Camilla Nord (Paris, 36 years old) directs the Mental Health Laboratory at the University of Cambridge, where she is a professor of cognitive neuroscience. With a certain air of adult Hermione Granger, she receives us between lessons in a glass office that overlooks a garden where squirrels play. She was born in France and raised in Washington, the daughter of an American and a Dutchman, as revealed by an accent that is difficult to spot on the map. In an essay published this year, The brain in balance (Paidós), supports three theses: that there is no single remedy for depression, that drugs are not as harmful as many claim and that the nervous system seeks stability throughout life which, unfortunately, will always be precarious.
Q. This morning I saw a painting by Ithell Colquhoun at Tate Britain, entitled Depression: a taut and tangled bundle of wires. Does it tell you something?
R. It tells me a lot. Describe 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 don’t choose a side: you accept multiple treatments and consider them all valid.
R. 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. We scientists have already passed that screen. Now it’s time to explain it better to the public.
Q. Some use depression as a synonym for sadness. How do you refute that?
R. Depression is a profound alteration of emotional and partly physical experience that compromises our vital functions. We must distinguish normal changes in mental health, because we do not always have to be happy, from illness, which requires treatment to recover these functions. Being sad is normal, but getting depressed is debilitating.
Q. There is a lot of mistrust in the relationship between scientists and the pharmaceutical industry.
R. This 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. Drugs should not be excluded, but not made the only way out either. Biology is also modified by experiences and habits.
Q. He claims that having a coffee in the sun or laughing at a movie can act on the brain in a way comparable to a drug.
R. Our experiences change how the brain works. There are valuable 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 pathways: pharmacological, of course, but also experiential.
Q. Spain is among the European countries with the highest number of mental health diagnoses. Why are there countries with more depression than others?
R. There are large geographical and temporal variations. Part of this is explained by access to care: with more access, there are more and more diagnoses. But, with equal access, environmental factors – poverty, perhaps pollution -, small genetic differences and, above all, the different cultural expressions of emotions have an influence. Each culture expresses discomfort in different ways and this also has repercussions on psychiatric disorders. And the stigma also weighs heavily: where there is more shame, there are fewer and fewer diagnoses.
Q. Are we more depressed today or do we simply talk about it more?
R. There is no definitive answer. Part of the visible increase in cases is due to this improved access. But there are also signs of a slight worsening of well-being, especially among young people. Having a greater awareness of the problem has the downside: it encourages you to monitor symptoms and attribute them to clinical reasons, when sometimes they are the normal ups and downs of life. On the other hand, the state of the world has an influence. The pandemic has damaged mental health and we also see this with the climate crisis or the proximity of war, especially among young people, although this remains to be confirmed on a demographic scale.
Q. You study the balance of the nervous system. What is a stable brain and how is it achieved?
R. The brain continually readjusts. It is a predictive organ that aligns what you experience and expect with the environment to maintain homeostasis, the body’s ability to maintain stable internal conditions despite external changes. We don’t achieve brain balance once and for all. We are forced to readjust it throughout our lives.
Q. THE electric shock They have a bad reputation. You say that unfortunately they work.
R. I hesitated to include electroconvulsive therapy in my book because of its dark history, but the data shows great effectiveness in very severe depression. The problem is the side effects, especially on memory. Even so, the models do not indicate brain damage and cellular increases have even been observed in specific areas. But if someone suffers from memory loss, it needs to be taken very seriously. That’s why it’s reserved for cases where no other solution has worked, always with consensus and careful monitoring.
Q. The hypothesis that drugs compensate for serotonin deficiency is discredited, but she claims that antidepressants work in about half of patients. How is it explained?
R. In the second half of the 20th century there was deceptive marketing: there was talk of correcting this supposed deficit without sufficient evidence and the negative effects were downplayed. Even so, this drug works for many people, without a clear explanation. I wouldn’t rule it out, but not because they correct a supposed deficit, but because they alter the way we process the ambiguity of some emotions, which we can decode as good or bad.
Q. How do antidepressants work if they don’t correct a deficit?
R. By changing serotonin levels, without the need for a prior deficit, they alter the processing of emotional signals and move us towards a more neutral or positive position. They don’t lift our spirits all at once, but rather adjust the bias with which we interpret these ambiguous interactions and 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 with a drug. They need to be able to access it”
Q. What do you say to those who oppose excessive treatment and rapid diagnoses?
R. I understand: with health systems so saturated, prescribing is more immediate than offering psychotherapy, which requires time and resources. I would also prefer more appropriate decisions, but excluding drugs is not the solution. There are people who, after trying everything, come out of the hole with a drug. I think they should be able to access it.
Q. He dedicates the book to his daughter and his wife and opens it with a scene from their wedding. Why expose yourself, something that many scientists avoid?
R. In my scientific articles I never talk about myself. In the book I also 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 to teach how to look at the world as a scientist, I had to show a little who I was looking at.
Q. Have you suffered from depression?
R. Not me, but very close people do it. Maybe that’s why I’m obsessed with figuring it out. An eminence of the field, Nolan Williams, recently committed suicide. It was devastating. This reminds us that no matter how close we are to science’s solutions, nothing is enough to address depression.
Q. Would I be a better scientist if I were depressed?
R. I would be a worse scientist if I didn’t work side by side with those who experienced it or if I didn’t listen to them.
Q. And the last one: they tell me she’s a big fan Buffy the Vampire Slayer. Did it influence you?
R. 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 means receiving credit for always collective work. I try to never put myself ahead of the team. You can be a successful and supportive person at the same time.
