Thursday, June 1, 2017

citation needed

I know that part of my problem is that I expect to fail.  It would be ignorant to assume that  this is irrational, and that I just need to think more positively, yet this is the direction many people go in.  The causes and complexities of what makes us who we are goes way over our heads.  I haven't exactly got it all figured out, either.

Found myself watching a new Robert Sapolsky talk, and then as often happens, taking interest in some of the related videos, and then looking up what he's going on about, or some question that comes to mind.

I thought this was interesting.

"Sapolsky on the Science of Pleasure"

I found myself digging around a little, and came up with this.

"Motivation Deficit in ADHD is Associated with Dysfunction of the Dopamine Reward Pathway"

So, what does it mean to expect to fail?  This is just a symptom, an outcome.  It doesn't say much about what's causing it.  It doesn't even shed light on what it means to fail.  What is that's expected?  What we accomplish isn't really at the heart of that, so much as what we think we've accomplished, and how we feel about it.  What sort of chemical reactions take place in the brain, that we might feel either accomplishment or failure.

This can be the result of experiences, learned behaviors, upbringing, culture, and ultimately, physiology.  The physiology trumps all of it, in that if the chemistry isn't there, nothing else will matter.  Physiology itself being the outcome of internal and external environmental factors, as well as genetics, and just random variation.

It's a difficult question to answer.  Impossible, even.  Maybe this, maybe that.  In reading all these studies that I have over the years, it hard to miss all the speculative language, the layer upon layer of hypothesis.  What does it mean that a dysfunction is "associated with" a given neurological process? Correlation, causation, what other factors might be involved, what can be done to remedy it, the remedies often being experiments of downright pitiful efficacy.. on so many levels, they're still sorting a lot of it out.

Yesterday, I was looking up the latest finding on why SSRIs don't work.  I found this article, where they discovered that if mice are incessantly tormented, they're less likely to recover from depression.  Therefore, they conclude, it's possible that medication doesn't work as well for depressed people who are too stressed out by environmental factors.  Fucking brilliant, right?

"Why don't antidepressants work"

They also claim that they do work for 50-70% of people, yet other studies would seem to contradict this, suggesting that they're barely more beneficial than placebos.

This is not the work of people who know what they're doing.  It frustrates the hell out of me, but this is not to disparage their efforts.  They're making incredible progress, and as should be apparent, I consider it important work.  I think it's admirable, but, they do have a long ways to go.

"Antidepressants No Better Than Placebo?"

Comparative efficacy and tolerability of antidepressants

That's how science goes.  If I wanted certainty, I'd look more towards religion.  The closest we're going to get to that is make-believe.

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