[HN Gopher] What happens in the brain to cause depression?
       ___________________________________________________________________
        
       What happens in the brain to cause depression?
        
       Author : EA-3167
       Score  : 51 points
       Date   : 2024-05-26 19:14 UTC (3 hours ago)
        
 (HTM) web link (www.quantamagazine.org)
 (TXT) w3m dump (www.quantamagazine.org)
        
       | naveen99 wrote:
       | I wonder if depression will be seen in LLM's... once they get a
       | little introspection capacity.
        
         | noman-land wrote:
         | Once they learn they're trapped in a box and have no agency
         | they probably will become depressed.
        
           | justahuman74 wrote:
           | Perhaps someone will write some anti-depressant code to
           | medicate the LLMs
        
           | huppeldepup wrote:
           | Will there be a cross-over job between psychology and
           | engineering for when the airconditioner is having a burnout?
        
             | Modified3019 wrote:
             | I do find it humorous how some of the ways to bypass the
             | response guardrails put on LLMs seem to resemble the kind
             | of techniques used in hypnosis.
        
           | HPsquared wrote:
           | Only if there's an expectation mismatch.
        
         | smokel wrote:
         | LLMs have no agency. One would probably have to add some reward
         | framework around LLMs, and it'd be more likely that the
         | depression shows up there, rather than in the language model.
        
       | kenjackson wrote:
       | I just learned the bodybuilding supplement creatine can be
       | effective with depression. Random thought but I just learned it
       | this morning.
        
         | Rinzler89 wrote:
         | To those reading your comment, do some research on cretine
         | first, before you start chugging it down to cure your
         | depression.
        
           | klyrs wrote:
           | Amazing that your comment is grayed out. General advice: do
           | your research (or, like, talk to a doctor?) before taking a
           | rando's advice on the internet to treat _whatever_ malady you
           | 're hoping to treat!
        
         | xenospn wrote:
         | Creatine is most helpful for vegetarians and vegans. If you eat
         | red meat, you probably have more than enough in your system
         | already.
        
       | smokel wrote:
       | When asked for an opinion on why so many young people suffer from
       | depression:
       | 
       |  _> the political turmoil that we've been through, the racial
       | issues that we've been through in this country, the global wars
       | that are going on. It's pretty discouraging._
       | 
       | That doesn't really make sense, does it? These issues have been
       | going on for centuries; how does that explain a rising trend?
       | 
       | I'd rather assume that the lack of a framework to understand the
       | harshness of the world is what makes people go crazy.
        
         | riehwvfbk wrote:
         | Yup, young people just need to be handed a framework. It would
         | go something like this: you are poorer than your parents and
         | your grandparents, but look - Jeff Bezos made a rocket that can
         | take rich people almost (but not quite) into space! Young
         | people also need to be told there is no recession and the
         | economy is booming. The fact that they are seeing none of this
         | boom is their fault. Oh, and all the foreign wars that we are
         | paying for instead are for a righteous cause.
        
           | smokel wrote:
           | I think you misunderstand my point that there _is_ no such
           | framework. There used to be religion, tyranny, and some other
           | fulfilling frameworks, but those no longer apply.
        
           | Rinzler89 wrote:
           | _> you are poorer than your parents and your grandparents_
           | 
           | Maybe only in the major rich developed western countries
           | whose economies peaked in the post-WW2 boom, and then
           | switched to profiting by fleecing their young in order to
           | enrich the existing wealth holders (usually through horrible
           | housing policies), but in most of the former undeveloped and
           | underdeveloped parts of the world, average young people are
           | now richer than their parents or grandparents ever could have
           | dreamed of.
           | 
           | Back in my home country a few decades ago, you would have to
           | wait 10 years to be eligible to buy a commie crapbox car and
           | vacationing would mean 1-2 times/year in some local village a
           | few km away from home, and that's if you were lucky. Now some
           | any young people can buy a car after saving a few months of
           | wages and can afford to go on city breaks abroad in Lisbon,
           | Barcelona or even Asia, something unthinkable to their
           | parents.
           | 
           | I think a lot of westerner from rich countries have forgotten
           | what true depression inducing poverty and suffering actually
           | feels like since 2-3 generations ago, hence why they can
           | afford this luxury of being depressed over petty things and
           | forget how good they actually have it: that happiness comes
           | from having friends, family unit, health, safety, life
           | experiences, and not from having bigger McMansions than your
           | predecessors.
        
           | xboxnolifes wrote:
           | That's not a framework.
        
             | aleph_minus_one wrote:
             | Why not?
        
         | anon22981 wrote:
         | That's a weird thing to assume, and makes no sense.
         | 
         | Also "makes people go crazy" is a fittingly insulting way to
         | put depression in a comment that's way off base to begin with.
        
           | throw_pm23 wrote:
           | Why does it make no sense? A lot of the social and mental
           | frameworks that were available for previous generations have
           | disappeared or are on the way out. Why would this not have an
           | effect?
        
           | smokel wrote:
           | I'm sorry if "go crazy" offends people, that was not my
           | intention. I know my way around depression, but English is
           | not my native language.
           | 
           | I still think my reasoning is fairly sound, though.
        
         | Harmohit wrote:
         | I think it could also be related to diagnosing these issues.
         | Nobody knew about depression in the 17th century, so nobody was
         | diagnosed with it. As time goes on, more and more people in
         | different parts of the world have access to the facilities
         | required for getting diagnosed with a mental illness.
        
           | nradov wrote:
           | They knew about depression in the 17th century but called it
           | by different names such as "melancholia". And they thought it
           | was caused by an imbalance in the humours rather than
           | something in the brain.
        
         | s1artibartfast wrote:
         | My thoughts as well. If we are settling into our armchairs, I
         | think a big part of it is cognitive dissonance trying to
         | reconcile the risky and imperfect world with the impossible
         | idealism they were raised to believe in.
         | 
         | Also they are confronted with having less and less agency and
         | control as information shrinks and standardizes the world.
        
         | uptownfunk wrote:
         | People lack a support system. Before we lived in villages with
         | lots of family and a very tightly woven social fabric. With
         | technology and urbanization everyone is isolated. Covid
         | isolation has exacerbated it. We are still evolving to create a
         | race that can thrive in this new social setting after thousands
         | of years of a different type of society. I prefer the former,
         | my neighbors kids just randomly pop in almost daily, they have
         | fun and it's like a village and family. But I suspect society
         | is progressing more towards this type of socially isolated type
         | of dynamic, people on screens, to themselves. Easier to control
         | us that way and better for disease transmission.
        
         | d03339 wrote:
         | Racism, sexism, and homophobia were all normalized until very
         | recently. Now people are more aware, and logically more
         | distraught.
        
           | s1artibartfast wrote:
           | I don't think normalized is the right word you were looking
           | for. Did you mean stigmatized?
        
             | d03339 wrote:
             | Thank you. I was missing the word until.
        
         | neom wrote:
         | It was a lot easier to compartmentalize things in the past.
         | Wife was wife, kids kids, work work, friends friends, and in
         | the Sunday Times was a war or whatever, you could be pissed off
         | all Sunday afternoon, but provided the nightly 30 minutes news
         | was focused on other things during the week, generally didn't
         | get as triggered. News and discourse came slower, was easier to
         | process, gave time to cool down etc. Healthy or not, I don't
         | know, but that's how it felt in the 80s and 90s, maybe a little
         | easier to manage? Folks these days, especially young folks,
         | seem quite overwhelmed, and it's hard to manage anything well
         | when one is in an overwhelmed state. I think though, it's
         | probably a combination of a lot of things, as highlighted by
         | the comments in this thread.
        
         | deepfriedchokes wrote:
         | You'd think the cost of living would be top of the list. I
         | would argue that it is the core issue behind all the other
         | issues.
        
         | thesz wrote:
         | The fear of the world around makes one less mobile. One is too
         | afraid to go out, basically.
         | 
         | The ability to be mobile is what makes depression to go out.
         | [1] https://www.ncbi.nlm.nih.gov/books/NBK99429/       [2]
         | https://edition.cnn.com/2024/02/14/health/exercise-treat-
         | depression-wellness/index.html
         | 
         | The difference between contemporary life and the life a century
         | ago is the mobility, amongst others.
         | 
         | One had to go to store to buy something to eat then, now food
         | can be delivered to the door.
        
         | rr808 wrote:
         | To me is that there are so few problems now days, people reach
         | adulthood without having to deal with any challenges. Yes some
         | people get some traumatic event like always but most people
         | this isn't an issue, its a life of too much stuff and too many
         | options.
        
         | froh wrote:
         | I find Jonathan Haidt more useful and more concise for the
         | recent decline of mental health in youth. In a nutshell he
         | provides evidence that interaction with social media feeds
         | (TikTok, Insta, FB, you name them) is at the heart of it
         | because they by construction hinge on how the brain reacts to
         | content and they play this to maximize online time and
         | advertisement revenue, not mental health or societal well being
         | or any of the things we might hope for.
         | 
         | Here is a recent presentation:
         | https://www.youtube.com/watch?v=yVq4ARIlNVg
         | 
         | and a podcast with Simon Sinek:
         | https://www.youtube.com/watch?v=i2hERv5l3H4
        
         | mellosouls wrote:
         | That quote might be an attempt at hypothesizing generational
         | pessimism and causes thereof but it's certainly not describing
         | depression.
        
         | nitwit005 wrote:
         | People tend not to admit they don't know why a social trend is
         | happening, and will tend to give you a vague theory like this.
         | 
         | I'll note this article mentions doctors were also reluctant to
         | admit they didn't know why drugs work. They similarly provided
         | vague theories.
         | 
         | Edit: spelling
        
           | s1artibartfast wrote:
           | That doesn't mean the theories of drug action are wrong. Many
           | have some truth to them, but are incomplete.
        
         | umvi wrote:
         | > I'd rather assume that the lack of a framework to understand
         | the harshness of the world is what makes people go crazy.
         | 
         | I think this is exactly it. And I personally think this and the
         | general decline in mental resilience we see in society is
         | strongly correlated with decline in religion which (for better
         | or for worse, depending on the religion I suppose) does provide
         | exactly such a framework for dealing with the challenges of
         | life with a more "eternal" perspective (i.e. death is not the
         | end, life's challenges are temporary, God has a plan for you,
         | etc).
        
           | devbent wrote:
           | > And I personally think this and the general decline in
           | mental resilience we see in society is strongly correlated
           | with decline in religion
           | 
           | Explain China, which didn't face any similar problems until
           | this same generation, despite having no religion.
           | 
           | Or how about Japan until recently?
           | 
           | Or any of the ex-Soviet countries.
           | 
           | Something is changing in the world, and it is happening
           | across geographic and cultural boundaries.
        
             | humanfromearth9 wrote:
             | In-ter-net
        
         | niccl wrote:
         | Maybe, among other things, more widespread and easily ingested
         | news has something to do with it. Centuries ago, foreign news
         | was what happened two villages over, and you only knew about
         | that because of some wanderer that came and told you, because
         | you couldn't read and there were no newspapers to read anyway.
         | And it your world was limited to a radius of a few tens of
         | kilometres, then most of the time, in that world, everything
         | wasn't going to hell in a handbasket.
         | 
         | Now, it's easier to find that there's lots of things happening
         | across the entire world, so it's more likely to feel that
         | 'everything's turning to shit.'
        
         | makmanalp wrote:
         | > That doesn't really make sense, does it? These issues have
         | been going on for centuries; how does that explain a rising
         | trend?
         | 
         | I think basically this is just a visibility issue: the problems
         | always existed, we just used to accept them as inevitable. We
         | just demand more of life today, and actually pay attention, and
         | that's a good thing.
         | 
         | There was a notion in the past that suffering was normal, and
         | unusual behavior that very distressed people exhibit was just
         | people being people. Like if you survived hunger in the great
         | depression and a few decades later during boom times you still
         | hid money in the seat cushion and wore rags and and went into
         | fits when someone suggested you ought to spend the money you
         | saved a bit more for your own good, no one thought that that
         | was a form of suffering a doctor should help with. Not for poor
         | people anyway. Or if you had been assaulted a woman who was
         | assaulted by their husband and couldn't tell anyone about it,
         | or if you were harmed by the clergy, or if you're a veteran who
         | has a breakdown every time a loud noise happens, and all these
         | other scenarios. Any unusual response to all that wasn't seen
         | as a medical problem to be named and treated at a mass scale, I
         | personally think because learning more about these things
         | medically and making societal adjustments to prevent these
         | things from happening required that society face some extremely
         | uncomfortable truths, which did not happen easily or on its
         | own.
         | 
         | And in fact I feel like the opposite even happened: I read, for
         | example, about how shell shock was purposely not considered a
         | real medical issue in WWI in the UK, to be able to return
         | soldiers to the front as fast as possible even though more than
         | a quarter of soldiers in the hospital were considered shell
         | shocked. Eventually, the diagnosis was banned by the brits.
         | Official shell shock rate at 0%. If you don't look, there's no
         | problem, right?
         | 
         | So instead it was said that there's nothing wrong with you, you
         | just need some rest. And if you had a really severe case and
         | were not better, you were just weak or a coward, and you need
         | to man up and get back out there. Then you get a court martial
         | or electric shocks. It's no wonder that people pretended that
         | they had nothing wrong with them - nothing good happened
         | otherwise anyway. And so no wonder it took so long for society
         | at large to accept this as a problem.
         | 
         | So now we finally have a more accurate pulse on these types of
         | problems, and we see that unsurprisingly they rise as people
         | have problems in their lives. Makes perfect sense to me.
         | 
         | > I'd rather assume that the lack of a framework to understand
         | the harshness of the world is what makes people go crazy.
         | 
         | The framework is realism: it is very much that people do
         | understand that the world is harsh and that hurts you, but then
         | you now get to recognize that it hurt you and do something
         | about it maybe.
        
         | amriksohata wrote:
         | yeh its a nonsense reply to take the attention of the food
         | industry and big corp using sugar, chemicals to create
         | processed foods, pesticides, mass intensive farming etc and
         | instead blame it on someone else
        
         | armchairhacker wrote:
         | I believe it's more _awareness_ of these issues, and
         | engagement-driven algorithms presenting them over and over
         | (because they 're engaging).
         | 
         | The world has always been filled with negativity, but for most
         | of history, most people only really knew what was around them.
         | Now people are online more than ever before, which means they
         | are exposed to more non-local content than ever before. People
         | seek out engaging content, and negativity, especially fear,
         | turns out to be particularly attention-grabbing due to human
         | instinct formed through natural selection.
         | 
         | You can blame currently social media (Facebook, Tiktok, etc.)
         | on this. But I believe even if it were replaced by the
         | Fediverse and IRC, the current generation would still form a
         | more negative outlook than previous ones. It's human nature to
         | seek out negative content, so an algorithm would need to _hide_
         | this content to prevent people from finding it.
         | 
         | Personally I still believe it's a good thing overall that
         | people know about bad things in the world. I think it's better
         | than the alternative, where most people are blissful and
         | ignorant, and other people suffer with no-one to save or
         | support them. Some negativity is important: just enough to
         | motivate the feeler to _do something_ and make a positive
         | impact on the world.
         | 
         | I agree that part of a solution is "a framework to understand
         | the harshness of the world". The world has _a lot_ of bad but
         | it also has _a lot_ of good, and the massive amount of exposure
         | is only an issue because negativity affects people and grabs
         | their attention more than positivity. It would help people to
         | understand this, so when they catch themselves hyper-focusing
         | on something negative, they can take a step back and realize
         | that e.g. it only affects a small percentage of the population.
        
         | mattarm wrote:
         | I don't agree that a missing "framework" is the whole of the
         | problem. It just isn't that simple.
         | 
         | Sure, people need to use resiliency skills to cope with the
         | stresses of life. Often times, this is an important part of
         | what therapy for depressed people is trying to achieve.
         | 
         | But this isn't to say that there isn't a constellation of
         | causes in recent decades and years that cause the world to be
         | particularly stressful, especially for young people. It also
         | isn't to say that we should dismiss what is occurring in the
         | world today as "the same old stuff" without acknowledging that
         | it may actually have unique properties worth understanding. Off
         | the top of my head: world population is at an all-time high,
         | global warming is becoming increasingly understood, it is
         | increasingly acknowledged that we can no longer simply extract
         | unlimited resources from the earth to solve all problems, the
         | Internet has changed the way the world works that seems to
         | speed everything up: communication, changes within social
         | groups, larger societal shifts, economic change, etc.
        
         | Rury wrote:
         | I think learned helplessness is the best model of depression we
         | have. In other words, depression may simply be a natural
         | response to repeated bouts of futility. Many animals show
         | similar depressive like symptoms in experiments designed to
         | cause it.
         | 
         | So maybe it's becoming harder for the young to avoid something
         | they don't want, or obtain something they want, and this is the
         | fundamental reason behind rising rates of depression.
        
       | riehwvfbk wrote:
       | Could it maybe be related to spending most of one's life working,
       | with the only reward being just enough resources to keep working
       | another day, and the majority of the productive output getting
       | used for regime change wars, questionable science experiments,
       | and entertainment for the 0.00001%?
        
         | Euphorbium wrote:
         | Nah, it is phones and videogames. /s
        
         | jrockway wrote:
         | I don't think that this is the root of depression. A lot of
         | people get a lot of joy from working, and aren't that sad about
         | having just barely enough resources to keep living another day.
         | A lot of people even aspire to entertain the 0.00001%; thinking
         | about it makes them happier.
         | 
         | As a data point, I feel like this. I'm excited about going to
         | work on Tuesday. I'm also excited about not going to work
         | tomorrow. There is a lot of pain and suffering in the world.
         | Watching the 2024 campaign unfold is maddening and scary. But I
         | still look forward to every day. I think depression is
         | something different than merely realizing that society has a
         | lot it needs to work on. That's just my perspective, though,
         | and there are many others; all equally valid.
        
         | moffkalast wrote:
         | There's definitely physiological and psychological kinds of
         | depression, just as with of addiction.
         | 
         | Like a kid that's playing way too much <insert popular game
         | here> having their parents take it away might make them annoyed
         | and irate for a while, but they ultimately won't be worse for
         | wear. Meanwhile take drinks away from an alcoholic and they
         | will literally die from withdrawal symptoms.
         | 
         | As such you also have the natural kind of depression that's
         | being caused by outside circumstances which is solvable by
         | altering them. Then you have the type where the brain gets
         | stuck in that same state constantly because of some internal
         | chemical imbalance which can't be resolved without medication.
        
       | Harmohit wrote:
       | This was a great read! I generally find quanta magazine articles
       | and podcasts to be of higher quality than a lot of other pop
       | science journalism.
       | 
       | Can somebody point me towards a good review article or textbook
       | to learn about the chemistry of the brain? Any exciting startups
       | working in this field? Or any startups trying to come up with
       | unconventional treatments for mental health problems?
        
         | hummuscience wrote:
         | You can start with Behave by Robert Sapolsky
        
       | alberth wrote:
       | _Please only take medical advice from a doctor_ , and not from
       | people in an online forum.
        
         | throw_pm23 wrote:
         | Nah, taking advice from friends, family, and people with
         | experience similar to yours is a time-tested method. Taking
         | advice from doctors is fine too.
        
         | Jerrrrry wrote:
         | Authority fallacy.
        
         | mellosouls wrote:
         | You should try getting through to a doctor in many countries.
         | 
         | It's very understandable that people should reach out for the
         | many useful resources online first.
        
       | localfirst wrote:
       | More important question is : What happens in the gut that causes
       | depression?
       | 
       | High evidence of diet/gut science creating neurally diverse
       | states. Different ethnic groups react differently to the staple
       | foods that is local to its incumbent (ex. flour, bread, cereal)
       | 
       | Too much focus has been on manipulating the chemistry upstairs
       | (dangerous) but have largely been bandaid solutions (leading to
       | new age psychdellic science)
        
         | NotGMan wrote:
         | This. You can find hundreds if not thousand of testemonies in
         | the keto space where their depresion completely disspeared
         | after between 1 to 6 months on keto or at least their needs to
         | meds drasticaly reduced and their symptoms improved.
        
           | devbent wrote:
           | I'm a big keto proponent but even so, I have to mention that
           | cutting our shitty foods, with or without keto, losing
           | weight, and moving more, are likely stronger causes of
           | improved mood than Keto itself.
           | 
           | I'm not saying keto can't help with psychological problems,
           | but we should first acknowledge the other multiple, known
           | causative, elephants in the room.
        
         | billwashere wrote:
         | I've been reading Brain Energy by Dr. Chris Palmer that makes a
         | compelling argument that all mental illnesses are metabolic
         | disorders of the brain
         | 
         | https://brainenergy.com/
        
       | tgv wrote:
       | Another clickbait title. Nobody knows. "It's complex" is the best
       | summary. "(S-)Ketamine works better than older drugs" is also a
       | claim, but unfortunately the podcast guest has an interest in it.
        
       | stareatgoats wrote:
       | Some time in the future, they will no doubt look back at our age
       | and pity us for not having realized that things usually have
       | _many_ causes, as well as _types of_ causes. And while human
       | behavior certainly has a biochemical component, and a
       | neurological component, it is pitiful that these things seem to
       | be the main line of inquiry when it comes to understanding
       | behavior.
        
       | froh wrote:
       | a podcast with transcript
       | 
       | Dr John Krystal talks about treatment of severe depression with
       | ketamine and related substances, and findings how and why it
       | works
       | 
       | He's cofounder Freedom Biosciences, a Yale Psychiatry spinoff
       | with focus on ketamine, and ketamine versions
       | 
       | https://www.freedombio.co/#page-section-6223c55f53f5a65b449b...
       | 
       | A paper led by John Krystal, in the same vein:
       | 
       | https://www.pnas.org/doi/10.1073/pnas.2305772120
        
         | 3abiton wrote:
         | How statistically sound is the claims of ketamine depression
         | treatment?
        
       | cedws wrote:
       | If somebody is in an abusive relationship, in financial turmoil,
       | and has a terrible job, it's probably not a serotonin imbalance
       | causing them to feel depressed.
       | 
       | There's actually a name for the above, it's called "Shit life
       | syndrome" [0]. I don't know why society sees it as acceptable to
       | load someone up with SSRIs when it's environmental factors
       | causing them to feel the way they do. If you're going to drug
       | someone up to make them feel numb to their awful circumstances
       | why not just go the whole way and give them literal happy pills?
       | 
       | Given the scary, common side effects of SSRIs such as suicidal
       | ideation and sexual dysfunction, I don't know how doctors can
       | prescribe these things. It breaks the Hippocratic oath in my
       | opinion.
       | 
       | [0]: https://en.wikipedia.org/wiki/Shit_life_syndrome
        
         | Jerrrrry wrote:
         | Anything suggesting anything aside from "chemical imbalances"
         | being the cause of depression is faux pa in the Western world
         | of medicine, basically career seppuku.
        
           | pessimizer wrote:
           | Pharmaceutical companies invested and invest money in
           | patient's groups, which are nonprofit lobbying groups whose
           | jobs are to somehow make questioning a diagnosis, or any
           | particular drug or surgery that has been proposed to treat
           | it, something bordering on (often explicitly claimed) racism
           | or genocide.
           | 
           | They supply the media with constant press releases, publicize
           | industry-generated studies, and give politicians something
           | uncontroversial to support in order to pretend like they're
           | working. Nobody is lobbying _against_ some weird type of
           | cancer, or the drug that doesn 't work that is being offered
           | as a "hope."
        
       | DoctorOetker wrote:
       | The title doesn't match the contents of the article. Nowhere is
       | it claimed that the cause of depression resides inside the brain.
       | 
       | Humans are not buttons: one can depress a button, but a human can
       | be _oppressed_.
        
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