Here is an excerpt from the New York Times entitled "The New Science of the Mind.":

We are beginning to discern the outlines of a complex neural circuit that becomes disordered in depressive illnesses. Helen Mayberg, at Emory University, and other scientists used brain-scanning techniques to identify several components of this circuit, two of which are particularly important.
One is Area 25 (the subcallosal cingulate region), which mediates our unconscious and motor responses to emotional stress; the other is the right anterior insula, a region where self-awareness and interpersonal experience come together.
These two regions connect to the hypothalamus, which plays a role in basic functions like sleep, appetite and libido, and to three other important regions of the brain: the amygdala, which evaluates emotional salience; the hippocampus, which is concerned with memory; and the prefrontal cortex, which is the seat of executive function and self-esteem. All of these regions can be disturbed in depressive illnesses.
In a recent study of people with depression, Professor Mayberg gave each person one of two types of treatment: cognitive behavioral therapy, a form of psychotherapy that trains people to view their feelings in more positive terms, or an antidepressant medication. She found that people who started with below-average baseline activity in the right anterior insula responded well to cognitive behavioral therapy, but not to the antidepressant. People with above-average activity responded to the antidepressant, but not to cognitive behavioral therapy. Thus, Professor Mayberg found that she could predict a depressed person’s response to specific treatments from the baseline activity in the right anterior insula.
These results show us four very important things about the biology of mental disorders. First, the neural circuits disturbed by psychiatric disorders are likely to be very complex.
Second, we can identify specific, measurable markers of a mental disorder, and those biomarkers can predict the outcome of two different treatments: psychotherapy and medication.
Third, psychotherapy is a biological treatment, a brain therapy. It produces lasting, detectable physical changes in our brain, much as learning does.
And fourth, the effects of psychotherapy can be studied empirically. Aaron Beck, who pioneered the use of cognitive behavioral therapy, long insisted that psychotherapy has an empirical basis, that it is a science. Other forms of psychotherapy have been slower to move in this direction, in part because a number of psychotherapists believed that human behavior is too difficult to study in scientific terms.
ANY discussion of the biological basis of psychiatric disorders must include genetics. And, indeed, we are beginning to fit new pieces into the puzzle of how genetic mutations influence brain development.

Go to the NYT's website for the full article.

Perhaps a brain scan should be the first test done on people with long-term depression to determine if they will react better to therapy or to medication. It might be expensive but in the long run it might prove to be cost effective.

[Rohag]

NYT: The New Science of Mind by Eric R. Kandel, 6 Sep 2013
Interesting; movement towards a more empirical presentation of depression and mental illness.

[pachyderm]

This article is the kind that triggers me. "If you are a hammer, everything looks like a nail." If you are a neuroscientist, everything is explained by the mechanics of brain function. I do not find this a productive way at looking at mental illness. It is part of the story, not the whole story. It almost entirely overlooks what happens to people in early life, and how that affects the brain. And by concentrating on brain mechanics it crowds out paying attention to how people and society affect how people turn out. Grrrrrrrrrr!

And by "empirical" they really mean concentrating on things that certain people like (i.e. mechanics), and ignoring things that those people find too uncomfortable to deal with. Does "empirical" mean denying some of the evidence?

[Perna]

We know food can affect mood, depression/other illnesses can affect the brain as can living life! I think the number of people diagnosed with depression (MDD) for whom neural science can be most helpful is extremely small. We need to combat bad parenting and poor living conditions more than telling the brain how to do its job.

I'm not saying nurture is more important or beats nature but we cannot fix nature, other than setting broken bones and sometimes removing "masses" that probably shouldn't be there, medicine is only a "helper" and often a very poor one so the body can repair itself. I'm for better understanding the brain but I don't think we'll be in a position to make it "better" anytime soon. We create the social structures and probably can help more by making them work better.

[pachyderm]

Originally Posted by Perna

I'm for better understanding the brain but I don't think we'll be in a position to make it "better" anytime soon.

I think some will try, though, with unpredictable results.

We create the social structures and probably can help more by making them work better.

We don't seem to be too good at this either.

So...
It probably doesn't help that, once again, mainstream media is misrepresenting research.
Typically, it's a New York Times op-ed and in response to that

.

I actually found and read the first article to which the author of the NYT op-ed is referring. The title is Toward a Neuroimaging Treatment Selection Biomarker for Major Depressive Disorder; it cn be found in the Aug 1, 2013 issue of JAMA Psychiatry. What is sort of interesting is that the NYT author cites the article authored by "Helen Mayberg, at Emory University, and other scientists".

Why is this interesting?
Helen Mayberg is actually listed last on the article of all the contributing authors. This means that, as agreed upon by the authors, she contributed the least to the research and the article of all the listed authors.

Why would the NYT author only mention the author that contributed the least to the article that is one of the main focuses of his article?

...not odd at all, right?

Also, the NYT author completely muddied the results of the article that Mayberg helped author and, actually, the aim of the research to begin with.

There are a few areas where it seems he is subtly leading his audience to believe the aim and result of the research done by Mayberg, et al is in fact determining a diagnosis of depression from a PET scan.
Example:

Second, we can identify specific, measurable markers of a mental disorder, and those biomarkers can predict the outcome of two different treatments: psychotherapy and medication.

The first part of the sentence indicates that the markers [signs] would indicate that a person HAS a mental disorder, and the second part would indicate which treatment would best treat that disorder. I don't think there is any other way to interpret that.

The actual aim of the study was as follows [taken from the article in JAMA Psychiatry]:

To identify a candidate neuroimaging “treatment specific biomarker” that predicts differential outcome to either medication or psychotherapy.

This does not indicate that they are looking for a marker to indicate a diagnosis.

All the participants in the study were previously diagnosed with depression when they began the established protocol:

Patients aged 18 to 60 years were recruited through the Mood and Anxiety Disorders Program at Emory University via advertisements and clinician referrals.45 Patients were required to have moderate to severe symptoms of depression, defined as a 17-item Hamilton Depression Rating Scale (HDRS)46 score of 18 or more at screening...

Another point is that the NYT author discusses differences in "activity" but neglects to mention what that "activity" in various parts of the brain actually is.

The activity is metabolism of glucose. Which is sort of important. So if an SSRI- a medication for depression- is not as successful in a person with a lower metabolism of glucose... it actually is sort of intuitive that that might turn out that way? If someone does not metabolize glucose, it may follow that they may not metabolize a medication properly as well.

But he does not acknowledge this.

Also- remission in this study is considered evidence of successful treatment [ few or no symptoms according to a rating scale] at ten and twelve weeks.

The authors also state follow up studies are necessary.

I'm not even getting into the second portion of the article.

But my point is... mainstream media tends to skew and muddle research, particularly stuff about brains and such, all the time and work everyone into a frenzy.

This was long, but it is a particular annoyance of mine.
It is frustrating, because things get skewed and people in general feel hood-winked when they finally understand that what they've been told is only a half-truth or completely untrue.

I've found the NYT has been especially guilty of this... but of course they are ABSOLUTELY not the only source to do this. Not at all.

[Gus1234U]

way to slash and burn, Josie~! i haven't read such a scathing indictment of a bogus review in a long time,, how succinct, how pertinant~! i'm not being scarcastic, either,, i actually enjoyed your rebuttal~!

on the other hand, there were a couple of comments already that i find interesting: it IS time we had some empirical evidence for all the toxic chemicals we throw at the brain, AND the "therapy" that depends so much on the person giving it. the long term studies on that are not very encouraging~

as for there being no way to repair the brain, that is just not true. if a person manages to reconfigure brain function to "healthy", they are said to be "In Remission",, like uh, they might fall off that horse yet~ such nay-sayers keep many people from utilizing methodologies and technologies that take advantage of the brain's neuroplasticity~!

i personally know that the brain can be repaired~! not only have i done it, but i have known others who have done it. ok, maybe it's harder for some, but that is the nature of having a body... some work better than others. that is no reason to say that NO ONE can recover from depression, DID, anxiety, PTSD, etc, even schizophrenia.

Believe and Work. hand in hand those are the way to improvement. and keep studying, and keep ripping those studies to shreds~!

Gus

Originally Posted by Gus1234U

on the other hand, there were a couple of comments already that i find interesting: it IS time we had some empirical evidence for all the toxic chemicals we throw at the brain, AND the "therapy" that depends so much on the person giving it. the long term studies on that are not very encouraging

So... not sure how much you've been paying attention to the reaction of the NIMH to the release of the DSM 5- but they are none too pleased with it. I actually wrote about the whole playground tussle in which the NIMH basically said "We're taking our ball and going home". Not going to rewrite them here, but you can catch up on the issue ^there^, which is a BIG HAIRY DEAL and anyone remotely involved in any aspect of behavioral health in the west should be all about that- even if you are not in the USA. It will likely have some rippling effect on you as well.

as for there being no way to repair the brain, that is just not true. if a person manages to reconfigure brain function to "healthy", they are said to be "In Remission",, like uh, they might fall off that horse yet~ such nay-sayers keep many people from utilizing methodologies and technologies that take advantage of the brain's neuroplasticity~!

i personally know that the brain can be repaired~! not only have i done it, but i have known others who have done it. ok, maybe it's harder for some, but that is the nature of having a body... some work better than others. that is no reason to say that NO ONE can recover from depression, DID, anxiety, PTSD, etc, even schizophrenia.

Were... you responding to me here?
I'm just a little bit confused.
I actually have a bit of a background in brain stuff, a basic understanding.
No, I'm certainly not a professional. But I do have a bit of knowledge? Enough to understand the concept of neuroplasticity and that some medications actually encourage this... to know about the necessary function of pruning at certain ages, about kindling, about... well... blah blah blah. I would certainly be the last person to suggest brains can not heal and repair.
Cognitive psych and neuropsych were two of my favorite classes

But yeah- RDoC versus DSM 5
*ding ding ding*

ROUND 3- FIGHT!

[Gus1234U]

poorly phrased, i meant a couple of comments by other people,, pardon~

Originally Posted by Gus1234U

poorly phrased, i meant a couple of comments by other people,, pardon~

It's ok.
obviously the universe revolves singularly around me, so I had to respond to everything you wrote :P

[pachyderm]

Letters from New York Times readers commenting on the original article:

http://www.nytimes.com/2013/09/16/op...f=opinion&_r=0

only a matter of time before some article turns this into a story about how women's brains are better than men's. I'll see you back here in a week.