Depression, bad and/or good. Plus environmental blog mortality, health care debate morality, research paper absurdity, fetal cosmetology
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DEPRESSION IS GOOD FOR YOU. David Dobbs, at Neuron Culture, analyzes and ruminates richly and at length on the possible evolutionary benefits of depression. Dobbs is exploring the hypothesis that depression can be, if not a good thing in itself, at least a byproduct of good things. The good things being genes that promote sensitivity to experiences — and, potentially, illumination and insight.
Dobbs has been writing about this and related ideas for a while, but this post was prompted by a recent New York Times Magazine piece by Jonah Lehrer that has made something of a splash. Lehrer's piece argued that some recent research suggests that depression comes with what he calls "a net mental benefit." That benefit might be a "capacity for intense focus," a resistance to being distracted from some pressing problem in need of solution. (Lehrer's is a genuine article, not a blog, but here is the link, which I offer as a public service. Don't tell anyone I linked to a nonblog.)
I guess this is a sort of dispute — a completely friendly one, I hasten to add. But what's intriguing is that Dobbs and Lehrer disagree only about the possible reasons depression exists and persists. They don't disagree on the basic premise, somewhat radical for our therapied times. The semi-radical premise is that depression serves some useful ends in human life, even though it can result in early human death. To say nothing of early human misery, and not just for those afflicted.
DEPRESSION IS BAD FOR WEBMD. Andrew Van Dam at Covering Health called attention Wednesday to a post in February by shrink Daniel Carlat. Carlat tackled the much-respected WebMD's ambiguous relationship with pharma giant Eli Lilly. Carlat accuses WebMD of "allowing its content to be transformed into one long stream of stealth advertising."
His case in point is a WebMD self-quiz aimed at consumers curious about whether they might be suffering from depression. Carlat argues, angrily but pretty plausibly, that the list of questions, underwritten by Lilly, was doctored so as to encourage prescriptions of a specific Lilly drug. WebMD claims its content is editorially independent of the sponsor.
BLOGGING ABOUT JOURNALISM BLOGGING. Some publications have dealt with downsizing by ghettoizing specialized topics like science, relegating them to blogs. Now there's a teeny trend toward reversing that process, at least with respect to environmental blogging, reports Curtis Brainard at the Columbia Journalism Review's Observatory.
Hard to know what to make of this, if indeed a trend it is. The Christian Science Monitor's editor explains that the now-entirely-virtual "paper" is abandoning its Bright Green blog because environmental coverage has become so important. All its reporters are now expected to be versed in environmental issues and weave them into their pieces no matter what the ostensible topic.
This seems a very odd expectation, to say nothing of impractical. A more reasonable approach to knitting specialized yarns into stories is the bourgeoning trend to collaborative reporting. Stories with three or four bylines are all over the place. News stories are threatening to become as topheavy with authorial partnerships as genome projects and physics papers.
The Wall Street Journal has, likewise, abandoned its Environmental Capital blog, although it has not explained why. OTOH, there's also the reverse example of Andrew Revkin, discussed here late last year. Revkin left the New York Times staff but is still writing its Dot Earth blog.
There's a subtext in the CJR piece. The Monitor editor seems to suggest that management abandoned Bright Green in part because blogging takes time away from other things they'd rather a staffer be doing. Revkin's departure was also occasioned in part by the exhausting demands of piling blogging on top of everything else journalists must do. Limited resources tend to render priorities stark and clear. Dot Earth is a star among blogs, which may have helped Revkin choose it over traditional journalism.
ABSURDITY AS A RESEARCH TOPIC. Top Ten lists are supposed to be a sure-fire way for bloggers to get attention, but with the exception of those Best Of lists that seem to be required at a year's end, they are not all that common on science and medical blogs. This week the Discoblog NCBI ROFL this week reran its list of Top Ten absurd science papers of 2009 because they are proud that Wired UK had picked up the list. Of the 10, 3 are about sex and another 3 relate to getting high (2 beer, 1 cocaine). No scatology, unless navel lint counts as scatological.
It's not clear just what the folks at NCBI ROFL mean by "absurd." Do they think these topics are comical? Or do they think these topics are idiotic and not worthy of scientific study?
HEALTH CARELESS, BUT HANGING IN THERE. You can catch up on prognoses and speculations about the fate of federal health care legislation at Kate Steadman's roundups for Kaiser Health News's Blog Watch here and here. If you're good and swallow the medicine, you'll find the lollipop hidden within: a Stephen Colbert clip explaining the reconciliation process for welding the House and Senate bills into one. Really.
FETAL COSMETOLOGY. The Hastings Center's Bioethics Forum is tackling one of those grey area topics that are the heart and soul of bioethics. (Dan Callahan, my boss when I was at Hastings in the last century, once explained to me that bioethics was not about ethical outrages like Nazi doctors and their appalling human experiments. It's about ethical conundrums where there's something to be said for both sides of a debate.) This one is a bit exotic: What, if anything, should be done about congenital adrenal hyperplasia (CAH)?
CAH is a genetic birth defect that causes a female infant's genitals to appear male — with, for example, an enlarged clitoris. One approach has been to give an at-risk mother the steroid dexamethazone very early in pregnancy, which makes the developing female genitalia look less male.
I caught up with the debate only this week, in a commentary insisting that dexamethasone is so effective that some treated girl babies appear entirely normal and others are only slightly affected. The authors concede that not much is known about potential side effects to mothers and babies, but regard that as a reason not to ban the treatment, at least not yet.
This post was a response to one in February attacking the dexamethasone treatment and calling it "fetal cosmetology." Maybe you should read this one first, because it explains CAH and the potential problems pretty clearly, whereas this week's post presents its counterarguments in academese. See also the post from early this month, which is a swell example of on-the-one-hand-on-the-other-hand evenhandedness leading to insipid conclusions — or none at all.
For me the salient alarming factor is that this steroid treatment with its largely unknown long-term consequences can be prescribed for any at-risk pregnancy (meaning that both parents possess a gene for the relevant enzyme deficiency, not a particularly common occurrence.) Steroids are administered long before it can be known whether the fetus is affected — indeed, before it can even be discovered what sex the fetus is. Yet, speaking mathematically, only 12.5% of at-risk fetuses turn out to have CAH. Meaning that 87.5% of the at-risk fetuses do not. But they, and their moms, get early steroids anyway. Just to be on the safe side. Gulp.
