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Study Casts Doubt on Whether Seasonal Affective Disorder Is Real

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Though American psychiatrists now recognize Seasonal Affective Disorder (SAD) as a subset of depression, it’s a fairly recent condition in medical history. The condition was first defined in 1984, and it’s still not accepted by all scientists. A new study in the journal Clinical Psychological Science suggests that while winter may be a literally dark time, it’s not an emotionally dark one.

Researchers from Auburn University at Montgomery asked 34,300 people of various ages to complete a questionnaire about their depression, where they lived, and other factors. Though a lack of sunlight is often cited as one of the reasons behind SAD (and is the reason people use those bright lamps to beat the winter blues, at least in theory), they found that overall depression levels did not fluctuate with the seasons or with changes in sunlight. People who lived at higher latitudes, who would see less sun during the winter, weren’t any more depressed than people who lived in the south.

“Merely being depressed during winter is not evidence that one is depressed because of winter,” the researchers write. “In clinical cases of recurrent depression, stressful life events associated with episodes may coincidentally co-occur with seasonal changes for some people.” It’s also possible that SAD exists, but at such low rates that this population sample didn’t reveal it.

"The idea of seasonal depression may be strongly rooted in folk psychology, but it is not supported by objective data," they conclude. "Consideration should be given to discontinuing seasonal variation as a diagnostic modifier of major depression."

Research on the Arctic town of Tromsø, Norway, where it’s dark for months at a time, indicates that wintertime woes could be about attitude. There, most residents don’t just ride out the winter; they actively enjoy it, emphasizing its coziness rather than its darkness.

However, that’s not to say your brain doesn’t change from season to season. Another new study, this one in PNAS, found that cognitive function varied throughout the year for 28 volunteers who underwent fMRI testing. However, the researchers found that this change in brain responses wasn’t related to the participants' self-reported moods.

[h/t Science of Us]

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10 Mind-Boggling Psychiatric Treatments
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by Dan Greenberg

Nobody ever claimed a visit to the doctor was a pleasant way to pass the time. But if you're timid about diving onto a psychiatrist's couch or paranoid about popping pills, remember: It could be worse. Like getting-a-hole-drilled-into-your-skull worse.

1. INSULIN COMA-THERAPY

The coma-therapy trend began in 1927. Viennese physician Manfred Sakel accidentally gave one of his diabetic patients an insulin overdose, and it sent her into a coma. But what could have been a major medical faux pas turned into a triumph. The woman, a drug addict, woke up and declared her morphine craving gone. Later, Sakel (who really isn't earning our trust here) made the same mistake with another patient—who also woke up claiming to be cured. Before long, Sakel was intentionally testing the therapy with other patients and reporting a 90 percent recovery rate, particularly among schizophrenics. Strangely, however, Sakel's treatment successes remain a mystery.

Presumably, a big dose of insulin causes blood sugar levels to plummet, which starves the brain of food and sends the patient into a coma. But why this unconscious state would help psychiatric patients is anyone's guess. Regardless, the popularity of insulin therapy faded, mainly because it was dangerous. Slipping into a coma is no walk in the park, and between one and two percent of treated patients died as a result.

2. TREPANATION

Ancient life was not without its hazards. Between wars, drunken duels, and the occasional run-in with an inadequately domesticated pig, it's no surprise that archaic skulls tend to have big holes in them. But not all holes are created with equal abandon. Through the years, archaeologists have uncovered skulls marked by a carefully cut circular gap, which shows signs of being made long before the owner of the head passed away. These fractures were no accident; they were the result of one of the earliest forms of psychiatric treatment called trepanation. The basic theory behind this "therapy" holds that insanity is caused by demons lurking inside the skull. As such, boring a hole into the patient's head creates a door through which the demons can escape, and—voila!—out goes the crazy.

Despite the peculiarity of the theory and lack of major-league anesthetics, trepanation was by no means a limited phenomenon. From the Neolithic era to the early 20th century, cultures all over the world used it as a way to cure patients of their ills. Doctors eventually phased out the practice as less invasive procedures were developed. Average Joes, on the other hand, didn't all follow suit. Trepanation patrons still exist. In fact, they even have their very own organizations, like the International Trepanation Advocacy Group.

3. ROTATIONAL THERAPY

Charles Darwin's grandfather Erasmus Darwin was a physician, philosopher, and scientist, but he wasn't particularly adept at any of the three. Consequently, his ideas weren't always taken seriously. Of course, this could be because he liked to record them in bad poetic verse (sample: "By immutable immortal laws / Impress'd in Nature by the great first cause, / Say, Muse! How rose from elemental strife / Organic forms, and kindled into life"). It could also be because his theories were a bit far-fetched, such as his spinning-couch treatment. Darwin's logic was that sleep could cure disease and that spinning around really fast was a great way to induce the slumber.

Nobody paid much attention to Darwin's idea at first, but later, American physician Benjamin Rush adapted the treatment for psychiatric purposes. He believed that spinning would reduce brain congestion and, in turn, cure mental illness. He was wrong. Instead, Rush just ended up with dizzy patients. These days, rotating chairs are limited to the study of vertigo and space sickness.

4. HYDROTHERAPY

If the word "hydrotherapy" conjures up images of Hollywood stars lazily soaking in rich, scented baths, then you probably weren't an early 20th-century psychiatric patient. Building off the idea that a dip in the water is often calming, psychiatrists of yore attempted to remedy various symptoms with corresponding liquid treatments. For instance, hyperactive patients got warm, tiring baths, while lethargic patients received stimulating sprays.

Some doctors, however, got a bit too zealous about the idea, prescribing therapies that sounded more like punishment than panacea. One treatment involved mummifying the patient in towels soaked in ice-cold water. Another required the patient to remain continuously submerged in a bath for hours or even days—which might not sound so bad, except they were strapped in and only allowed out to use the restroom. Finally, some doctors ordered the use of high-pressure jets. Sources indicate that at least one patient was strapped to the wall in the crucifixion position (never a good sign) and blasted with water from a fire hose. Like many extreme treatments, hydrotherapy was eventually replaced with psychiatric drugs, which tended to be more effective.

5. MESMERISM

Much like Yoda, Austrian physician Franz Mesmer (1734-1815) believed that an invisible force pervaded everything in existence, and that disruptions in this force caused pain and suffering. But Mesmer's ideas would have been of little use to Luke Skywalker. His basic theory was that the gravity of the moon affected the body's fluids in much the same way it caused ocean tides, and that some diseases accordingly waxed and waned with the phases of the moon. The dilemma, then, was to uncover what could be done about gravity's pernicious effects. Mesmer's solution: use magnets. After all, gravity and magnetism were both about objects being attracted to each other. Thus, placing magnets on certain areas of a patient's body might be able to counteract the disruptive influence of the moon's gravity and restore the normal flow of bodily fluids.

Surprisingly, many patients praised the treatment as a miracle cure, but the medical community dismissed it as superstitious hooey and chalked up his treatment successes to the placebo effect. Mesmer and his theories were ultimately discredited, but he still left his mark. Today, he's considered the father of modern hypnosis because of his inadvertent discovery of the power of suggestion, and his name lives on in the English word mesmerize

6. MALARIA THERAPY

Ah, if only we were talking about a therapy for malaria. Instead, this is malaria as therapy—specifically, as a treatment for syphilis. There was no cure for the STD until the early 1900s, when Viennese neurologist Wagner von Jauregg got the idea to treat syphilis sufferers with malaria-infected blood. Predictably, these patients would develop the disease, which would cause an extremely high fever that would kill the syphilis bacteria. Once that happened, they were given the malaria drug quinine, cured, and sent home happy and healthy. The treatment did have its share of side effects—that nasty sustained high fever, for one—but it worked, and it was a whole lot better than dying. In fact, Von Jauregg won the Nobel Prize for malaria therapy, and the treatment remained in use until the development of penicillin came along and gave doctors a better, safer way to cure the STD.

7. CHEMICALLY INDUCED SEIZURES

Nobody ever said doctors had flawless logic. A good example: seizure therapy. Hungarian pathologist Ladislas von Meduna pioneered the idea. He reasoned that, because schizophrenia was rare in epileptics, and because epileptics seemed blissfully happy after seizures, then giving schizophrenics seizures would make them calmer. In order to do this, von Meduna tested numerous seizure-inducing drugs (including such fun candidates as strychnine, caffeine, and absinthe) before settling on metrazol, a chemical that stimulates the circulatory and respiratory systems. And although he claimed the treatment cured the majority of his patients, opponents argued that the method was dangerous and poorly understood.

To this day, no one is quite clear on why seizures can help ease some schizophrenic symptoms, but many scientists believe the convulsions release chemicals otherwise lacking in patients' brains. Ultimately, the side effects (including fractured bones and memory loss) turned away both doctors and patients.

8. PHRENOLOGY

Around the turn of the 19th century, German physician Franz Gall developed phrenology, a practice based on the idea that people's personalities are depicted in the bumps and depressions of their skulls. Basically, Gall believed that the parts of the brain a person used more often would get bigger, like muscles. Consequently, these pumped-up areas would take up more skull space, leaving visible bumps in those places on your head. Gall then tried to determine which parts of the skull corresponded to which traits. For instance, bumps over the ears meant you were destructive; a ridge at the top of the head indicated benevolence; and thick folds on the back of the neck were sure signs of a sexually oriented personality. In the end, phrenologists did little to make their mark in the medical field, as they couldn't treat personality issues, only diagnose them (and inaccurately, at that). By the early 1900s, the fad had waned, and modern neuroscience had garnered dominion over the brain.

9. HYSTERIA THERAPY

Once upon a time, women suffering from pretty much any type of mental illness were lumped together as victims of hysteria. The Greek physician Hippocrates popularized the term, believing hysteria encompassed conditions ranging from nervousness to fainting fits to spontaneous muteness. The root cause, according to him, was a wandering womb. So, whither does it wander? Curious about Hippocrates's theory, Plato asked himself that very question. He claimed that if the uterus "remains unfruitful long beyond its proper time, it gets discontented and angry and wanders in every direction through the body, closes up the passages of the breath, and, by obstructing respiration, drives women to extremity." Consequently, cures for hysteria involved finding a way to "calm down" the uterus. And while there was no dearth of methods for doing this (including holding foul-smelling substances under the patient's nose to drive the uterus away from the chest), Plato believed the only surefire way to solve the problem was to get married and have babies. After all, the uterus always ended up in the right place when it came time to bear a child. Although "womb-calming" as a psychiatric treatment died out long ago, hysteria as a diagnosis hung around until the 20th century, when doctors began identifying conditions such as depression, post-traumatic stress disorder, and phobias.

10. LOBOTOMY

Dr. Walter Freeman, left, and Dr. James W. Watts study an X ray before a psychosurgical operation
Harris A Ewing, Saturday Evening Post, Public Domain, Wikimedia Commons

Everybody's favorite psychiatric treatment, the modern lobotomy was the brainchild of António Egas Moniz, a Portuguese doctor. Moniz believed that mental illnesses were generally caused by problems in the neurons of the frontal lobe, the part of the brain just behind the forehead. So when he heard about a monkey whose violent, feces-throwing urges had been curbed by cuts to the frontal lobe, Moniz was moved to try out the same thing with some of his patients. (The lobe-cutting, not the feces-throwing.) He believed the technique could cure insanity while leaving the rest of the patient's mental function relatively normal, and his (admittedly fuzzy) research seemed to support that. The accolades flooded in, and (in one of the lower points in the Karolinska Institute's history) Moniz was awarded the Nobel Prize in 1949.

After the lobotomy rage hit American shores, Dr. Walter Freeman took to traveling the country in his "lobotomobile" (no, really), performing the technique on everyone from catatonic schizophrenics to disaffected housewives. His road-ready procedure involved inserting a small ice pick into the brain through the eye socket and wiggling it around a bit. While some doctors thought he'd found a way to save hopeless cases from the horrors of life-long institutionalization, others noted that Freeman didn't bother with sterile techniques, had no surgical training whatsoever, and tended to be a bit imprecise when describing his patients' recovery.

As the number of lobotomies increased, a major problem became apparent: The patients weren't just calm—they were virtual zombies who scarcely responded to the world around them. Between that and the bad press lobotomies received in films and novels such as One Flew Over the Cuckoo's Nest, the treatment soon fell out of favor.

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11 Fascinating Facts About Sigmund Freud
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Next to sheep, no one has done more for dreams than Austrian neurologist and psychiatrist Sigmund Freud (1856-1939). While you may know him as the founder of psychoanalysis, you may not know as much about his work with therapy dogs, his Hollywood courtship, or his love affair with cocaine.

1. HE HAD A RARE BIRTH ANOMALY.

The first of eight children born to Jacob and Amalia Freud, newborn Sigmund arrived in 1856 with a curious aberration: A membrane known as a caul covered his head and face. Cauls are very unusual events, but harmlessly removed by attending physicians or midwives. Far from distressed, Amalia was overjoyed at the sight. She believed the folklore that says cauls herald the birth of a child destined for great accomplishments.

2. HE EXAMINED FROG BRAINS.

Freud’s early education and work was focused on neurology. After studying the sexual organs of the eel via dissection, he moved to comparing the brains of vertebrates and invertebrates. For six years, Freud dissected the brains of frogs, crayfish, and lampreys, describing the medulla oblongata and other then-oblique components of the brain and nervous system. He also made important contributions toward the discovery of the neuron.

3. HE EXPERIMENTED WITH HYPNOSIS.

After graduating from the University of Vienna, Freud began working at Vienna General Hospital and collaborating with fellow physician Josef Breuer. Breuer was an advocate of treating patients via hypnosis, which intrigued Freud. One of Breuer’s patients, known as “Anna O.,” seemed to recall unpleasant memories only when under the influence of hypnotic suggestion. Freud traveled to Paris to learn more from other physicians using hypnosis, but when he returned to Vienna in 1886 and opened his own practice, he began to step away from hypnosis—patients simply relaxing on his couch seemed to produce a similar recall effect.

4. HIS ETHICS COULD BE A LITTLE SHAKY.

Over time, Freud’s influence on psychiatry has been both celebrated and minimized. His critics argue that Freud was sometimes prone to manipulative behavior directed at his patients, as in the case of Horace Frink, an American psychoanalyst who submitted to Freud’s probing in 1921. Under Freud’s guidance, Frink divorced his wife and married Angelika Bijur—one of Frink's patients. This Match Game brand of psychiatry drew criticism after correspondence revealing Freud’s involvement in the pair was unearthed by Frink’s daughter in the 1970s.

5. HE HATED THE U.S.

Though Freud was feted in the United States for his provocative psychoanalytical theories, he disliked everything but the compliments. Traveling to America by steamship in 1909 with Carl Jung, Freud recoiled at the manners of his American hosts (who used his first name) and felt the culture as a whole was too preoccupied with money. Such was his dislike for the country that when the Nazis took over Vienna in 1938, Freud initially stuck around rather than accept a relative’s invitation to come seek shelter in Manhattan. (However, he willingly fled to London after Princess Marie Bonaparte, Napoleon’s great-granddaughter, intervened.)

6. HOLLYWOOD WANTED HIS HELP.

Following the publication of several books on his theories, including 1899’s The Interpretation of Dreams, Freud’s notoriety grew exponentially. In 1925, MGM head Samuel Goldwyn declared him the “greatest love specialist in the world” and asked him to consult on scripts for several love stories from history, including Antony and Cleopatra. Freud had no interest in that film or any other. He did, however, once make time for an informal examination of actor Charlie Chaplin. Chaplin’s “Tramp” character, Freud wrote in 1931, was Chaplin channeling his own self “as he was in his early dismal youth.”

7. HE LIKED HIS COCAINE.

Before being stigmatized as a dangerous and addictive stimulant, cocaine was enjoyed at the turn of the century as a safe and practical way to stimulate activity. Freud found relief from bouts of sadness while on the drug and also appreciated its ability to provoke extended monologues about things normally tucked away in the recesses of his brain. He wrote four papers celebrating the drug’s effects and even used it on some of his patients. He quit the drug later in life, calling it a distraction.

8. HE HAD THERAPY DOGS.

Freud was using animal companions to soothe anxious patients long before it was common. He sometimes allowed his Chow-Chow, Jofi, to sit in with his patients during appointments and noticed that they became measurably more relaxed. When the idea of therapy dogs was explored further in the 1960s, researchers drew support from Freud’s writing about Jofi to help establish credibility for the approach.

9. HE HELPED SELL COUCHES.

Freud’s preference for patients to splay out on a couch, staring at the ceiling to help clear their mindS for revelatory thinking, became a standard of psychoanalytic practice. In the 1940s, the Imperial Leather Furniture Company of Queens manufactured couches that were specifically for the psychoanalytical field, lacking buttons or cushions that might distract nervous patients.

10. HE WAS NOMINATED FOR A NOBEL PRIZE 13 TIMES.

Between 1915 and 1938, Freud was nominated for the Nobel Prize in Medicine 12 times and the Nobel in Literature once—yet was never awarded any of them. His critics charged that psychoanalysis was an unproven practice. Asked to endorse him for a prize, Albert Einstein begged off, citing uncertainty about Freud’s conclusions. Freud did receive the Goethe prize (given by the city of Frankfurt, Germany, in honor of the poet Goethe) in 1930: His daughter, Anna, traveled to Frankfurt, Germany to accept on his behalf, since Freud was ill with cancer.

11. THIEVES ONCE TRIED TO STEAL HIS ASHES.

Freud died by suicide in 1939, after a long and painful struggle with epithelioma. In 2014, his cremated ashes—housed in a 2300-year-old Greek urn given to him by Princess Marie Bonaparte—were nearly snatched by thieves at Golders Green Crematorium in London. The urn, which also contained the remains of his wife Martha, was damaged in the attempted theft. Crematorium employees then moved the urn from public display to a more secure location; it's unclear if the culprits were ever apprehended.

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