A review of 'Great and Desperate Cures' by Elliot Valenstein, which examines the history of lobotomy and psychosurgery, explaining how tens of thousands of patients underwent dangerous brain operations from the 1930s-1950s despite poor evidence of effectiveness. Longer summary

The post reviews 'Great and Desperate Cures' (1986) by psychologist Elliot Valenstein, exploring how lobotomy became widespread despite its horrific consequences. The review details the procedure itself (inserting an ice-pick-like instrument through the eye socket into the brain), then examines six factors Valenstein identifies for its acceptance: desperate patients and families, physician ambition (especially Egas Moniz and Walter Freeman), uncritical acceptance by researchers and media, territorial disputes between medical specialties, and cold economics. The post includes extensive details about key figures, particularly Freeman's aggressive promotion of transorbital lobotomy and his traveling surgery roadshows. It discusses patient outcomes, the lack of theoretical justification, media hype, and the procedure's eventual replacement by psychoactive drugs. The review concludes by reflecting on modern parallels and the tragic story of Howard Dully, lobotomized at age twelve, arguing that while Freeman likely had good intentions, the safeguards that might have prevented such harm were inadequate then and remain concerning today. Shorter summary

Scott Alexander presents a detailed guide on depression, covering its causes, symptoms, and various treatment options, including lifestyle changes, therapies, medications, and other interventions. Longer summary

Scott Alexander provides a comprehensive guide on depression, covering its causes, symptoms, and various treatment options. He discusses lifestyle changes, therapies, medications, supplements, and other interventions like TMS and ECT. The post offers practical advice on how to approach treatment, including specific regimens for different situations, and guidelines on how long to continue treatment once it starts working. Shorter summary