Understanding Depression, Visual Edition

I want to share a little gem of a resource that I’ve been admiring for some time.* It is a web comic about depression. That might not sound all that inspiring, but if you’ve ever cared about someone with depression or struggled to explain your depression to someone who cares — you know that it can be very difficult.

That’s where Hyperbole and a Half comes in, a website that includes some amazing comics about what it is like to be depressed. And perhaps the best starting point, is the episode: Depression Part Two. The art is rudimentary, even crude. The message is as spot on as anything I’ve ever read about depression. Here’s a sample quote:

It would be like having a bunch of dead fish, but no one around you will acknowledge that the fish are dead. Instead, they offer to help you look for the fish or try to help you figure out why they disappeared…

…The problem might not even have a solution. But you aren’t necessarily looking for solutions. You’re maybe just looking for someone to say “sorry about how dead your fish are” or “wow, those are super dead. I still like you, though.”

I’ve also added, in the sidebar under the heading “blogs on depression”, links to both this and the first comic in the series, Adventures in Depression. It is equally insightful and funny, and begins: “Some people have a legitimate reason to feel depressed, but not me. I just woke up one day feeling sad and helpless for absolutely no reason.”

I hope you gain some comfort or understanding from the comics.

*As a coda, I was unaware that the author, Allie Brosh, just published a book of her comics with Simon and Schuster and has been getting some press recently. In fact, she did an interview on NPR which aired yesterday. Recommended.

Also:

Meet Allie Brosh, Reclusive Genius Behind the Blog (and Book) “Hyperbole and a Half” at Mother Jones.

‘Hyperbole and a Half’ illustrates Allie Brosh’s precise crudeness at NY Daily News.

“Hyperbole and a Half” creator Allie Brosh: “Good comedy has a lot in common with good horror” at Salon.com

 

Your Brain on Meditation: Role of the Posterior Cingulate

If this topic interests you, I recommend you click on the “mindfulness” tag at the end of the article to bring up other posts on this and related topics.

What if you could enhance your well being? Just published by Judson Brewer, PhD, MD, medical director of the Yale Therapeutic Neuroscience Clinic, a solid piece of exploratory (and confirmatory) research on the role of a part of the brain called the posterior cingulate in meditation.

Meditators have been speculating about the states of mind evoked by meditative states and various relationships between meditating and well being. Turns out, the posterior cingulate is implicated, mostly negatively, in the subjective well being of meditators. What makes this interesting, is that the meditators could control the activity of this part of the brain, through real-time feedback.

There have been a number of studies that have shown that meditation lights up certain brain regions, that it’s associated with changes in brain thickness, and that it alters the way our brains respond to stressful stimuli. But meditation is complex, and it involves processes like attention, working memory, and self-monitoring. So, which components of meditation actually line up with specific brain regions?

Researchers found that the posterior cingulate increases activity during states of distraction, discontentment, and a particular kind of mental effort — all states implicated in unhappiness. A decrease in posterior cingulate activity was associated with states of effortlessness and contentment.

The implications of this are great. Not only does it mean that meditation can be used to enhance well-being, but eventually the technology could be used to help people to learn to meditate more quickly. Learning to meditate more efficiently also potentially means strengthening the “wiring” in those parts of the brain that bring about well being.

If you’re curious about Judson Brewer’s work, here’s his TEDx talk on meditation: You’re Already Awesome. Just Get Out of Your Own Way! which touches on the effects of tracking and training flow states, turning off the blah blah blah part of the brain.

Or an interview at Buddhist Geeks, Mapping the Mindful Brain.

NIMH Withdraws Support for DSM-5

There’s been some big news this week in the world of mental health (for one that suicide among baby boomers is increasing to the point where the number of suicides per year in the United States now exceeds deaths by automobile accidents), but perhaps the biggest story relates to the National Institute for Mental Health rejecting the authority of the soon-to-be-released Diagnostic and Statistical Manual of Mental Disorders, known to most in the business as simply, DSM-5.

Here’s a brief excerpt from Christopher Lane’s Psychology Today piece:

In a humiliating blow to the American Psychiatric Association, Thomas R. Insel, M.D., Director of the NIMH, made clear the agency would no longer fund research projects that rely exclusively on DSM criteria. Henceforth, the NIMH, which had thrown its weight and funding behind earlier editions of the manual, would be “re-orienting its research away from DSM categories.” “The weakness” of the manual, he explained in a sharply worded statement, “is its lack of validity.” “Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.”

This could prove to be a very thorny issue for insurance companies, practitioners, not to mention clients — if the diagnoses in the manual, which are used for billing, are not considered to be reliably valid.

Psychiatric Diagnosis and Genetics

An interesting piece by Vaughan Bell of Mind Hacks. He notes that recent studies in medical genetics tend to undermine the foundations of some psychiatric diagnoses. At Mind Hacks he summarizes as follows:

The “mental illness is a genetic brain disease” folks find that their evidence of choice – molecular genetics – has undermined the validity of individual diagnoses, while the “mental illness is socially constructed” folks find that the best evidence for their claims comes from neurobiology studies.

And here’s a snippet from the Observer piece he wrote, well worth a read:

This new realisation rests on evidence that genetic factors initially associated with, for example, schizophrenia have now been recognised as equally important in raising the risk for several other problems including epilepsy, attention deficit disorder, autism and learning disability.

If you speak the language of science, there’s also a link to a British Journal of Psychiatry review article on the topic:

There is accumulating evidence for shared genetic as well as environmental risk between intellectual disability and other conditions with a neurodevelopmental basis such as autism, attention-deficit hyperactivity disorder, epilepsy and schizophrenia. These can be conceived as lying along a continuum of genetically and environmentally induced neurodevelopmental causality.

As usual, not suggesting diseases such as schizophrenia don’t exist – but our understanding of their causes is far from complete. And of course, DSM-V (Diagnostic and Statistical Manual of Mental Disorders) is slated to come out this May 2013.

 

 

Your Phone vs. Your Heart

If you’re interested in mindfulness practices, such as meditation, you might find this article, from the New York Times, of interest.  Researchers had one group of subjects perform the fairly well known mindfulness practice lovingkindness, which encourages one to “develop more warmth and tenderness toward themselves and others.”

We discovered that the meditators not only felt more upbeat and socially connected; but they also altered a key part of their cardiovascular system called vagal tone. Scientists used to think vagal tone was largely stable, like your height in adulthood. Our data show that this part of you is plastic, too, and altered by your social habits.

The curious twist, is the writer suggests that lack of face-to-face interaction, as can sometimes happen with extensive smart phone use, might be problematic to our mental health. Some more on the health benefits:

To appreciate why this matters, here’s a quick anatomy lesson. Your brain is tied to your heart by your vagus nerve. Subtle variations in your heart rate reveal the strength of this brain-heart connection, and as such, heart-rate variability provides an index of your vagal tone.

By and large, the higher your vagal tone the better. It means your body is better able to regulate the internal systems that keep you healthy, like your cardiovascular, glucose and immune responses.

Beyond these health effects, the behavioral neuroscientist Stephen Porges has shown that vagal tone is central to things like facial expressivity and the ability to tune in to the frequency of the human voice. By increasing people’s vagal tone, we increase their capacity for connection, friendship and empathy.

In short, the more attuned to others you become, the healthier you become, and vice versa. This mutual influence also explains how a lack of positive social contact diminishes people. Your heart’s capacity for friendship also obeys the biological law of “use it or lose it.” If you don’t regularly exercise your ability to connect face to face, you’ll eventually find yourself lacking some of the basic biological capacity to do so.

The article ends on a striking note: “Friends don’t let friends lose their capacity for humanity.”

12 Steps to Motivating When You’re Depressed

I’m just passing this on, in case someone might find it useful. There’s nothing more irritating to a depressed person than being told you should just do blah blah blah. If you’ve never been depressed, the simplicity of some of the suggestions might shock you. Such as “Wash Up” or “Get Dressed” or “Go Outside”.

In any case, some food for thought at PsychCentral.

The Hurry to Heal

That’s the title of psychologist Paula Caplan’s article at the Psychology Today website.

But in dominant American culture, we want to race beyond the pain as fast as we can: Let’s get started right this minute on the coping and the healing. It is cruel to do so. Instead, Dr. Joanne Cacciatore of the Center for Grief and Trauma in her essay yesterday writes with her usual gentleness and sensitivity about what we can and ought to do instead. Rather than reprint her essay here, I urge everyone to read every word of it at http://drjoanne.blogspot.com/2012/12/no-words-for-such-tragedy.html It is meaningful and full of heart.

If you’re looking for some kind of reassurance or insight, the link might be helpful.