Part 3 of the TED Radio Hour episode Headspace.
About David Anderson's TED Talk
Neurobiologist David Anderson explains why psychiatric drugs don't always work, and how researchers are working to find targeted forms of treatment — including his own experiments with fruit flies.
About David Anderson
David Anderson is the Seymour Benzer Professor of Biology at the California Institute of Technology. He is also an investigator at the Howard Hughes Medical Institute.
By studying the brains of lab mice and fruit flies, he searches for answers to some big questions: How is emotional behavior encoded in the brain? Where do depression, anxiety and other emotions originate in the brain?
By looking at how neural circuits give rise to emotions, Anderson hopes to advance a more nuanced view of psychiatric disorders.
GUY RAZ, HOST:
It's the TED Radio Hour from NPR. I'm Guy Raz. And on the show today, Headspace, ideas about our emotional well-being and the problems of the mind, problems we don't always discuss. And earlier in the show, you heard from writer Andrew Solomon and his experience with depression. It started around 1991, right after Andrew found out his mom was dying. And at the time, he'd been living in the U.K. So Andrew moved back to the U.S., back to New York, where he was born, to be with her.
ANDREW SOLOMON: I moved back in 1991, and then my mother died shortly thereafter. And my first book was published just after that. Before I moved back, a relationship I'd been in that I had thought might be a long-term and permanent one ended rather catastrophically, I think because I was so emotionally preoccupied with my mother's illness and death. I weathered the storms of 1991 fairly well, and got through in reasonably good shape. And then I found over the years that followed that I began to get sort of disconnected.
RAZ: Many years later, after Andrew got his Ph.D. in psychology and then won almost every major award in literature for his writing on depression, he kind of grew to understand that is this how it starts for so many people. It's not, like, a sudden strike of sadness, but more of a gradual graying out of everything that matters.
SOLOMON: I went from being full of grief and sorrow to a feeling instead of withdrawal and distance from what was happening to me.
RAZ: What did you notice that was happening inside of you?
SOLOMON: I often say that the opposite of depression is not happiness but vitality. And I think what began to disappear was vitality. But I was depressed and feeling kind of withdrawn and thinking, well, you know, I feel depressed because there's stuff that's wrong with my life. And anyone who experiences depression automatically thinks, I'm depressed because there are problems in my life - because there are problems in everyone's lives. And initially, you can attach your depression to whatever it is that's gone wrong in your life, and sometimes what's gone wrong in your life is in fact what's triggered the depression. I didn't understand how out of proportion it was until I got to the point of really having a breakdown.
RAZ: And that breakdown? Here's how Andrew Solomon described it on the TED stage.
(SOUNDBITE OF TED TALK)
SOLOMON: Finally, one day I woke up and I thought perhaps I'd had a stroke because I lay in bed completely frozen looking at the telephone thinking, something is wrong and I should call for help. And I couldn't reach out my arm and pick up the phone and dial. And finally, after four full hours of my lying and staring at it, the phone rang and somehow I managed to pick it up. And it was my father. And I said, I'm in serious trouble, we need to do something. The next day, I started with the medications and the therapy. I had two advantages as I went into the fight. The first is that I knew that, objectively speaking, I had a nice life, and that if I could only get well, there was something at the other end that was worth living for. And the other was that I had access to good treatment. But I nonetheless emerged and relapsed, and emerged and relapsed, and emerged and relapsed and finally understood I would have to be on medication and in therapy forever. And I thought, but is it a chemical problem or a psychological problem? And does it need a chemical cure or a philosophical cure? And I couldn't figure out which it was. And then I understood that, actually, the chemical cure and the psychological cure both have a role to play, and I also figured out that depression was something that was braided so deep into us that there was no separating it from our character and personality.
RAZ: Why does it seem like such an important question to us, you know, like, is my depression chemical or psychological?
SOLOMON: I think these are all different vocabularies for the same set of experiences. Anyone who is depressed has different things going on chemically in their brain. And anyone who is depressed is having feelings and sensations that are specific to depression. There are two points of confusion. The first is to think that they're two different ideas or two different experiences that are somehow in competition - which one is it really? - as though it were really one thing when not really the other. But the other is the confusion which people think that if you can figure out the etiology, the origin of the depression, that that dictates the cure. The fact that your depression was triggered by external circumstances doesn't mean that it will be unresponsive to medication. And the fact that your depression has chemical manifestations does not mean it will be unresponsive to conversation or dialogue or talk therapy of some kind.
RAZ: What else, you know, do you think that we do not understand or misunderstand about depression?
SOLOMON: Well, we don't understand what it is really. I mean, we have seen various areas of the brain that are over activated, or under activated or irregularly activated, but we don't really understand where it is located. We don't understand why the medications that help so many people are helpful really. I mean, it looks more and more as though they encourage neuronal growth and as though that has some positive effects, but it's still very vague and very confused. We don't understand the relationship between illness and personality. We'd like to say you have a personality, and added to it - as if it were a bacterial invasion - is this illness, and if you take the medication, we get rid of the illness and we're left with your personality. But there's no sharp line between personality and illness. There's not self that is the un-depressed self that is more real than the depressed self. There's always ourselves. I mean, we mold ourselves all the time. We do it when we get an education, we do it when we drink a cup of coffee. But there is a molding of the self that's involved, and I think we don't understand that either at the medical or really at the philosophical level.
RAZ: What ultimately helped Andrew Solomon overcome his own depression, as with so many people, turned out to be both chemical and psychological.
SOLOMON: I was very fortunate in that I had access to excellent treatment. And I took my meds and they helped me to get better, and I did a lot of psychotherapy to make sense of how I could understand my personality in the wake of the knowledge that I couldn't be fully myself without chemical support.
RAZ: Slowly, in the years that followed his 1994 breakdown, Andrew's life retook some shape. He got married, he had some more success with his writing, and it was through his writing that he began to understand certain things about his own depression.
(SOUNDBITE OF TED TALK)
SOLOMON: A lot of people said when I chose to write about my depression that it must be very difficult to be out of that closet, to have people know. They said, do people talk to you differently? And I said yes, people talk to me differently. They talk to me differently insofar as they start telling me about their experience, or their sister's experience, or their friend's experience. Things are different because now I know that depression is a family secret that everyone has. I went, a few years ago, to a conference. And on Friday of the three-day conference, one of the participants took me aside, and she said, I suffer from depression and I'm a little embarrassed about it, but I've been taking his medication, and I just wanted to ask what you think. And so I did my best to give her such advice as I could, and then she said, you know, my husband would never understand this. He's really the kind of guy to whom this wouldn't make any sense so I just, you know, it's just between us. And I said, yes, that's fine. On Sunday, at the same conference, her husband took me aside...
SOLOMON: ...And he said, my wife wouldn't think that I was really much of a guy if she knew this, but I've been dealing with this depression and I'm taking some medication, and I wondered what you think. They were hiding the same medication in two different places in the same bedroom. And I said that I thought communication within the marriage might be triggering some of their problems. But I was also struck by the burdensome nature of such mutual secrecy. Depression is so exhausting, it takes up so much of your time and energy, and silence about it, it really does make the depression worse.
RAZ: We're so secretive about depression, you know, and America does this - lots of things America doesn't do well, but one of the things it does well is actually talk about depression better than most other countries do.
SOLOMON: People do talk better about depression than in most other countries, and people are dying to talk about their experience. And a lot of what they feel is that no one else could understand. But my experience is that all of those depressed people who are afraid of the impression they'll make on all of those people they perceive never to have deal with depression are actually keeping a secret from people who have the same secret from them.
SOLOMON: But if people were able to talk more openly about these experiences, they would discover that most people's response is not to laugh at them but to say, that happened to sister, or to say, my best friend went through that and I was worried that he was going to kill himself, or to say, oh, my God, me too.
(SOUNDBITE OF TED TALK)
SOLOMON: It's a strange property of the English language, and indeed of many other languages, that we use the same word depression to describe how a kid feels when it rains on his birthday and to describe how somebody feels the minute before they commit suicide. You don't think in depression that you've put on a gray veil and are seeing the world through the haze of a bad mood. You think that the veil has been taken away, the veil of happiness, and that now you're seeing truly. It's easier to help schizophrenics who perceive that there's something foreign inside of them that needs to be exorcised, but it's difficult with depressives because we believe we are seeing the truth. People say to me, well, is it continuous with normal sadness? And I say, in a way, it's continuous with normal sadness. There is a certain amount of continuity, but it's the same way there's continuity between having an iron fence outside your house that gets a little rust spot that you have to sort of sand-off and maybe do a little repainting and what happens if you leave the house for a hundred years and it rusts through until it's only a pile of orange dust. And it's that orange dust spot, that orange dust problem, that someone were setting out to address. So now people say, you take these happy pills, and do you feel happy? And I don't. But I don't feel sad about having to eat lunch, and I don't feel sad about my answering machine, and I don't feel sad about taking a shower. I feel sad about professional disappoints, about damaged relationships, about global warming. Those are the things that I feel sad about now. And I said to myself, well, what is the conclusion? How did those people who have better lives, even with bigger depression, manage to get through? What is the mechanism of resilience? And what I came up with over time was that the people who deny their experience - the ones who say, I was depressed a long time ago and I never want to think about it again and I'm not going to look at it and I'm just going to get on with my life, ironically, those are the people who are most enslaved by what they have. Shutting out the depression strengthens it. While you hide from it, it grows. And the people who do better are the ones who are able to tolerate the fact that they have this condition. Those who can tolerate their depression are the ones who achieve resilience.
RAZ: What if, you know, depression or anxiety or something, like, we could just admit, you know, to ourselves, I mean, to everyone that we're struggling with, you know? I mean, you know, like, the way you tell people, you know, don't shake my hand 'cause I have a cold.
SOLOMON: But I'll tell you the weird thing, or at least a weird thing, which is that when I am well, I have found it manageable, if not easy, to talk openly about these experiences and have had a sense of purposefulness in doing so. And then I get another minor occurrence and I have to rearrange some things and cancel some plans. And all of a sudden, I'm ashamed again. And I find myself telling people that I had food poisoning or that I had to stay home because one of the kids was sick or something like that because I can't - even having published a book, done a TED talk, appeared here on the TED Radio Hour now, done all of these other things, I still can't say to people, I'm so sorry, I can't come, but I'm having a depressive episode. It's not too bad, it probably won't last too long.
RAZ: How often does that happen?
SOLOMON: I don't know. Probably every two or three years, I have some little period of relapse. I was once being rather casual about the possibility in the office of the therapist I've now seen for many years, a wonderful psychiatrist. And I was little off-hand about something, and he said, Andrew, in this room, we never forget that you are fully capable of taking the express elevator to the bargain-basement of mental health.
SOLOMON: So I would say it happens once every few years.
RAZ: It's true that Andrew, because he's written and spoken about his depression so much over the years, has a different kind of relationship with his own mental health than you or I might, and it's arguably easier for him to laugh about it and easier for him to talk about it. But he still believes that every single person has the ability to build meaning from even the darkest places our minds can sometimes take us.
SOLOMON: The question is not so much of finding great meaning and deciding your depression has been very meaningful, it's of seeking that meaning and thinking, when comes again, this will be hellish, but I will learn something from it. I had learned in my own depression how big an emotion can be, how it can be more real than facts. And I have found that that experience has allowed me to experience positive emotion in a more intense and more focused way. The opposite of depression is not happiness but vitality. And these days, my life is vital even on the days when I'm sad. And I have discovered something inside of myself that I would have to call a soul, that I had never formulated until that day 20 years ago when hell came to pay me a surprise visit. I think that while I hated being depressed and would hate to be depressed again, I found a way to love my depression. I love it because it has forced me to find and cling to joy. I love it because each day I decide, sometimes gamely and sometimes against the moment's reason, to cleave to the reasons for living. And that, I think, is a highly privileged rapture. Thank you.
RAZ: Writer and psychologist, Andrew Solomon. His book about depression is called, "The Noonday Demon." Andrew's also given several incredible TED talks, ones we've featured on the show before, in fact. You can find those episodes and his talk about overcoming depression at ted.npr.org.
(SOUNDBITE OF SONG, "TOO MUCH ON MY MIND")
THE KINKS: (Singing) There's too much on my mind, there's too much on my mind. And I can't sleep at night thinking about it. I'm thinking all the time. Transcript provided by NPR, Copyright NPR.