Drug intervention and PCT

CSGnet Archive CSG1997
1

[From Bruce Abbott (971217.2015 EST)]

Bill Powers (971217.1212 MST) --

Do medical researchers check to see
whether a treatment has destroyed someone's ability to factor polynomials?
To categorize usefully? To control relationships? To grasp principles? Do
they measure loop gains before and after treatment, to see if simple or
complex control systems have lost some stability, or some bandwidth, or
some range of control? I think you know the answer to that: they do not;
such ideas mean nothing to them. They don't see destructive effects mainly
because their tests for system function are too primitive to pick up any
but the most obvious malfunctions. Not only that, but destructive effects
that are observed are termed "side-effects," which, unless they are
perceived as serious, are usually ignored. Effects which are entirely
subjective, such as a feeling of dullness or ennui, are not objectively
measurable, and the judgement of whether they are serious is heavily biased
against giving them much weight.

One condition where drug intervention may relate rather precisely to
control-system action is bipolar affective disorder (formerly known as
manic-depressive psychosis). In this disorder a person swings between
states of mania (hyper-excited, like a person high on speed, and delusional)
and deep clininal depression (completely lacking in energy, has difficulty
thinking and initiating voluntary movement, irrational thought processes).
These swings follow a regular period of days, weeks, or months. My guess is
that it represents a regulatory failure -- the system in question has some
serious lags in it, so that it "hunts" around the reference level,
overshooting and undershooting, rather than stabilizing near the reference.
Most likely there is at first an overproduction of certain receptors in the
relevant neural system, leading to a hyperactive state; when this imbalance
is finally detected, the receptor numbers are reduced, but this process is
carried too far, leading to a hypoactive state with associated physical and
emotional depression. Lithium chloride (a drug used to treat the disorder)
appears to stabilize the system, perhaps by slowing the regulatory changes
in receptor densities. I know that this is pure speculation on my part, but
I can't help but think that something like this is at work. The question
is, how to test the theory.

It would appear that this is one disorder for which "talk therapy" (even
PCT-style) is not the answer. Even so, PCT may provide a framework for
analyzing the problem at the physical systems level. Oscillation is a
well-known defect in control systems whose parameters are not properly "tuned."

Regards,

Bruce

2

[From Bill Powers (971217.2254 MST)]

Bruce Abbott (971217.2015 EST)

One condition where drug intervention may relate rather precisely to
control-system action is bipolar affective disorder (formerly known as
manic-depressive psychosis). In this disorder a person swings between
states of mania (hyper-excited, like a person high on speed, and delusional)
and deep clininal depression (completely lacking in energy, has difficulty
thinking and initiating voluntary movement, irrational thought processes).
These swings follow a regular period of days, weeks, or months. My guess is
that it represents a regulatory failure -- the system in question has some
serious lags in it, so that it "hunts" around the reference level,
overshooting and undershooting, rather than stabilizing near the reference.
Most likely there is at first an overproduction of certain receptors in the
relevant neural system, leading to a hyperactive state; when this imbalance
is finally detected, the receptor numbers are reduced, but this process is
carried too far, leading to a hypoactive state with associated physical and
emotional depression.

I agree that this type of problem is quite likely a hardware problem, or if
it is a software problem the software can't get out of it, and some sort of
hardware reset is needed. Of course such a lock-up (as Martin Taylor
suggested) will entail signals that are stuck at high or low levels, or
that are unstably oscillating between extreme limits. It would be highly
surprising if this didn't entail corresponding variations in
neurotransmitter levels, since signals are mediated by neurotransmitters.

Manic-depressive psychosis, as it used to be called, is an example of what
I call extreme problems, and given the state of our knowledge of the brain,
drug treatments might well be the only recourse. The same holds for
extremes of any condition such as depression. In such cases, side-effects
are of little concern, compared with the effects of NOT doing something
about the problem (and also considering the limited range of conventional
non-drug treatments that are likely to be tried).

Unfortunately, when a person gets diagnosed as having bipolar disorder,
this is a category, and treatments are selected by category. If lithium is
indicated for this disorder, lithium is what you get. That is, if the
intervener's orientation is strictly medical, and other approaches are
considered ineffective so they are not tried first. The categorical
approach is indicated in what you say:

It would appear that this is one disorder for which "talk therapy" (even
PCT-style) is not the answer. Even so, PCT may provide a framework for
analyzing the problem at the physical systems level. Oscillation is a
well-known defect in control systems whose parameters are not properly

"tuned."

So you either have the disorder or you don't, and if you do have it, talk
therapy is not the answer and drugs are.

I prefer to see the extremes as just that, and to assume that any other
form of therapy is preferable to drug therapy if it can be made to work.

I had an acquaintance who had to take lithium for this or a similar
disorder. He used to play championship chess. Now he no longer plays chess
at all. For a long time he kept failing to take his medication, because it
dulled his mind so much that he couldn't think straight. Then he began
taking it regularly, and stopped complaining about that. Forced
hospitalizations convinced him that the lithium was a necessity. Now,
fortunately, he is on another drug that at least allows him to function a
bit mentally, and is doing considerably better. But he still doesn't play
chess.

When you say that even PCT-style therapy is not called for, I wonder what
evidence you have for that.

Best,

Bill P.

3

19:30 PST 971218 David Wolsk suggested:

[From Bruce Abbott (971217.2015 EST)]>

One condition where drug intervention may relate rather precisely to
control-system action is bipolar affective disorder (formerly known as
manic-depressive psychosis).

snipped

It would appear that this is one disorder for which "talk therapy" (even
PCT-style) is not the answer. Even so, PCT may provide a framework for
analyzing the problem at the physical systems level. Oscillation is a
well-known defect in control systems whose parameters are not properly "tuned."

There are so many other alternatives between talk and drugs: visualisation,
biofeedback, relaxatation approaches, hypnotism, faith healing. I feel all
of them demonstrate the ability of the mind to learn new control parameters.
Since the long-term effects of the drug therapies are often terrible, PCT
may benefit many by research on these alternative approaches.
David W.

ยทยทยท

At 19:14 17/12/97 -0600, you wrote: