Sep 11, 2023 04:55 PM
https://www.theguardian.com/books/2023/s...rd-reviews
EXCERPTS: ... Philip Gold (Breaking Through Depression) argues that many cases of depression result from “a stress response that has run awry”. When a healthy person faces a dangerous situation – a forest fire, say – it makes sense to focus on the threat itself, and how to deal with the immediate risk until you have found safety. The brain starts to prepare the body for action, which includes increasing inflammation and blood clotting to reduce the risk of infection and haemorrhage after injury.
For many people with depression, however, the brain’s alarm bells keep ringing long after a real threat has passed. It continues to look for potential signs of danger or hostility while ignoring things that might bring reward. As Gold writes, “it’s one thing to maintain a singular focus when there is a wildfire raging nearby, but in normal life the inability to appreciate any pleasurable stimulus is a great burden”. This results in the profound dread and lack of pleasure and motivation that characterise the disease, and severely disrupt normal routines of eating and sleeping. Living in a state of permanent stress can result in brain-cell death and a reduced ability to form new neural networks, which leaves the person locked in their doom-laden thinking. For this reason, Gold describes depression as a neurodegenerative disease, and says that any effective treatments will need to undo this damage and prevent it from occurring again.
Gold makes a convincing argument for his theory, but Camilla Nord’s The Balanced Brain offers many alternative viewpoints. Nord leads the Mental Health Neuroscience Lab at the University of Cambridge, and her writing is masterfully nuanced in its treatment of depression, without sacrificing the clarity of her argument. Throughout, she is careful to explain how experiences can vary widely from person to person. Rather than opting for a simplistic narrative, she acknowledges the ambiguities in the academic research on mental illness.
There has been a lot of excitement about the potential role of bodily inflammation as a potential cause of depression, rather than a consequence. But only a subset of patients show higher-than-average inflammation, while others have normal levels. And even among those with heightened inflammation, the underlying source may be found in different parts of the immune system. “Targeting the immune system might represent a new route to treat or improve mental health but it would require carefully finding the right immunological targets and tailoring treatments for each individual on the basis of their particular immune system,” Nord writes.
The cognitive causes of depression can be similarly varied....
[...] Nord and Gold suggest a constellation of promising options for treatment, including other psychedelic drugs and various forms of brain stimulation. Through brain imaging and genetic testing, it may even be possible to predict which treatments will work best for each person. Without offering false hope, both these books are ultimately optimistic about our future understanding of depression. The chemical imbalance theory may have been extinguished, but there are now many more flashes of light in the darkness.... (MORE - missing details)
EXCERPTS: ... Philip Gold (Breaking Through Depression) argues that many cases of depression result from “a stress response that has run awry”. When a healthy person faces a dangerous situation – a forest fire, say – it makes sense to focus on the threat itself, and how to deal with the immediate risk until you have found safety. The brain starts to prepare the body for action, which includes increasing inflammation and blood clotting to reduce the risk of infection and haemorrhage after injury.
For many people with depression, however, the brain’s alarm bells keep ringing long after a real threat has passed. It continues to look for potential signs of danger or hostility while ignoring things that might bring reward. As Gold writes, “it’s one thing to maintain a singular focus when there is a wildfire raging nearby, but in normal life the inability to appreciate any pleasurable stimulus is a great burden”. This results in the profound dread and lack of pleasure and motivation that characterise the disease, and severely disrupt normal routines of eating and sleeping. Living in a state of permanent stress can result in brain-cell death and a reduced ability to form new neural networks, which leaves the person locked in their doom-laden thinking. For this reason, Gold describes depression as a neurodegenerative disease, and says that any effective treatments will need to undo this damage and prevent it from occurring again.
Gold makes a convincing argument for his theory, but Camilla Nord’s The Balanced Brain offers many alternative viewpoints. Nord leads the Mental Health Neuroscience Lab at the University of Cambridge, and her writing is masterfully nuanced in its treatment of depression, without sacrificing the clarity of her argument. Throughout, she is careful to explain how experiences can vary widely from person to person. Rather than opting for a simplistic narrative, she acknowledges the ambiguities in the academic research on mental illness.
There has been a lot of excitement about the potential role of bodily inflammation as a potential cause of depression, rather than a consequence. But only a subset of patients show higher-than-average inflammation, while others have normal levels. And even among those with heightened inflammation, the underlying source may be found in different parts of the immune system. “Targeting the immune system might represent a new route to treat or improve mental health but it would require carefully finding the right immunological targets and tailoring treatments for each individual on the basis of their particular immune system,” Nord writes.
The cognitive causes of depression can be similarly varied....
[...] Nord and Gold suggest a constellation of promising options for treatment, including other psychedelic drugs and various forms of brain stimulation. Through brain imaging and genetic testing, it may even be possible to predict which treatments will work best for each person. Without offering false hope, both these books are ultimately optimistic about our future understanding of depression. The chemical imbalance theory may have been extinguished, but there are now many more flashes of light in the darkness.... (MORE - missing details)