Camilla Nord, 36, directs the Mental Health Laboratory at the University of Cambridge, where she is a professor of cognitive neuroscience. Bearing a certain resemblance to adult Hermione Granger, she welcomes us between lessons in a glass-walled office overlooking a garden, where squirrels scamper. Nord was born in France and raised in Washington, D.C., the daughter of an American father and a Dutch mother, as evidenced by a hard-to-pinpoint accent. In his book The balanced brain: the science of mental health (2023), makes three points: that there is no single cure for depression, that medications are not as harmful as many claim, and that the nervous system seeks stability throughout life, a stability that, unfortunately, will always be difficult to achieve.
Q. This morning at Tate Britain I saw a painting by Ithell Colquhoun entitled depression: a bundle of tense and tangled threads. Does this tell you anything?
TO. It tells me a lot. It describes the cage of depression: the feeling of not being able to escape. But that door can be opened. There are always ways out, even if they are not the same for everyone.
Q. Unlike other experts, you do not take sides: you accept multiple treatments and consider most of them valid.
TO. One treatment doesn’t work for everyone. Research proves the opposite: disorders are different, the causes are multiple and therefore there must be different ways to treat them. Scientists have already passed that stage. Now we need to explain it better to the public.
Q. Some people use depression as a synonym for sadness. How do you respond to this?
TO. Depression is a profound alteration of emotional – and partly physical – experience that compromises basic functioning. We need to distinguish normal changes in mental health – because we don’t have to be happy all the time – from illness, which requires treatment to restore those functions. Being sad is normal, but depression is debilitating.
Q. There is a lot of mistrust in the relationship between scientists and the pharmaceutical industry.
TO. It is a legitimate concern, born of prejudice, the concealment of adverse results and the unfair promotion of some drugs. I don’t collaborate with industry, although I know of concrete work financed by pharmaceutical companies. We must not exclude drugs, but nor make them the only path. Biology can also be modified by experiences and habits.
Q. She argues that having a coffee in the sun or laughing at a movie can act on the brain in a way comparable to a drug.
TO. Our experiences change the way the brain works. There are beautiful studies: watching a comedy with friends activates the endogenous opioid system and raises the pain threshold. Its effect resembles, on a smaller scale, that of an analgesic. It demonstrates that there can be common biological roots through different paths: the pharmacological one, obviously, but also the experiential one.
Q. Spain is among the European countries with the highest number of mental health diagnoses. Why do some countries have more cases of depression than others?
TO. There are large geographical and temporal variations. This is partly explained by access to care: the greater the access, the greater the number of diagnoses. But, given equal access, environmental factors – poverty, perhaps pollution – small genetic differences and, above all, different cultural expressions of emotions play a role. Different cultures express distress in different ways, so psychiatric disorders may also differ somewhat depending on the cultural context. Stigma also matters: where there is more shame, there are fewer and fewer diagnoses.
Q. Are we more depressed today or do we talk about it more?
TO. There is no definitive answer. Part of the visible increase is due to improved access. But there are also signs of a slight decline in well-being, especially among young people. Greater awareness has the flip side: it encourages you to monitor symptoms and attribute them to the clinical setting, when sometimes they are the normal ups and downs of life. On the other hand, the state of the world has an impact. The pandemic has damaged mental health, as has the climate crisis or the proximity of war, especially among young people, although this has yet to be confirmed at a population level.
Q. You study the balance of the nervous system. What is a stable brain and how is it achieved?
TO. The brain constantly readjusts. It is a predictive organ that aligns what is experienced and what is expected from the environment to maintain homeostasis, the body’s ability to keep internal conditions stable despite external changes. We don’t achieve brain balance once and for all. We are forced to readjust it throughout our lives.
Q. Electroshock therapy has a bad reputation. You say that, unfortunately, it works.
TO. I hesitated to include electroconvulsive therapy because of its dark history, but the data shows great effectiveness in more severe cases of depression. The problem is the side effects, especially on memory. But the patterns do not indicate brain damage, and cellular increases have also been observed in specific areas. However, if someone experiences memory loss, this must be taken very seriously. That’s why it’s reserved for cases where no other solution has worked, always with consensus and careful follow-up.
Q. The hypothesis that drugs compensate for serotonin deficiency has been disproven, yet you claim that antidepressants work in about half of patients. How do you explain it?
TO. In the second half of the 20th century there was deceptive marketing: there was talk of correcting that supposed deficit without sufficient evidence, and the negative effects were downplayed. Even so, these drugs work for many people, without a clear explanation. I wouldn’t reject them, but not because they correct an alleged deficit. Rather, because they alter the way we process the ambiguity of certain emotions, which we can decode as good or bad.
Q. How do antidepressants work if they don’t correct a deficiency?
TO. By changing serotonin levels – without any need for a previous deficit – they alter the processing of emotional signals and shift us towards a more neutral or positive attitude. They don’t lift your mood all at once; they regulate the bias with which we interpret such interactions and ambiguous signals. It’s like changing the filter you look through.
Excluding drugs is not the solution. There are people who, after trying everything, come out of the hole thanks to a drug. I think they should be able to access it
Q. What do you say to people who oppose over-medication and rapid diagnoses?
TO. I understand: with health systems so overloaded, prescribing is more immediate than offering psychotherapy, which requires time and resources. I would also prefer more targeted decisions, but excluding drugs is not the solution. There are people who, after trying everything, come out of the hole thanks to a drug. I think they should be able to access it.
Q. You dedicate the book to your daughter and your wife and open it with a scene from your wedding. Why expose yourself so much, which many scientists avoid?
TO. In my scientific articles I never talk about myself. In the book I wanted to open up the world of us who do science: why we think what we think, where our vocation comes from and when we change our minds. If I wanted people to look at the world like a scientist, I had to show a little bit of who is looking.
Q. Have you experienced depression yourself?
TO. I don’t, but the people very close to me do. Maybe that’s why I’m obsessed with figuring it out. An industry luminary, Nolan Williams, recently died by suicide. It was devastating. It reminds us that no matter how close we may be to science’s solutions, it is never enough to deal with depression.
Q. Would you be a better scientist if you were depressed?
TO. My science would be worse if I didn’t work side by side with those who lived it, or if I didn’t listen to them.
Q. And finally: I hear you’re a big fan of Buffy the Vampire Slayer. Did it influence you?
TO. For me it is an ethical model: doing the right thing and thinking of the common good, even when it doesn’t bring benefits. In academia, you can advance at the expense of others. Managing a laboratory implies receiving credits for work that is always collective. I try to never put myself ahead of the team. You can have success and support.
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