Does This New Machine Cure Depression?
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Let us first talk briefly about the slightly older tech that this may replace, transcranial magnetic stimulation (TMS).
TMS involves electromagnetic fields to stimulate the left half of the brain and inhibit the right half of the brain. It sounds like something from the late 19th century—“cure your melancholy with the mystical power of magnetism”—but the thing is, it works:
The main barriers to its use are that the machine itself is expensive, and it has to be done in a clinic by a trained clinician. Which, if it were treating one’s heart, say, would not be so much of an issue, but when treating depression, there is a problem that depressed people are not the most likely to commit to (and follow through with) going somewhere probably out-of-town regularly to get a treatment, when merely getting out of the door was already a challenge and motivation is thin on the ground to start with.
Thus, antidepressant medications are more often the go-to for cost-effectiveness and adherence. Of course, some will work better than others for different people, and some may not work at all in the case of what is generally called “treatment-resistant depression”:
Antidepressants: Personalization Is Key!
Transcranial stimulation… At home?
Move over transcranial magnetic stimulation; it’s time for transcranial direct-current stimulation (tDCS).
First, what it’s not: electroconvulsive therapy (ECT). Rather, it uses a very low current.
What it is: a small and portable headset (as opposed to the big machine to go sit in for TMS) that one can use at home. Here’s an example product on Amazon, though there are more stylish versions around, this is the same basic technology.
In a recent study, 45% of those who received treatment with this device experienced remission in 10 weeks, significantly beating placebo (bearing in mind that placebo effect is strongest when it comes to invisible ailments such as depression).
See also: How To Leverage Placebo Effect For Yourself ← this explains more about how the placebo effect works, to the extent that it can even be an adjuvant tool to augment “real” therapies
And as for the study, here it is:
…which rather cuts through the “depressed people don’t make it to the clinic consistently, if at all” problem. Of course, it still requires adherence to its use at home, for example three 30-minute sessions per week, but honestly, “lie/sit still” is likely within the abilities of the majority of depressed people. However…
Important note: you remember we said “in 10 weeks”? That may be critical, because shorter studies (e.g. 6 weeks) have previously returned without such glowing results:
Home-Use Transcranial Direct Current Stimulation for the Treatment of a Major Depressive Episode
This means that if you get this tech for yourself or a loved one, it’ll be necessary to persist for likely 10 weeks, certainly more than 6 weeks, and not abandon it after a few sessions when it hasn’t been life-changing yet. And that may be more of a challenge for a depressed person, so likely an “accountability buddy” of some kind is in order (partner, close friend, etc) to help ensure adherence and generally bug you/them into doing it consistently.
And then, of course, you/they might still be in the 55% of people for whom it didn’t work. And that does suck, but random antidepressant medications (i.e., not personalized) don’t fare much better, statistically.
Want something else against depression meanwhile?
Here are some strategies that not only can significantly help, but also are tailored to be actually doable while depressed:
The Mental Health First-Aid You’ll Hopefully Never Need ← written by your writer who has previously suffered extensively from depression and knows what it is like
Take care!
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Brain Food – by Dr. Lisa Mosconi
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We know that we should eat for brain health, but often that knowledge doesn’t go a lot further than “we should eat some nuts… but also not the wrong nuts, which would be bad”.
However, as Dr. Lisa Mosconi lays out for us, there’s a lot more than that!
This book is as much a treatise of brain health in the context of nutrition, as it is a “eat this and avoid that” guide.
Which is good, because our brains don’t exist in isolation, and nor do the nutrients that we consume. Put it this way:
We have a tendecy to think of our diets as a set of slider-bars, “ok, that’s 104% of my daily intake of fiber, I need another 10g protein and that’ll be at 100%, I’ve had 80% of the vitamin C that I need, and…”
Whereas in reality: much of what we eat interacts positively or negatively with other things, and thus needs to be kept in balance. And not only that, but other peri-nutritional factors play a big part too! From obvious things like hydration, to less obvious things like maintaining good gut microbiota, our brains rely on us to do a lot of things for them.
This book is very easy-reading, though a weakness is it doesn’t tend to summarise key ideas much, give cheat-sheets, that sort of thing. We recommend reading this book with a notebook to the side, to jot down things you want to attend to in your own dietary habits.
Bottom line: this is an excellent overview of brain health in the context of nutrition, and is more comprehensive than most “eat this for good brain health and avoid that” books.
Click here to check out “Brain Food” on Amazon and treat your brain like it deserves!
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Pinch of Nom – by Kate Allinson & Kay Allinson
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“Home-style recipes”, because guess where most readers live!
And: slimming, because trimming the waistline a little is a goal for many after holiday indulgences.
The key idea here is healthy recipes that “don’t taste like diet food”—often by just switching out a couple of key ingredients, to give a significantly improved nutritional profile while remaining just as tasty, especially when flavors are enhanced with clever spicing and seasoning.
The food is simple to prepare, while being “special” enough that it could be used very credibly for entertaining too. For that matter, a strength of the book is its potential for use as a creative springboard, if you’re so inclined—there are lots of good ideas in here.
The recipes themselves are all you’d expect them to be, and presented clearly in an easy-to-follow manner.
Bottom line: if you’ve ever wanted to cook healthily but you need dinner on the table in the very near future and are stuck for ideas, this book is exactly what you need.
Click here to check out Pinch of Nom, and liven up your healthy cooking!
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Egg Noodles vs Soba Noodles – Which is Healthier?
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Our Verdict
When comparing egg noodles to soba noodles, we picked the soba.
Why?
First of all, for any unfamiliar, soba noodles are made with buckwheat. Buckwheat, for any unfamiliar, is not wheat and does not contain gluten; it’s just the name of a flowering plant that gets used as though a grain, even though it’s technically not.
In terms of macros, egg noodles have slightly more protein 2x the fat (of which, some cholesterol) while soba noodles have very slightly more carbs and 3x the fiber (and, being plant-based, no cholesterol). Given that the carbs are almost equal, it’s a case of which do we care about more: slightly more protein, or 3x the fiber? We’re going with 3x the fiber, and so are calling this category a win for soba.
In the category of vitamins, egg noodles have more of vitamins A, B12, C, D, E, K, and choline, while soba noodles have more of vitamins B1, B2, B3, B5, B6, and B9. That’s a 6:6 tie. One could argue that egg noodles’ vitamins are the ones more likely to be a deficiency in people, but on the other hand, soba noodles’ vitamins have the greater margins of difference. So, still a tie.
When it comes to minerals, egg noodles have more calcium and selenium, while soba noodles have more copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. So, this one’s not close; it’s an easy win for soba noodles.
Adding up the sections makes for a clear win for soba noodles, but by all means, enjoy moderate portions of either or both (unless you are vegan or allergic to eggs, in which case, skip the egg noodles and just enjoy the soba!).
Want to learn more?
You might like to read:
Egg Noodles vs Rice Noodles – Which is Healthier?
Take care!
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Feel Better In 5 – by Dr. Rangan Chatterjee
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We’ve featured Dr. Rangan Chatterjee before, and here’s a great book of his.
The premise is a realistic twist on a classic, the classic being “such-and-such, in just 5 minutes per day!”
In this case, Dr. Chatterjee offers many lifestyle interventions that each take just 5 minutes, with the idea that you implement 3 of them per day (your choice which and when), and thus gradually build up healthy habits. Of course, once things take as habits, you’ll start adding in more, and before you know it, half your lifestyle has changed for the better.
Which, you may be thinking “my lifestyle’s not that bad”, but if you improve the health outcomes of, say, 20 areas of your life by just a few percent each, you know much better health that adds up to? We’ll give you a clue: it doesn’t add up, it compounds, because each improves the other too, for no part of the body works entirely in isolation.
And Dr. Chatterjee does tackle the body systematically, by the way; interventions for the gut, heart, brain, and so on.
As for what these interventions look like; it is very varied. One might be a physical exercise; another, a mental exercise; another, a “make this health 5-minute thing in the kitchen”, etc, etc.
Bottom line: this is the most supremely easy of easy-ins to healthier living, whatever your starting point—because even if you’re doing half of these interventions, chances are you aren’t doing the other half, and the idea is to pick and choose how and when you adopt them in any case, just picking three 5-minute interventions each day with no restrictions. In short, a lot of value to had here when it comes to real changes to one’s serious measurable health.
Click here to check out Feel Better In 5, and indeed feel better in 5!
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AI: The Doctor That Never Tires?
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AI: The Doctor That Never Tires?
We asked you for your opinion on the use of Artificial Intelligence (AI) in healthcare, and got the above-depicted, below-described set of results:
- A little over half of respondents to the poll voted for “It speeds up research, and is more methodical about diagnosis, so it’s at least a good extra tool”
- A quarter of respondents voted for “I’m on the fence—it seems to make no more nor less mistakes than human doctors do”
- A little under a fifth of respondents voted for “AI is less prone to fatigue/bias than human doctors, making it an essential new tech”
- Three respondents voted for “AI is a step too far in medical technology, and we’re not ready for it”
Writer’s note: I’m a professional writer (you’d never have guessed, right?) and, apparently, I really did write “no more nor less mistakes”, despite the correct grammar being “no more nor fewer mistakes”. Now, I know this, and in fact, people getting less/fewer wrong is a pet hate of mine. Nevertheless, I erred.
Yet, now that I’m writing this out in my usual software, and not directly into the poll-generation software, my (AI!) grammar/style-checker is highlighting the error for me.
Now, an AI could not do my job. ChatGPT would try, and fail miserably. But can technology help me do mine better? Absolutely!
And still, I dismiss a lot of the AI’s suggestions, because I know my field and can make informed choices. I don’t follow it blindly, and I think that’s key.
AI is less prone to fatigue/bias than human doctors, making it an essential new tech: True or False?
True—with one caveat.
First, a quick anecdote from a subscriber who selected this option in the poll:
❝As long as it receives the same data inputs as my doctor (ie my entire medical history), I can see it providing a much more personalised service than my human doctor who is always forgetting what I have told him. I’m also concerned that my doctor may be depressed – not an ailment that ought to affect AI! I recently asked my newly qualified doctor goddaughter whether she would prefer to be treated by a human or AI doctor. No contest, she said – she’d go with AI. Her argument was that human doctors leap to conclusions, rather than properly weighing all the evidence – meaning AI, as long as it receives the same inputs, will be much more reliable❞
Now, an anecdote is not data, so what does the science say?
Well… It says the same:
❝Of 6695 responding physicians in active practice, 6586 provided information on the areas of interest: 3574 (54.3%) reported symptoms of burnout, 2163 (32.8%) reported excessive fatigue, and 427 (6.5%) reported recent suicidal ideation, with 255 of 6563 (3.9%) reporting a poor or failing patient safety grade in their primary work area and 691 of 6586 (10.5%) reporting a major medical error in the prior 3 months. Physicians reporting errors were more likely to have symptoms of burnout (77.6% vs 51.5%; P<.001), fatigue (46.6% vs 31.2%; P<.001), and recent suicidal ideation (12.7% vs 5.8%; P<.001).❞
See the damning report for yourself: Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors
AI, of course, does not suffer from burnout, fatigue, or suicidal ideation.
So, what was the caveat?
The caveat is about bias. Humans are biased, and that goes for medical practitioners just the same. AI’s machine learning is based on source data, and the source data comes from humans, who are biased.
See: Bias and Discrimination in AI: A Cross-Disciplinary Perspective
So, AI can perpetuate human biases and doesn’t have a special extra strength in this regard.
The lack of burnout, fatigue, and suicidal ideation, however, make a big difference.
AI speeds up research, and is more methodical about diagnosis: True or False?
True! AI is getting more and more efficient at this, and as has been pointed out, doesn’t make errors due to fatigue, and often comes to accurate conclusions near-instantaneously. To give just one example:
❝Deep learning algorithms achieved better diagnostic performance than a panel of 11 pathologists participating in a simulation exercise designed to mimic routine pathology workflow; algorithm performance was comparable with an expert pathologist interpreting whole-slide images without time constraints. The area under the curve was 0.994 (best algorithm) vs 0.884 (best pathologist).❞
About that “getting more and more efficient at this”; it’s in the nature of machine learning that every new piece of data improves the neural net being used. So long as it is getting fed new data, which it can process at rate far exceeding humans’ abilities, it will always be constantly improving.
AI makes no more nor
lessfewer mistakes than humans do: True or False?False! AI makes fewer, now. This study is from 2021, and it’s only improved since then:
❝Professionals only came to the same conclusions [as each other] approximately 75 per cent of the time. More importantly, machine learning produced fewer decision-making errors than did all the professionals❞
See: AI can make better clinical decisions than humans: study
All that said, we’re not quite at Star Trek levels of “AI can do a human’s job entirely” just yet:
BMJ | Artificial intelligence versus clinicians: pros and cons
To summarize: medical AI is a powerful tool that:
- Makes healthcare more accessible
- Speeds up diagnosis
- Reduces human error
…and yet, for now at least, still requires human oversights, checks and balances.
Essentially: it’s not really about humans vs machines at all. It’s about humans and machines giving each other information, and catching any mistakes made by the other. That way, humans can make more informed decisions, and still keep a “hand on the wheel”.
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What’s the difference between autism and Asperger’s disorder?
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Swedish climate activist Greta Thunberg describes herself as having Asperger’s while others on the autism spectrum, such as Australian comedian Hannah Gatsby, describe themselves as “autistic”. But what’s the difference?
Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD.
Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.
When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of autism spectrum disorder is made.
Where do the definitions come from?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders.
Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4.
In 2013, the DSM-5 collapsed both diagnoses into one autism spectrum disorder.
How did we used to think about autism?
The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder.
Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress.
Kanner and Asperger described different thinking patterns in children with autism.
Roman Nerud/ShutterstockBetween the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism.
The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech.
Today, as a legacy of the recognition of the autism itself, the majority of people diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability.
What changed with ‘autism spectrum disorder’?
The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term.
It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things.
The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”.
The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in.
Why do some people prefer the old terminology?
Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism.
The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, Tony Attwood and Carol Gray, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges.
What about identity-based language?
A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”.
The neurodiversity rights movement describes its aim to push back against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism.
Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.
Alex and Maria photo/ShutterstockThe movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments.
However the social model contrasts itself against a very outdated medical or clinical model.
Current clinical thinking and practice focuses on targeted supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism.
A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.
Andrew Cashin, Professor of Nursing, School of Health and Human Sciences, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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