Mind Hacks

A forthcoming study from the Journal of Affective Disorders looked at people who seem to have the ‘ups’ of manic depression but none of the ‘downs’. While people with pure hypomania were more likely to have had legal troubles and be impulsive, they were also more likely to earn more and be married.

The study looked at people who had never been diagnosed with a mood disorder but, during a general population survey, seem to have experiences akin to hypomania – an upswing in activity and energy that falls short of the extremes that can lead to psychosis in full blown mania.

This is normally only classified when it accompanies depression, which could lead to one of the bipolar disorder diagnoses.

In contrast, the study found ‘pure hypomania’ was generally not distressing, had its benefits, but could lead to complications.

Pure hypomanics were characterised by physical and social overactivity, elevated and irritable mood, as well as increases in extraversion, sexual interest, and risk-taking behaviors.

They had higher monthly incomes and were more often married than controls. Subjective distress due to hypomanic symptoms was virtually absent.

Quality of life and treatment rates for mood and anxiety were not different from controls, although sleep disturbances, substance abuse and binge eating were more frequent.

The absence of subjective distress is interesting, as it is part of a realisation that psychiatry has traditionally based its ideas about psychopathology on a sample bias – it’s only studied people who are treated by psychiatrists.

This means that classifications have often based on people who are either distressed or impaired. People who experience similar symptoms but who didn’t become significantly disabled by them were not considered.

In the last 20 years, efforts have been made to survey the community and discover who has benign ‘symptoms’. For example, a ground breaking study by Romme and Escher found that only one third of people who hear voices had ever needed psychiatric help, despite the fact is traditionally considered a tell-tale sign of mental illness.

Link to abstract of ‘pure hypomania’ study.

NPR Radio’s All Things Considered just had an interesting feature on two six-year old boys who identify with and want to be girls. It’s something that might be diagnosed as gender identity disorder or GID and the programme looks at how the two psychologists dealt with the issue in very different ways.

One psychologist, Ken Zucker, suggested that the family encourage their son to only associate with traditionally male toys and activities to encourage him to be more comfortable with his born sex, while the other, Diane Ehrensaft encouraged the family to allow their son to explore his cross-gender interests.

Whatever your immediate reaction to these approaches the psychologists in the programme make interesting points on both sides of the debate:

Ehrensaft sees transgenderism as akin to homosexuality, she says, she thinks Zucker’s therapy ‚Äî which seeks to condition children out of a transgender identity ‚Äî is unethical.

But that isn’t how Zucker sees it. Zucker says the homosexuality metaphor is wrong. He proposes another metaphor: racial identity disorder.

“Suppose you were a clinician and a 4-year-old black kid came into your office and said he wanted to be white. Would you go with that? … I don’t think we would,” Zucker says.

If a black kid walked into a therapist’s office saying he was really white, the goal of pretty much any therapist out there would be to make him try to feel more comfortable being black.

Gender identity disorder is a controversial area. The diagnosis requires “a strong and persistent cross-gender identification” and significant distress related to the birth gender.

Some cross-gender people feel they are being labelled as mentally ill for having atypical gender desires and suggest that any associated distress is because they have to live in a society that marginalises their life choices.

There are some proponents that maintain that any cross-gender identification is an illness, although these are often the same people that think that being gay is a disorder and run ‘treatment centres’ for homosexuality.

Perhaps unsurprisingly, it seems Zucker’s work is quoted rather favourably by many of these organisations – something that has given him a bad name amongst some parts of the the LGBT community. Although, from what I can make out, he’s never associated himself with any of these views or organisations.

The mainstream professionals who defend the GID diagnosis usually suggest that the distress, rather than the desire itself, is key and this legitimises its classification and treatment. From this point of view, happy and adjusted transgender people would not be considered to have a disorder.

The program is well worth listening to as it tackles many of these thorny issues of gender politics.

Incidentally, the producer is Alix Spiegel, who produced 81 words, one of the finest documentaries on the history of psychiatry I’ve ever heard.

It looks at the how homosexuality was de-listed as a mental illness, but is more than that, it’s also a moving story from Spiegel’s family. The remarkable thing was that the the two were inextricably linked.

I’ve mentioned it before on Mind Hacks, but I highly recommend it if you’ve not encountered it before.

Link to NPR programme on cross-gender desires in children.
Link to audio archive of 81 words (click ‘Full Episode’ for free stream).

An article in today’s New York Times looks at the ‘mad pride’ movement and meets many of the people who aim to destigmatise mental illness by being upfront about their experience of altered states of mind.

The article features journalist Liz Spikol, who we interviewed back in 2006, and professor of law Elyn Saks, who we featured last year, among a host of others who are associated with what might loosely be termed as ‘mad pride’.

‘Loosely’ is certainly an apt description, because, apart from fighting stigma, views within the mad pride movement vary widely.

There are a few lingering Marxists who see all psychiatry as part of the capitalist system to oppress the working class, but most simply want better care for mental distress and society to be more accepting of differing states of mind.

Mad Pride is often rather clumsily related to ‘antipsychiatry’ but they are often at the forefront of campaigns when essential services are threatened.

In London, the campaign against the shutting of the Maudsley Hospital psychiatric emergency clinic was spearheaded by several ‘mad pride’ organisations – who had a mischievous and witty banner at one demo saying “We must be mad! We want the emergency clinic kept open!”.

I do share Phil Dawdy’s bemusement at being overlooked, as he’s surely one of the most thorough and effective of campaigning writers, but good to see the NYT continue its tradition of high quality mental health journalism.

Link to NYT article ‘Mad Pride Fights a Stigma’.

The link between attractiveness and facial symmetry seems to hold across both black and white faces, but also in non-human primates, according to a study just published in the open-access science journal PLoS One.

One of the most striking studies in sex and symmetry research isn’t mentioned, however. A 1995 study found that the likelihood of female orgasm during sex was related to the extent of bodily symmetry in the male partner.

The study was led by biologist Randy Thornhill and recruited 86 young couples who completed a number of relationship questionnaires, including one on how often the female partner orgasmed during sex. The males then had their bodies measured and assessed for how much one side differed compared to the other – a measure of bodily asymmetry.

In the final analysis neither the male’s age, wealth, social skills, physical attractiveness or relationship style predicted the frequency of female orgasm. Only male bodily symmetry was statistically associated with the chance of the women climaxing during sex.

The researchers thought that maybe women who have more orgasms, or who are just more sexual, simply get the more symmetrical (maybe hotter) guys. But when they looked at frequency of orgasm outside copulation (such as during oral sex or masturbation), the relationship to male symmetry disappeared, suggesting that this wasn’t the case.

This study, and the new study published in PLoS One, also suggested that symmetry was associated with more masculine features generally – a bigger body in the orgasm study, and a more typically male face in the PLoS research.

The evolutionary explanation suggested by the authors is that female orgasm during copulation may make pregnancy more likely, so it’s an adaptive strategy to increase fertility when making love to males with genes more likely to lead to healthy children.

How orgasm increases with body symmetry is not clearly understood, though. The authors speculate that female perception of a highly symmetrical male might psychologically prime sexual arousal, but the mechanism is left largely to guesswork.

Link to PLoS One study on attractiveness and symmetry (via Anthro).
Link to abstract of orgasm and symmetry study.