. that people collect all sorts of finely-made things encourages the growth of a wide range of technologies.

Incidentally, Henry is currently working on a movie about Tiny Tim. If you can’t wait for the movie, you can read a book it will be based on.