As my last keystrokes about depression here on Hacker News pointed out, there isn't just one disease known as depression. Depression is a symptom pattern (prolonged low mood contrary to the patient's current life experience) found often in the broad category of illnesses known as mood disorders. Behavior genetic studies of whole family lineages, genome-wide association studies, and drug intervention studies have all shown that there are a variety of biological or psychological causes for mood disorders, and not all mood disorders are the same as all other mood disorders. I know a LOT of people of various ages who have these problems, so I have been prompted for more than two decades to dig into the serious medical literature on this topic. (I am not a doctor, but I've discussed mood disorders with plenty of doctors and patients.) I've seen people who tried to self-medicate with street drugs end up with psychotic symptoms and prolonged unemployment, and I've seen people with standard medical treatment supervised by physicians thrive and enjoy well off family life. The best current treatment for depression is medically supervised medication combined with professionally administered talk therapy.
The human mood system can go awry both by mood being too elevated (hypomania or mania) and by it being too low (depression), with depression being the more common symptom pattern. But plenty of people have bipolar mood disorders, with various mood patterns over time, and bipolar mood disorders are tricky to treat, because some treatments that lift mood simply move patients from depression into mania. And depression doesn't always look like being inactive, down, and blue, but sometimes looks like being very irritable (this is the classic sign of depression in teenage boys--extreme irritability--and often in adults too). Physicians use patient mood-self-rating scales (which have been carefully validated over the years for monitoring treatment) as a reality check on their clinical impression of how patients are doing.
As the blog post kindly submitted here points out, a patient's mood disorder influences the patient's whole family. The more other family members know about depression, the better. Encouraging words (NO, not just "cheer up") are important to help the patient reframe thought patterns and aid professional cognitive talk therapy. Care in sleep schedules and eating and exercise patterns is also important. People can become much more healthy than they ever imagined possible even after years of untreated mood disorders, but it is often a whole-family effort that brings about the best results.
 Combination psychotherapy and antidepressant medication treatment for depression: for whom, when, and how.
Craighead WE1, Dunlop BW.
Annu Rev Psychol. 2014;65:267-300. doi: 10.1146/annurev.psych.121208.131653. Epub 2013 Sep 13.
"In conclusion, the depression observed in children with high potential would seem to be characterized by narcissistic vulnerability associated with genuine traumatophilia,"
and the old-fashioned terminology like "narcissistic" and the use of outmoded (and never validated) projective tests of personality (like the Rorschach) shows the article is far out of the mainstream of current psychology. I was wondering how such an old-fashioned article could come from 2012, so I focused my attention on the academic affiliations of the authors (not from major centers for the study of high IQ or of depression) and the journal of publication (not a top journal in this field).
There is a huge prior literature on associations between high IQ and mood disorders, with much of that literature summarized in the authoritative textbook by Goodwin and Jamison.
As a parent of four high-IQ children myself, painfully aware of how toxic the United States school system can be for such children,
I first of all sought local friendship networks of other parents who understand such children. We have been homeschoolers throughout our children's childhoods, and that seems to have provided our children with some extra scope for creativity and added resilience for facing personal challenges (including two international moves during the childhoods of our three oldest children). Through association with the Davidson Institute for Talent Development Young Scholars program,
we have learned about--and have shared--resources with other parents about building optimism in children. I especially like Martin E. P. Seligman's book The Optimistic Child
as a framework for children to learn how to reality-check their own thinking and not to be depressed by setbacks in life.
It has been known for quite a while that if a person is in a prolonged depressed mood state, simply shortening that person's periods of sleep (usually by getting the person up earlier, to bright light) can do a lot to boost the person's mood state.
On the other hand, for the many people who have bipolar mood disorders (so that they have abnormally elevated mood as well as abnormally depressed mood not related to immediate events in the people's lives), sleep deprivation can be dangerous, as it can trigger mania. Severe sleep deprivation can result in all the psychotic symptoms of florid mania even for most people without a medical history of mood disorders, and it is particularly dangerous for people who have already been through an episode of mania. So as other people here have already commented, regularity of sleep (sleep while it's dark, and get up while it's day) is helpful for mood disorders, up or down, and sleep deprivation by itself will not be a cure-all for all cases of depression.
AFTER EDIT: I appreciate HN participant falcolas reminding all of us, in a first reply to this comment, that the submitted article is about an animal model of a proposed drug treatment that may have some of the effects of sleep deprivation without having other effects. Yes, that is what the article is about, and I acknowledged that even after reading the article, the first part of this comment's text (above) had as much to do with other comments here as it had to do with the actual article, maybe more. That said, as investigation of new drug treatments moves from animal models to human clinical trials, the thing to look for in any drug proposed to treat "depression" (depressed mood) is whether it might trigger mania (elevated mood) in the patient receiving the treatment. It's tough to develop an animal model of the psychotic symptoms of mania, which is why this is not an easy problem to solve--how to develop a drug that makes depressed patients enjoy normal mood states without breaking through to florid mania.
Abstract of the article, including link to a related resource:
The research finding here was surprising to me, so I submitted it even though it will eventually need more replication.
The research group involved in the research
has an appropriate background for conducting this kind of research.
This preliminary finding about a serotonin reuptake inhibitor helping brain cells stay healthy is consistent with earlier findings I have read about in relation to lithium, another drug used to treat depression. Animal necropsy studies appear to show that lithium preserves nerve cells in the brains of animals treated with it as compared to controls. The references to this can be found in the standard medical textbook about mood disorders by Frederick Goodwin and Kay Redfield Jamison.
So perhaps the findings generalize to the idea that preserving youthfulness ("plasticity," that is adaptability) of the brain helps people suffering from depressed mood develop new thought patterns, perhaps with additional help from talk therapy such as cognitive behavioral therapy.
I have to disagree with this statement and ask you to provide better sources than just the result of some Google search. The evidence gathered with citations to peer-reviewed literature in one of the definitive medical textbooks on the issue,
strongly suggests that lithium for bipolar mood disorders has long term benefit. (That's based both on the decades of human use of lithium in some countries and on the basis of animal studies followed up by necropsies of brain tissue.)
Apparently we are all in agreement that "self-medication" with alcohol is a very bad idea. But prescribed medication under supervision by a medical doctor can be a very good idea indeed.
After edit: Thanks for the mention of the interesting book in your reply. I read some of the reviews, and found this useful interview
with the author, who has a balanced point of view:
"Q: So do you think psychiatric drugs should be used at all?
A: I think they should be used in a selective, cautious manner. . . . I think we should look at programs that are getting very good results. This is what I love about Keropudas Hospital’s program in Finland. They have 20 years of great results treating newly psychotic patients. They see if patients can get better without the use of meds, and if they can’t, then they try them. It’s a best-use model, not a no-use or anti-med model."
After one more edit, an interesting review of the book mentioned in the reply to first version of this post:
Citations, please? I have the best regarded textbook on bipolar disorder
at hand as I type this, and there is no recommendation of nicotine for any patient there. I'm quite sure that "mood stabilizer" is an incorrect characterization of the drug effect of nicotine. Nicotine has very harmful effects on the personalities of long-term users. I've seen too many examples in the previous generation to recommend it to anyone in my generation.
One study on harm of smoking:
Socioeconomic Status, Smoking, and Health: A Test of Competing Theories of Cumulative Advantage
# Fred C. Pampel and Richard G. Rogers
# Journal of Health and Social Behavior, Vol. 45, No. 3 (Sep., 2004), pp. 306-321
One study on personality factors interacting with nicotine use:
Nicotine dependence, psychological distress and personality traits as possible predictors of smoking cessation. Results of a double-blind study with nicotine patch
Kay Redfield Jamison has been on lithium for a long time and credits it with saving her life. Lithium does have some nasty side effects and not all patients who start with it stay on it. Lithium does need to be used with medical supervision, as its "therapeutic range" is narrow.
It is incorrect that patients using mood stabilizing medications lack normal emotional affect. What they are often able to achieve, with differing patients benefitting more or less from differing medications, is freedom from ENDOGENEOUS mood variation unconnected to life events, and a return to the normal functioning of the human mood system as a response to what is objectively happening to the patient.
Investigation of long-term treatment effects of lithium on the human brain reported in the primary sources cited in the Goodwin-Jamison textbook
suggests lithium has a neuroprotective effect on brain cells. That is demonstrated by neuroimaging and brain chemistry studies in human beings, by in vitro studies of animal cells, by necropsy studies of animal subjects and by autopsy studies of human beings who die from causes other than mood disorders.
As I noted in each of those threads, the issue of connections between creativity and mood disorders has been studied at book length. The most authoritative of the several books on that issue is by psychologist (and mood disorder patient) Kay Redfield Jamison, author of Touched with Fire: Manic-Depressive Illness and the Artistic Temperament,
and co-author of the definitive text on manic-depressive illness
who has thought out loud in her writings over the years about whether treatments for depression that help suffering people may also deprive society of creative output. Her current thinking on the issue--and she takes lithium herself every day--is that the best-evidenced mood-stabilizing treatments for mood disorders are helpful to patients and increase rather than decrease their ability to contribute useful work product to society. Her co-author, Frederick K. Goodwin, M.D., is still deeply skeptical of some antidepressant medications (e.g., the selective serotonin reuptake inhibitors) because of their capacity for inducing mania in many bipolar patients.
P.S. The illness of game theorist John Nash, the subject of the wonderful book A Beautiful Mind, was almost surely manic-depressive illness rather than schizophrenia. At the time he was diagnosed, American physicians misdiagnosed about 50 percent of cases of manic-depressive illness as schizophrenia, because of the mistaken diagnostic criteria used in Freudian psychiatry. Patients started getting better sooner in America as their diagnosis and treatment improved based on ideas from Europe (Kraepelin's diagnostic categories), Australia (lithium treatment for mood disorders), and America itself (cognitive talk therapy as pioneered by Aaron Beck, a former Freudian who found out that Freudian views of depression were incorrect).
There seems to be a seasonal surge of interest in this subject on HN right now. Hm.
that submitted this article, Kay Redfield Jamison, author of Touched with Fire: Manic-Depressive Illness and the Artistic Temperament,
has thought out loud in her writings over the years about whether treatments for depression that help suffering people may also deprive society of creative output. Her current thinking on the issue--and she takes lithium herself every day--is that the best-evidenced mood-stabilizing treatments for mood disorders are helpful to patients and increase rather than decrease their ability to contribute useful work product to society. Her co-author, Frederick K. Goodwin, M.D., is still deeply skeptical of some antidepressant medications (e.g., the selective serotonin reuptake inhibitors) because of their capacity for inducing mania in many bipolar patients.
It took me a while in my offline personal life for the very evident counterexample to come to mind. In fact, it is well known that human mood can go wrong in two ways: by being too low (depression) but also by being too high (mania). To date, there isn't any medication that reliably raises the mood of individuals in normal mood states without subjecting some of those individuals to severe risk of psychotic mania. Anyone proposing policy reform as to this issue should be aware of this fact. Here are some reading references for HN participants who would like to know more about the medical research on mood disorders:
Depression: Causes and Treatment, 2nd Edition
(a very recent book, by the inventor of cognitive therapy)
(a very authoritative textbook with extensive references to primary research literature).
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