MRIs are a limited resource. To do regular scans in the number of people diagnosed with a common disorder like depression would require an enormous infrastructure and supply chain investment....
In the not-too-distant future, a screening assessment for depression could include a quick brain scan to identify the best treatment.
MRIs are a limited resource. To do regular scans in the number of people diagnosed with a common disorder like depression would require an enormous infrastructure and supply chain investment. Hopefully more research like this finds more easily tested biomarkers.
One of the six biotypes uncovered in the study showed no noticeable brain activity differences in the imaged regions from the activity of people without depression. Williams believes they likely haven’t explored the full range of brain biology underlying this disorder...
Or, you know, they might have a disorder other than depression. Dysautonomias like Postural Orthostatic Tachycardia Syndrome, for example, are typically misdiagnosed as depression and/or anxiety for 5-10 years before being correctly diagnosed. It would help so many people if medical professionals would consider that people diagnosed with depression and not responding to treatment might have been misdiagnosed.
I wonder if depression caused by physical illness manifests as this one with no difference in the fMRIs or if it manifests as one of the other types based on whatever the biological mechanism is....
I wonder if depression caused by physical illness manifests as this one with no difference in the fMRIs or if it manifests as one of the other types based on whatever the biological mechanism is. I have hypothyroidism which also causes depression, and I wonder how that affects things like these brain scans.
EDIT TO ADD:
Noticed this quote in the article that at least gives me optimism for other ways than fMRI to test for these types:
The different biotypes also correlate with differences in symptoms and task performance among the trial participants
Even if it's not perfect, it can't be much worse than the current "just try it until you find what sucks the lease" method of treating depression.
There's tremendous overlap between inflammatory disease states and depression. If you want to take a deep dive into MRI studies on depression as a correlate of neuroinflammation, here you go. Most...
There's tremendous overlap between inflammatory disease states and depression. If you want to take a deep dive into MRI studies on depression as a correlate of neuroinflammation, here you go. Most of the current drugs sold as antidepressants cross the blood-brain barrier and exert anti-inflammatory and immunomodulatory effects.
It's about damn time. Psychiatry has been fitting people's psyches into these huge boxes for over a hundred years. fMRI, time and again, has been shown to be effective at mapping activity in the...
It's about damn time.
Psychiatry has been fitting people's psyches into these huge boxes for over a hundred years. fMRI, time and again, has been shown to be effective at mapping activity in the brain. More psychiatric treatment should be employing similar.
This seems urgent as depression is one of the leading causes of death, in our modern age.
Want to bet that we'd find there are more than 3 types of "ADHD"? And that they respond to different treatments?
How about ASD? Or OCD? The list goes on.
DISCLAIMER: while I've read studies about fMRI use to understand emotions felt by a person in near real time, I haven't looked for any on identifying subtypes and different treatment modalities as this article describes. Perhaps there are other studies that preceded and led up to this one. Exercise for future me and/or the reader.
Be careful we don't discover what I suspect is the reality: nobody is "neurotypical". My layperson's interpretation is that early attempts to classify people lead to overly broad categories, and a...
Be careful we don't discover what I suspect is the reality: nobody is "neurotypical". My layperson's interpretation is that early attempts to classify people lead to overly broad categories, and a fabricated "normal" human that doesn't actually describe any real people. The result is that everyone is trying to fit into boxes that don't adequately describe them, and suffering as a result. I have no data to support this... feeling
Yeeaahhhhh, I'm gonna push back on the frustratingly common assertion that "no one is neurotypical," because it's simply false. Saying "everyone's a little neurodiverse" because human experience...
Yeeaahhhhh, I'm gonna push back on the frustratingly common assertion that "no one is neurotypical," because it's simply false. Saying "everyone's a little neurodiverse" because human experience and expression are a spectrum is like saying "everyone's a little bit trans" because that guy likes getting pedicures and that girl likes wrenching on cars. If your birth-body matches your self-perception, you are cis, and your gender expression (or lack thereof) has no bearing on this fact. Similarly, if the culture into which you were born feels reflective of your internal experience (and not like a fun house mirror at best) you are neurotypical.
There are spectrums within each of these binary categories, because as I said the human experience is varied and diverse; but it is not one long continuum from NT->ND, or cis->trans, and claiming otherwise is invalidating and often dangerous.
The irony here is that more often than not the folks who claim "there is no normal" are often, themselves, "not normal" and just don't realize/haven't acknowledged it (yet). Of course "everyone seems ND" when descriptions of those experiences mirror your own, that's your normal. But it's not the normal. Society would look a whole lot different if it was.
Yeah, I saw it earlier, and I actually don't disagree with most of your conclusions, but the fundamental premise is flawed. I get it though, being ND (especially online) makes it feel like...
Yeah, I saw it earlier, and I actually don't disagree with most of your conclusions, but the fundamental premise is flawed.
I get it though, being ND (especially online) makes it feel like everyone's masking and struggling with a society that exists at odds with humanity. But it's confirmation bias- most of the "chronically online," most of those commenting on threads like this, are also ND. Those for whom society was built have little need to join the discussion, because they can't relate. They have no idea what we're talking about. Like someone who has never been suicidal, all they can do is give a reassuring pat and go on about their days because it's so foreign as to be impenetrable.
It's a fair pushback , and thanks. I think your reacting to the absolute nature of my assertion, in which case I agree. But, I don't think you've refuted the underlying concept, which I may not...
It's a fair pushback , and thanks. I think your reacting to the absolute nature of my assertion, in which case I agree.
But, I don't think you've refuted the underlying concept, which I may not have communicated well. Namely, the concept of "normal" is just a convenient lie for allowing a range of people to feel like they conform to some cultural standards and feel like they have a place. And, I absolutely do not believe the ND-NT continuum is anywhere near as clear cut as the trans comparison you've made. Being trans is, to my limited understanding, a very specific thing where-in biological sex does not match a person's internal concept of gender (please forgive me if I missed the mark there. Intentions do not always align with ability or understanding). I submit that the line between ND and NT is fairly arbitrary, and culturally driven. But I'm way outside my realm of expertise here...
Also, I am AuDHD. I am aware of and acknowledge that fact, and have been wrestling with it for over a year now, after 50+ years of struggle. In my lived experience, very few people are "normal". Lots of people are masking in some way or another.
Lots of people are masking, you're right- lots of people who don't know or won't admit they're ND, and lots of us who will admit it but still have to mask to exist. Look, I hear you, and I could...
Lots of people are masking, you're right- lots of people who don't know or won't admit they're ND, and lots of us who will admit it but still have to mask to exist.
Look, I hear you, and I could hazard a guess as to where your assertions are coming from, but until science can prove one of us right we'll have to agree to disagree. I do think it's that clear-cut, and I don't think the line is arbitrary. Abnormal psych has been a special interest of mine for decades, and it's one of the few subjects I feel I can speak on with authority. I'm open to being proven wrong, but until then I think it's less potentially harmful to discuss neurodivergence as a binary rather than a spectrum. There's a reason Asperger's was lumped in with ASD, and it's so "high functioning" autistics could get the help they needed rather than being dismissed as "closer to normal" than those other autistics who have higher support needs.
Logical, though. Most things seem to exist in normal distributions/bell curves. By that thinking, every aspect of psychological make-up could be viewed as a continuum. My supposition atop this is...
Logical, though.
Most things seem to exist in normal distributions/bell curves. By that thinking, every aspect of psychological make-up could be viewed as a continuum.
My supposition atop this is that "normal", then, is a form of masking that occurs in the bulk of a population. Such masking, then, is externally imposed upon the individual by the prevailing culture. This then questions the definition of "normal".
I'd suggest "normal" is what is deemed as creating the most societal value for a given society at a given point in time.
"Neurodivergents", then, are the people whose nature-nurture construction deviates far enough from the culturally defined "norm" that they are perceived as deviant—either due to inability or ignorance/lack of cultural education and enforcement of same.
fMRI may allow for parsing the difference between inability and ignorance. I wonder though if that's true. Our brains are partly our experience (nurture) and so I wonder to what extent ignorance may look the same to the machine as nature.
ADHD, for instance, has been argued to have had and possibly still have evolutionary benefit: novelty seeking, lack of "focus", et al. If a small percentage of the population has these traits, they will create some pressure on the larger population to experiment. You could argue about the potential for disruption and violence among people with ADHD. Though this also perhaps creates value by giving them a vigilant and soldierly inclination.
Homogeneity leads to stagnation. Some extremes then shake the "norm" from stagnancy.
Disclaimer: this is largely supposition based upon a small set of scientific theories.
EDIT: wow, there we spellcheck failures aplenty in here to amend. Sorry.
Fwiw, there have actually been trends in the opposite direction with these specific three diagnoses -- there have been hints that there may be some common element between them biologically because...
Want to bet that we'd find there are more than 3 types of "ADHD"? And that they respond to different treatments?
How about ASD? Or OCD? The list goes on.
Fwiw, there have actually been trends in the opposite direction with these specific three diagnoses -- there have been hints that there may be some common element between them biologically because they're so frequently comorbid and have some striking similarities. Nothing super concrete yet but it's an interesting path that researchers are exploring.
I swear, I have been anecdotally guesstimating 16-ish different types (requiring, mostly, distinct treatments) for well over a decade. I had one type in my teens which was devastating,...
I swear, I have been anecdotally guesstimating 16-ish different types (requiring, mostly, distinct treatments) for well over a decade.
I had one type in my teens which was devastating, soul-consuming. It lasted 3-4 years, somehow magically/miraculously snapped out of it following a serious car accident (that may or may not have been at least partially suicidal).
I have had a second type that has re-emerged three times in my life, lasting about a year each time, every 15-20 years, that has been something quite different, more of a consuming obsession, borderline OCD-ish experience.
Now, for the past decade, I've had a third type, completely different from both the others. Having experienced what I did in my teens, it feels insulting to even call this new thing "depression" ... I prefer "ennui". But, regardless, the fact that they are all three, still categorized as the same condition is mind-blowing.
If you weren't "Eric", I'd wonder if you were my 81 year old father. Except mine didn't end with that car accident or at all. He's never been diagnosed or, at least, admitted to same. I've...
If you weren't "Eric", I'd wonder if you were my 81 year old father. Except mine didn't end with that car accident or at all.
He's never been diagnosed or, at least, admitted to same. I've suspected so many conditions in him...
I don't think I've seen any data that shows or suggests this. For example, it's not among the WHO top 10 causes of death. My second guess is you could have meant that depression leads to worsening...
This seems urgent as depression is one of the leading causes of death, in our modern age.
I don't think I've seen any data that shows or suggests this. For example, it's not among the WHO top 10 causes of death.
My second guess is you could have meant that depression leads to worsening physical health, which results in the said causes. But then again, that's a hypothesis, and while it's certain that depression leads to a bunch of other health problems, I don't think again I've seen any data that suggests these leading causes are mostly attributable to depression. I think it's very unlikely that's the case.
So I'm a bit baffled on what you meant by this. Could you elaborate?
Ah, thank you. I wonder what criteria CDC uses, because while they say suicide is a leading cause of death, they don't list in their top 10 list of leading causes of death. And they the published...
Ah, thank you. I wonder what criteria CDC uses, because while they say suicide is a leading cause of death, they don't list in their top 10 list of leading causes of death. And they the published leading causes of death -annoyingly- seem to focus on top 10. It's close to the cutoff point of top 10 reasons though, so I think it's reasonable to say it must be in top 20.
So that's a much stronger hypothesis, but I'm still not convinced they are entirely attributable to depression. There are a lot of different mental illnesses that lead to suicide, including mood disorders. I don't think this is any less reason to study depression, of course. It's a serious issue that affects a lot of people (including me).
When I was in Uni I mostly relied on Uni’s “search engine” that can bring you up a bunch of research papers, with the occasional google. Nowadays since I graduated, how can someone do research as...
When I was in Uni I mostly relied on Uni’s “search engine” that can bring you up a bunch of research papers, with the occasional google.
Nowadays since I graduated, how can someone do research as well if they don’t have access to such search engine, Google being mostly a kind of garbage search engine and how common AI slop is?
PubMed is helpful. It doesn't get past the paywalls, but it turns up anything available without paywalls and at least shows the abstracts for everything. Sometimes local libraries subscribe to...
PubMed is helpful. It doesn't get past the paywalls, but it turns up anything available without paywalls and at least shows the abstracts for everything. Sometimes local libraries subscribe to journals, with access at the library computers.
Interesting endeavor to try an grapple with the difficulty of the heterogeneity found within the major depressive disorder diagnosis. At best it links some fMRI findings with a clinical reality...
Interesting endeavor to try an grapple with the difficulty of the heterogeneity found within the major depressive disorder diagnosis.
At best it links some fMRI findings with a clinical reality that’s already known; i.e. there are more biological seeming depressions, and more psychosocial/psychological determined depressions. At worst it’ll be used in the softening of the ontological uncertainty of the depression diagnosis concept. We got fMRI findings now; it’s a real ‘thing’.
MRIs are a limited resource. To do regular scans in the number of people diagnosed with a common disorder like depression would require an enormous infrastructure and supply chain investment. Hopefully more research like this finds more easily tested biomarkers.
Or, you know, they might have a disorder other than depression. Dysautonomias like Postural Orthostatic Tachycardia Syndrome, for example, are typically misdiagnosed as depression and/or anxiety for 5-10 years before being correctly diagnosed. It would help so many people if medical professionals would consider that people diagnosed with depression and not responding to treatment might have been misdiagnosed.
I wonder if depression caused by physical illness manifests as this one with no difference in the fMRIs or if it manifests as one of the other types based on whatever the biological mechanism is. I have hypothyroidism which also causes depression, and I wonder how that affects things like these brain scans.
EDIT TO ADD:
Noticed this quote in the article that at least gives me optimism for other ways than fMRI to test for these types:
Even if it's not perfect, it can't be much worse than the current "just try it until you find what sucks the lease" method of treating depression.
There's tremendous overlap between inflammatory disease states and depression. If you want to take a deep dive into MRI studies on depression as a correlate of neuroinflammation, here you go. Most of the current drugs sold as antidepressants cross the blood-brain barrier and exert anti-inflammatory and immunomodulatory effects.
It's about damn time.
Psychiatry has been fitting people's psyches into these huge boxes for over a hundred years. fMRI, time and again, has been shown to be effective at mapping activity in the brain. More psychiatric treatment should be employing similar.
This seems urgent as depression is one of the leading causes of death, in our modern age.
Want to bet that we'd find there are more than 3 types of "ADHD"? And that they respond to different treatments?
How about ASD? Or OCD? The list goes on.
DISCLAIMER: while I've read studies about fMRI use to understand emotions felt by a person in near real time, I haven't looked for any on identifying subtypes and different treatment modalities as this article describes. Perhaps there are other studies that preceded and led up to this one. Exercise for future me and/or the reader.
Be careful we don't discover what I suspect is the reality: nobody is "neurotypical". My layperson's interpretation is that early attempts to classify people lead to overly broad categories, and a fabricated "normal" human that doesn't actually describe any real people. The result is that everyone is trying to fit into boxes that don't adequately describe them, and suffering as a result. I have no data to support this... feeling
Yeeaahhhhh, I'm gonna push back on the frustratingly common assertion that "no one is neurotypical," because it's simply false. Saying "everyone's a little neurodiverse" because human experience and expression are a spectrum is like saying "everyone's a little bit trans" because that guy likes getting pedicures and that girl likes wrenching on cars. If your birth-body matches your self-perception, you are cis, and your gender expression (or lack thereof) has no bearing on this fact. Similarly, if the culture into which you were born feels reflective of your internal experience (and not like a fun house mirror at best) you are neurotypical.
There are spectrums within each of these binary categories, because as I said the human experience is varied and diverse; but it is not one long continuum from NT->ND, or cis->trans, and claiming otherwise is invalidating and often dangerous.
The irony here is that more often than not the folks who claim "there is no normal" are often, themselves, "not normal" and just don't realize/haven't acknowledged it (yet). Of course "everyone seems ND" when descriptions of those experiences mirror your own, that's your normal. But it's not the normal. Society would look a whole lot different if it was.
I'm "ND" and I see it as a continuum. 🤷🏻♂️
See my argument, imperfect though it certainly is, below.
Yeah, I saw it earlier, and I actually don't disagree with most of your conclusions, but the fundamental premise is flawed.
I get it though, being ND (especially online) makes it feel like everyone's masking and struggling with a society that exists at odds with humanity. But it's confirmation bias- most of the "chronically online," most of those commenting on threads like this, are also ND. Those for whom society was built have little need to join the discussion, because they can't relate. They have no idea what we're talking about. Like someone who has never been suicidal, all they can do is give a reassuring pat and go on about their days because it's so foreign as to be impenetrable.
It's a fair pushback , and thanks. I think your reacting to the absolute nature of my assertion, in which case I agree.
But, I don't think you've refuted the underlying concept, which I may not have communicated well. Namely, the concept of "normal" is just a convenient lie for allowing a range of people to feel like they conform to some cultural standards and feel like they have a place. And, I absolutely do not believe the ND-NT continuum is anywhere near as clear cut as the trans comparison you've made. Being trans is, to my limited understanding, a very specific thing where-in biological sex does not match a person's internal concept of gender (please forgive me if I missed the mark there. Intentions do not always align with ability or understanding). I submit that the line between ND and NT is fairly arbitrary, and culturally driven. But I'm way outside my realm of expertise here...
Also, I am AuDHD. I am aware of and acknowledge that fact, and have been wrestling with it for over a year now, after 50+ years of struggle. In my lived experience, very few people are "normal". Lots of people are masking in some way or another.
Lots of people are masking, you're right- lots of people who don't know or won't admit they're ND, and lots of us who will admit it but still have to mask to exist.
Look, I hear you, and I could hazard a guess as to where your assertions are coming from, but until science can prove one of us right we'll have to agree to disagree. I do think it's that clear-cut, and I don't think the line is arbitrary. Abnormal psych has been a special interest of mine for decades, and it's one of the few subjects I feel I can speak on with authority. I'm open to being proven wrong, but until then I think it's less potentially harmful to discuss neurodivergence as a binary rather than a spectrum. There's a reason Asperger's was lumped in with ASD, and it's so "high functioning" autistics could get the help they needed rather than being dismissed as "closer to normal" than those other autistics who have higher support needs.
Logical, though.
Most things seem to exist in normal distributions/bell curves. By that thinking, every aspect of psychological make-up could be viewed as a continuum.
My supposition atop this is that "normal", then, is a form of masking that occurs in the bulk of a population. Such masking, then, is externally imposed upon the individual by the prevailing culture. This then questions the definition of "normal".
I'd suggest "normal" is what is deemed as creating the most societal value for a given society at a given point in time.
"Neurodivergents", then, are the people whose nature-nurture construction deviates far enough from the culturally defined "norm" that they are perceived as deviant—either due to inability or ignorance/lack of cultural education and enforcement of same.
fMRI may allow for parsing the difference between inability and ignorance. I wonder though if that's true. Our brains are partly our experience (nurture) and so I wonder to what extent ignorance may look the same to the machine as nature.
ADHD, for instance, has been argued to have had and possibly still have evolutionary benefit: novelty seeking, lack of "focus", et al. If a small percentage of the population has these traits, they will create some pressure on the larger population to experiment. You could argue about the potential for disruption and violence among people with ADHD. Though this also perhaps creates value by giving them a vigilant and soldierly inclination.
Homogeneity leads to stagnation. Some extremes then shake the "norm" from stagnancy.
Disclaimer: this is largely supposition based upon a small set of scientific theories.
EDIT: wow, there we spellcheck failures aplenty in here to amend. Sorry.
You've stated what I was getting at much better than I. Thanks
Edit: speeling
Fwiw, there have actually been trends in the opposite direction with these specific three diagnoses -- there have been hints that there may be some common element between them biologically because they're so frequently comorbid and have some striking similarities. Nothing super concrete yet but it's an interesting path that researchers are exploring.
I also believe this could pan out. Or, frankly, why not both? Same condition, manifesting differently? 🤷🏻♂️
Perhaps an example of same drugs, different therapies (or perhaps the other way) when it comes to treatment?
I swear, I have been anecdotally guesstimating 16-ish different types (requiring, mostly, distinct treatments) for well over a decade.
I had one type in my teens which was devastating, soul-consuming. It lasted 3-4 years, somehow magically/miraculously snapped out of it following a serious car accident (that may or may not have been at least partially suicidal).
I have had a second type that has re-emerged three times in my life, lasting about a year each time, every 15-20 years, that has been something quite different, more of a consuming obsession, borderline OCD-ish experience.
Now, for the past decade, I've had a third type, completely different from both the others. Having experienced what I did in my teens, it feels insulting to even call this new thing "depression" ... I prefer "ennui". But, regardless, the fact that they are all three, still categorized as the same condition is mind-blowing.
If you weren't "Eric", I'd wonder if you were my 81 year old father. Except mine didn't end with that car accident or at all.
He's never been diagnosed or, at least, admitted to same. I've suspected so many conditions in him...
I don't think I've seen any data that shows or suggests this. For example, it's not among the WHO top 10 causes of death.
My second guess is you could have meant that depression leads to worsening physical health, which results in the said causes. But then again, that's a hypothesis, and while it's certain that depression leads to a bunch of other health problems, I don't think again I've seen any data that suggests these leading causes are mostly attributable to depression. I think it's very unlikely that's the case.
So I'm a bit baffled on what you meant by this. Could you elaborate?
Presumably they're referring to the fact that suicide is one of the leading causes of death in the United States.
Ah, thank you. I wonder what criteria CDC uses, because while they say suicide is a leading cause of death, they don't list in their top 10 list of leading causes of death. And they the published leading causes of death -annoyingly- seem to focus on top 10. It's close to the cutoff point of top 10 reasons though, so I think it's reasonable to say it must be in top 20.
So that's a much stronger hypothesis, but I'm still not convinced they are entirely attributable to depression. There are a lot of different mental illnesses that lead to suicide, including mood disorders. I don't think this is any less reason to study depression, of course. It's a serious issue that affects a lot of people (including me).
When I was in Uni I mostly relied on Uni’s “search engine” that can bring you up a bunch of research papers, with the occasional google.
Nowadays since I graduated, how can someone do research as well if they don’t have access to such search engine, Google being mostly a kind of garbage search engine and how common AI slop is?
Could be useful for a future reader to know.
SciHub, which is just out-of-date enough to be immune to AI slop. Questionably legal, but unquestionably the best tool.
Good one. I've used this too.
PubMed is helpful. It doesn't get past the paywalls, but it turns up anything available without paywalls and at least shows the abstracts for everything. Sometimes local libraries subscribe to journals, with access at the library computers.
Google Scholar is still decent, as far as I can tell.
Google scholar is pretty good. It's not the same as Google search
Kagi Academic search works for me to get DOI numbers, then SciHub to get around the paywalls.
Interesting endeavor to try an grapple with the difficulty of the heterogeneity found within the major depressive disorder diagnosis.
At best it links some fMRI findings with a clinical reality that’s already known; i.e. there are more biological seeming depressions, and more psychosocial/psychological determined depressions. At worst it’ll be used in the softening of the ontological uncertainty of the depression diagnosis concept. We got fMRI findings now; it’s a real ‘thing’.