A man with virtually no serotonin or dopamine

[mimac]

Neuroskeptic covers a fascinating case of a man born with a genetic mutation meaning he had a severe lifelong deficiency of both serotonin and dopamine.

The case report concerns a gentleman with sepiapterin reductase deficiency, a genetic condition which prevents the production of the enzyme sepiapterin reductase which is essential in the synthesis of both dopamine and serotonin.

The most widely recognised symptoms of the condition, linked to the deficiency in dopamine which has an important role in controlling movement, are problems coordinating both conscious movements and the unconscious control of muscles that allows simple actions. Unconscious control requires that the brain signals one muscle to contract while releasing the complementary muscle, and problems with this process cause spasticity.

The effects the condition on serotonin, often stereotyped as the 'happy chemical', are less well known, but in this case it was clear that the patient wasn't depressed but did some other difficulties:

These included increased appetite - he ate constantly, and was moderately obese - mild cognitive impairment, and disrupted sleep:

"The patient reported sleep problems since childhood. He would sleep 1 or 2 times every day since childhood and was awake during more than 2 hours most nights since adolescence. At the time of the first interview, the night sleep was irregular with a sleep onset at 22:00 and offset between 02:00 and 03:00. He often needed 1 or 2 spontaneous, long (2- to 5-h) naps during the daytime."

After doctors did a genetic test and diagnosed SRD, they treated him with 5HTP, a precursor to serotonin. The patient's sleep cycle immediately normalized, his appetite was reduced and his concentration and cognitive function improved (although that may have been because he was less tired)...

Overall, though, the biggest finding here was a non-finding: this patient wasn't depressed, despite having much reduced serotonin levels. This is further evidence that serotonin isn't the "happy chemical" in any simple sense.

This is another piece of evidence against the common myth that depression is "caused by low serotonin" although Neuroskeptic speculates whether the link between disrupted sleep and depression may indicate an effect of serotonin dysfnction.


http://www.mindhacks.com/blog/2010/03/a_man_with_virtually.html

 

[Roger&Me]

Overall, though, the biggest finding here was a non-finding: this patient wasn't depressed, despite having much reduced serotonin levels. This is further evidence that serotonin isn't the "happy chemical" in any simple sense.

This is another piece of evidence against the common myth that depression is "caused by low serotonin" although Neuroskeptic speculates whether the link between disrupted sleep and depression may indicate an effect of serotonin dysfnction.

This is simply confirming something I've known for a long time: the "serotonin deficiency causes depression" line is a crock of shit.

Unhappiness is not a biochemical disease, its a psychological/emotional/spiritual problem. The sooner depressed people realize this fact, the sooner they can get assistance that will actually help them feel better instead of just shoving pills down their throat to correct a phantom "imbalance".

 

[Enlitx]

This is simply confirming something I've known for a long time: the "serotonin deficiency causes depression" line is a crock of shit.

Unhappiness is not a biochemical disease, its a psychological/emotional/spiritual problem. The sooner depressed people realize this fact, the sooner they can get assistance that will actually help them feel better instead of just shoving pills down their throat to correct a phantom "imbalance".

What do you think controls the psychological and emotional aspects of our consciousness if not biochemistry? Depression may take root after environmental factors fail to strengthen certain neural pathways that stimulate dopaminergic and serotonergic release, or it may take root because it strengthens pathways that increase fear and anxiety (amygdala, etc..). Whatever the case, it is still linked to biochemistry. I fail to see any way to look out it without coming back to biochemistry as the basis for all psychological conditions. Even though SSRI's might not "cure" the disease, they release serotonin which improves a patient's mood and allows them to break the cycle of depression, forming neural networks that reinforce pleasure.

I have never understood how people can say that a problem with the brain does not have a basis in biochemistry. Even something purely behavioral, such as CBT therapy, aims to strengthen pathways that reinforce pleasure. So it really doesen't matter if you are taking a pill to release dopamine or you are performing healthy activities, the goal is to alter the biochemistry of a patient in every single case.

 

[dragonslayer428]

Roger,

Try living in someone's shoes that has been diagnosed with clinical depression with NO environmental factors involved, and then tell me that it doesn't require medication.

 

[monstanoodle]

A very interesting case this. Thanks for posting this mimac

 

[smokeymcpot42088]

"Unhappiness is not a biochemical disease, its a psychological/emotional/spiritual problem. The sooner depressed people realize this fact, the sooner they can get assistance that will actually help them feel better instead of just shoving pills down their throat to correct a phantom "imbalance".

^ I agree with you again, everyone told me I was depressed and I told them, well its because my life is depressing right now, I still live at home I can't find a job Im struggling to stay in college, no car etc etc.

But nooo every day they asked me so finally I took the anti-depressants, they may have helped a little bit, but I kind of think its bullshit still

*Edit. Im not saying I don't think there is any such thing as a depression that does result in a chemical inbalance and needs pharmaceutical treatment, I just think in my, many, and even most cases people are depressed because life is freakin depressing all over.

 

[sdripper]

This is simply confirming something I've known for a long time: the "serotonin deficiency causes depression" line is a crock of shit.

Unhappiness is not a biochemical disease, its a psychological/emotional/spiritual problem. The sooner depressed people realize this fact, the sooner they can get assistance that will actually help them feel better instead of just shoving pills down their throat to correct a phantom "imbalance".

This :D

although I would like to add, a very important factor imo, Nutritional

 

[sdripper]

Roger,

Try living in someone's shoes that has been diagnosed with clinical depression with NO environmental factors involved, and then tell me that it doesn't require medication.

no environmental factors? Are you kidding us?

That is an impossibility, and you're outrageous to say it.

We exist in an environment, period

 

[Huaca]

...I just think in my, many, and even most cases people are depressed because life is freakin depressing all over.

You're right, this world sucks. In my case, cannabis has been like a life line.

 

[jamesmartin]

interesting .. thanks for sharing man

 

[narco anonomous]

"no environmental factors? Are you kidding us?

That is an impossability, and your outrageous to say it.

We exist in an environment, period "

The suggestion was that there weren't any factors that could be attributed as the cause of the presented symptoms. Traditional examples of those factors would be job loss, break up, financial problems, etc.

I don't understand the suggestion that happiness is something that exists purely in a psychological space. Brain MRI's have made it pretty clear that emotion is a function of the limbic system. When you get into making inductions based on evidence such as this case, you have to look at the relationship of correlation and causality. Just because something treats x doesn't mean that said thing causes x. A lot of psychiatrists are becoming skeptical of the orthodox teaching that serotonin is the focus of major depression, and that SSRI's should be the first line treatment. And there are quite a few neurotransmitters that effect mood.

I'm working on a graduate degree in psychology, although my intention is to be a neuro psychologist so I kind of Straddle the two fields. My view is that currently the best treatment available for depression is medication in conjunction with therapy(not psychoanalysis). The aim of this treatment should be the removal of the symptoms of depression with best case scenario being the patient eventually moves towards something resembling fulfillment. This is not "happy", happy is a carrot on a stick in my opinion. In some cases depression may have factors such as childhood abuse, or the development of pessimistic paradigms. In these cases psychology is invaluable for understanding the symptoms, but my experience less helpful for treating them. And even in these cases the factors are memory related, which is neurological. I for one see little evidence that depression can be treated with logic. Not a fan of Freud.

 

[slimvictor]

Happiness is a choice.

 

[narco anonomous]

Happiness is a choice.

That's a clever opinion, would you care to offer empirical evidence to support this, or should we just accept that because you attribute your own happiness to your having chosen to experience it, that all peoples subjective experience of happiness is a matter of choice.

See how I subtracted the logic of what you were saying and expanded on the implication of your statement, and thus made you look like a complete moron? reductio ad absurdum, it's pretty cool.

 

[nuke]

The people who say depression is all "in the heads" of the persons with depression probably has not seen the inside of a mental ward and looked at patients who have barely moved for three days at a time. The people who want to insist that it's only a spiritual problem are actually only making it a lot harder for the people who have a serious medical condition by making them feel invalidated.

 

[orangescrewpen]

yeah I mean this guy clearly has some seriously abnormal brain functioning, to be able to draw lessons applicable to more "normal" functioning brains is perhaps possible but requires a much more in depth look.

From what I can see from the replies, it seems many people are posting based of their personal experiences with depression. I would only say across the vast populations of individuals, YMMV

 

[slimvictor]

See how I subtracted the logic of what you were saying and expanded on the implication of your statement, and thus made you look like a complete moron?

Actually, I contributed a profound statement that can serve as the crux of a philosophy that permits people in any life situation to achieve happiness, and you didn't recognize it for what it was, and were unable to learn from it, instead turning it into drivel.

Who looks like the moron here? 8)

 

[narco anonomous]

Actually, I contributed a profound statement that can serve as the crux of a philosophy that permits people in any life situation to achieve happiness, and you didn't recognize it for what it was, and were unable to learn from it, instead turning it into drivel.

Who looks like the moron here? 8)

Oh whats that you'd like to enter the realm of my minor? Alright then. I'd like to start by discussing some of my opinions on the relationship between philosophy and science. They have existed for centuries in an interesting relationship in which discoveries so to say in one field have driven the search in the other, and the entire frame work by which we conduct scientific experience was formulated by philosophy. Post Descartes the relationship has in essence been, science finds evidence, science makes induction based on evidence, philosophy comments on evidence, makes meaning of evidence, and in some cases questions the implications of said evidence. In some cases science questions or confirms the validity of philosophic propositions.

You're proposition, if you can call one sentence that(you most certainly can in one sense of the meaning), is basically a direction of philosophy begun in Western philosophy by Epicurus. That happiness is not a result of outcome, rather of expectation. You will get no argument from me as to whether this theory is applicable. You will however get an argument on to what degree it is applicable. There is a wide degree of variance in human architecture, and social structure. In addition I believe that for a discussion such as this we need to produce a criteria for happy, which I will leave to you.

I will suggest that you expand on your "profound" theory, perhaps by giving hypothetical examples of it's mechanics. And perhaps tell me what you make of some counter theories such as Schopenhauer's which suggests that desire is merely a carrot on a stick, which can never be satisfied in a true sense, with the carrot always falling short of the expectation. With this he suggests that one is best to deny sensory impulse towards epicurean drives, of which in my opinion drug use is the epitome of(in a way it's kind of like masturbating with you're nervous system). He than examines the next area people aim to find happiness in, human relationships, and gives his opinions on the futility and inherent narcissism of such endeavors. He gives a comparison by analogy relating the human social condition to porcupines in a cold environment, all shivering from the cold because they are thin skinned and as result come together and try to snuggle or something like that to create warmth and in the process they poke each other. They retreat to tend to there wounds, get cold again, and repeat the dance. He suggests that those who closest approach happiness are those who learn to create their own warmth(his suggestion on how to do those is rejection of the first two drives towards happiness, and seeking refuge in careful, contemplative thought).

I could go on forever, ultimately leaving aesthetics and entering epistemology, sociology, linguistics, and my favorite/least favorite religion. Now if you're sentence was the tip of a philosophical ice berg, than I welcome it with open arms and an open mind. Now I'd like to say that by philosophy, in this case, I do not mean spirituality/religion. If this is where you want to go I disrespectfully decline, on the grounds that, "where of one cannot speak, thereof one must be silent."

And in regards to who looks like a moron, I'd like to point out that it's totally subjective, and your reply doesn't alter my perspective that your a perfect match for my criteria of moronic.

 

[narco anonomous]

Outside of the aims of this argument, I'd like to personally apologize to you slimvictor for some of the less civil aspects of my argument style, which in this case is approaching red hearing territory. I still disagree with the implications of your statements, but hold no umbrage towards you personally. I'm not the most mature person in the world...

 

[thujone]

Roger,

Try living in someone's shoes that has been diagnosed with clinical depression with NO environmental factors involved, and then tell me that it doesn't require medication.

what medication? you don't know what the psychiatrists are feeding you, the fuckin psychiatrists don't know what they're feeding you! fact of the matter is, the vast, vast majority of the antidepressants being prescribed are only known about insofar as they act on serotonin and dopamine. that's their main function! that's their only function! given that, how are you gonna sit there and defend your point in direct contrast with an article that plainly states a gross lack of serotonin and dopamine does not lead to depression?

and hey, i have been in those shoes myself. "clinical depression" was the exact words some headshrinker used to describe me with, one who, by the way, i was refered to from my family doc who i've trusted since before high-school. he's a good man, i doubt he'd set me up with some hot-shot joe-blow know-nothing seat-filler with a shitload of framed papyrus hanging on his office wall.

you know what the good thought controller gave me? fucking SSRIs/SNRIs. the very first thing. it didn't matter that there are other drugs out now, those new drugs, well, nobody knows a fucking thing about their side-effects because that is the nature of new drugs. even despite the known risks of these relatively old (by today's fast-paced standards) serotonin and dopamine tweaking drugs, they're still the first thing psychiatrists and doctors alike think of using when someone's depressed for whatever fucking reason.

you know that suicide is a side-effect of most of those drugs? it's a sure-fire way to end depression, i'll give you that, but it's just plain NFG in the grand scheme. and hey, how about those BRAIN ZAPS? yeah, that's real fucking good. I have a novel theory on how these drugs treat depression: by burning out half your fucking neurons so you're too retarded to think enough to be depressed!

when i told the doc "hey, this shit doesn't work, it just tweaks me out more than normal" he cycled me on a bunch of other antidepressants until finally we got to the root of the problem which was anxiety. then i got the benzos, and my god, those actually helped! right up until i couldn't function normally without them because i was dependent. then shit REALLY hit the fan. you know when i got out of depression? WHEN I STOPPED USING DRUGS!

i'm not just talking about weed, blow, meth, whatever the average bluelighter loves to take; PSYCHIATRIC MEDS ARE DRUGS TOO. and they're far more sinister under any kind of questionable supervision than anything any of us take because unlike LSD, SSRI/SNRIs don't exactly have a good fucking track record for actually CURING DEPRESSION!!!

they're a bandage solution that YOU don't need, that nobody else needs. you think life is hard because you're depressed? guess what, not being depressed doesn't make like any fucking easier. drugs make you forget the problems not address them like you should be, just like everyone who is depressed should be, instead of fucking going to shrinks and letting those dipshits rape your brains to early degeneration with drugs that just flew off the fucking conveyer belt yesterday.

you think the guy with a fucked-up spine is taking oxycontin to cure his fucked-up spine? NO, he's taking it to forget about the pain while he goes to his physical therapy sessions in order to fix his spine! the paradox of antidepressants is that you take them to feel happy when there was nothing wrong with you in the first place then when you're weaned off of them years down the road you're somehow miraculously expected to adjust back to a normality you never knew sober!

 

[slimvictor]

N.A.,

Using an "argument style" such as yours, which seems to be based on bragging about how intellectual you are and putting your opponent down, and then apologizing for doing so seems rather conflicted. Do you think that you could simply be more gentle in the first place, instead of choosing such an argument style? It would certainly come off as more sincere.

I never said that this was my own "theory". However, if you look around you, you can see enough evidence to support the general thrust of the idea. A rich person sits in a gorgeous, manicured garden and feels alone and depressed. A high-security inmate revels in the joy of being, enjoying each moment alive and feeling thankful for having the opportunity to live.
The very fact that such things are possible argues that happiness does not come from outside. Your mention of Schopenhauer discussed his argument, which was essentially that happiness does not come from outside.
I completely agree.
Happiness that relies on some external set of conditions is ultimately doomed to become sadness or despair. The conditions will change, or they will no longer be satisfying. It is really quite simple.

True happiness comes from within.

If we can make the choice to be happy, we can find happiness in ourselves regardless of the outer circumstances in which we find ourselves.
If you want to test this idea, simply try it for yourself.
The empirical evidence you demand is inferior to direct personal experience.
The way I learned it was by trying it myself. I was able to be happy in the midst of what I had previously perceived as stressful situations.
I have no reason to sell the idea. No patent, no book to sell. If you don't agree with me, I really couldn't care less.

Your original argument is unclear. Is it that I can not know what happiness is for other people? I cannot provide empirical evidence that happiness is a choice? Therefore, I am a moron?
My goal is not to provide empirical evidence, or to claim that happiness is the same for all people. I was also not trying to argue philosophy with you.

I simply hoped to share an idea that can help people in their lives.

Then, in your next post, you seem to be arguing that people are all different, so I cannot say if their happiness is a choice. You say that "There is a wide degree of variance in human architecture, and social structure." I couldn't agree more. And yet, (nearly?) all people can experience happiness. This is because it comes from within, and is not ultimately dependent on external situations. You want me to provide a definition for happiness? Sorry, that is part of the beauty of my statement. People intuitively know what happiness is, and it likely varies depending on the person. No definition is necessary. They can feel the call to their particular happiness within (or, as in your case, maybe they simply interact with my statement at a more cerebral level, and are unable to take anything of value from it. That is fine with me.)

As for your promise that you could take your argument to linguistics, etc., I somehow doubt you. Maybe it stems from the fact that you are unable to correctly differentiate between "your" and "you're" as well as "their" and "they're", which seems like it should be far simpler than discussing happiness in linguistics. Furthermore, what would you do, talk about different words for "happy", and what they show about your argument? It would bear no relation to what I said, which is a truth that can be directly experienced.