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Comment by iandanforth | Hacker News Reader

Lot of behavioral claptrap in the comments here. Depression is a disorder of neurochemistry. It has physical causes.

Yes our current toolset to fix the malfunctioning system is limited but we are not limited to shaking the case. Behavioral interventions are external, indirect, poorly targeted and broad spectrum. Really turn-it-off-and-turn-it-back-on-again thinking.

Instead of bringing in further poorly defined ideas like consciousness, let's keep the conversation focused on 1. Direct physical interventions and their methods of action and 2. The known limitations of the above.

E.g. If the below effect of psilocybin holds up the question is why?! It too is poorly targeted and broad spectrum. Is this down regulating a dopamine reuptake pathway, or is it upregulating some countervailing transmitter?

https://www.forbes.com/sites/daviddisalvo/2017/10/23/magic-m...

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“Depression” isn’t one disorder it is a convenient diagnoses for a cluster of symptoms with many underlying causes.

Don’t lean too hard on a dichotomy between what is just “chemistry” and what is not. Do not lean too hard on neurotransmitters, they are sold to the public as one dimensional “serotonin does X, dopamine does Y”.

Your brain is more or less the most complicated feedback system in the universe. Depression is a high level dysfunction of this system, it doesn’t have a simple cure like turning up the thermostat on one variable.

Behavioral interventions are physical interventions. What isn’t reasonable is expecting a “do this it’s good for you” solution, regardless of what that solution is.

Usually the solution is many things, and it will take a very long time to understand them well unless you want to volunteer for experimental brain surgery.

If there was neurochemistry that was uniquely and consistently associated with depression it still would not follow that "direct physical intervention" is the best treatment approach. Lifestyle modifications and behavioral interventions also change the brain. It is standard to combine both approaches.

No one really disagrees that depression has physical causes. What other causes are there? I am guessing you are not a Cartesian dualist.

>Really turn-it-off-and-turn-it-back-on-again thinking.

Unfortunate analogy since the article you linked talks about "resetting" the brain with psilocybin.

How do you come to these conclusions?

If I am not unaware of some brand new research, the cause of depression is still either unknown or multi-factorial, depending on how cynical you want to be. The Wikipedia section on this reflects this:

"The biopsychosocial model proposes that biological, psychological, and social factors all play a role in causing depression.[5][28] The diathesis–stress model specifies that depression results when a preexisting vulnerability, or diathesis, is activated by stressful life events. [...]" [0]

Similarly, Cognitive Behavioral therapy which, well, focuses on behavioral interventions and has had astonishing successes with medium as well as major depression, often on par or exceeding drug therapy - and absolutely shining in combination with drug therapy.

As I said, I might be out of date on my information, but IMO depression is a bit too important too take weirdly partisan stances like "external treatment is claptrap" just because...

[0] https://en.wikipedia.org/wiki/Major_depressive_disorder#Caus...

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