FUNCTION THE YIN AND YANG OF HAPPINESS AND DEPRESSION

WRITER: RICHARD T. BOSSHARDT, M.D., FACS

Happiness. Everybody wants it. It is enshrined in the fabric of life in this country in the words: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

Happiness is ephemeral. We can’t put our hands on it. We even have a hard time defining exactly what it is. If you “Google” happiness, you will pull over 300 MILLION sites that deal with it in some way. To paraphrase a Supreme Court justice, speaking on an unrelated matter, we may not know what happiness is but we recognize it when we feel it.

Martin Seligman, a psychologist came up with the acronym, PERMA, to categorize the things that correlate with human happiness. These are:

• Pleasure — which may be derived from physical sensations, experiences, etc.

• Engagement — having enjoyable, challenging activities to occupy one’s attention

• Relationships — good ones are extremely reliable indicators of happiness

• Meaning — having something outside one’s self to give purpose to life

• Accomplishments — having realized, tangible goals

You will notice that all of the above have in common the fact that they are external factors. Internal factors also come into play. People can be happy despite terrible personal circumstances or life situations which defy logic or reason. Perhaps we can better understand happiness by looking at its opposite.

The opposite of happiness is sadness. In medicine, sadness has another name: depression. Depression is sadness on steroids. It is more than just feeling sad because your goldfish died or you saw a sad movie; it is an overwhelming sense that life is not good, indeed, sometimes not worth living.

Modern medical science has tried to distill happiness and depression down to basic biochemical processes. We know that there are centers in the brain which, if stimulated, produce intense feelings of pleasure. We know that brain cells communicate with one another by means of several chemicals, known as neurotransmitters. These include such things as dopamine and serotonin. Studies have indicated that depression may be the result of disturbances in the metabolism of serotonin.

Studies have identified a specific gene which controls the movement of serotonin in brain cells. People with this specific gene are more likely to experience depression in the presence of certain stressors such as demanding life experiences, illnesses, etc. It is tempting to think of depression as the result of this inherited genetic trait. As usual, in medicine, things are not that simple.

As with many medical conditions, it is likely that clinical depression results from multiple factors: an underlying genetic susceptibility, yes, but also exposure to certain stressors, age, sex (depression is much more common in women), environmental factors (depression is more common in cold, gray winter months than in the summer), and many more.

In the wake of studies on depression, a variety of different drugs have been designed to attempt to normalize the brain abnormalities in depression in order to treat it. Antidepressants are the second most commonly prescribed class of drugs. The problem is that after decades of such medical therapy, questions remain as to the effectiveness of these drugs. Reputable psychiatrists have expressed concern that depression drugs do little more than a placebo. Placebos (e.g. sugar pills) are effective in nearly 30 percent of patients — but to be considered therapeutically effective, a drug must work in a higher percentage of patients than this.

Given the complex nature of depression it would actually be surprising if any single medication was universally successful. Since we are unsure of the underlying mechanism(s) behind depression, we are also unsure how anti-depressants work. Yet, it is inarguable that, at least in some people they do work, and can be literally life-saving. The challenge for physicians is to know who will benefit, who will not, and who will experience some of the unpleasant side effects of these drugs. Psychiatrist Steven Reidbord says, “We cannot predict whether an individual patient will improve with antidepressant medication.” Much work remains to be done in this area of medicine.

While happiness may, to a great extent, be within our power to control, the same cannot be said for depression. You can’t tell people to “just snap out of it,” They can’t. On the other hand, it is known that there are many things that can help people who are depressed. Some may even resolve mild to moderate depression permanently. These include such things as exercise, volunteerism, avoiding things like caffeine and tobacco, getting proper medical care for chronic ailments, eliminating stress, and actively pursuing challenging physical and mental activities. Few things make people happier than going outside themselves to help others.

In reflecting on happiness, I cannot improve on the words of Henry David Thoreau, who said, “happiness is like a butterfly; the more you chase it, the more it will elude you, but if you turn your attention to other things, it will come and sit softly on your shoulder….”

The Task At Hand

Is multitasking more efficient?

WRITER: TRISH VAN ETTEN

Multitasking is a myth! Pure and simple! Wishful thinking at best! It is the appearance of doing several things at the same time. Psychiatrist Edward M. Hallowell has described multitasking as a “mythical activity in which people believe they can perform two or more tasks simultaneously as effectively as one.”

The term “multitasking” originated in the computer engineering industry. It refers to the ability of a microprocessor to apparently process several tasks simultaneously. Computer multitasking in single core microprocessors actually involves time-sharing the processor; only one task can actually be active at a time, but tasks are rotated through many times a second. With multicore computers, each core can perform a separate task simultaneously – but each core still processes only one task at a time. So, how does this relate to humans? What happens in the human brain when we attempt to multitask?

Since the 1990s experimental psychologists have been asking that very question, and have started experiments on the nature and limits of human multitasking. These studies have revealed that people show severe interference when even very simple tasks are performed at the same time, if both tasks require selecting and producing action.

Research has also been done in specific domains, such as learning. Scientists have studied the phenomenon of cognitive load in multimedia learning and have concluded that it is difficult, and possibly even impossible to learn new information while engaging in multitasking. Researchers examined how multitasking affects academic success and found that students who engaged in more multitasking reported more problems with their academic work. So much for allowing children to do their homework while watching TV with their iPod plugged in one ear!

When the brain tries to do two things at once, it divides and conquers, dedicating onehalf of its capacity to each task.

Etienne Koechlin and Sylvain

Charron, neuroscientists at the French biomedical research agency, INSERM, in Paris, used functional magnetic resonance imaging to measure brain activity in 16 men and 16 women, age 19 to 32, as they performed a complicated lettermatching task. To multitask, they also had to deal with uppercase and lowercase letters at the same time.

Working on one lettermatching task at a time activated both sides of the volunteers’ brains, setting off the anterior-to-posterior chain of command to get the job done. But as soon as the volunteers took on a second task, their brains split the labor: activity in the left side of the brain corresponded to one task while the right side took over the other task. Each side of the brain worked independently, pursuing its own goal.

When it comes to task management, the prefrontal cortex is the key. The anterior part of this brain region forms the goal or intention — “I want a glass of water” for example — and the posterior prefrontal cortex talks to the rest of the brain so that your hand reaches toward the cabinet, gets a glass, fills it with water, and your mind knows whether you have the glass of water.

According to Koechlin the brain can’t efficiently juggle more that two tasks because it has only two hemispheres available for task management. During the above mentioned study, when volunteers were given a third task of matching letters of the same color, they consistently forgot one of their tasks. They also made three times as many errors as they did while dual-tasking. Because the brain cannot fully focus when multitasking, people take longer to complete tasks and are predisposed to error. In terms of everyday behavior, the problem arises when you attempt three tasks at one time. Your prefrontal cortex will always discard one.

When attempting to do many things at once, the brain is forced to restart and refocus with each switch between tasks and in the interim between each exchange, the brain makes no progress whatsoever. Because the brain actually pauses and refocuses continuously between tasks, this is considered to be “rapid toggling among tasks rather than simultaneous processing.” According to a study done by Jordan Grafman, chief of the cognitive neuroscience section at the National Institute of Neurological Disorders and Stroke, the most anterior part [of the brain] allows [a person] to leave something when it’s incomplete and return to the same place and continue from there.” Focusing on multiple dissimilar tasks at once forces the brain to process all activity in its anterior. Though the brain is complex and can perform myriad tasks, it cannot multitask well.

Not only is multitasking not efficient, it has also been criticized as a hindrance to completing tasks or feeling happiness. In our Internet era, we develop a habit of dwelling in a constant sea of information with too many choices, which has been noted to have a negative effect on human happiness. Relationships also suffer as we give “continuous partial attention” to several tasks at once, but not the focused, undivided attention which healthy relationships require in order to thrive. Effective communication is hindered, or stopped altogether when the brain is engaged in many tasks. Have you ever tried to talk to someone who was preoccupied with several things? Multitasking also greatly increases stress levels and pressure on individuals to become both specialists and generalists. We become a “jack of all trades and master of none.”

Instead of attempting to do the impossible and becoming increasingly frustrated and irritated in the process, perhaps we should focus on doing each job to the best of our abilities, giving our full attention to the task at hand. As Thomas Edison noted, “The first requisite of success is the ability to apply your physical and mental energies to one problem without growing weary.” That’s not a description of multitasking! I think I’ll remove “Great at multitasking” from my résumé and replace it with “Focused and fully present!” How about you?