Sunday, February 25, 2007

My Three Shrinks Podcast 12: Bilingual


[11] . . . [12] . . . [13] . . . [All]


We had two other topics recorded from a prior session, one on the side effects of psychotherapy and the other on the street value of psych drugs in Las Vegas, but GarageBand somehow lost them (I really don't think it was me.) If I find them later I'll put them out in a podcast.

As a result, this one's shorter... about 18 minutes.

February 25, 2007:

Topics include:

  • Evolutionary Psychopathology. LA Times article, The Mind as it Evolves, by Julia M. Klein, about a developing area that theorizes that the illness of depression developed as an evolutionary strategy, which helped signal and stabilize social ranking. Very interesting reading. See also the journal article, The evolutionary significance of depressive symptoms, by Matthew Keller and Randolph Nesse from VCU.
  • Mental Health Parity Act of 2007. Well, we have been trying to get this passed for years (see NAMI's review), despite popular bipartisan support. It passed the Senate, and will hopefully pass the House for the president's signature. We also talk about Maryland's 1993 landmark parity legislation.
  • Psych Blog: Psychiatry for All, by Saminkie. A psychiatry resident in Baghdad who writes about learning psychiatry while having to deal with bullets, explosions, no electricity and other war-related problems. (Sent to us by DrivingMissMolly.)
  • The Psychiatrist Blog, by Michelle Tempest. A UK psychiatrist, and author of The Future of the NHS, blogs about psychiatry, health and politics.
Next week: Could be anything. Send us your questions at mythreeshrinksATgmailDOTcom.

Last week's musical snippet was from Monty Python -- Spam; and Finland, Finland, Finland.






Find show notes with links at: http://mythreeshrinks.com. This podcast is available on iTunes (feel free to post a review) or as an
RSS feed. You can also listen to or download the .mp3 or the MPEG-4 file from mythreeshrinks.com. Thank you for listening.

18 comments:

sophizo said...

You might want to listen to the podcast and focus on 9:52 to 10:10. There are 2 Roys talking about 2 different things. I think you overlapped part of one podcast over this one. Maybe it's one of your missing podcasts.

BTW...the Mental Health Parity Act of 2007 is only in the Senate committee on Health, Education, Labor, and Pensions. It will be awhile until (if) it makes it to the Senate floor. It will be interesting to watch this one. Since I'm snowed in, I might just read the bill for fun.

Sarebear said...

I was one of those people turned away, from the county mental health system. It's part of what I talked with my state Governor on the radio about. And then the state head of the Dept. of H&HS.

Thing is, I am getting back into that situation of having dwindling access to therapy (no money, visit quota running out), and then it'll run out.

I don't know what to do. I NEED the services like I need air to breathe; without either, well, you know the rest.

I guess we'll see. It's a PAINFUL reality.

Roy said...

Sophizo- thanks for the tip. I fixed it.

Sara- we've got the same probs here. It's awful.

SEAMONKEY said...

It's not hard to imagine that evolutionary adaptations which were useful in our primitive past could become the source of dysfunctional behaviours in modern times. Evolution often leaves its creations with physical vestiges of outdated survival mechanisms; why not psychological ones?

But in the context of which Roy spoke-- i.e. avoiding aggession toward higher-ups in the hierarchy to prevent wasteful fighting within the group-- surely depression would be overkill even in primitive times. Why incapacitate a large area of the organism's functioning when only aggression needs to be defused?

Even given that depression is such an evolutionary hangover, suggesting that it could still be a good coping strategy (speaking of the abstract here, not Roy) seems a bit contradictory to the definition of depression.

There exist theories which postulate the evolutionary usefulness of schizophrenia, autism, and OCD among others. To my mind they're all very interesting and also utterly irrelevant.

Sarebear said...

Seamonkey, I have a theory that just sprang to mind to explain that . . . . .

I've discovered that only 5-10 mins of exercise on a stationary bike a day, or even only 3 days a week (little exercise to start out with as I'm rather out of shape) had a very noticeable effect on my mental health, especially the depression side of things.

So as evolutionary theories go, the people back when who were evolving, were also alot more physically active than most today (hunting/gathering and then agriculture, etc.)

So I submit that all the endorphins and whatnot released by exercising kept the depression from being overkill, and, in fact, that the depression, if it was an evolutionary thing (not that I necessarily believe in evolution but this is just a thought exercise for me), would have been a positive thing, to help keep all those endorphin-full people in line. Sort of.

Anyway, I know light physical activity has a strong positive effect on my depression, so there you go.

Roy said...

Exercise is one of the cheapest, most effective antidepressants, with very few undesireable side effects. I prescribe that, plus 20 minutes of early AM outdoors sunlight, often.

SEAMONKEY said...

Just wait for some wiseguy to patent the sun.

Sarebear said...

8^D @ Seamonkey!! You make me smile, which is great since I'm so down!

Roy, I just wish I could turn the thought into action more often (the story of my life; no matter how much I mentally whip myself, it seems like only 1% of what I want or try to do makes it into action; I'll keep trying, though, because that's what I DO.)

Oh, and even though I had read about the mental health benefits of exercise, it was so so amazing and different and COOOL to FEEL and EXPERIENCE the positive effects; it is so hard to explain, but AWESOME!

sophizo said...

Ok...I don't get this whole exercise thing! Why doesn't it work for me??? I've never felt better after exercising when I'm in a depressed mood. As a depressed teenager, I was working out at least 20 hours a week (played very competitive volleyball) and still badly wanted to die. If working out 20 hours a week doesn't make you feel better, then what the heck?! Aargh! I just hate being told exercise will help take your depression away. For me, it only keeps my body physically healthy and in-shape. Ugh!

Roy said...

Sophizo- Guess it's like medications... doesn't work for everyone, your mileage may vary.

The positive impact of light therapy on mood is also dependent on unknown factors, but one of them may be having two copies of the long allele of the 5HTTLPR promoter gene, which is a serotonin-related gene. Being homozygous (ie, having 2 copies) for this genetic variant was associated with improved response to light therapy combined with sleep deprivation (yet another environmental treatment for depression).

Also, a 2001 study of over 300 people found that having a particular serotonin 2A receptor gene polymorphism (102C instead of 102T, if you care) made you 7.5 times more likely to have a seasonal pattern type of depression.

I couldn't find any similar studies looking at genetic influences on the response to exercise in depression. This would be a good study to do.

Midwife with a Knife said...

I'm surprised that sleep deprivation improves mood in some people. It makes me really unhappy, especially when prolonged (like taking call 2 consecutive days (48 hrs on in house call)). I also get very cranky too. I feel like a completely different person (a person who I don't particularly like) after 2 days on call. (Although sleep may be only 1 of a number of factors in that).

And now after catching up on some sleep from a similar spell, I feel super fantastic (hm.. I don't know that there's a psychiatric term for a mood that's super fantastic yet not quite good enough to be suspiciously fantastic?).

I'm wondering what the mechanism for sleep deprivation improving mood could be? Or is it like those starved-mouse longevity studies? Sure, if you only let people sleep 0-4 hours/night (or cut their caloric intake to 1000 kcals/day) they might report better moods (or live longer), but feeling crappy from sleep deprivation (or never eating chocolate) might ultimately not be that much better than feeling depressed (or living an extra 5 years doesn't make up for all of that chocolate you would have missed).

sophizo said...

Roy - If you ever do find a study about genetics on exercise and mood, I'd be interested in hearing about it. Everything about me seems to go against the norm, so it would be interesting to see why exercise may not do anything for me.

Dinah said...

It seems to me some people are more endorphin sensitive than others-- why do some folks vomit from morphine while others get high and crave it? Do we think everyone would become a heroin addict with enough exposure? Maybe it's those same endorphin-sensitive folks who get that high feeling when they run.
Me, I hate exercise. No endorphins here, but I think I get that nonspecific effect of feeling like I've accomplished something and have started my day in a positive take-charge-of-my-life-way that I don't get from just puttering around, I'm always THRILLED when I'm done, and there's the general feeling self-righteousness because I exercised. If I'm feeling anxious, it blows off steam.
And if I walk Max a few miles, his mood is definately better (he's one of those endorphin-sensitive folks who lives for his next exercise fix.)
No one has ever told me that exercise hurts their mood and many patients have said it helps.
And, in moderation it keeps you limber, keeps your heart working, keeps you younger than if you don't do it. In excess, I think the wear and tear on your joints outweighs the overall benefit.
And if you run in the city, inhaling car exhaust, on the pavement, all bets are off.

Now it let me sign in.

ClinkShrink said...

I have to say it warms the cockles of my little heart to hear people talking about exercise. At this point I've been working out for more than half my life and it is truly one of the best decisions I ever made to start running. As to the variable effects on mood, I compare it to diabetes. Sometimes behavioral changes can improve the disease but sometimes the disease is just too severe. But following unhealthy behaviors can make the disease worse. Exercise may not cure depression, but physical inactivity doesn't help and the immobility may make things worse.

Anyway, it's a nice discussion. I will be celebrating the 25th anniversary of my first jog in September of this year.

Dinah said...

ummmm, that makes you over 50. You could have invited me to the party

ClinkShrink said...

Sweetie, 25 years is *over* half my life which means I could be 30. I was a precocious toddler.

Harold the Vampire Cat moved back from Tennesee this week so I'm no longer fur-deprived. I'll still house-sit Max. Maybe we'll work out together.

sophizo said...

You guys crack me up!

I'd definitely make a horrible junkie. I guess I'm not endorphine sesitive either. People think I'm nuts because I absolutely hate pain killers or any other kind of drugs that seem to make people "feel good". And I don't understand why people like the stuff. Oh well!

With exercise, I only get a high off beating someone else or myself rather than the actual exercise. (I'm a little too ultra-competitive!) I need that competitiveness to enjoy it. But if I loose or don't achieve my goal, my mood is shot and often worse. So I guess exercising actually CAN make a person's mood worse...it's just not the ACT of exercising that causes it. Otherwise, exercise is boring and I'm like Dinah and can't wait for it to end. No running for me!

Sarebear said...

I guess I started an exercise conversation. Cool!

I actually don't get a rush, really, while exercising, although there was one time that was very . . .ok I can really FEEL and be CONNECTED with my body and FULLY PRESENT and ENJOY the working up a sweat thing, because I was really feeling my whole body. That was once, the rest of the time it's still work, although it's not bad once I'm doing it. And I enjoy various aspects of it . . . sometimes I listen to my psychotherapy sessions that I record on my Samsung MP3 player Ipod-like dealie that I take to therapy every week (I LOVE having instant access to my "pocket therapist" lol!) while I exercise.

It wasn't so much the immediate effects of the exercise that I noticed, either, although I noticed 'em. It was . . . being able to activate myself more, to DO things, . . . noticing at the end of a day, or two or three, that I had actually had "more" inside, to work with, or something . . . . it's something I notice when I think back on a day or a week when I've been exercising . . . that I notice after the fact that it wasn't as hard to be, to do, to exist, to . . . . . . be me, to . . . well, it's hard to explain. It's a more lasting effect, that takes awhile to taper off after I haven't exercised for a week and a half or two . . . It evens out my mood swings, too.

It's sort of like I'm slogging through waist deep snow, or a cranberry bog, or molasses, or something, and the exercise changes the density of what I'm moving through, lowers it by a third or something; something I don't notice right off cause everything looks the same, but over time I can definitely tell the difference . . .

Agh. There's my own rambly guest post on exercise. I'd better blog about it!! I'll try to do a thoughtful and well-written job of it.