Folk Neuroscience

March 6, 2013 8:22 PM

Folk Neuroscience: how inaccurate neurological concepts have become cultural staples.
posted by Scientist (52 comments total)

Which hemisphere of my brain should I use to read this article?
posted by chrchr at 8:38 PM on March 6 [4 favorites]

Northern
posted by Eyebrows McGee at 8:39 PM on March 6 [14 favorites]

It is important to bear in mind that part of this persuasive force comes from genuine scientific progress.

Well, yes. Like all pop science, these utterances are a mixture of concrete findings and socially constructed interpretations. On the one hand there are some positives to recognizing that we are at least partially driven by biological systems, and on the other hand someone please send this to my CEO because I am tired of pat, facile "neuroscience sez!" arguments.
posted by Miko at 8:43 PM on March 6 [1 favorite]

Every time I hear someone on the radio or TV who says "our brains are hardwired for X" makes me scream like a pterodactyl and smash my hand through the off button. (It's weird that I do that. I guess I'm hardwired for it.)
posted by JHarris at 8:55 PM on March 6 [20 favorites]

One of the more fundamental laws of online journalism must state that, for every article in the popular press that deals with neuroscience in any capacity, there will be a flock of the outraged in the comments section who insist that the author has gotten the basics of their field wrong and must, therefore, be ignored on every count. There's a lengthy argument about the embodied, embedded brain running below this article (it's one of a few), which begins with an outright dismissal of Bell, as if he has every responsibility to write a book-length introduction to the field, for having brought the brain up at all. (Or: as if every mention of the "brain" must be footnoted, to include the caveat that no brain has yet been observed functioning on its own, in a jar. This, in addition to any other caveat commenter x has made it their goal to harp on.) I don't know if these scrums come about because neuroscience is so young and often on the defensive, there being a number of challenges to its worth—most of which seem to take the tone of, "well, it isn't a cure-all, so it must not be very useful"—or because, well, it's the internet: bring on the bickering.

Obviously this article was written for an audience that has often been exposed to all this "folk neuroscience," in an attempt to urge its members into thought. And it's done well enough, really.
posted by mcoo at 9:02 PM on March 6 [1 favorite]

I dunno about you people but I am just a brain in a vat somewhere
posted by Divest_Abstraction at 9:10 PM on March 6 [3 favorites]

Every time I hear someone on the radio or TV who says "our brains are hardwired for X" makes me scream like a pterodactyl and smash my hand through the off button. (It's weird that I do that. I guess I'm hardwired for it.)

I definitely am!
posted by Mrs. Pterodactyl at 9:10 PM on March 6 [18 favorites]

■ Low serotonin causes depression
A concept almost entirely promoted by pharmaceutical companies in the 1980s and 90s to sell serotonin-enhancing drugs like Prozac. No consistent evidence for it.

The whole article is worth it for this. The concept of depression as a "chemical imbalance" promotes the ridiculous idea that we know what the correct "chemical balance" is, and we can just tune you up and off you go. This is not how it works. See AskMe for any number of people describing long periods of trial-and-error in their antidepressant prescriptions.
posted by thelonius at 9:19 PM on March 6 [18 favorites]

Having read the article, I thought the "Folk Neuroscience Popular Misconceptions" bit at the end was interesting (if not surprising) and I wish there had been more of that. The article itself was longer than it needed to be and didn't seem to say anything particularly groundbreaking. I think it could have been improved by basically just saying:

We use neuroscience all the time as an excuse or explanation for different behaviors, but the science doesn't support this. We are still learning a lot about how the brain works and as a neurologist I can tell you that we still have a long way to go and it's hard to interpret the information we are getting at this point in time. Be wary of people using neuroscience to make a point because a lot of the time the actual study doesn't support their interpretation and remember that the fact that "everyone knows that..." doesn't actually make it true. Here are just some examples of ways people think about the brain that are wrong!
posted by Mrs. Pterodactyl at 9:22 PM on March 6 [3 favorites]

The concept of depression as a "chemical imbalance" promotes the ridiculous idea that we know what the correct "chemical balance" is, and we can just tune you up and off you go. This is not how it works. See AskMe for any number of people describing long periods of trial-and-error in their antidepressant prescriptions.

That's true and very fair, but I think that socially there has been value to that idea in that it makes it more "medical"; unfortunately mental health issues are still fairly stigmatized and having something wrong with your brain helps convince people you aren't faking it or lazy or attention-seeking or whatever and that you actually do need medication, and I say this as someone who has had a TON of "trial-and-error" antidepressant prescriptions, some of which made me worse instead of better. The thing is, as the article points out, the brain is not simple and lots of different things affect it and, thinking about your tune up idea and the article's point that there are many factors that affect how our brains work, for many people with mental health issues medicine is going to need to continue to be changed and tweaked forever (for example, I take less of my anti-depressants in the summer or I get pretty manic and I up the dose in the winter so I am able to get out of bed in the morning). I think any recognition that the brain is super, super complicated is helpful but if that isn't going to happen right away at least a recognition that mental health issues are real health issues is an improvement.
posted by Mrs. Pterodactyl at 9:29 PM on March 6 [5 favorites]

unfortunately mental health issues are still fairly stigmatized and having something wrong with your brain ...

... causes people to stigmatize it more:

[A] review of the literature to date in 2006 found that overall, biogenetic causal theories, and labelling something as an “illness”, are both positively related to perceptions of dangerousness and unpredictability, and to fear and desire for social distance. They identified 19 studies addressing the question. 18 found that belief in a genetic or biological cause was associated with more negative attitudes to people with mental health problems. Just one found the opposite, that belief in a genetic or biological cause was associated with more positive attitudes.

These findings are at odds with everything that many people who campaign against stigma have assumed for many years, but they’re not entirely nonsensical. ... [A] story about genetic causes may lead to people being conceived of as “defective” or “physically distinct”. It can create an “associative stigma” for the whole family, who in turn receive new labels such as “at risk” or “carrier”. What’s more, this stigma may persist long after the ADHD symptoms have receded in adulthood: perhaps a partner will wonder: “do I really want to risk having a child with this person, given their genetic predisposition?”

Perhaps it will go further than that: your children, before they even begin to show any signs of inattentiveness or hyperactivity, will experience a kind of anticipatory stigma. Do they have this condition, just like their father? “It’s genetic you know.”

posted by John Cohen at 9:39 PM on March 6 [17 favorites]

I'm waiting 'til they find the part of the brain that hungers for simplistic mechanical explanations.
posted by benito.strauss at 9:40 PM on March 6 [6 favorites]

"Brightly coloured brain scans are a media favourite as they are both attractive to the eye and apparently easy to understand but in reality they represent some of the most complex scientific information we have."

When I was in grad school about 10 years ago I was a "brain dummy" at a brain imaging research center -- that is, I was a research subject in as many studies as I could get into (which was eventually ALL of them) because they paid some insane amount (I think it was like $20/hour. Don't judge, I was in grad school) and I had probably 20 fMRIs in three years for all these different studies, ranging from fledgling grad students to emeritus researchers. The MRI tech and I got to be good buddies. I did all kinds of tasks while they scanned my brain -- watched movies, played video games, looked at pictures, answered questions, listened to music, played an on-purpose malfunctioning video game that made me want to STAB EVERYTHING ... all different stuff. What struck me (as a layperson subject) about the studies was how scattershot most of them were; they weren't focused in on a narrow question or trying to discriminate a particular outcome, but more like, "What happens if I do this?" Brain imaging is just such an incredibly young field, it's still kind-of in the "poke with stick, see what happens" era of research. I also participated in a couple where they were still trying to develop a method that would get at whatever they were trying to get at, and it was interesting to see them flail about for methods that would get them good data.

Anyway I mostly want to tell that story because I want to brag that I had so many MRIs that I learned to nap in the (yes, extremely loud) machine, which led to several MORE scans either to serve as "anatomical normal" because they could get such a good clear scan because I wasn't moving around at all or to get an MRI of someone sleeping because that is apparently something of an experimental challenge what with all the banging magnety things.

Whenever I see an article with side-by-side brain scans, one labeled "normal" and the other labeled "cat stoned out of its gourd on catnip," I check the source and get excited if it's the place I got scanned, because that just might be my brain!

Participating in EEG studies sucked, though, because they paid badly, had terrible parking, left you with gross goop in your hair, and people were constantly reprimanding you for blinking. Any neuroscience conclusions drawn from EEG studies are based entirely on aliens wearing human skins who never need to blink. You've been warned.
posted by Eyebrows McGee at 10:16 PM on March 6 [26 favorites]

Dear Neuroscience,

Your turn!

love,
Genetics
posted by en forme de poire at 10:32 PM on March 6 [16 favorites]

trial and error in their antidepressant prescriptions

Trust me, the trial and error feeling goes for pretty much all of psychiatric medicine. I have been given, in the last year alone, thirteen different medications attempting to manage my symptoms. That is just the number of different medications, the dose age and combination variations I have been through puts the total number of differing programs in the high 30's.

Sometimes, I think that Scientology must be onto something in their complete rejection of psychiatric medicine. Well, until I realize that was just Elrond Hubbard's way of assuring his disciples would not seek outside help..
posted by mediocre at 10:45 PM on March 6

One era's state of the art becomes the next era's incorrect folk science. But not the one we are in right now, this time we understand it.
posted by psycho-alchemy at 10:56 PM on March 6 [3 favorites]

The concept of depression as a "chemical imbalance" promotes the ridiculous idea that we know what the correct "chemical balance" is, and we can just tune you up and off you go. This is not how it works.

Not to mention that the serotonin-level-altering effect of SSRIs happens essentially immediately, but the therapeutic effects usually take weeks to show up.
posted by en forme de poire at 10:56 PM on March 6 [2 favorites]

The saddest thing about misinformation about neurology is, to me, that it just takes away from how genuinely phenomenal the current research is.

Neurology is at that wonderful point -- like physics in the 1920s, maybe, or chemistry in the mid 19th century -- where we're just starting to get an idea of what we don't know, and have the tools to solve the problems. With brain imaging, MR spectroscopy, biochemistry, epigenetics... there are discoveries just sitting there waiting for a curious researcher to stumble upon them.

We have a neuropsych post-doc visiting in our MRI research lab (we're a bunch of dumb physicists) who every day in casual conversation suggests really cool research projects that just need time and funding. Talking to her is always an experience: "I notice you're left handed and wear glasses! That reminds me of a study I've been meaning to do....".

So there's such wonderful information to be mined by journalists, if they were willing to try to understand the research. You don't have to be Oliver Sacks. The stuff should write itself without having to fall back on stereotypes and tropes.
posted by no regrets, coyote at 11:05 PM on March 6 [5 favorites]

Neurologists, as a group, are really clear writers and explainers. As a fairly science-naive journalist, I find neurologists the easiest scientists to interview (or tied with paleontologists, maybe).

I actually think a lot of the problems come from a) university press releases, and b) psychologists writing about neurology (Psychology Today is a particularly frequent offender).
posted by Sidhedevil at 11:17 PM on March 6 [1 favorite]

Neither usefully accounts for the complex ways in which our social world and neurobiology affect our mood but in non-specialist debate that rarely matters.

This would have been a great opportunity for him to summarize the scientific consensus on how our 'social world and neurobiology' affect our mood - and any serious scientific disagreements on the matter.

■ We have no control over our brain but we can control our mind
The mind and the brain are the same thing described in different ways and they make us who we are. Trying to suggest one causes the other is like saying wetness causes water.

This seems very problematic to me. If I describe the color-sensation of red and a collection of grey neurons in the visual cortex, is this really describing the same thing in different ways like wetness and water? I don't like the water - wetness analogy because it's too tautological in comparison. Seems to me it would be better to say mind and brain are like water and H20.

So the mind and the brain are the same. Do 'we' have control over 'it,' then, or not? I suppose the next step is to clarify that 'we' or 'I' and the brain are also the same thing (or 'I' is part of the brain at least). Does the brain have control? I would guess the neuroscientific answer would be basically yes, with some randomness involved. So what is the fundamental problem with this pop neuroscience idea:

Unpleasant experiences from malaise to trauma to mental illness are re-framed as primarily neurological problems, while art and music are evaluated for their neurochemical effect.

Am I missing the difference between a neurological problem, behavior problem, and a brain problem?

It seems to me this article, and a lot of popular science articles, and maybe scientists themselves, overstate how much the scientific community truly understands and how much consensus there is - perhaps suggesting that (they) may not fully know their own actions and that their post-event justifications might be improvised. I guess I must admit the problem here may be that I am just confused and unable to understand.

Neurology is at that wonderful point -- like physics in the 1920s, maybe, or chemistry in the mid 19th century -- where we're just starting to get an idea of what we don't know, and have the tools to solve the problems. With brain imaging, MR spectroscopy, biochemistry, epigenetics... there are discoveries just sitting there waiting for a curious researcher to stumble upon them.

This is awesome and I look forward to reading about it.
posted by Golden Eternity at 11:29 PM on March 6 [1 favorite]

"Folk psychology" was originally a concept used by hard-core philosophy of mind materialists, such as the Churchlands, to deride the idea that our ordinary concepts of people's motives or intentions or goals have any actual explanatory power about the mind. So it's clever to apply the same disdainful term to the new neurological "common sense" wisdom about ourselves.

Someone smarter and less lazy than me could write a really interesting book about the development of "folk" science or philosophical explanatory frameworks for the mind. The dominant technology seems to inspire them - first there was mechanistic explanation (La Mettre's "Man, A Machine") then much later, the unlikely assumption that minds must work like programmable von Neumann computers. But people have adapted ideas from fields like ecology to the task as well.
posted by thelonius at 11:42 PM on March 6 [4 favorites]

The sad thing is that we really are hardwired for some things, like grammar. I find solid, empirically defensible neuroscience fascinating, but it's drowning in a sea of flimsy articles and preposterous newspaper headlines. (Girls are hardwired to like pink? No.)
posted by justsomebodythatyouusedtoknow at 12:27 AM on March 7 [1 favorite]

One that always annoys me is the "we only use 10% of our brain capacity" one that new agers tend to trot out. Unless we know exactly how the brain works, how can we say how much capacity we're using? Snopes has some good stuff on this one/
posted by memebake at 12:51 AM on March 7 [2 favorites]

As someone who spent some time studying neurophysics before, ironically, my brain went awry and (surprise!) I ended up with a very different life, one where I've been reading about linguistics in a fair amount of detail...

This is what happens to your brain when you read about a subject you know well in the mass media. You are shocked at the way journalists twist objective ideas to make narrative sense, and incensed when the people who used to ignore you at parties are now seemingly able to help fix your research problem with their own theories.

Also everyone is grateful to find out that they aren't prejudiced, they just spotted an objective fact before the scientists did.
posted by Wrinkled Stumpskin at 12:57 AM on March 7 [3 favorites]

I actually think a lot of the problems come from a) university press releases, and b) psychologists writing about neurology (Psychology Today is a particularly frequent offender).

I saw Dr. Drew prattle on about Neurology once, after Whitney Huston died. He was claiming that "addicts" had a certain part of their brain "Light up" when they took drugs or whatever and this was somehow the trigger of addiction or some crazy nonsense, and this was why prescription drugs were so dangerious for them.

The funny thing was they had Sanjay Gupta on a split screen with him and he just had this "WTF!?" look on his face while Dr. Drew was talking

The anchor actually asked Gupta if he agreed and he just said something like "Well, Drinking alcohol while on Xanax can be dangerous for everyone..."

This seems very problematic to me. If I describe the color-sensation of red and a collection of grey neurons in the visual cortex, is this really describing the same thing in different ways like wetness and water? I don't like the water - wetness analogy because it's too tautological in comparison. Seems to me it would be better to say mind and brain are like water and H20.

Water and H₂O are the same thing.

Am I missing the difference between a neurological problem, behavior problem, and a brain problem?

The problem is that people are vastly overstating our current understanding of neurochemistry when they make these kinds of claims
posted by delmoi at 1:28 AM on March 7

we really are hardwired for some things, like grammar

Well, that has been interestingly disputed, eg by Everett. My impression is that the thesis is something Chomsky came up with from his armchair, with some weakish corroboration from neurology, rather than a finding of modern neuroscience per se. But your neurons may vary.
posted by Segundus at 1:50 AM on March 7 [2 favorites]

The concept of depression as a "chemical imbalance" promotes the ridiculous idea that we know what the correct "chemical balance" is, and we can just tune you up and off you go. This is not how it works. See AskMe for any number of people describing long periods of trial-and-error in their antidepressant prescriptions.

Uhh, having to try several very close but different things until you get the best result is *exactly* what tuning is -- a period of trial and error until you get an acceptable signal.

Note "acceptable." It may be, with further antenna and tuner tweaks you could get a better signal, but tuning costs time, and you're trading that time for quality. At a certain point, the cost of time exceeds the benefit of a stronger signal, and you stop tuning and listen to the show.

Tuning is a wonderful description of the process with antidepressants.
posted by eriko at 2:07 AM on March 7

Whenever I see an article with side-by-side brain scans, one labeled "normal" and the other labeled "cat stoned out of its gourd on catnip," I check the source and get excited if it's the place I got scanned, because that just might be my brain!

You're a cat?? No wonder they kept scanning your brain...
posted by EndsOfInvention at 2:32 AM on March 7 [2 favorites]

Mumble mumble wedged mumble mumble never know mumble carry on.
posted by Segundus at 2:36 AM on March 7 [5 favorites]

The concept of depression as a "chemical imbalance" promotes the ridiculous idea that we know what the correct "chemical balance" is, and we can just tune you up and off you go. This is not how it works.

I'll take "chemical imbalance" as a concept over "character flaw", if you please.
posted by dhartung at 3:00 AM on March 7 [2 favorites]

The funny thing was they had Sanjay Gupta on a split screen with him and he just had this "WTF!?" look on his face...

I wonder if it's the same WTF look that's on my face whenever Gupta says something?
posted by Kirth Gerson at 3:43 AM on March 7 [1 favorite]

I'll take "chemical imbalance" as a concept over "character flaw", if you please.

These are not the only two choices, and they haven't been for a long long time.
posted by OmieWise at 5:53 AM on March 7 [2 favorites]

I'll take "chemical imbalance" as a concept over "character flaw", if you please.
Your brain prefers the former because it lets you off the hook. I prefer hamburger.
posted by Obscure Reference at 6:20 AM on March 7

I'll take "chemical imbalance" as a concept over "character flaw", if you please.

If people are made up of chemicals, what's the difference?
posted by John Cohen at 6:48 AM on March 7 [1 favorite]

Bridges are made of chemicals too, but if a bridge collapses, it's not really useful to think in terms of the bridge having been chemically imbalanced.
posted by Elementary Penguin at 6:50 AM on March 7 [2 favorites]

You just need to pull yourself together, dhartung.
posted by Segundus at 7:00 AM on March 7

The criticism is that the concept is misleading, in that it was used to imply that depression is solved biochemically and SSRI's are the answer. I agree with the writer that this is as much marketing as it is science, to put it charitably. I admit I don't have anything but lay knowledge here, but my understanding is, there are in fact all different kinds of neurotransmitter levels in depressed patients, some of them "normal". So this really simplified idea of "imbalances" does not have a lot of developed science behind it.

Advocating for antidepressants as help for suffering people is not the same thing as doing medical research about depression, but the two have been intentionally mixed up in the public's information stream. "Our medicine fixes chemical imbalances that make you feel sad" is a better sales pitch than "try this, it works for some people", but the latter is a lot more accurate, as far as I can see.
posted by thelonius at 7:15 AM on March 7

real treatment > chemical imbalance > character flaw. However, real treatment means doing away with the chemical imbalance theory as much as with the character flaw theory.

I used to think that, because chemical imbalance > character flaw, it was a good stepping stone to help people get treatment. However, thanks to John Cohen's link, I'm rethinking that.

So now, I don't know. I'd be willing to put up with bad science if it truly helped people, especially if the alternative was that people did not get the help they needed - either because the true treatment was not accepted by their society, or because the popular conception shamed people out of seeking treatment. But, now I don't know if it's worth it. Sometimes people need a helpful nudge. Other times they need a lighthouse.
posted by rebent at 7:27 AM on March 7

Water and H2O are the same thing.

Not exactly. You can have a bunch of hydrogen atoms and oxygen molecules sitting around in exactly the right proportions and still not have a glass of water, just as you can have handlebars, a seat, a chain, two wheels and all the other parts of a bike in an old box in the back of a storage shed without having a working bike.

It's the arrangement of the component parts of water and what emergent properties that arrangement leads to at a higher-level of abstraction that makes them into a liquid with all the properties we recognize as inhering to water. It's in the context of human biological life and culture that water has a function that further refines what "water" is--and at that level of analysis, it's not at all the same thing as H20. H20 doesn't have any intrinsic purpose or use at the molecular level; at the higher level of complex biological organisms, societies and economies, it has features and properties it doesn't have when viewed only at the level of its parts, without regard for any higher-level function. Quenching thirst, for example, is not a function of H20, but water does it quite nicely.

High-level organizational structure matters, as I would think any programmer could appreciate. Encapsulation is a powerful feature of object-oriented software development languages precisely because it's possible to model behaviors differently at different levels of abstraction and there is power in the way lower-level information is organized that may not be evident without considering the patterns at a higher level of abstraction. So I think this is mistaken. Water reduces to H20 at a certain level of abstraction, but water is not H20 anymore than a state machine is just a bunch of ones and zeros.
posted by saulgoodman at 7:41 AM on March 7 [3 favorites]

Fox News' (easy target) hilarious example of journalistic misrepresentation of a neuroscientific report.

Headline says: "Scientists Locate 'God Spot' in Human Brain"

A few paragraphs down: "Such results fit with previous research which shows that no single 'God spot' exists in the brain."

Also, listen to The Brain Science Podcast with Dr. Ginger Campbell, for excellent neuroscience-for-interested-lay-persons that articulates the contingencies of the discipline really well.
posted by aunt_winnifred at 7:51 AM on March 7 [3 favorites]

Water and H2O are the same thing.

I'll just leave this (pdf) here.
posted by Jonathan Livengood at 7:56 AM on March 7 [2 favorites]

Water reduces to H20 at a certain level of abstraction, but water is not H20 anymore than a state machine is just a bunch of ones and zeros.

Sense experience<>neurons is still more problematic than Water<>H20 or state machine<>bits it seems to me. I could envision a finite element simulation, or whatever, of H2O molecules capable of showing many of the properties of water, but could you do a simulation of neurons and have the simulation produce sensations like a color in a similar way? I guess some AI people might say the computer running the simulation is experiencing the sensations.
posted by Golden Eternity at 9:09 AM on March 7

Yes. Loved this article for articulating a frustration I often feel in the face of people taking bad pop-science journalism seriously.
posted by forkisbetter at 9:50 AM on March 7

From the same author:

The unsexy truth about dopamine: Dopamine might be the media's neurotransmitter of choice for scare stories about addiction, but the reality is rather more nuanced
posted by homunculus at 10:31 AM on March 7

Golden Eternity, my take on it is:

Sense Experience : Neurons :: Fuel/Oxygen/Heat : Fire

To me it seems likely conscious experience will ultimately be found to be a series of irreducibly complex, chaotic electro-chemical reactions. While I think it is possible to trigger/alter certain conscious states by jiggering around with the neuronal structures (just as it's possible to snuff a fire by removing the fuel source and oxygen it relies upon), I think there's a loose coupling between the level of neurons and consciousness and possibly a sort of non-linearity in the causality of the relationship. In the same way that fire is a complex phenomenon in a certain sense independent of its specific triggers and particular fuel sources, human brains are machines for making consciousness happen, but I don't think consciousness is necessarily dependent on any particular consciousness-making machine (if you follow me).
posted by saulgoodman at 10:34 AM on March 7

Vaughan Bell is a brilliant and prolific psychologist who does a great job of alerting readers to obvious fallacies. He shies away from the uncomfortable fact that scientists in the field often regard each other's beliefs about minds and brains as childish, folky, religious, or plain old dumb. His statement of mind/brain equivalence is a good example of a strong statement that looks ridiculous to a great number of scientists in the area(s). Science isn't the placid, wise domain of arcane knowledge it is often cracked up to be.
posted by stonepharisee at 11:05 AM on March 7 [1 favorite]

(And as if right on cue, from Scientific American today, turns out there's new evidence that brain function isn't all about neurons after all, though this doesn't really get us anywhere new with regards to the problem of consciousness necessarily:

Study shows that intelligence derives from brain cells other than neurons)
posted by saulgoodman at 11:14 AM on March 7 [1 favorite]

Water and H2O are the same thing.

There's a semantic game here. You could argue that clouds or ice are technically just water, but you wouldn't usually use the words in conversation like: "I saw a shape of water in the sky" or "I slipped on the water on the sidewalk". Pop-Science sometimes seems to be attracted to funny metaphors like this...
posted by ovvl at 8:29 PM on March 7

thelonius: "The concept of depression as a "chemical imbalance" promotes the ridiculous idea that we know what the correct "chemical balance" is, and we can just tune you up and off you go."

"Depression" is just a term for a set of grab-bag of behaviors that lead to poor outcomes, or maladaptation, or subjective distress. When medicalised, we try to qualify and quantify the behaviors along several axes. When applied to the DSM, that enables us to classify a specific set of them as "Major Depressive Disorder", and hopefully grade them. This is important because, as RCTs have show and whatever about the serotonin neurobiology, SSRIs tend to function better than placebo only for populations with MDD Moderate to Severe, and that is in people where the MDD emerges not from a medical condition, not from chronic substance use (such as alcohol or amphetamine or cocaine). And there's the whole time course of the behavior to consider. If it's persisted, unchanged, for decades then that's not MDD, that's personality. And that also just does not respond well to SSRIs. Or ECT. Or DBS. Or ketamine. Right now I'm in a job where I spend around 75% of my time taking people off SSRIs and SNRIs and NDRIs that were prescribed because the patients "looked depressed". But it wasn't MDD, so the prescription was a mistake, and the pill is causing more harm than good. But over-prescribing of anti-depressant and anti-psychotic and anti-seizure medications is rampant throughout medicine.

And as others have pointed out, during the whole evolution into DSM 4, the desire to turn psychiatry into a biological science led to the promotion of the simple neurotransmitter imbalance etiology and the effective abandonment of neuroses as potentially crippling, homeostatic response patterns. I see people in therapy whose entire lives have been blighted by sometimes one or two singularly well-defined neuroses. They are simply not achieving anything like their potential, and on occasion, they have the ability to reflect on where they could be, and where they are, and sometimes despair or dissatisfaction manifests as depressive symptoms. But this is not primarily driven by some neurotransmitter ratios that are minutely different from population averages. This is not MDD Moderate to Severe, and I know that if I prescribe an SSRI for them, it would be no better than placebo. But lots of people still want pills to cure ills, however, and lots of doctors, faced with sick patients, want to do *something*. So the pills get prescribed.
posted by meehawl at 10:09 PM on March 7 [3 favorites]

Golden Eternity, my take on it is:

Sense Experience : Neurons :: Fuel/Oxygen/Heat : Fire

To me it seems likely conscious experience will ultimately be found to be a series of irreducibly complex, chaotic electro-chemical reactions.

I don't see what complexity has to do with irreducibility, but I don't think I understand emergentism. If electro-chemical reactions are just part of the signal transmission and processing of a neural network similar to a Boltzmann machine, then I don't get how they explain consciousness. Though, I do sense that this sort of model could explain a lot of what the brain does, subconsciously. I sometimes wonder if there is something else happening in neurons or the brain in addition to 'information processing' that might be observable somehow, and might have a more direct 'isomorphic' relation to experience. It would have to have non-local properties, for one thing, that allow all this separate activity in the brain to unite into a single Gestalt.

I don't know. "Mind" or "consciousness" is the entire world of experience. It's the world we know. Our physical explanation of the world doesn't seem to explain it (why we have sound sensations and why they sound the way they do, or colors look the way they do, what the brain is doing that allows us to hear and see, etc). Modern Scientism makes the problem seem so small. I don't know how Sean Carroll and the like can be so sure the physics we have is sufficient to explain consciousness experience.
posted by Golden Eternity at 12:54 AM on March 9

The history of the birth of neuroculture
posted by homunculus at 11:35 AM on March 11

Well, Golden Eternity, "irreducibly complex" is a pretty loaded phrase, and I should have steered away from it, on review. All I really mean is that consciousness itself might prove to be too non-deterministic and complex to reduce to a simple, linear physical model that can yield repeatable predictions. (But I risk getting in over my head here, as it's been a while since I kept up with the latest work being done in PoM.)
posted by saulgoodman at 11:32 AM on March 12