Category: mood disorders

Our Need for Morning Faces: Does Isolation Cause Delusions?

Seth Roberts7 Comments

In 1995, I discovered that seeing faces in the morning raised my mood the next day. For example, seeing faces Monday morning improved my mood on Tuesday (but not Monday). Study of the effect suggested we have a face-sensitive oscillator that controls mood and sleep. The oscillator needs morning-face exposure to work properly — faces “push” the oscillator as you would push a swing. Long ago, this oscillator synchronized the mood and sleep of people who lived together. The synchronization helped them cooperate. It is much easier to work with a happy person than an unhappy person and, of course, much easier to work with someone awake than someone asleep.

My results suggested you need to see morning faces on the order of 30 minutes to get a big effect. The faces need to be similar to what you’d see in a conversation. Looking at people on the subway doesn’t count. Nowadays, as far as I can tell, hardly anyone gets the right input. In extreme cases, this causes depression, poor sleep, bipolar disorder, and anxiety disorders. What else might it cause?

A friend, whom I’ll call Ben, recently told me something that sheds light on this. Three years ago he was a graduate student at Columbia. He lived in a basement apartment, with no sunlight. It was between semesters. He had no regular contact with anyone. He was depressed. Then things got worse: He became delusional. He started thinking that every conversation he heard was about him. “Everything I heard or saw was directed at me,” he said. There was a boiler in the room next to his apartment. He believed it was a nuclear reactor.

Although Ben was isolated in terms of seeing other people, he had non-visual contact with people online. He told them about his strange thoughts. Some thought he had a problem, some didn’t. Some thought he sounded mystical. He felt physical discomfort — a “pulling inside”. His heart seemed to be beating differently. He called his parents. They were so alarmed that they contacted someone they knew in New York. Eventually an ambulance arrived at Ben’s apartment and took him to a mental hospital. At the hospital, he told them he thought he was dead. After a day or so at the hospital, on a locked ward, he felt much better. However, he wasn’t allowed to leave for two weeks because the doctors didn’t know what was wrong with him.

After leaving the hospital he took a break from graduate school and went to stay with his parents. He saw a psychiatrist and was prescribed Risperdal (an antipsychotic) and Depakote (for mania).

The pattern is okay during semester (when he sees others on campus), sick between semesters (when he doesn’t see others), okay in locked ward (when he sees others). Bipolar disorder sometimes includes delusions during mania, so the association of disordered internal rhythms and delusions is not new. But why should disordered internal rhythms cause delusions — in this case, paranoid ones? One possibility is that it is beneficial to be paranoid in the middle of the night. If someone wakes you up, you will wake up thinking they tried to wake you up, which will make you especially mad. The madder you are, the less likely they will do it again. I argued that the irritability associated with depression is beneficial in the middle of the night for just this reason: It protects sleep. If someone wakes you up you will get mad at them. This explanation predicts a circadian rhythm in paranoia, increasing in the evening. However, I’m not sure this explains why he thought a boiler in the next room was a nuclear reactor.

 

 

 

Stagnation in Psychiatry

Seth Roberts6 Comments

A recent New York Times article lays it out:

Fully 1 in 5 Americans take at least one psychiatric medication. Yet when it comes to mental health, we are facing a crisis in drug innovation. . . . Even though 25 percent of Americans suffer from a diagnosable mental illness in any year, there are few signs of innovation from the major drug makers.

The author has no understanding of the stagnation, yet is opinionated:

The simple answer [to what is causing the stagnation] is that we don’t yet understand the fundamental cause of most psychiatric disorders [what does “fundamental cause” mean? — Seth], in part because the brain is uniquely difficult to study; you can’t just biopsy the brain and analyze it. That is why scientists have had great trouble identifying new targets for psychiatric drugs.

The great increase in depression has an environmental cause. Meaning that depressed brains (aside from the effects of depression) are the same as non-depressed brains. Someone who knows that would not talk about biopsying the brain.

You come to a room with a door. If you don’t know how a door works, you are going to do a lot of damage getting inside. That is modern psychiatry. I described a new explanation for depression in this article (see Example 2).

Thanks to Alex Chernavsky.

Suicidal Gestures at Princeton: A Staggering Increase

Seth Roberts16 Comments

A friend of mine knows a former (retired) head of psychological services at Princeton University. She told him that in the 1970s, there were one or two suicidal gestures per year. Recently, however, there have been one or two per day.

Something is terribly, horribly wrong. Maybe the increase is due to something at Princeton. For example, maybe new dorms are more isolating than the old dorms they replaced. Or maybe the increase has nothing to do with Princeton. For example, maybe the increase is due to antidepressants, much more common now than in the 1970s.

Whatever the cause, tt would help all Princeton students, present and future, and probably millions of others, if the problem were made public so that anyone, not just a vanishingly small number of people, could try to solve it. It isn’t even clear that anyone is trying to explain/understand/learn from the increase.

Princeton almost surely has records that show the increase. If, as is likely, Princeton administrators never allow the increase to be documented, it will be a tragedy. It is an extraordinary and unprecedented clue about what causes suicidal gestures. Nothing in all mental health epidemiology has found a change by factor of a hundred or more — much less a mysterious huge change.

The increase is an unintended consequence of something else, but what? Because it is so large, there must be something extremely important that most people, or at least Princeton administrators, don’t understand about mental health. The answer might involve seeing faces at night. I found that seeing faces in the morning produced an enormous boost in mood and that faces at night had the opposite effect. I cannot say, however, why seeing faces at night would have increased so much from the 1970s to now.

Butter = Antidepressant?

Seth Roberts9 Comments

On the Shangri-La Diet forums, babyhopes wrote:

At 10 am, I NCd [nose-clipped] a cup of milk, coffee and 2 small spoons of butter (I really like the anti-depressant effects of butter so I am making it part of my breakfast every day)

I noticed something similar the first time I ate a lot of butter (about 60 g). It was at lunch. A few hours later I felt a pleasant warm feeling in my head. The butter was the only unusual thing I had eaten.

When I googled “butter antidepressant” the first result was this blog — I wrote about this three years ago. Well, here is new evidence.

Assorted Links

Seth Roberts5 Comments
  • Interview with Royce White, the basketball player. I agree with him that addictions should be considered mental disorders. I think they are usually self-medication for a mood disorder, such as depression. His view that more than half of Americans have a mental disorder is consistent with my view that you need to see faces in the morning to have your mood control system work properly. Hardly anyone sees enough faces in the morning.
  • Racial quotas at Harvard by Ron Unz. “Top officials at Harvard, Yale, and Princeton today strenuously deny the existence of Asian-American quotas, but their predecessors had similarly denied the existence of Jewish quotas in the 1920s, now universally acknowledged to have existed.”
  • Traditional Filipino fermented foods (scientific paper)
  • Omega-6 supplementation (with concurrent decrease in saturated fat) increases heart disease
  • How not to globalize Korean food. For one thing, don’t assume all foreigners are alike.

Thanks to dearime.

Twenty Dead Schoolchildren in Newtown, Conn.

Seth Roberts14 Comments

Adam Lanza, the Sandy Hook shooter, was taking medication, according to a neighbor. Here’s what someone said in 2008: “Every young, male shooter [who] has gone on a killing spree in the United States also has a history of treatment with psychotropic drugs — typically SSRI antidepressants. These shootings have three things in common: 1) The shooters are young males. 2) The shooters exhibit a mind-numbed disconnect with reality. 3) The shooters have a history of taking psychiatric medications.”

Lanza was considered by his mom to have Asperger’s. No doubt that, and the associated isolation, had something to do with the medication. As I point out every year at Nobel Prize time, the research methods favored by the healthcare establishment have done little to reduce major diseases, such as depression. With few exceptions, year after year little progress is made on figuring out the environmental cause of anything, including Asperger’s and autism. The result of this lack of progress is that almost every serious health problem, including mental health problems, gets treated with drugs or surgery rather than prevented or treated safely with necessary nutrients (as scurvy is treated with lime juice). The little progress that is made in finding environmental causes is undervalued. The researchers who figured out that smoking causes lung cancer didn’t even get a Nobel Prize. The effect of failing year after year to find environmental causes is that people take more and more drugs with little-known or unknown side effects, which are almost always bad. The association of SSRI antidepressants and violence is still unknown to many people, for example. The problem has been made worse by drug companies hiding data. As Ben Goldacre says in Bad Pharma, one of the worst cases involved an antidepressant called paroxetine, whose manufacturer (GlaxoSmithKline) withheld data about its tendency to cause suicide. My work has suggested that a lot of depression may be due to lack of exposure to faces in the morning, an idea utterly different than the neurochemical theories of depression favored by psychiatrists. I am sure that seeing faces in the morning is safer than taking psychiatric drugs.

 

 

Positive Psychology Talk by Martin Seligman at Tsinghua University

Seth Roberts7 Comments

Here at Tsinghua University, the Second Annual Chinese International Conference on Positive Psychology has just begun. The first speaker was Martin Seligman, a professor at the University of Pennsylvania and former president of the American Psychological Association (the main professional group of American psychologists). Seligman is more responsible for the Positive Psychology movement than anyone else. Here are some things I liked and disliked about his talk.

Likes:

1. Countries, such as England, have started to measure well-being in big frequent surveys (e.g., 2000 people every month) and some politicians, such as David Cameron, have vowed to increase well-being as measured by these surveys. This is a vast improvement over trying to increase how much money people make. The more common and popular and publicized this assessment becomes — this went unsaid — the more powerful psychologists will become, at the expense of economists. Seligman showed a measure of well-being for several European countries. Denmark was highest, Portugal lowest. His next slide showed the overall result of the same survey for China: 11.83%. However, by then I had forgotten the numerical scores on the preceding graph so I couldn’t say where this score put China.

2. Work by Angela Duckworth, another Penn professor, shows that “GRIT” (which means something like perseverance) is a much better predictor of school success than IQ. This work was mentioned in only one slide so I can’t elaborate. I had already heard about this work from Paul Tough in a talk about his new book.

3. Teaching school children something about positive psychology (it was unclear what) raised their grades a bit.

Dislikes:

1. Three years ago, Seligman got $125 million from the US Army to reduce suicides, depression, etc. (At the birth of the positive psychology movement, Seligman proclaimed that psychologists spent too much time studying suicide, depression, etc.) I don’t mind the grant. What bothered me was a slide used to illustrate the results of an experiment. I couldn’t understand it. The experiment seems to have had two groups. The results from each group appeared to be on different graphs (making comparison difficult, of course).

2. Why does a measure of well-being not include health? This wasn’t explained.

3. Seligman said that a person’s level of happiness was “genetically determined” and therefore was difficult or impossible to change. (He put his own happiness in “the bottom 50%”.) Good grief. I’ve blogged several times about how the fact that something is “genetically-determined” doesn’t mean it cannot be profoundly changed by the environment. Quite a misunderstanding by an APA president and Penn professor.

4. He mentioned a few studies that showed optimism (or lack of it) was a risk factor for heart disease after you adjust for the traditional risk factors (smoking, exercise, etc.). There is a whole school of “social epidemiology” that has shown the importance of stuff like where you are in the social hierarchy for heart disease. It’s at least 30 years old. Seligman appeared unaware of this. If you’re going to talk about heart disease epidemiology and claim to find new risk factors, at least know the basics.

5. Seligman said that China had “a good safety net.” People in China save a large fraction of their income at least partly because they are afraid of catastrophic medical costs. Poor people in China, when they get seriously sick, come to Beijing or Shanghai for treatment, perhaps because they don’t trust their local doctor (or the local doctor’s treatment failed). In Beijing or Shanghai, they are forced to pay enormous sums (e.g., half their life’s savings) for treatment. That’s the opposite of a good safety net.

6. Given the attention and resources and age of the Positive Psychology movement, the talk seemed short on new ways to make people better off. There was an experiment with school children where the main point appeared to be their grades improved a bit. A measure of how they treat each other also improved a bit. (Marilyn Watson, the wife of a Berkeley psychology professor, was doing a study about getting school kids to treat each other better long before the Positive Psychology movement.) There was an experiment with the U.S. Army I couldn’t understand. That’s it, in a 90-minute talk. At the beginning of his talk Seligman said he was going to tell us things “your grandmother didn’t know.” I can’t say he did that.

 

 

“The Scale of the Scandal”: Tony Scott’s Suicide Quite Possibly Due to Antidepressant

Seth Roberts10 Comments

As pointed out by dearime, the columnist Peter Hitchens recently made the following comment in The Mail on Sunday:

When I read in August that the talented Hollywood film director Tony Scott had killed himself without any apparent good reason, I was fairly sure that pretty soon we would find that the poor man had been taking ‘antidepressants’. Well, a preliminary autopsy has found ‘therapeutic’ levels of an ‘antidepressant’ in his system. I take no pleasure in being right, but as the scale of this scandal has become clear to me, I have learned to look out for the words ‘antidepressant’ or ‘being treated for depression’ in almost any case of suicide and violent, bizarre behavior. And I generally find it. The science behind these pills is extremely dubious. Their risks are only just beginning to emerge. It is time for an inquiry.

“ Tony Scott Suicide Remains a Mystery After Autopsy,” wrote a Vanity Fair editor. The autopsy found that he had been taking the antidepressant Remeron, whose known side effects include suicide. SSRI’s, of which Remeron is an example, cause suicidal thinking in people who are not depressed.

The psychiatrist David Healy was the first to emphasize this point. In 2000, after he began this research, he was offered a job at the University of Toronto. In a very unusual move, the job offer was rescinded. Apparently psychiatry professors at the University of Toronto realized that Healy’s research made the psychiatric drug industry look bad.

I don’t think it’s wrong to sell drugs that improve this or that condition (e.g., depression), even if the improvement is slight. I do think it’s wrong to make false claims to induce people to buy the drugs. In the case of depression, the false claim is that depression is due to a “chemical imbalance.” No chemical difference has ever been shown between people who later become depressed and people who don’t later become depressed. This claim, repeated endlessly, makes it harder to do research into what causes depression. If you figured out what caused depression, you could treat it and prevent it much better. This false claim does enormous damage. It delays by many years discovery of effective treatment and prevention of depression, a disease from which hundreds of millions of people now suffer.

This happens in dozens of areas of medicine. Dermatologists say “ acne is caused by bacteria“. Most doctors appear to believe “ulcers are caused by bacteria”. Ear nose and throat surgeons claim that part of the immune system (the tonsils) causes illness. The “scale of the scandal” — medical school professors either (a) don’t understand causality or (b) deceive the rest of us — is great.

Assorted Links

Seth Roberts5 Comments

Thanks to Tim Beneke and Bryan Castañeda.

The Value of Moodscope

Seth Roberts4 Comments

In 2007, Jon Cousins started tracking his mood to help NHS psychiatrists decide if he was cyclothymic (a mild form of bipolar disorder). After a few months of tracking, he started sharing his scores with a friend, who expressed concern when his score was low. Jon’s mood sharply improved, apparently because of the sharing. This led him to start Moodscope, a website that makes it easy to track your mood and share the results.

I was curious about the generality of what happened to Jon — how does sharing mood ratings affect other people? In January, Jon kindly posted a short survey about this. More than 100 people replied.

Their answers surprised me. First, in a survey about sharing your mood — not about tracking your mood — most respondents did not share their mood. It is as if, in a survey about being tall, most respondents were not tall. Second, although Jon’s mood sharply rose as soon as he started sharing, this was not the usual experience. Sharing helped, some people said, but other people said sharing hurt. For example, one person said her mood was used against her in arguments. Finally, the respondents gave all sorts of persuasive reasons that rating their mood helped them. To me, at least, the value of mood rating isn’t obvious. I can list a dozen hypothetical benefits but whether they actually happen is unclear to me. I rated my mood for years and did it only to learn about the effects of morning faces. MoodPanda, another mood-rating site, gives a few brief vague unenthusiastic reasons to track your mood. And their site is all about mood rating.

In contrast, Moodscope users were clear and enthusiastic about the value of tracking. Here are some reasons they liked mood-tracking:

It is useful to look back sometimes to help you find ways of ‘keeping up’ a positive mood/outlook.

My mood range has definitely narrowed since starting mood stabilizers, so using Moodscope has given me solid evidence that the treatment is working well. I also run statistical analyses of my mood charts against variables like sleep, medication use, and alcohol consumption. The correlations were not particularly meaningful using a 9-point Likert-like scale from a standard mood chart. When I used my Moodscope scores instead, I suddenly found that some of the correlations are (ridiculously!) statistically significant, which also made me feel more certain about what I need to do and change to better manage my mental health.

I could express my miserableness in total safety, without leaning on anybody else. It has proved wonderful. My profile has risen from a score of 7 on day 1 (11 months ago) to the 90s now. Being able to track my reasons for feeling better or worse has been part of this. The patterns are visible, ditto the triggers that send me up or down.

The great benefit of Moodscope has been to confirm the advantages of my own lifestyle management for coping with bipolar disorder. It has shown that what I felt was bad for me, is indeed bad, and what I felt was good for me, is indeed good. (I know that I have to take the meds.)

It helps that I can post things about sleep hours in the comments and see the correlation to the chart.

I have found the tool immensely helpful in gaining insight into how my own behaviour and thoughts can impact upon my mental health. I have gained more control.

It helps me to gain insight into my moods, take responsibility for them and steer a calmer, more productive course through life.

It allows me not to panic when I am low as I can see that ups and downs are all part of life.

Pre-Moodscope, I would not realize i was on the way down until 10 or so days had passed, and so I had done nothing. But with Moodscope, I can see if it’s a trend and do something immediately. It means I deliberately intervene earlier.

I use my scores, and comments, to understand what triggers my low mood and take steps to stop it getting lower, in so far as I am able.

I view it as a diary of sorts, private for my own contemplation.

I want to catch myself before I make a deep plunge and stay down too long. I do use the info with my doctor. I love having something concrete to show and talk about.

It has helped me feel like there is a greater safety net there, and given me a greater awareness of when I’m slipping back into my treacle pit; I now know that any score between 20 and 30 means I am in dangerous territory and need to take some remedial action, and if I get below 20 then I’m really in a bad way.

Moodscope has helped me identify incidents in my life with my mood. For example if I have to assert myself strongly with someone, I feel exhilarated and very proud of myself for about two day then gradually my mood will lower and a week later I will feel apathetic and down. I love that it is helping me make sense of my emotions and as a result I am not judgmental of them.

I’ve found Moodscope really useful in finding out what influences my moods. I am bipolar and after 20 years on lithium I’m managing without any meds. Don’t worry, I came off it slowly, under medical supervision!

I use Moodscope as a sort of diary of how I am feeling. Looking back I can see what really pushed my mood down and oddly it’s not always the major things that you’d imagine. In my case depression is brought on more by physical health problems – I am a CFS sufferer.

I sum up their reasons like this: 1. Helps understand causality (what causes mood to be low or high?). 2. Immediate guidance (should I take action to raise it?). 3. Self-expression (similar to diary). 4. Reassurance (low moods are “part of life”). Alexandra Carmichael wrote about the value of mood-tracking and mood-sharing. Her experience did not repeat Jon’s: She found little initial benefit of sharing, but great eventual benefits (“a kind of deep, healing therapy”). This was the main benefit of tracking for her — that it allowed this sharing. Kari Sullivan also tried Moodscope. She didn’t share her mood. The benefits she list fall under the heading of Reason #1 (helps understand causality). For example, she learned “most social interaction lowers my mood,” which surprised her.

Not everyone liked tracking:

My girlfriend . . . stopped using Moodscope. In her words, “I don’t want Moodscope to remind me how terrible I’m doing.”

She has now decided to give up on taking the test as it just reinforces her feelings of general greyness and sometimes despair.

At a website devoted to collecting new ideas about health, Moodscope ranked #1 out of about 500 ideas.

When I started my self-experimentation I didn’t get anywhere for a long time (after initial success with acne). After 1990, however, I was astonished at the progress I made. One useful discovery after another — how to lose weight, sleep better, be in a better mood, and so on. Over the next 20 years, I improved my health considerably more than all the other scientists in the world put together. I came to see what was happening as a kind of catalysis. The useful information was already there; my personal science was the catalyst that turned it into something useful. (Lack of people like me was why the discoveries were so abundant — a counter-example to Tyler Cowen’s lack-of-low-hanging fruit explanation for stagnation.) Professional scientists were too restricted in what they did.

The Moodscope story is similar. Psychologists have been studying and measuring mood for a long time. The Profile of Mood States is an important result of their research. But no psychologist saw it as an agent of change. It was simply a research tool, albeit a popular one. Only when Jon Cousins started using it for his own selfish purposes did it become clear how useful it could be. He was the catalyst.

Both my story and Jon’s are examples of what I say about DIYization of science: It gets tools into the hands of a larger and more diverse group of possible innovators, who are less “stuck” — less committed to old ways of doing things — than the professionals. They are also more motivated to do something useful than the professionals, who are weighed down with other big concerns — about status, job security, money, and so on.