Thoughts on the astrocyte depletion theory of MDD?

[futureapppsy2]

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I came across this theory recently and was wondering what you all thought. A couple of review articles:

https://onlinelibrary.wiley.com/doi/abs/10.1002/glia.23994?casa_token=yEpSaN-1yacAAAAA%3A3isV6SWEiDjX1APT06_98tXQXvuMhacrmJH7Je1e7Dkz8up8iBi598l9IpfD3r4RKLOjWaL5lp6MLA

https://onlinelibrary.wiley.com/doi/abs/10.1002/glia.23143?casa_token=vVdav4YVe2cAAAAA:QHEMjtncxPujOdgDJxcCdAFo9e9BbB-biq3xoNaZQAU5eABLnTc_6jD9Tmg7MM2aM3ett6GjyneW_g

 

[Fan_of_Meehl]

1) they've been searching in vain (using millions of dollars) to find 'a' or 'the' biological cause of clinical depression for many decades. It is always 'just around the corner.'
2) biological correlates are interesting but do not establish causation nor necessarily illuminate clinically useful explanations or treatments

That's just from reading the abstracts, though. Not gonna pay for the articles.

 

[comp1]

Much like anything else, I am sure it correlates to some of what we label depression in some people. Pretty much everything does...

 

[futureapppsy2]

Much like anything else, I am sure it correlates to some of what we label depression in some people. Pretty much everything does...

Yeah, I think that's a big challenge in MDD research in general--we're likely labeling different things with different pathophysiologies under the same term.

 

[Stagg737]

Yeah, I think that's a big challenge in MDD research in general--we're likely labeling different things with different pathophysiologies under the same term.

That's a big challenge with most of the diagnoses in our field, especially when using a set of definitions using a categorical model like the DSM that's based off of subjective reporting and observation vs objective data. It's something I talk about regularly with our residents. How many different disorders have we called schizophrenia over the years? Is the patient's depression/anxiety the core disorder, or just a symptom of something else (whether biological/medical or psychosocial)? Is this symptom most likely d/t X diagnosis or Y? Imo it's both a huge negative and something that makes our field so interesting diagnostically.

 

[futureapppsy2]

That's a big challenge with most of the diagnoses in our field, especially when using a set of definitions using a categorical model like the DSM that's based off of subjective reporting and observation vs objective data. It's something I talk about regularly with our residents. How many different disorders have we called schizophrenia over the years? Is the patient's depression/anxiety the core disorder, or just a symptom of something else (whether biological/medical or psychosocial)? Is this symptom most likely d/t X diagnosis or Y? Imo it's both a huge negative and something that makes our field so interesting diagnostically.

And then there’s also the issue of patients using imprecise terms to describe their symptoms (e.g., “anxiety” can mean anything from full-blown panic attacks to feeling kind of ill at ease to depressive guilt). I always drill into my supervisees’ heads the importance of asking “what does X look like/feel like for you?”, “Can you tell me about some times when X has affected you?” Working in ASD differential diagnosis, I heard “meltdown” used to describe sooo many different things.

 

[Fan_of_Meehl]

And then there’s also the issue of patients using imprecise terms to describe their symptoms (e.g., “anxiety” can mean anything from full-blown panic attacks to feeling kind of ill at ease to depressive guilt). I always drill into my supervisees’ heads the importance of asking “what does X look like/feel like for you?”, “Can you tell me about some times when X has affected you?” Working in ASD differential diagnosis, I heard “meltdown” used to describe sooo many different things.

Entire books could be written regarding how veterans in the VA system often report vague symptoms/labels without any phenomenological texture to them.
The VA should be where business majors go to learn how not to be 'leaders' and where theater majors should go to learn how not to engage in bad acting.

 

[calvnandhobbs68]

Working in ASD differential diagnosis, I heard “meltdown” used to describe sooo many different things.

100%. Outburst, meltdown, breakdown....almost every time I have to go "so describe to me what a meltdown looks like", "what happens right before a meltdown", "how do you respond to a meltdown"....etc etc

 

[Fan_of_Meehl]

100%. Outburst, meltdown, breakdown....almost every time I have to go "so describe to me what a meltdown looks like", "what happens right before a meltdown", "how do you respond to a meltdown"....etc etc

'I had a PTSD episode'

 

[Stagg737]

'I had a PTSD episode'

I always ask what the flashback/episode looked like and I’ve seen heard some crazy stories from vets. In residency we had a VA patient on the medical floor literally throwing tele packs like grenades thinking he was in Vietnam. The guy probably damaged 6 figures worth of medical devices lobbing them down the halls.