Psychiatry & Psychology
Prince Hamlet’s Depression and its Neuroanatomical Correlate
“How weary, stale, flat and unprofitable seem to me all the uses of this world!” Shakespeare’s arguably depressed and suicidal Prince Hamlet uttered those words to himself almost five centuries ago. But what if he had confessed them in his doctor’s office today, how would his mood disorder be approached?
Well, in my dream the Prince’s family physician would issue a covered referral to a psychiatrist who would begin by pulling out her “Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)” and asking if he has suffered at least three symptoms from a list that includes, but is not limited to diminished appetite, disturbed sleep, pessimistic thoughts, loss of weight, feelings of worthlessness and decreased sex drive. To which the Prince might answer as he did half a millennium ago, “I have of late, but wherefore I know not, lost all my mirth, forgone all custom of exercises; and indeed it goes so heavily with my disposition…” But our thorough psychiatrist wouldn’t stop there. In addition to this inclusion criteria, she would focus on exclusion criteria, ensuring no evidence of schizophrenia, recent traumatic events or anything else that might explain his mood. Notwithstanding the recent death of Hamlet’s father, she decides to press on.
Because she is trained as a brain scientist, she would order and interpret the results of his functional magnetic resonance imaging (fMRI) studies, and based on decade old studies such as W.C. Drevets et al, she would watch for evidence of decreased activity in a specific area of his prefrontal cortex. Lastly, based on the publications of the psychiatrist and Nobel Laureate Eric R. Kandel that she had come across in her medical school Psychiatric Genetics course, she would genotype the Prince looking for an anomalous locus on the long arm of his chromosome number 18. Assuming a remarkable result on all of these tests, the psychiatrist would reassure the insurance company that while no one of the tests is diagnostic of depression, together they support the supposition that Mr. Hamlet’s disorder is based in part on a verifiable, physical anomaly and therefore treatment should be covered by his insurance policy.
That’s how it goes in my dream. But perhaps the Prince said it best, “A dream itself is but a shadow.”
Related Articles
3 Comments
David Kwon D.O./M.S. candidate
David,
A very subtle observation you’ve made here. It is indeed tempting to see President Lincoln’s “melancholic ambition” and the Parkinsonian personality as two points on the same continuum.
I also share your frustration with what seems sometimes to be “scienceless science.” Hence, my preoccupation with identifying the neuroanatomical correlates of behavior. For instance maybe we’d find out that both depressed and Parkinsonian patients actually do share some anatomical anomaly.
KEEP THINKING David
I read your piece. Very interesting “roundtable”
topic. It’s a great thing to get people discussing
and I love how you got Shakespear to help you introduce the topic. A distinguished contributor to your
roundtable :)I didn’t know about the MRI and genotype studies on depression. I feel it’s really important to get that stuff out there, because there is a perception, I
think, that psychiatry is “fuzzy” science.
Leave a Reply
Saturday, July 5, 2008
- The Anti-Psychiatry Movement
- Vaccines - A Two-Edged Sword
- Should Doctors Have Guns?
- Woman Comparable to Men in Domestic Violence: Stereotypes and their Consequences
- Extremist Muslim Doctors Do More Than Heal
- The Bipolar Trend
- The Biopsychosocial Model of Health & Illness
- Unhinging from Theory: Autism and Opinions
- The Implications of Implanted Chips
- Anti-Smoking Campaign Doesn't Mess Around
- Meditation for Troubled Minds: Can the Mind Heal the Mind?
- Encephalon, Thirty-Third Edition
- Mind-Body: We Want Evidence, Don't We?
- Usually It's Cheaper to Pay Than to Go To Court
- God And Religion: Is It All In Our Heads?
- Integrating Schizophrenia Management
- Is War A Psychosis?
- Encephalon, Forthy-Third Edition
- Acknowledging Vaccination Concerns
- Staying the Course Prescribed for Major Depressive and Bipolar Disorders: A Family's Journey Thus Far
- Breaking News - Exercise is Good for You!
- Ethical Obligations of Health Care Workers During a Pandemic
- Treating Psychiatric Disorders - Something Smells Fishy
- Going Beyond Informed Consent
- Anti-Smoking Campaign Doesn’t Mess Around
- Vaccines - A Two-Edged Sword
- Prescriptive Authority - Are Pharmacists “Write”?
- Should Patients with Schizophrenia Receive Free Medication?
- Should Doctors Unionize?
- Blood Glucose and the Brain: Sugar and Short-Term Memory
- Should Doctors be Paid by Drug Companies for Research?
- How Do We Feed Our Children?
- Ethics 101 - Patients Who Hide The Truth
- Food Additives, Hyperactivity, and Common Sense
- Concierge Medicine - The Future or the Past?
- Brain Blogging, Thirty-Fifth Edition
- Are Placebos A Betrayal?
- New Technology for Intracranial Aneurysms
- Stem Cell Research - Man vs. God
- Using Infrared Light to Diagnosis Alzheimer’s
- Sorry - that last post was mine.
We have better medical care than they did in...
- What a great, informative article! I'm new to the blogging world, and found your...
- Thanks Toby, Yes, the numbers are frightening.
So it would be 39 million d...
- Starlight,
On the HHS webcast with teh OSHA folks they did admit that 68% ...
- GASP! Breaking news... Excuse me while I go lay down for a bit... whew
:D...
- Bless you starlight for your realistic math. The WHO numbers don't relate to re...
- I'm writing in RP, too. Once at Ivillage, (sorry, I've been signed in for awhile...
- My father passed away from bladder cancer caused by secondhand smoke. The 38,000...
- I agree about the necessity of DHA. However, DHA from fish is not ideal as it i...
- Since my vote is supposed to represent who I think would best serve my prioritie...
- Also, regarding the "Presidential Elect" (ughhh....) don't blame me - I was a RP...
- We have a lot in common. I pay "little attention" to GMF's (bad I know, but the...
- The WHO's numbers are not accurate.
There are approximately 6.5 Billion peopl...
- Thanks, Kobie.
I appreciate the heads-up regarding the upcoming event. I will d...
- Thanks for the article. Dept of Health and human services is having a webcast on...
- What benefits would a patient with schizophrenia have if they were to have a MRI...
- How ironic to address these issues on the anniversary of our "independence", as ...
- Hi,
I followed a conscious feeding regime with my eldest boy many years ago. ...
- LOL - I know too well of the revolving door of FDA/NIH and Pharma... if you real...
- Dr. Sherry Tenpenny's theory is that if mainstream medicine dares to question '...
Advertisement
Sponsored Links
Neuroscience & Neurology
June 26, 2008 | 4 Comments | By Jennifer Gibson, PharmD
Blood Glucose and the Brain: Sugar and Short-Term Memory
More In Neuroscience & Neurology
- New Technology for Intracranial Aneurysms
- Using Infrared Light to Diagnosis Alzheimer’s
- God And Religion: Is It All In Our Heads?
- Brain Prosthesis: Coming to a Hospital Near You?
- The Great Embryonic Stem Cell Debate
Neuroscience & Neurology
Opinion
July 05, 2008 | 2 Comments | By J. R. White
Breaking News - Exercise is Good for You!
More In Opinion
- Vaccines - A Two-Edged Sword
- How Do We Feed Our Children?
- Stem Cell Research - Man vs. God
- Only the Rich Get Old?
- Extremist Muslim Doctors Do More Than Heal
Opinion
Psychiatry & Psychology
July 03, 2008 | 2 Comments | By Jennifer Gibson, PharmD
Treating Psychiatric Disorders - Something Smells Fishy
More In Psychiatry & Psychology
- Should Patients with Schizophrenia Receive Free Medication?
- Does Having ADHD Mean Doing Poorly in School?
- Self-Medicating with Over-The-Counter Medicines for Mental Illness
- Interactive Effects of Genetics on Depression
- Postpartum Depression: Not Just For Moms















Also, Lincoln’s “melancholy” as to how it affected his politics and stance on abolitionism. Do you think it’s conceivable that some with depression turn to ambition to self-medicate and/or as escapism [ie log cabin birth to President of the United States]? I find what is classified as “behavioral” in medicine to be fascinating and yet vexing. It seems to me at times a science without science, as it were.