Considering depression (in terms of thermodynamic constraints)

In thermodynamic computation, neuroscientists address the energetic efficiency of information processing. In terms of clinical practice, we take these energetic considerations into account to address the fatigue and numbness of depression.

Depression affects a lot of people. In 2021, an estimated 21.0 million adults in the United States had at least one major depressive episode. This number represented 8.3% of all U.S. adults.

Depression is defined as a period of at least two weeks when the individual experienced a depressed mood or loss of interest or pleasure in daily activities, and had a majority of specified symptoms on the PHQ9, which addresses issues with sleep, appetite, concentration, and self-worth. Individuals are excluded from this diagnosis in the case of medical illness, medications, or substance use disorders.

Standard of care may include pharmacological interventions, such as selective serotonin reuptake inhibitors (SSRIs), and psychotherapy, which may entail for example cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT).

Yet in clinical practice, there is no clear link between the efficacy of pharmaceutical interventions and the efficacy of psychotherapy. How is information processing related at all to the neurophysiological processes that are affected by SSRIs?

Our improved understanding of thermodynamic computation may help us to forge a direct link between neuroscience and psychology: a long awaited goal for both fields.

Thermodynamic computation is a new approach to neurocomputation that leverages the principles of thermodynamics - particularly the natural tendency of biophysical systems to dissipate energy efficiently and continually reach equilibrium - to understand how the brain processes information. This approach specifically accounts for time and energy requirements when considering perceptual accuracy, cognitive flexibility, and decision-making capability - and it provides practitioners and patients with the training and tools to improve these aspects of neurocomputation.

Our improved understanding of thermodynamic computation may help us to concretely forge a direct link between neuroscience and psychology.

In the view of thermodynamic computation, the lethargy associated with depression is due to a discrepancy in the amount of neural information processing needed and the amount of energy available to complete the task.

A trained practitioner will determine whether depression is due to biological factors (which may be addressed with pharmaceutical intervention) or environmental factors (which may be addressed by supportive talk therapy) - and of course both methods may be used, as is currently standard practice.

The key difference here is the use of talk therapy to engage with the thermodynamic requirements of information processing and the thermodynamic constraints of the individual. If the amount of external information has increased recently, the individual may become overwhelmed, without the energetic resources to handle the situation. If the amount of internal resources are insufficient to handle the demands of normal information processing, the individual may also come to feel overwhelmed.

In either case, the goal of therapy in this framework is to help the individual effectively distribute time and energy resources toward healthy neurocomputation: perception, predictive modeling, and decision-making. The process may involve training the patient to tolerate uncertainty in areas where there is limited agency, and supporting the patient to reduce uncertainty in areas of life where there is capacity for agency.

Thermodynamic computation is a useful framework for understanding how we distribute time and energy resources toward perceiving the world, understanding the world, and acting within the world. The overall goal of this systematic approach is for the individual to grow stronger and more capable of interacting with the world, with healthy improvements in sleep, appetite, mood, concentration, and self-worth.

Conifold Counseling addresses the time and energy constraints of information processing, with a respect for the individual as having both intrinsic limitations and the ability to improve that intrinsic capacity with gradual effort and training. The goal here is to ensure the neurophysiological and neuropsychological aspects of computation are addressed in the course of developing a care plan.