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Antidepressants Make it Harder to Empathize, Harder to Climax, and Harder to Cry
Dr. Julie Holland relays the dangers related to overprescribed medications. She suggests several alternatives to relying on antidepressants.
Dr. Julie Holland is a board-certified psychiatrist in New York City. From 1996 to 2005, Dr. Holland ran the psychiatric emergency room of Bellevue Hospital on Saturday and Sunday nights. A liaison to the hospital's medical emergency room and toxicology department, she is considered an expert on street drugs and intoxication states, and lectures widely on this topic. She published a paper in the Journal of Psychoactive Drugs, describing a resurgence of the drug phenomenon smoking marijuana soaked in embalming fluid, which may be a carrier for PCP. She is available for forensic consultations involving embalming fluid intoxication.
During her college years, Dr. Holland grew interested in a new drug being used as a psychotherapeutic catalyst, and authored an extensive research paper on MDMA (ecstasy), resulting in multiple television appearances, forensic consultations, and a book, Ecstasy: The Complete Guide.
Her other books include The Pot Book: A Complete Guide to Cannabis, Weekends at Bellevue: Nine Years on the Night Shift at the Psych ER, and her latest release Moody Bitches: The Truth About the Drugs You're Taking, the Sleep You're Missing, the Sex You're Not Having, and What's Really Making You Crazy.
Dr. Holland has been quoted as an authority on MDMA in magazine, newspaper and website articles (Harper's, Slate, SF Chronicle, LA Times, Wall Street Journal).
Dr. Holland runs a private psychiatry practice in Manhattan, established in 1996.
Julie Holland: The main kind of antidepressant that is the most popularly prescribed are the SSRIs and these are medicines that increase serotonin transmission. And when you start to push on the doses of these SSRIs, you start to lose some sort of quintessential feminine things. First of all it becomes much hard to climax and it becomes much, much harder to cry. But you also see decreases in empathy, in sensitivity, in passion.
The simple way of thinking about an SSRI is that you have two brain cells and one is a pitcher and one is a catcher. So pitch, catch. Pitch, catch. So this nerve cell is throwing serotonin across and this one is catching it. What the medicines do is they block the recycling back into the pitcher. So, you know, I’m throwing; I’m throwing. Some of this gets caught; some of it gets dropped. It just doesn’t get over there, but I’ll suck it back in and try again. So if you block the recycling, more is in the middle to get across. So there’s more, you know, the space between the nerve cells is called the synapse. If you block the recycling of the serotonin into the releasing cell, more is available for the catching cell. So it ends up enhancing the transmission. How enhanced serotonergic transmission translates into feeling better and feeling less anxious is much more complicated. But, you know, the simplistic way to think about it is that if you have higher levels of serotonin, if your transmission is better, you will be more relaxed and more happy. It’s a little easier to smile. It’s a little harder to cry.
So, you know, I’ve had patients come to me and say, you know, I’ve tried antidepressants before, but they always made me feel like a zombie or they didn’t make me feel like myself. Or I had a patient who said like I cut my finger and I looked down and I saw that it was bleeding and I saw that it was my blood, but I didn’t really feel like connected to my finger or the blood. You know, things like that that are really, really worrisome. Or I’ve had patients say, you know, I was in this situation where I knew I should be crying and I couldn’t cry. And, you know, I felt terrible that I couldn’t express that emotion to bond with my friend or something like that.
So these antidepressants do scale back a lot of expression of emotion and feeling emotion even sort of thinking emotional thoughts. If you’re terribly depressed and you need antidepressants to get out of bed and function and go to work, I get it. That’s one thing. But what I’m worried about is more and more women deciding to go on antidepressants because their friends are doing it and that’s what’s, you know, more and more women who are at work are taking these SSRIs so that they cannot cry, not get flustered, keep going forward. You know I think it jives with this sort of forward-momentum agenda that so many of us have and especially in the workplace. But, you know, I would say at what cost? You know it is true that SSRIs can help you get ahead and there have been really interesting animal studies where, you know, the primates who are on SSRIs ascended up the dominance hierarchy. And the ones who became dominated over got stressed out and had lower serotonin levels. So there does seem to be some component of serotonin affecting dominance hierarchies and, you know, the ability to move ahead or to lean in.
So I totally get that there are advantages to being on an SSRI in the workplace. But, you’re going to miss out on knowing what’s right because you feel it or being hurt by what somebody said and showing them that you’re hurt. And so that person can learn that their behavior has emotional consequences for other people. So and it changes the whole sort of tone of the workplace. There’s going to be less accountability and less sort of calling people on their misbehavior if you’re not even feeling that anyone misbehaved.
When you think about risks, you know, if you’re really being thorough, you want to look down both tunnels. You know if this really works out well, how is that — if this works out badly, how is that and how would that be for me. And so when you’re evaluating risk you need to be in touch with things like fear or vulnerability or anxiety. So if you’re medicating yourself to be invulnerable and to let things sort of flow by you and, you know, oh it’s all good, no problem, whatever. You really may make decisions that are riskier and feel better about them. There are other antidepressants like there’s an antidepressant called Wellbutrin, which — well the makers of Wellbutrin won’t really say what it’s mechanism of action is. It does seem that it more increases your dopamine. It’s not so much of a serotonergic antidepressant. It increases dopamine and dopamine helps you to be motivated and to have a vector and keep going and to be pretty headstrong.
So again in that situation, you may make decisions that are potentially disastrous, you know, in the same way that somebody who is sort of hypomanic. If you think about somebody who’s manic depressive and they have ups and downs; when they’re in this hypomanic up they get some bad ideas that seem like pretty reasonable ideas to them. Somebody who’s in a hypomanic episode may be more promiscuous and make bad choices sexually, spend money that they don’t have, you know. There’s this overinflated sense of self and invulnerability. And you can see the same thing with somebody who is sort of overmedicated on serotonergic medicines is damn the torpedoes, full steam ahead. And sometimes those torpedoes are going to get you.
So there’s quite a few things you can do that aren’t prescription medicine. You know the first thing is to really look at how you’re living your life. How much sleep are you getting? What is your diet like? Are you moving your body? Are you getting sunshine? Just sort of, you know, the basic things that we as social primates should be doing which also includes being social, being interactive and not being isolated and withdrawn. My patients who have sort of gotten off their meds and left me for the most part are people who have adopted regular cardio practice where they’re exercising regularly. I think that’s really important. The other thing is that you can take herbal medicines. You can take things like St. John’s Wort or 5HTP, which is an amino acid. Or you can take SAMe. There is also a lot of evidence that the ancient medicinal plant cannabis can be used to treat insomnia, anxiety, depression. So you do have other options.
Dr. Julie Holland argues that women are designed by nature to be dynamic and sensitive — women are moody and that is a good thing. Yet millions of women are medicating away their emotions because we are out of sync with our own bodies and we are told that moodiness is a problem to be fixed. One in four women takes a psychiatric drug. If you add sleeping pills to the mix, the statistics become higher. Overprescribed medications can have far-reaching consequences for women in many areas of our lives: sex, relationships, sleep, eating, focus, balance, and aging. Dr. Holland's newest book is titled Moody Bitches: The Truth About the Drugs You’re Taking, the Sleep You’re Missing, the Sex You’re Not Having and What’s Really Making You Crazy.
Andy Samberg and Cristin Milioti get stuck in an infinite wedding time loop.
- Two wedding guests discover they're trapped in an infinite time loop, waking up in Palm Springs over and over and over.
- As the reality of their situation sets in, Nyles and Sarah decide to enjoy the repetitive awakenings.
- The film is perfectly timed for a world sheltering at home during a pandemic.
The multifaceted cerebellum is large — it's just tightly folded.
- A powerful MRI combined with modeling software results in a totally new view of the human cerebellum.
- The so-called 'little brain' is nearly 80% the size of the cerebral cortex when it's unfolded.
- This part of the brain is associated with a lot of things, and a new virtual map is suitably chaotic and complex.
Just under our brain's cortex and close to our brain stem sits the cerebellum, also known as the "little brain." It's an organ many animals have, and we're still learning what it does in humans. It's long been thought to be involved in sensory input and motor control, but recent studies suggests it also plays a role in a lot of other things, including emotion, thought, and pain. After all, about half of the brain's neurons reside there. But it's so small. Except it's not, according to a new study from San Diego State University (SDSU) published in PNAS (Proceedings of the National Academy of Sciences).
A neural crêpe
A new imaging study led by psychology professor and cognitive neuroscientist Martin Sereno of the SDSU MRI Imaging Center reveals that the cerebellum is actually an intricately folded organ that has a surface area equal in size to 78 percent of the cerebral cortex. Sereno, a pioneer in MRI brain imaging, collaborated with other experts from the U.K., Canada, and the Netherlands.
So what does it look like? Unfolded, the cerebellum is reminiscent of a crêpe, according to Sereno, about four inches wide and three feet long.
The team didn't physically unfold a cerebellum in their research. Instead, they worked with brain scans from a 9.4 Tesla MRI machine, and virtually unfolded and mapped the organ. Custom software was developed for the project, based on the open-source FreeSurfer app developed by Sereno and others. Their model allowed the scientists to unpack the virtual cerebellum down to each individual fold, or "folia."
Study's cross-sections of a folded cerebellum
Image source: Sereno, et al.
A complicated map
Sereno tells SDSU NewsCenter that "Until now we only had crude models of what it looked like. We now have a complete map or surface representation of the cerebellum, much like cities, counties, and states."
That map is a bit surprising, too, in that regions associated with different functions are scattered across the organ in peculiar ways, unlike the cortex where it's all pretty orderly. "You get a little chunk of the lip, next to a chunk of the shoulder or face, like jumbled puzzle pieces," says Sereno. This may have to do with the fact that when the cerebellum is folded, its elements line up differently than they do when the organ is unfolded.
It seems the folded structure of the cerebellum is a configuration that facilitates access to information coming from places all over the body. Sereno says, "Now that we have the first high resolution base map of the human cerebellum, there are many possibilities for researchers to start filling in what is certain to be a complex quilt of inputs, from many different parts of the cerebral cortex in more detail than ever before."
This makes sense if the cerebellum is involved in highly complex, advanced cognitive functions, such as handling language or performing abstract reasoning as scientists suspect. "When you think of the cognition required to write a scientific paper or explain a concept," says Sereno, "you have to pull in information from many different sources. And that's just how the cerebellum is set up."
Bigger and bigger
The study also suggests that the large size of their virtual human cerebellum is likely to be related to the sheer number of tasks with which the organ is involved in the complex human brain. The macaque cerebellum that the team analyzed, for example, amounts to just 30 percent the size of the animal's cortex.
"The fact that [the cerebellum] has such a large surface area speaks to the evolution of distinctively human behaviors and cognition," says Sereno. "It has expanded so much that the folding patterns are very complex."
As the study says, "Rather than coordinating sensory signals to execute expert physical movements, parts of the cerebellum may have been extended in humans to help coordinate fictive 'conceptual movements,' such as rapidly mentally rearranging a movement plan — or, in the fullness of time, perhaps even a mathematical equation."
Sereno concludes, "The 'little brain' is quite the jack of all trades. Mapping the cerebellum will be an interesting new frontier for the next decade."
What happens if we consider welfare programs as investments?
- A recently published study suggests that some welfare programs more than pay for themselves.
- It is one of the first major reviews of welfare programs to measure so many by a single metric.
- The findings will likely inform future welfare reform and encourage debate on how to grade success.
Welfare as an investment<p>The <a href="https://scholar.harvard.edu/files/hendren/files/welfare_vnber.pdf" target="_blank">study</a>, carried out by Nathaniel Hendren and Ben Sprung-Keyser of Harvard University, reviews 133 welfare programs through a single lens. The authors measured these programs' "Marginal Value of Public Funds" (MVPF), which is defined as the ratio of the recipients' willingness to pay for a program over its cost.</p><p>A program with an MVPF of one provides precisely as much in net benefits as it costs to deliver those benefits. For an illustration, imagine a program that hands someone a dollar. If getting that dollar doesn't alter their behavior, then the MVPF of that program is one. If it discourages them from working, then the program's cost goes up, as the program causes government tax revenues to fall in addition to costing money upfront. The MVPF goes below one in this case. <br> <br> Lastly, it is possible that getting the dollar causes the recipient to further their education and get a job that pays more taxes in the future, lowering the cost of the program in the long run and raising the MVPF. The value ratio can even hit infinity when a program fully "pays for itself."</p><p> While these are only a few examples, many others exist, and they do work to show you that a high MVPF means that a program "pays for itself," a value of one indicates a program "breaks even," and a value below one shows a program costs more money than the direct cost of the benefits would suggest.</p> After determining the programs' costs using existing literature and the willingness to pay through statistical analysis, 133 programs focusing on social insurance, education and job training, tax and cash transfers, and in-kind transfers were analyzed. The results show that some programs turn a "profit" for the government, mainly when they are focused on children:
This figure shows the MVPF for a variety of polices alongside the typical age of the beneficiaries. Clearly, programs targeted at children have a higher payoff.
Nathaniel Hendren and Ben Sprung-Keyser<p>Programs like child health services and K-12 education spending have infinite MVPF values. The authors argue this is because the programs allow children to live healthier, more productive lives and earn more money, which enables them to pay more taxes later. Programs like the preschool initiatives examined don't manage to do this as well and have a lower "profit" rate despite having decent MVPF ratios.</p><p>On the other hand, things like tuition deductions for older adults don't make back the money they cost. This is likely for several reasons, not the least of which is that there is less time for the benefactor to pay the government back in taxes. Disability insurance was likewise "unprofitable," as those collecting it have a reduced need to work and pay less back in taxes. </p>
What are the implications of all this?<div class="rm-shortcode" data-media_id="ceXv4XLv" data-player_id="FvQKszTI" data-rm-shortcode-id="3b407f5aa043eeb84f2b7ff82f97dc35"> <div id="botr_ceXv4XLv_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/ceXv4XLv-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/ceXv4XLv-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/ceXv4XLv-FvQKszTI.js"></script> </div> <p>Firstly, it shows that direct investments in children in a variety of areas generate very high MVPFs. Likewise, the above chart shows that a large number of the programs considered pay for themselves, particularly ones that "invest in human capital" by promoting education, health, or similar things. While programs that focus on adults tend to have lower MVPF values, this isn't a hard and fast rule.</p><p>It also shows us that very many programs don't "pay for themselves" or even go below an MVPF of one. However, this study and its authors do not suggest that we abolish programs like disability payments just because they don't turn a profit.</p><p>Different motivations exist behind various programs, and just because something doesn't pay for itself isn't a definitive reason to abolish it. The returns on investment for a welfare program are diverse and often challenging to reckon in terms of money gained or lost. The point of this study was merely to provide a comprehensive review of a wide range of programs from a single perspective, one of dollars and cents. </p><p>The authors suggest that this study can be used as a starting point for further analysis of other programs not necessarily related to welfare. </p><p>It can be difficult to measure the success or failure of a government program with how many metrics you have to choose from and how many different stakeholders there are fighting for their metric to be used. This study provides us a comprehensive look through one possible lens at how some of our largest welfare programs are doing. </p><p>As America debates whether we should expand or contract our welfare state, the findings of this study offer an essential insight into how much we spend and how much we gain from these programs. </p>
Richard Feynman once asked a silly question. Two MIT students just answered it.
Here's a fun experiment to try. Go to your pantry and see if you have a box of spaghetti. If you do, take out a noodle. Grab both ends of it and bend it until it breaks in half. How many pieces did it break into? If you got two large pieces and at least one small piece you're not alone.
But science loves a good challenge<p>The mystery remained unsolved until 2005, when French scientists <a href="http://www.lmm.jussieu.fr/~audoly/" target="_blank">Basile Audoly</a> and <a href="http://www.lmm.jussieu.fr/~neukirch/" target="_blank">Sebastien Neukirch </a>won an <a href="https://www.improbable.com/ig/" target="_blank">Ig Nobel Prize</a>, an award given to scientists for real work which is of a less serious nature than the discoveries that win Nobel prizes, for finally determining why this happens. <a href="http://www.lmm.jussieu.fr/spaghetti/audoly_neukirch_fragmentation.pdf" target="_blank">Their paper describing the effect is wonderfully funny to read</a>, as it takes such a banal issue so seriously. </p><p>They demonstrated that when a rod is bent past a certain point, such as when spaghetti is snapped in half by bending it at the ends, a "snapback effect" is created. This causes energy to reverberate from the initial break to other parts of the rod, often leading to a second break elsewhere.</p><p>While this settled the issue of <em>why </em>spaghetti noodles break into three or more pieces, it didn't establish if they always had to break this way. The question of if the snapback could be regulated remained unsettled.</p>
Physicists, being themselves, immediately wanted to try and break pasta into two pieces using this info<p><a href="https://roheiss.wordpress.com/fun/" target="_blank">Ronald Heisser</a> and <a href="https://math.mit.edu/directory/profile.php?pid=1787" target="_blank">Vishal Patil</a>, two graduate students currently at Cornell and MIT respectively, read about Feynman's night of noodle snapping in class and were inspired to try and find what could be done to make sure the pasta always broke in two.</p><p><a href="http://news.mit.edu/2018/mit-mathematicians-solve-age-old-spaghetti-mystery-0813" target="_blank">By placing the noodles in a special machine</a> built for the task and recording the bending with a high-powered camera, the young scientists were able to observe in extreme detail exactly what each change in their snapping method did to the pasta. After breaking more than 500 noodles, they found the solution.</p>
The apparatus the MIT researchers built specifically for the task of snapping hundreds of spaghetti sticks.
(Courtesy of the researchers)
What possible application could this have?<p>The snapback effect is not limited to uncooked pasta noodles and can be applied to rods of all sorts. The discovery of how to cleanly break them in two could be applied to future engineering projects.</p><p>Likewise, knowing how things fragment and fail is always handy to know when you're trying to build things. Carbon Nanotubes, <a href="https://bigthink.com/ideafeed/carbon-nanotube-space-elevator" target="_self">super strong cylinders often hailed as the building material of the future</a>, are also rods which can be better understood thanks to this odd experiment.</p><p>Sometimes big discoveries can be inspired by silly questions. If it hadn't been for Richard Feynman bending noodles seventy years ago, we wouldn't know what we know now about how energy is dispersed through rods and how to control their fracturing. While not all silly questions will lead to such a significant discovery, they can all help us learn.</p>
Finding a balance between job satisfaction, money, and lifestyle is not easy.
- When most of your life is spent doing one thing, it matters if that thing is unfulfilling or if it makes you unhappy. According to research, most people are not thrilled with their jobs. However, there are ways to find purpose in your work and to reduce the negative impact that the daily grind has on your mental health.
- "The evidence is that about 70 percent of people are not engaged in what they do all day long, and about 18 percent of people are repulsed," London Business School professor Dan Cable says, calling the current state of work unhappiness an epidemic. In this video, he and other big thinkers consider what it means to find meaning in your work, discuss the parts of the brain that fuel creativity, and share strategies for reassessing your relationship to your job.
- Author James Citrin offers a career triangle model that sees work as a balance of three forces: job satisfaction, money, and lifestyle. While it is possible to have all three, Citrin says that they are not always possible at the same time, especially not early on in your career.