Scott Alexander reviews 'The Body Keeps The Score', a book on PTSD, praising its historical context but criticizing its outdated science and uncritical embrace of alternative therapies. Longer summary

Scott Alexander reviews 'The Body Keeps The Score', a book about post-traumatic stress disorder (PTSD) by Bessel van der Kolk. The review covers the book's historical context, its insights into PTSD symptoms and neurobiology, and its treatment recommendations. Scott praises the historical accounts of PTSD recognition but criticizes the book's outdated scientific claims, lack of consideration for genetic factors, and uncritical enthusiasm for alternative therapies. He notes the book's emphasis on bodily disconnection in PTSD patients and the importance of reconnecting with the body in treatment. Overall, Scott finds the book less helpful than expected for guiding clinical practice, but acknowledges its potential value in highlighting the importance of trauma screening and specialized trauma clinics. Shorter summary

Scott Alexander examines the synapse hypothesis of depression, which links decreased synaptogenesis to various depression research findings, and raises questions for future investigation. Longer summary

This post explores the synapse hypothesis of depression, which proposes that decreased synaptogenesis, regulated by the protein complex mTORC1, may be the underlying cause of depression. Scott Alexander reviews various lines of research on depression, including life adversity, inflammation, serotonin, glutamate, folate, and electroconvulsive therapy, and shows how the synapse hypothesis could potentially unify these diverse findings. He then expresses some skepticism about the theory, noting that it's easy to find connections between any proposed cause and various symptoms. The post concludes with six questions or areas of confusion that the author hopes will be addressed in future research, including why decreased synaptogenesis should cause depression specifically, why BDNF can't be used as a direct treatment, and how bipolar disorder fits into this framework. Shorter summary