Post Prozac Nation

Fabulous and fascinating article on anti-depressants and depression in the NYT magazine today.  Siddhartha Mukherjee nicely summarizes the evidence and controversy about whether and how SSRI’s work.  I think he goes by a little too breezily the fact that the best evidence suggests that anti-depressants actually do very little, if anything, for mild to moderate depression beyond the placebo effect (but a powerful effect it is).  That said, it’s a really interesting look at evolving theories on the neurobiology of depression.   Short version: it seems that SSRI’s in some way actually help to stimulate the growth of new brain cells in a key area of the brain.  Here’s the complicated, but succinct, explanation of what may be going on:

A remarkable and novel theory for depression emerges from these studies. Perhaps some forms of depression occur when a stimulus — genetics, environment or stress — causes the death of nerve cells in the hippocampus. In the nondepressed brain, circuits of nerve cells in the hippocampus may send signals to the subcallosal cingulate to regulate mood. The cingulate then integrates these signals and relays them to the more conscious parts of the brain, thereby allowing us to register our own moods or act on them. In the depressed brain, nerve death in the hippocampus disrupts these signals — with some turned off and others turned on — and they are ultimately registered consciously as grief and anxiety. “Depression is emotional pain without context,” Mayberg said. In a nondepressed brain, she said, “you need the hippocampus to help put a situation with an emotional component into context” — to tell our conscious brain, for instance, that the loss of love should be experienced as sorrow or the loss of a job as anxiety. But when the hippocampus malfunctions, perhaps emotional pain can be generated and amplified out of context — like Wurtzel’s computer program of negativity that keeps running without provocation. The “flaw in love” then becomes autonomous and self-fulfilling.

We “grow sorrowful,” but we rarely describe ourselves as “growing joyful.” Imprinted in our language is an instinct that suggests that happiness is a state, while grief is a process. In a scientific sense too, the chemical hypothesis of depression has moved from static to dynamic — from “state” to “process.” An antidepressant like Paxil or Prozac, these new studies suggest, is most likely not acting as a passive signal-strengthener. It does not, as previously suspected, simply increase serotonin or send more current down a brain’s mood-maintaining wire. Rather, it appears to change the wiring itself. Neurochemicals like serotonin still remain central to this new theory of depression, but they function differently: as dynamic factors that make nerves grow, perhaps forming new circuits. The painter Cézanne, confronting one of Monet’s landscapes, supposedly exclaimed: “Monet is just an eye, but, God, what an eye.” The brain, by the same logic, is still a chemical soup — but, God, what a soup.

On a quasi-related note, Mukherjee is the author of one of my favorite books I read last year.  The Emperor of All Maladies: A Biography of Cancer.

Photo of the day

Nice set of Earth Day photos from the Big Picture.  This one is easily my favorite:

An Ibex stands on a cliff-edge above the Ramon Crater in southern Israel’s Negev Desert on March 5, 2012. (Amir Cohen/Reuters) 

Nuns vs. Bishops

So, I read a little bit about the Catholic Bishops chastising American nuns for, you know, caring about what happens to poor people, and crazy stuff like that, but did not pay particularly close attention, just thinking “there they go again.”  But then I read this post by Amy Davidson and got really annoyed.  The “problem” of the nuns is not that they are advocating for gay marriage or abortion along with caring about poor people.  Apparently, they are just insufficiently committed to the anti-gay, pro-life agenda.  Of course, all you need to do is check the Gospels.  Jesus spends all his time railing about the evils of gay marriage and legal abortion and hardly even mentions concern for the poor and oppressed.  Anyway:

What is striking, though, is the absence of a smoking gun in the Congregation of the Defense of the Faith’s findings on matters of faith, other than faith in bishops (which is presented as one of the Church’s doctrines). What seemed to bother the Vatican’s investigators was not that nuns were speaking out on political matters, but that they were failing to engage politically in the way the Church wanted them to: the L.C.W.R. had been

silent on the right to life from conception to natural death, a question that is part of the lively public debate about abortion and euthanasia in the United States. Further, issues of crucial importance to the life of Church and society, such as the Church’s Biblical view of family life and human sexuality, are not part of the LCWR agenda in a way that promotes Church teaching.

The Congregation also noted

the absence of initiatives by the LCWR aimed at promoting the reception of the Church’s teaching, especially on difficult issues such as Pope John Paul II’s Apostolic Letter Ordinatio sacerdotalis and Church teaching about homosexuality.

In other words, instead of just talking about “social justice,” the nuns should be out on the barricades, agitating against abortion and gay marriage. And, again, they need to listen to the bishops.

Davidson also recounts the case from a few years back when a nun/administrator at a Catholic hospital approved the termination of a pregnancy that literally saved the life of a mother so she could go home and care for her already born four small children.  The nun got excommunicated for that (here’s my link from back when this case happened).  So long as the nuns are the ones following the stuff Jesus actually talked about, I’ll go with them over the bishops ever time.

Female voter myths

This week’s “5 myths” in the Post is myths about women voters.  As usual, some of them don’t seem very myth-y to me, i.e., does anybody really think that we can look at female voters as a single, homogenous bloc?  I did like myth #3, though, as this seems particularly pervasive in a lot of journalistic accounts:

3. Women vote based on “women’s issues,” such as abortion rights and contraception.

A recent poll of voters in swing states showed that women’s top priorities are health care, gas prices, unemployment and the deficit — in that order — with “government policies toward contraception” coming in last. (Women are, however, much more likely than men to rate government policy on birth control as important — 55 percent to 35 percent in the same USA Today-Gallup poll.)

Even on abortion rights, women are nearly as divided as the country as a whole, which broke 49 percent to 45 percent in favor of abortion rights in Gallup polling last year. And though 50 percent of women identify as pro-choice and 44 percent as pro-life, age and party affiliation are far better predictors than gender of views on abortion.

Yep.  Every class I teach, I like to start out with a very basic True/False quiz on the first day to try and show my students that they might actually be wrong about a variety of things they think they already know.   The question that they probably most persistently get wrong is “women are substantially more likely than men to think abortion should be legal.”  Nope.  There are some interesting differences in how men and women see politics (and, in fact, women do care more about abortion– on both sides of the issue), but by and large, women are voting on the same sorts of things as men.

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