The Most Important Lesson From 83,000 Brain Scans

Daniel Amen is an American psychiatrist and brain disorder specialist who is a strong advocate of utilizing single photon emission computed tomography (SPECT) as a diagnostic tool for better identifying and treating mental illnesses. In the following TED Talk, he discusses his research involving the use of SPECT (including several touching success stories resulting from its application) and highlights its importance in improving the efficacy of psychiatric treatment.

Personally, I found Amen’s points to be compelling and reasonable. The growing prominence of psychiatric problems in our society, coupled with issues of inaccurate diagnosis and inadequate treatment, makes his argument for the wider use of SPECT seem self-evidently true.

However, after doing some research, I dug up quite a lot serious skepticism and criticism towards Amen’s claims, as well as his professional endeavors (apparently, he hawks a lot of pseudoscience while making hefty profits from his private practice). Much of the controversy and debate is cited and expanded upon in this article from Science Based Medicine, a source I deeply trust.

Personally, I remain undecided, as I just came across Amen and his subsequent detractors. I will have to look into these matters more deeply when I have the time, but I invite you all to see the video, read the criticism, and decide for yourselves. As always, feel free to weigh in with your thoughts here. Thanks for reading.

Books and Meaningful Activities Lead to Happy Lives

As a lifelong bibliophile and culture aficionado, I didn’t need any scientific verification that reading, listening to music, visiting art galleries, and engaging in other forms of cultural immersion were good for my heart and soul. Of course, it never hurts to have some sort of research back these things up, so I was pleased, if not unsurprising, with the following report from NPR:

Going to the library gives people the same kick as getting a raise does — a £1,359 ($ 2,282) raise, to be exact — according to a study commissioned by the U.K.’s Department for Culture, Media & Sport. The study, which looks at the ways “cultural engagement” affects overall well-being, concluded that a significant association was found between frequent library use and reported well-being. The same was true of dancing, swimming and going to plays. The study notes that “causal direction needs to be considered further” — that is, it’s hard to tell whether happy people go to the library, or going to the library makes people happy. But either way, the immortal words of Arthur the Aardvark ring true: “Having fun isn’t hard when you’ve got a library card!”

Well, this certainly explains why I legitimately get happy when I go to a library or bookstore, or even when I’m in my room surrounded by my books. I could never explain how or why I’d be happy exactly; I would just feel an ineffable and natural sense of calm and contentment, as if I were engaging in something therapeutic — which indeed, seems to be what these activities are. I feel a similar sensation when I’m gardening, tidying up my living space, or going to a local culture festival. 

This finding sort of coincides with another study I came across recently that came to a similar conclusion: people who regularly engage in meaningful activities — ranging from exercise and sports to gardening and art — tend to feel better in the long run, especially if they’re helping people along the way.

For the study, published today in the Proceedings of the National Academy of Sciences, the researchers followed a group of 39 teenagers over the course of one year to see whether the way their brains reacted to either eudaimonic or hedonic rewards correlated with how depressed they felt over time.

First, the subjects underwent an fMRI while making a decision about whether to keep money for themselves (a hedonic reward) or to donate it to their families (eudaimonic). They also played a game to determine if they were willing to take risks for the possibility of a greater financial reward (hedonic).

The subjects then filled out a self-report questionnaire of depressive symptoms during the initial scan, and again a year later.

It turned out the teens who had the greatest brain response to the generous, family-donation financial decision had the greatest declines in depressive symptoms over time. And those who got a boost from the risk-taking game were more likely to have an increase in depression. The types of rewards the teens responded to, it seems, changed their behavior in ways that altered their overall well-being.

“For example,” the authors write, “adolescents who show heightened activation in the ventral striatum during eudaimonic decisions likely experience a sense of reward from supporting their family and may therefore show increases in the time they spend helping their family.”

It’s important to note that this doesn’t necessarily mean parents can inoculate their teens against depression by forcing them to seek happiness through volunteering. But it could be that teens who already do that kind of thing because it really does lift their spirits are likely to have that lift stick with them.

“Taken together, our findings suggest that well-being may depend on attending to higher values related to family, culture, and morality, rather than to immediate, selfish pleasure,” the authors write.

Taken together, these findings — which coincide with plenty of anecdotal and philosophical observations as well — make clear that doing something meaningful and stimulating is beneficial to mental health. That may seem somewhat obvious, but it’s easy to underestimate how seemingly mundane activities and tasks could help enrich our lives to some degree or another. While results may vary, and such things are far from substitutes for psychiatric care, it never hurts to explore the world around us and find interests and activities that could make us feel better. 




Mental Health Clinics Closing Down Across the US

As NPR reports, there’s a countrywide shortage of psychiatric wards, leaving people in desperate need of such assistance to languish in hospitals that can’t properly care for them.

While the US has more prisoners than any other country in the world, it also institutionalizes the fewest number of citizens – suggesting that a lot of people in need of mental health treatment are being locked up or ignored instead. With our already meager mental health system crumbling from austerity, there’s no telling what the consequences will be.

Anglo-Saxon Culture and Depression

Even though they’re not the countries with the world’s highest suicide rate (that dubious distinction goes to a number of mostly East Asian and ex-communist countries) it seems that the US, Canada, and the UK have a much more developed culture of depression, in which the subject is considerably more public and ubiquitous in society, to the point of developing it’s own sub-culture and social apparatus.

Based on my own experience, most of the  websites and organizations that are formed around depression and mental illness originate in these countries, as do most of their members and clients. Depression also seems to be a far more prevalent topic,  frequently referenced in popular culture, literature, cinema, and media. Commercials advertising various treatments are common, and an entire “medical industrial complex” has formed in the face of growing diagnoses of clinical depression and it’s ilk.

Indeed, the psychiatric and psychological community is arguably more developed in Anglo-Saxon nations than anywhere else in the world.  Nowadays, both fields are perceived to be dominated by Americans in particular; the DSM – a handbook classifying various mental disorders – is published by the American Psychiatric Association, and is increasingly used across the world instead of international variants.

Of course, I must acknowledge that much of this is based on anecdotal evidence, namely my years serving as a moderator or active member of various websites for the mental illness community. It was mid-away through my “citizen psychiatry” that I began to ponder about this possible Anglo-Saxon connection.

There is also the issue of a causal dilemma. It’s possible that depression is simply more noticed in these countries because we’re more open to confronting it, and have more advance research and medical methodology to diagnose it. Widespread interest and treatment of mental illnesses often follows a country’s entrance into industrialization: a society overcomes the “old” evils of poverty or infectious disease, only for these to be superseded with “modern” ailments like obesity and psychological maladies.

I would like feedback on this, given my limited time to expand on this topic as much as I’d like. Is there something inherent in Anglo-Saxon culture and society that precludes higher incidences of depression? Is it the perverse influence of the highly developed medical and psychiatric community, which many people seem to regard cynically? Is it something else entirely, or maybe nothing at all?