psychiatry

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On ‘Radio Open Source,’ An Intimate Look At Decades Of Depression

I’ve never met the Cambridge-based writer George Scialabba, but now I can’t stop thinking about him.

About his personal psychiatric records, from his decades of treatment for depression, so courageously shared in a recent piece he wrote in The Baffler: “The Endlessly Examined Life,” subtitled “A Most Chronic Depression.” And about his extraordinary recent interview with his friend, Christopher Lydon, on “Radio Open Source.” You can hear it in the podcast above.

Writer George Scialabba (Courtesy Radio Open Source)

Writer George Scialabba (Courtesy Radio Open Source)

The conversation is interspersed with dramatic readings of excerpts from George’s medical records, and it includes a bit of kind encouragement from one who knows:

One of the things that hurts most about depression is that you don’t really believe that it’s ever going to go away, get better. It just doesn’t seem like something with a plausible cause. So you can’t imagine what the remedy is. So people should tell you: “Look, eventually, everybody gets a little better. Some people are still mildly depressed, but virtually no one is acutely depressed for decades and decades — their whole life. It’ll get a little better, and probably a lot better. So hang on.”

So many of us know depression personally — one in 10 Americans, by an estimate that must set the bar very high — that I expect this powerful, double-platform exploration of George Scialabba’s experience will elicit very varying personal responses. “Radio Open Source’s” post about the interview includes just one comment, at last look, but it’s a gorgeous one, including this:

Well, you would think that this subject is not where you want to go in this particular winter of 2015. But it’s not about depression. Or not about only that. What it’s really about is what happened in spite of it or because of it; what happens climbing out of it, or trying to. I have had to learn and will probably have to learn again that we are not only our particular illness. It’s the illness, the suffering, the pain, which you can never convey (but need to try) even to the most sympathetic, that pain itself that is the door through which you walk to somewhere else. But also I think one needs to have something to grab onto — maybe the rope of creative expression and reaching out. Something.

One brief personal reaction: I like George’s theory that depression may be the result of faulty emotional “shock absorbers.” But I was most struck by the possibility that, after he ended his intense involvement in the religious order Opus Dei, he never fully recovered because he needed that involvement, perhaps that faith, to face life. He had a great big Human Condition problem more than a personal psychological problem. Just a thought. But it’s what I find most echoing in my mind. That, and the fact that his psychiatrists seemed to mean very well, and some surely did help him, but they came nowhere near a solution to the enduring mystery of his long emotional suffering.

Read excerpts of George’s medical records in the Baffler piece here, listen to the podcast above, and please share what echoes most for you.

Further listening: “Radio Open Source: The Untethered, Untenured Mind

Anorexia: Potentially Deadly, Treatable And Still Not Always Covered By Insurance

(Mary Lock/Flickr)

(Mary Lock/Flickr)

By Drs. Gene Beresin and Steve Schlozman

People die from Anorexia Nervosa.

This is true of other psychiatric syndromes, but with anorexia, the cause of death couldn’t be more straightforward. People with anorexia literally expire from the complications of malnutrition.

They starve and they die.

Your heart cannot beat if you don’t feed it. Your immune system can’t protect you without food. Your bones crumble, your kidneys fail, your liver sputters and your brain wanders, all as a result of inadequate food.

Suicide is common. Without proper nutrition, depression is prominent and thinking is blurred. Coping mechanisms falter. Life can seem unlivable.

So, here’s the really strange thing about anorexia: Despite its awfulness and potentially fatal outcomes, despite a death rate more than 12 times higher than any other psychiatric syndrome, insurers still balk at providing adequate coverage.

In 2008, the Federal Mental Health Parity and Addiction Equity Act put special restrictions on the coverage of the treatment of eating disorders. While the explanations for this exception vary — some have suggested that this is because eating disorders are thought to lack a biological basis — it is clear that getting standard of care treatment for anorexia remains problematic even to this day.

In 2010, the U.S. Court of Appeals for the 9th Circuit found itself facing what was essentially a logic problem. The case of Harwick versus Blue Shield of California noted that while the insurer agreed that the residential treatment requested for a patient with anorexia was medically necessary — thus making it in compliance with existing parity statutes — coverage for residential treatment was not authorized because residential treatment was not part of the health plan. The court ruled in favor of the patient in this case, but the fact that this even ended up in court is shameful. Can you imagine an insurer refusing to pay equally for the medically necessary care of any other disease with such clear risks?

So, while patients, their families and physicians continue to fight for coverage, we know that treatment for this disorder can be life-saving.

In this context, here’s the story of a young woman who recovered.

Nicole (who asked that her last name not be used) is a remarkable 16-year-old. She is academically and socially accomplished and she speaks with wisdom that belies her age. She also faced Anorexia Nervosa head on and here discusses her struggles with humility and insight.

What we can learn from her story?

To begin with, we can acknowledge that her bout with anorexia has not been easy. She suffered significant depression and even suicidal ideation as she muscled through the course of the illness. This aspect of her history is perhaps the most important take-home message. The work towards recovery from an eating disorder is never straightforward. Each patient finds a unique way to work with his or her treatment team and family to progress towards health. We can also note that Anorexia is a typically insidious and largely unconscious development. As you can hear from Nicole, the syndrome essentially snuck up on her and her family. Continue reading

A Miracle Drug For Binge Eating? Not So Fast, Says Therapist

(Bloody Marty/Flickr)

(Bloody Marty/Flickr)

By Jean Fain
Guest Contributor

For more than 20 years, my binge-eating patients have wished for a magic wand. And for all that time I told them there is no wand — there are only strategies that require awareness and effort to get a handle on their eating.

Last week, when the FDA announced it had approved Vyvanse for the treatment of binge eating disorder (BED), I found myself at an uncharacteristic loss for words. With headlines touting a magical cure for this most common adult eating disorder, I feared there was nothing I could say to stop the stampede for this next, new drug.

The news, in and of itself, is hopeful. Vyvanse (lisdexamfetamine dimesylate) has been the subject of rigorous research, first for ADHD, and now for BED. In two good-sized studies with more than 700 adult participants diagnosed with moderate to severe binge eating, this central nervous system stimulant proved more effective at reducing binge days per week than placebo for three months.

What’s more, the FDA’s approval has proven a good opportunity for a drugmaker, U.S-based Shire, and leading eating disorder associations — the National Eating Disorder Association and Binge Eating Disorder Association — to coordinate a nationwide educational campaign. If even a fraction of the estimated 2.8 million Americans diagnosed with the disorder get help as a result of the campaign’s public service announcements and new website, there’s reason to be hopeful.

There’s also reason to be cautious. Consider some of the issues before you take tennis great and Shire spokesperson Monica Seles’ advice to “talk with your doctor.” To help you do that, here are the pros and cons in my clinical experience and that of my colleagues.

But first, if you’re unclear on what constitutes binge eating disorder, here’s how the Binge Eating Disorder Association defines it:

“Routinely eating far more food than most adults would in a similar time period under similar circumstances.” Binge eaters typically feel out of control during a binge, and afterward, they’re consumed with guilt, self-disgust and embarrassment. Other hallmarks of the disorder: eating extremely fast, in secret, to the point of uncomfortable fullness, even when not hungry. Unlike other eating disorders, people with BED don’t try to “undo” excessive eating by throwing up, taking laxatives and other excessive actions.

OK, so here are a few points to consider…

Pros:

•More Treatment Options

With the FDA’s first and only approved medication for BED, patients now have another way into treatment: their family doctor. Rather than seeking out a psychotherapist or a nutritionist, which many are reluctant to do, they might feel more comfortable asking their physician about a prescription and other treatment options for this lesser-known eating disorder, which was only recognized two years ago as a distinct disorder by the American Psychiatric Association.

•Fewer Binge Days

Vyvanse has been shown to markedly reduce, if not eliminate, binge episodes in two studies, both funded by Shire. According to last month’s JAMA Psychiatry study, participants who got a daily dose of 50-70 mg, reduced the frequency of binge days per week from about five to less than one over the course of 12 weeks. By comparison, those taking placebo continued to binge more than two days per week. What’s more, half the participants taking the 70 mg dose stopped binging after four weeks, compared to one fifth of those taking placebo.

•Possible Weight Loss

Because Vyvanse has yet to be studied as a weight loss aid, it’s approved only in the treatment of binge eaters, not the overweight or the obese. That said, study subjects who took Vyvanse lost about 10 pounds. The potential weight loss may come as welcome news to bingers taking an off-label prescription for an antidepressant or anti-seizure medication. A common side effect of most antidepressants is weight gain. While binge eaters are often thrilled with the weight loss that the anti-seizure drug Topomax can facilitate, they’re none too pleased by the mental impairment.

Cons:

•Greater Risk of Abuse/Dependency

There’s a reason Vyvanse is a controlled substance with a black box warning. The potential for abuse and dependence is a real risk. Take it from psychiatrist Daniel Carlat, editor in chief of The Carlat Psychiatry Report, who expressed his reservations in a recent email exchange:

“I’m concerned that the FDA’s approval of Vyvanse for binge eating disorder is going to worsen our problems with stimulant abuse,” Carlat says. Continue reading

Could Tsarnaev Argue, ‘My Immature, Pot-Impaired Brain Made Me Do It’?

In this courtroom sketch, Boston Marathon bombing suspect Dzhokhar Tsarnaev appears in federal court in Boston for a final hearing before his January trial. (Jane Flavell Collins/AP)

In this courtroom sketch, Boston Marathon bombing suspect Dzhokhar Tsarnaev appears in federal court in Boston for a final hearing before his January trial. (Jane Flavell Collins/AP)

By Judith G. Edersheim, JD, MD
Guest contributor

This week marked the start of what promises to be a four-month public reckoning: the trial of alleged Boston Marathon bomber Dzhokhar Tsarnaev. If the press reports about the evidence against him are accurate, most of the trial will not be about guilt or innocence; it will be about sentencing. Not a who-done-it, but a why-done-it.

If Tsarnaev is found guilty, the death penalty will be on the table, and the proceedings will turn to a grave question, part jurisprudence and part moral philosophy: Is this defendant the most evil and culpable of all? A human being who deserves the most severe of all punishments?

One thing, I believe, is certain: If this case proceeds to the sentencing phase, the black box everyone will be talking about will be the cranium, and how the brain drives behavior will be the central story.

In these protracted sentencing hearings, the scales of justice balance lists of aggravators and mitigators, all outlined by law.

Aggravating factors in this case might include the political motive for the bombings, the risk posed to others during the course of the Tsarnaev brothers’ dramatic attempt to flee, the “heinous”, “cruel” or “depraved” manner of the crime’s execution, and the substantial planning and premeditation that might have preceded the bombings.

In the end, behavior trumps brain scans.

Mitigating factors — factors that weigh in favor of life in prison rather than a death sentence — cast the broadest net. Any aspect of a defendant’s background, record, character or circumstance is fair game for the defense team. It could try to demonstrate that Tsarnaev had some kind of impaired capacity to appreciate that his acts were wrong or illegal, or that he was under some kind of demonstrable duress. It could also bring to light hardships during his upbringing that limited his opportunities or narrowed his ability to choose wisely.

The defense team has already given public hints as to the central themes of its mitigators. They will feature life within the Tsarnaev family, including Dzhokhar’s relationship with his parents, his brother Tamerlan, and his sisters. Will anything in these family dynamics rise to the level of psychological duress or impaired capacity? There will likely be plenty of traditional testimony from forensic psychologists and psychiatrists regarding whether or not Tsarnaev was under the sway of his radicalized and perhaps dominant older brother, particularly after the Tsarnaev parents left the country. The prosecution will likely counter with a line of evidence regarding Dzohokar’s relative independence and his network of friends and activities outside of the family structure.

Then comes the brain.

Judy Clarke, lead defense attorney and one of the nation’s premier death penalty litigators, will surely not overlook the new body of neuroscientific evidence regarding the immaturity of adolescent brains. In a recent trilogy of cases (known as Roper, Graham, and Miller ) the U.S. Supreme Court was influenced by neuroscientific evidence about the juvenile brain when making sweeping changes in how adolescents are tried and sentenced. The court concluded that adolescent brains were less mature than those of adults in ways which warranted differential treatment under our criminal laws.

Although Tsarnaev was 19 at the time of the bombings, his lawyers might argue that much of this brain research applies, as it outlines a period of relative immaturity that stretches from mid-adolescence all the way into the early 20s. Generally speaking, this research shows that adolescents are less mature, and they are more likely to make ill-considered decisions. They bow to peer influences and respond excessively to thrill seeking and immediate rewards. Think money, sex, drugs and friends.

Beginning in the teens, there are major changes in brain architecture and function that temper these qualities — among them, synaptic pruning of the prefrontal cortex, improved connectivity and changes in dopamine receptors — all of which support self control, delayed gratification and the development of a moral compass.

Here’s the rub. What the research doesn’t show makes it problematic for defense attorneys. The research does not show that adolescents are incapable of making well-considered choices. Quite the contrary. Continue reading

Related:

Beyond Sexual Assault: How One Victim Evolved Into An Activist

Ali Safran founded a website dedicated to supporting victims of sexual assault. (Courtesy of Erinn Lew)

Ali Safran founded a website dedicated to supporting victims of sexual assault. (Courtesy of Erinn Lew)

By Dr. Gene Beresin

Alison Safran is a 22-year-old who graduated from Mount Holyoke College in May 2014. She was the victim of a sexual assault as a senior in high school in one of Boston’s suburbs.

She initially didn’t confide in her parents because she was unsure that they’d understand. However, when her symptoms of post-traumatic stress disorder (PTSD) increased, she sought help from a clinician who referred her to the psychiatrist she is currently seeing. She has since improved immensely.

Ali’s story is about her resilience, but it’s also about how good can emerge from a terrifying experience.

Symptoms After An Assault

“After I was assaulted,” Ali said. “I developed what I now understand as PTSD symptoms, but at the time, I didn’t even know what PTSD was. I was miserable. My symptoms continued into my first year of college, which made an already stressful time even more difficult. It was hard to sleep and function normally.”

When Ali attended a local university, she was assigned to a co-ed dorm, under the conditions of her housing contract. This situation was not easy for her; her PTSD was at its peak and she filed a criminal complaint against her assailant, adding more stress to her life. It was very difficult for her to live near male students who were often partially undressed in the common room.

“Even though living in a co-ed dorm is a normal part of college life, dealing with being around men while I was engaged in the criminal justice process made me feel unsafe,” she said.

Stress Of A Co-Ed Dorm

While Ali, her parents and even her psychiatrist tried to release her from her dorm contract, the university declined until eventually the administration was persuaded to alter its stance by a member of the Board of Trustees. Ali felt that though her professors were understanding and helpful in providing accommodations when needed (i.e. missing class for court), the university administration itself did not understand or appreciate the impact of her living situation given the sexual assault and upcoming trial.

“My stress level was already far above that of the average college freshman. Despite the legal process I was pursuing, my school could have at the very basic level chosen to help me relieve some of that stress. It chose not to do so,” Ali said.

The unfortunate failure on the part of her university preceded the recent focus on college campus sexual assaults, in which awareness has increased and schools are beginning to take steps to address the widespread problem. Continue reading

Persistent Stigma, Skepticism About Mental Illness Causes Real Harm

By Dr. Steve Scholzman
Guest Contributor

Profound misunderstanding about mental illness — its causes, its legitimacy and its treatment — permeate our culture. And the stigma that accompanies this lack of understanding hurts, a lot. Take this example — hardly original or rare.

Imagine a 15-year-old adolescent girl with fairly severe depression. She may be a classmate of your child, or the daughter of a friend. Let’s call her Sally.

Sally’s not so ill that she needs to be in the hospital, but she’s close. Her family and I — her psychiatrist — are doing our best to get her better as quickly as possible so she can get back to school. She’s been out now for about three days. Why? She literally lacks the capacity to think clearly. It’s all she can do to drag herself out of her bed and run a toothbrush across her teeth.

(Michael Summers/Flickr)

(Michael Summers/Flickr)

There’s a big family history of depression so Sally’s parents are both familiar with and frightened by her struggles.

“Can you call the school and ask them to give her more time on some work?” the parents ask.

“Sure,” I say, and I get in touch with the school administrator.

“Well,” I’m told by the very well-meaning administrator, “It IS a tough time of year. The other kids are getting through it somehow. I don’t see why she should get special treatment.”

“Because she has the equivalent of the flu,” I say. I like to use analogies at these crossroads.

“But the flu feels awful. Does she have a fever? Because if she does, she shouldn’t come to school…”

“No, she doesn’t have a fever,” I say. I try another analogy. “What if she had been in a car accident, God forbid?”

“Well, that’s pretty different, isn’t it?”

“How?” I ask.

“She’d be hurt,” I’m told. “This is an entirely different thing. You’ll need to get her pediatrician to call.”

I ask the pediatrician to call, and I can feel his discomfort over the phone. “I’m not very good at making this case,” he acknowledges. “It’s probably better if you just call them back.”

(I have to wonder whether he’d be so uncomfortable if I were a gastroenterologist asking him to call the school about a patient with ulcerative colitis?) Continue reading

Mass. Parents Report Early Logjam In Care For Mentally Ill Kids

LisaLambert-140x140

Lisa Lambert of PPAL (Courtesy)

It usually happens in spring, the annual back-up of mentally ill kids who need beds in Massachusetts psychiatric hospitals or residential care centers.

But Lisa Lambert, executive director of the Parent/Professional Advocacy League, which works on behalf of mentally ill children and their families, reports that already this fall, the waits are unusually long and the resulting crises severe. (Imagine: a child in severe emotional distress, stuck in an Emergency Room for days. Or stuck in a hospital far from home, because there are no local beds.)

What’s happening? It’s not exactly clear. Might it be that state social service agencies are putting kids into residential care more than usual in the wake of the Jeremiah Oliver case? Is it a longer-term effect of having more community-based treatment for kids? Community care is widely considered a good thing, but it could mean that because children in crisis stay at home longer, their needs are more acute when they’re brought in for care. Lambert writes that the bottom line is that no one seems to be taking responsibility for alleviating the back-up, and the situation is getting dire:

At my office, the phone and emails are nonstop. Often, they spill over to the weekend. A few days ago, we heard from a mom whose 14 year old son had swallowed a bottle of Tylenol. This was his third suicide attempt. She rushed him to the emergency room and got medical treatment right away. But once that was completed, he needed inpatient mental health care. “You have to wait, his mother was told twice a day. “There are no beds.” She’s a smart and proactive parent and was trying every avenue to budge a system that told her there was nowhere to admit her son for treatment. When she called us he’d been waiting for four days and counting.

We are hearing a new term this year: boarding at home.

We are not the only state grappling with this issue. Last summer, the Sacramento Bee reported that hospitalizations for California children and teens had spiked 38% between 2007 and 2012. Nationally, hospitalizations have also increased but at a slower pace than California. Connecticut also reports an increase in children and teens coming to emergency rooms in psychiatric crisis. Data from the state’s behavioral health partnership shows that the number of children and teens stuck in emergency rooms rose by 20 percent from 2012 to 2013. Continue reading

The Bionic Mind: Building Brain Implants To Fight Depression, PTSD

Liss Murphy this summer, with husband Brian, son Owen and sheepdog Ned. (Courtesy)

Liss Murphy, who had surgery to implant Deep Brain Stimulation for depression in 2006 and got much better, on Cape Cod in summer, 2014, with husband Scott, son Owen and sheepdog Ned. (Courtesy)

Ten years ago, with little warning, Liss Murphy fell victim to paralyzing depression, a “complete shutdown.”

She was 31, living in Chicago and working in public relations. The morning of Aug. 13, 2004, she had gone in to the office as usual. “It was Tuesday, and I remember the day so clearly,” she says. “The sun — everything — and I walked out — it was about 11 o’clock — and I never went back. The only time I left the house was to see my psychiatrist, who I saw three times a week.

“I have a hard time believing it was depression, in a way, because it was so pervasive and powerful,” she says. “It invaded every aspect of my life. It took so much away from me. And it happened so fast, and it was so degrading — it took everything from me.”

Murphy came home to Boston, and she tried everything — medications, talk therapy, even repeated rounds of electroshock. But she was barely able to get out of bed for months — then years. Her husband and family and top-flight doctors cared for her, but she sank so low she tried twice to commit suicide.

Finally, a psychiatrist told her about a cutting-edge trial to implant stimulation devices deep in the brains of patients with severe depression. She signed up. In June of 2006, she had the operation.

“My greatest hope that day was to have something go horribly wrong and die on the table,” she says. “I didn’t care.”

She didn’t die. Over the next few months, she got better. These days, eight years after the surgery, if you saw Liss Murphy walking her Old English Sheepdog, Ned, or playing with her 3-year-old son, Owen, only the faint silver scars on her clavicles would hint at anything unusual: That’s where the batteries that power her brain stimulator are implanted.

“We’re taking a wall of computers, basically, and putting it into something that would easily fit inside a box of Tic-Tacs.”

– Jim Moran, Draper Laboratory

But though the surgery changed Murphy’s life, “the trial, on average, didn’t work,” says Dr. Emad Eskandar, the Massachusetts General Hospital neurosurgeon who operated on her. “When you pooled everyone together it didn’t work. But there were like five people out of the 10 we did that had remarkable benefits and went into complete remission. We couldn’t continue with the study because on the average it failed, but for those people in whom it worked, boy did it work.”

Now, as part of a $70-million project funded by the military, researchers are aiming to take brain implants for psychiatric disorders to the next level.

Over the next five years, they aim to build a device that can sit inside a patient’s head, pick up the onset of depression or post-traumatic stress disorder, and head it off before it hits. One implant researcher calls it “a moonshot for the mind.” Continue reading

Inspired By Family Illness, Philanthropist Gives $650 Million For Psychiatric Research

The Broad Institute of Harvard and MIT  summer student Lydia Emerson and aesearch associate Aldo Amaya. (Courtesy/Kelly Davidson Photography)

Researchers at the Broad Institute plan to use Ted Stanley’s money to catalog all the genetic variations that contribute to severe psychiatric disorders. (Courtesy/Kelly Davidson Photography)

In the largest-ever donation to psychiatric research, Connecticut businessman Ted Stanley is giving $650 million to the Eli and Edythe Broad Institute of MIT and Harvard. The goal — to find and treat the genetic underpinnings of mental illnesses — was inspired by a family experience.

Ted Stanley made his fortune in the collectibles business. He founded The Danbury Mint, a company (later MBI, Inc.) whose first product was a series of medals commemorating the biggest scientific achievement of its time: the moon landing in 1969. While his business grew, his son Jonathan Stanley grew up as a normal Connecticut kid. Until, at age 19, Jonathan came down with bipolar disorder with psychosis, which got worse over the next three years.

“We’ll call it the epiphany from my dad’s standpoint at least,” Jonathan Stanley remembered of the turning point in his illness. “I went three days straight running through the streets of New York, no food, no water, no money, running from secret agents. And not surprisingly, after I stripped naked in a deli, ended up in a psychiatric facility.”

Jonathan was a college junior at the time.

“My dad came to visit, and he got to see his beloved son in a straitjacket,” Jonathan Stanley said.

The Stanleys were lucky. Jonathan responded well to the lithium, then a newly-approved drug. He went on to graduate from college and law school, too. Yet along the way, his father had met other fathers whose sons did not respond to treatment. He met other families who had to keep living with uncontrolled mental illness.

Ted Stanley said that gave him a focus for his philanthropy.

There was something out there that our son could take, and it made the problem go away,” he said. “And I’d like to see that happen for a lot of other people. And that’s why I’m doing what I’m doing.”

Continue reading

In Search Of ‘Computational Psychiatry:’ Why Is It A Hot New Field?

By Suzanne Jacobs
WBUR Intern

It’s around 10 a.m. on a weekday when I walk into a coffee shop that apparently doubles as the preferred study spot of every student on the Boston University campus. My instinct is to leave immediately and find a quieter place to caffeinate, but I’m not here for the coffee. I’m here for information — information on what I’m hearing is one of the hottest new trends in brain science.

Winding my way through tables of frazzled co-eds, I search every face for that “Are you who I’m looking for?” stare, but no one acknowledges me. So I step back out onto the sidewalk and wait. I’m early anyway.

About five minutes later, a young man who would have otherwise been indistinguishable from the crowd of students locks eyes with me from about 20 feet away. “That’s my guy,” I think to myself.

Lights of Ideas (Andrew Ostrovsky)

(Andrew Ostrovsky)

Minutes later, coffees in hand, we’re seated at a small back table, and I put my digital recorder down on it. “Is it okay if I record this?” I ask. He says that’s fine.

At this point, what I really want to do is grab him by the shoulders and yell, “What are you people doing? Let me into your world!” For weeks, I’ve been looking into this new field of research called computational psychiatry, but for the life of me, I can’t figure out what it is. More frustratingly, I can’t figure out why I can’t figure it out, despite a strong science background and hours of reading what little I could find about the topic on the Internet.

But I hold back, press the little red circle on my digital recorder and let the man speak.

In computational psychiatry, “What you try to do is come up with a toy world…,” he begins.

This all started a few weeks earlier when I was perusing the latest edition of Current Opinion in Neurobiology. Don’t ask me why I was perusing Current Opinion in Neurobiology — I don’t know. To avoid doing something else, probably.

One article caught my eye. It was titled “Computational approaches to psychiatry.” A longtime subscriber to the drugs-and-therapy stereotype of psychiatry, I found the idea of new “computational approaches” intriguing, so I read on. Continue reading