June 28, 2011

Stress and schizophrenia

From Nature News
City Living Marks the Brain: 
Epidemiologists showed decades ago that people raised in cities are more prone to mental disorders than those raised in the countryside. But neuroscientists have avoided studying the connection, preferring to leave the disorderly realm of the social environment to social scientists. A paper in this issue of Nature represents a pioneering foray across that divide. 
Using functional brain imaging, a group led by Andreas Meyer-Lindenberg of the University of Heidelberg's Central Institute of Mental Health in Mannheim, Germany, showed that specific brain structures in people from the city and the countryside respond differently to social stress (see pages 452 and 498). Stress is a major factor in precipitating psychotic disorders such as schizophrenia. 
The work is a first step towards defining how urban life can affect brain biology in a way that has a potentially major impact on society — schizophrenia affects one in 100 people. It may also open the way for greater cooperation between neuroscientists and social scientists. "There has been a long history of mutual antipathy, particularly in psychiatry," says sociologist Craig Morgan at the Institute of Psychiatry in London. "But this is the sort of study that can prove to both sides that they can gain from each others' insights." 
Meyer-Lindenberg works on risk mechanisms in schizophrenia, and previously focused on the role of genes. But although a dozen or so genes have been linked to the disorder, "even the most powerful of these genes conveys only a 20% increased risk", he says. Yet schizophrenia is twice as common in those who are city-born and raised as in those from the countryside, and the bigger the city, the higher the risk (see 'Dose response?').

The article goes on to describe some brain scan experiment in which a lovely young science lady with lots of dark hair and dark eyes "scolds" subjects while they do arithmetic, which sounds like something out of an Austin Powers movie. I can no more make sense of brain scan experiments than I can make sense of recipes so I won't comment on the experiment.

But, there are a few problems with attributing schizophrenia to "stress." The first is that "stress," while it definitely exists, can be used as one of those all-purpose hand-waving explanations. That doesn't mean that it's wrong, but I tend to have a prejudice against it.

The second is that schizophrenia is so catastrophic from a Darwinian point of view -- it ruins the lives of roughly 1% of the population, but generally not until after their families have almost fully invested in their upbringing -- that it deserves some careful explanation.

Third, it's not at all clear to me that we stress out more over stuff that wasn't around during the evolutionary past. Lots of people stress out over snakes and spiders, but people seem to get fairly used to, say, driving 75 mph on the Ventura Freeway. A few weeks ago, I got a cell phone call from some family friends who had a flat tire on the freeway, so I drove over to stand upstream from them and glare at drivers while they were changing it by the side of the freeway. From that perspective, a few feet from cars roaring past, the entire idea of driving on the freeway seems like utter madness. I drove home very slowly on surface streets. But the next day I was driving 75 mph down the Ventura Freeway with no more thought in my head than: "How come I didn't like Led Zep as much in the 1970s as I do now? Black Dog is awesome!"

Fourth, if city life correlates with schizophrenia, why stress instead of infection as a potential cause? Disease burden was such a problem for city dwellers until quite recently that, for example, sub-Saharan Africa had very few cities. People in Africa had to live spread out in small villages or they'd get sick and die.

93 comments:

Anonymous said...

God bless the suburbs. It saved a part of my youth. I must say though, a city without NAMs aint so bad. And with stress also comes stimulation. If you're used to city life, settling in a rural area can drive you nuts. Which is why I love the suburbs situated between the city and the countryside.

Anonymous said...

Or maybe people who live in cities tend to have a higher genetic incidence of schizophrenia.

You know.

Occam's Razor.

Re: Black Dog - hell yes.

Anonymous said...

The second is that schizophrenia is so catastrophic from a Darwinian point of view -- it ruins the lives of roughly 1% of the population, but generally not until after their families have almost fully invested in their upbringing -- that it deserves some careful explanation.

Is the figure of 1% constant across all races?

[I have a hard time believing that it would be - and surely the German data would be for Northern Europeans - wouldn't it?]


Using functional brain imaging, a group led by Andreas Meyer-Lindenberg of the University of Heidelberg's Central Institute of Mental Health in Mannheim, Germany, showed that specific brain structures in people from the city and the countryside respond differently to social stress (see pages 452 and 498).

Did they correct for religiousness as a variable here?

It is very difficult for me to imagine that religious people and atheists* do not respond [radically] differently to "social stress".

And it is also very difficult for me to imagine that there is not a vast gap in religiousness between rural folk and city folk.



*Although maybe I should make explicit the distinction between the "classically" religious -versus- the zealots in the pagan religion of atheism.

Anonymous said...

"Epidemiologists showed decades ago that people raised in cities are more prone to mental disorders than those raised in the countryside."

and

"Fourth, if city life correlates with schizophrenia, why stress instead of infection as a potential cause?"


In fact, your friend Greg Cochran has argued that it's likely that pathogen(s) are the trigger to many/most cases of what we term schizophrenia, hasn't he?

In addition, Cochran has said the same about male homosexuality, pointing out that gay males are much more likely to have been born/raised in urban areas than in less populated areas and he attributes this to pathogen and he has debunked the idea that stress in pregnancy might be the culprit.

I recommend to your readers anything written by Paul Ewald, eminent evolutionary biologist and infectious disease expert, and, of course, colleague of Cochran.


And, I recommend the very good 1999Atlantic article about Cochran and Ewald, an article that first opened my eyes to the idea that bugs are probably at the heart of our most chronic illnesses, including mental illnesses.

http://www.theatlantic.com/past/docs/issues/99feb/germs.htm

Anonymous said...

You weren't kidding about the attractive lady scientist, Steve. Hot.

Anonymous said...

Stress is a major factor in precipitating psychotic disorders such as schizophrenia.

Serious question - if there are any professional psychology people following this thread [La Griffe? Charles Murray?], then could you comment on the quality of the information presented at "Schizophrenia.com", such as e.g. their article Preventing Schizophrenia - Tactics and Risk Reduction Strategies?

I ask because "Schizophrenia.com" is a project of the Tides Center, which, in turn - as Glenn Beck has spent a great deal of time documenting - is a really nasty outfit.

Country Mouse said...

I would image urban living would increase the risk of sociopathy more than schizophrenia. It would be extremely hard to separate out the cause and effect.

The much higher density make all sorts of things seem disproportionally greater in urban centers - good and bad.

Also, cities and places like California are magnets for odd fellows. The disconnectedness, anonymity and indifference of urban life would appeal to socially and psychologically malformed in the same way it is a drawback for the normal.

Just Sayin' said...

*Although maybe I should make explicit the distinction between the "classically" religious -versus- the zealots in the pagan religion of atheism.

It seems the human compulsion towards religion in urban centers takes on a shallow leftist bent.

The difference is that faith-based leftist tend to be a self-created angry hateful group much more than their traditional religious counterparts.

Moreso than traditional religious conservatives, leftist are bound to experience more failures and frustration by tying their religious impulses to manifestly futile causes in this world.

Certainly this has to make life for the religious leftist much more stressful and unhappy than the conventional religious conservative.

Anonymous said...

Hasn't it been fairly well established that at least some cases of schiz are brought about by flu infection during pregnancy?

And don't many researchers attribute infection by t. gondii as a cause of other cases?

David F. said...

The most damaging kind of stress is the type caused by a situation in which:

1. There is some sort of danger
2. The danger is unpredictable and there isn't any way to fight or flee; the subject feels helpless.

The types of disorders known as "soldier's heart," "shell-shock," or PTSD first appeared about the time artillery bombardment and trench warfare developed.

Interestingly, we (at least males in general) are well adapted to heat-of-battle situations. Psychological trauma isn't really associated with bloody battles, but with sitting around helplessly, wondering if the next shell (or IUD) will take you out.

If one assumes that childhood/adolescent stress plays some role in the development of schizophrenia, I'd suggest that one is much more likely to feel "unable to fight or flee" in response to the stresses and dangers of city life.

Social trust is also higher in rural white areas, and relationships are more likely to be based on long familiarity and mutual aid.

A kid who feels safe anywhere in town and sees people everyhwere whom he knows are trustworthy is probably much less likely to feel helpless and vaguely endagered than a kid raised with lurid news stories of crime and and who is surrounded daily by strangers he can't trust.

Whiskey said...

New Orleans would be quite pleasant, save all the Black crime. In layout and structure, its really more like a giant concentrated suburb than say Manhattan, which I found intimidating or Hong Kong (which owing to geography is more navigable). The back side of Hong Kong Island is quite pleasant and leafy. Kowloon is a mess though.

Not all cities produce the same stress levels or same level of interactions that would cause schizophrenia to manifest if that was the cause. Auckland and pre-Quake Christchurch were pretty restful. Quite lovely actually.

Peter A said...

1% just seems too high. I know personally 3 or 4 people who are schizophrenic, out of several thousand acquaintances in my lifetime. And one of those schizophrenics grew up in rural New Hampshire.

Charlie said...

While I would agree that stress is a vague and catch-all explanation, I'm not sure that it's so inaccurate here, in that it may be a vague and catch-all explanation for a somewhat vague and catch-all diagnosis.

The typical idea of a schizophrenic is that sometime in his late teens or early twenties, a heretofore normal person starts hearing voices and acting completely nuts for the rest of his natural life, and either wanders the streets or lives in mental hospitals doing nothing useful with himself. If he can function at all it's because he's stuffed with antipsychotics.

In fact, about half of diagnosed schizophrenics don't hallucinate (and it's my educated guess that non-hallucinating schizos are much, much more likely to escape diagnosis), the condition is by no means a lifelong sentence, it's by no means a binary you-have-it-or-you-don't affliction (IOW, it's an attempt to split a continuous phenomenon into distinct categories, like calling parts of the electromagnetic spectrum "red" "orange" and so forth - like everything else in the DSM), and it's not something that just happens out of the blue to "normal" young people.

Look it up. A large fraction of paranoid schizophrenics have a psychotic episode in their youth, recover, and stay sane for the rest of their lives. It happened to me. All you have to do is avoid letting everyone see how crazy you are, and wait for your brain to notice that no, people are not plotting to kill you and no, you don't have a secret mission to save the universe. The main pitfall to avoid is...antipsychotic medication and hospitalization. People who go that route are generally a lost cause.

And instead of a clean diagnosis of "schizophrenia", many people get something like "bipolar with schizophrenic tendencies" or vice versa, or "schizophreniform disorder".

There does seem to be some kind of mental instability, which Hans Eysenck called psychoticism, underlying "schizophrenia" and "manic depression" and probably some other pseudo-scientific categorizations of human behaviour. But whether or not it manifests itself in a psychotic break from reality might really just come down to stress. It's a rather boring explanation but it seems at least plausible to me.

agnostic said...

I think the ev psych argument about why city living is more stressful is more about brain/soul overload than the novelty or unfamiliarity of it.

The best is somewhat sparse living for most of the time, with regular trips to some really dense and chaotic place, a way of life that reached its peak during the heyday of suburban mall culture during the '80s and early '90s.

No one went to buy much at all -- it wasn't a Cathedral of Consumerism or whatever other lame term the killjoys tried to give it. It was just to plunge into a turbulent sea of people for awhile in between long stretches of lower-density living back in your neighborhood.

It was like living on a country estate and making occasional trips into the city or fair or bazaar.

Going to school is like this too, but it's for far too long. Just as no one would hang around the mall, even on an exciting day, for 8 hours straight, no one can handle the pressure-cooker of school for that long.

It's fun to throw yourself into the mix of your schoolmates for a couple hours, but even by lunchtime you're ready to go back to lower-density places.

College is totally different in this respect, and that's what most people love the most about the change of place.

Udolpho.com said...

John B. Calhoun did seminal research on population density with rats in the 70s, and concluded that there were strong grounds for believing that the stress that comes with extremely high density (or, more precisely, high complexity of social interactions) dramatically changes animal behavior, including human behavior. I explored that idea at some length here: http://mpcdot.com/forums/index.php?/topic/155-the-limits-of-human-scale/

This is more or less the type of idea that I think Sailer has a bias against, because it is a simple explanation for a wide range of dysfunctional behavior. I don't know that it accounts for incidences of schizophrenia, but put it together with the work done by Putnam on population diversity and I think you have a compelling argument for greatly reducing population density. Maybe Matt Yglesias will pick up on this and demand 300 million more Americans!

Anonymous said...

I´m open to cities being more stress-inducing than the countryside.

You send people to some rest home in the trees to relax, after all, not to NYC.

Of course, probably a lot of confounding factors as well. In the US, having to cope with the black underclass in the city might very well heap on some extra stress, for instance.

airtommy said...

It may also open the way for greater cooperation between neuroscientists and social scientists. "There has been a long history of mutual antipathy, particularly in psychiatry,"

Is this just a subset of modern social science's general antipathy for reality?

Henry Canaday said...

Just back to Podunk-on-the-Potomac from Belgium and, of course, my first impression of America is, "Europe has cities, we don't." DC is basically an office park along the river, with leafy white residential neighborhoods in Northwest and grittier black residential neighborhoods, but no shopping, in the East.


I happen to love cities, because I like to walk and see people, even if I don't want to speak to them. Europe has cities for historical reasons, so they have to make the best of them. They can't afford to throw away space and infrastructure as profligately as we can.

But they sometimes feel like throwing away each other. The Flemish and Walloons have decided they can do perfectly well without each other in separate countries, as long as they both still have the Euro. Belgium's political parties have not been able to form a majority in parliament for three years, so there has been no government in the sense of a body that can enact new legislation.

But the civil servants, civilians and inertia seem to keep things humming along. Orchestras still play lovely concerts of adult, pre-60s music in the great city squares each night. Chocolate eclairs are available on every corner. Waffles are plentiful. What more do you want?

Aaron Baugher said...

One difference may be that urban stresses -- traffic, noise, pollution, poor nutrition, crowding, skewed sleep schedules, etc. -- tend to be chronic, affecting the person day to day if not hour to hour. Rural or wilderness stress tends to be acute -- tiger attack, the need to spend two straight days digging potatoes, weather extremes, food shortages.

The body is built to handle acute stresses much better than chronic stress. For acute stress, a burst of adrenaline gives us the energy to run from the tiger or whatever temporary danger we need to deal with. Chronic stress fires up the same fight-or-flight response, but we don't have anywhere to go with it, so it wears us down and we get sick.

A related potential issue is the gut-brain connection, which we're learning may be passed from mother to child to some extent through bacteria in the womb. If mom's chronically stressful city life has left her with compromised gut flora and immunity, she may be able to pass that to her children at/before birth, and poor gut health can lead to mental problems.

Tom in Va said...

Matt Y. will have something asinine to say about this any day now.

jeanne said...

I agree about the catch-all "stress" diagnosis. What a crock. When it first came into vogue, in the 1970s, I was living an idyllic life in my new home in Whiteopia, age 26, playing music full time by night and recreating by day. I went to a doctor for something and she leaned over sympathetically and asked if I weren't under a lot of stress. I may have had a hangover, I don't know, but I had to laugh and ask, are you kidding??

Or, hey, maybe my life was so stress-free that it actually caused stress? lol

Anonymous said...

"Yes" on Black Dog and the loveliness of the young woman in the article.

nooffensebut said...

Outside of psychiatry, I think there is skepticism about stress because it is less concrete than measuring, say, metabolites. However, it is not hand waving because there has been a lot of research on cortisol and the hypothalamic-pituitary-adrenal axis. Also, whereas fMRI studies have poor overall reliability, amygdala activation is fairly straightforward, like occipital lobe activation with visual stimuli. I have read work by Andreas Meyer-Lindenberg in the past because he published groundbreaking studies on the relationships between the violence gene, MAOA, hormone levels, and amygdala activation. He is really a leader in the field of fMRI.

With regard to schizophrenia, it certainly is catastrophic, but I do not think Darwinian theory poses a serious obstacle. While I have doubts about psychiatric diagnoses for mild depression, which is over-treated, psychotic symptoms are unmistakable and are probably made much more common by the prevalence of drug-induced psychosis. I have seen many young, otherwise healthy people who developed schizophrenia as a consequence of methamphetamines abuse. I also see from the studies cited that cannabis use is a risk factor. It makes sense that stress would at least exacerbate psychotic symptoms because of their labile, episodic nature.

It is important to note that this study did not compare city dwellers to the hunter-gatherers of antiquity. Life in rural America really is less stressful than the urban rat race. It would be interesting to know the prevalence of mental illness in antiquity and how genes for schizophrenia could overcome selective pressures. This could have affected the genetics of intelligence because it has become clear over the last several years that high IQ protects against ADHD and PTSD.

Also, infectious causes of schizophrenia are being investigated, particularly herpes, toxoplasmosis, and Epstein-Barr Virus.

Anonymous said...

Led Zep IV. In an era of great albums, stands out as one of the best. Still sounds great!

TGGP said...

Barry Marshall (the guy who discovered infections cause ulcers) still thinks there's no evidence implicating stress in anything.

Dahinda said...

I lived for the first 40 years of my life in the Chicago Area and for a brief time in Los Angeles. I now live in a rural area. I can say that there is stress in rural areas as much as in cities. You still have to work for a living and still have to deal with family issues, money etc.. I think if there is a difference is that cities are very indifferent at a community level and everybody is pretty much anonymous to everybody else. Rural areas are much quieter but the main difference between cities and rural areas is that everybody knows everbody else if you like it or not. I don't know if this affects mental health at all but this is the main difference that I have found.

Anonymous said...

COunting how many posts it takes to bring the jews into this.

Lucille said...

Or maybe people who live in cities tend to have a higher genetic incidence of schizophrenia.

How does Occam's razor suggest a genetic connection between living in a city and schizophrenia?

Kevin Michael Grace said...

Before we get all het up about the utility of this study, perhaps someone could demonstrate that schizophrenia is an actual disease and not a clumsy metaphor employed to excuse the terrible actions of middle-class men such as John Hinckley and Jim Gordon.

As Thomas Szasz never tires of pointing out, there is no such thing as asymptomatic schizophrenia. The symptoms are the disease.

Crazy Eddie said...

Dense urban living is a relatively new phenom in human history

It was enabled 9,000 years ago with the advent of agriculture, but only became dominate about 100yrs ago in the US when the urban population surpassed the rural.

Just as many humans seem to have not adapted to digesting grain crops or cows milk after thousands of years, there are probably many who have not adapted well to urban living over the past 100 or 200 years.

Anonymous said...

Interpret this as you will. My schizoid (similar, not equal to schizophrenic) episodes occur with much higher frequency when I've been staying in the city for more than a couple of weeks. There are a lot of lifestyle changes bundled into that distinction (water supply, diet, lifestyle, disease), but I certainly wouldn't count stress out of the equation. If nothing else, at the least it exacerbates the symptoms.

My experience seems to line up with the much more unfortunate John Nash, as described at Wikipedia:

[Quote]
Although he took prescribed medication, Nash wrote later that he only took it under pressure. After 1970, he was never committed to the hospital again and refused any medication. According to Nash, the film A Beautiful Mind inaccurately showed him taking new atypical antipsychotics during this period. He attributed the depiction to the screenwriter (whose mother, he notes, was a psychiatrist), who was worried about encouraging people with the disorder to stop taking their medication.[13] Others, however, have questioned whether the fabrication obscured a key question as to whether recovery from problems like Nash's can actually be hindered by such drugs,[14] and Nash has said they are overrated and that the adverse effects are not given enough consideration once someone is considered mentally ill.[15][16][17] According to Sylvia Nasar, author of the book A Beautiful Mind, on which the movie was based, Nash recovered gradually with the passage of time. Encouraged by his then former wife, de Lardé, Nash worked in a communitarian setting where his eccentricities were accepted. De Lardé said of Nash, "it's just a question of living a quiet life".[18]

Nash dates the start of what he terms "mental disturbances" to the early months of 1959 when his wife was pregnant. He has described a process of change "from scientific rationality of thinking into the delusional thinking characteristic of persons who are psychiatrically diagnosed as 'schizophrenic' or 'paranoid schizophrenic'"[19] including seeing himself as a messenger or having a special function in some way, and with supporters and opponents and hidden schemers, and a feeling of being persecuted, and looking for signs representing divine revelation.[20] Nash has suggested his delusional thinking was related to his unhappiness, and his striving to feel important and be recognized, and to his characteristic way of thinking such that "I wouldn't have had good scientific ideas if I had thought more normally." He has said, "If I felt completely pressureless I don't think I would have gone in this pattern".[21] He does not see a categorical distinction between terms such as schizophrenia and bipolar disorder.[22] Nash reports that he did not hear voices until around 1964, later engaging in a process of rejecting them.[23] Nash reports that he was always taken to hospitals against his will, and only temporarily renounced his "dream-like delusional hypotheses" after being in a hospital long enough to decide to superficially conform, behave normally or experience "enforced rationality". Only gradually on his own did he "intellectually reject" some of the "delusionally influenced" and "politically-oriented" thinking as a waste of effort. However, by 1995, he felt that although he was "thinking rationally again in the style that is characteristic of scientists," he felt more limited.[19][24]
[/Quote]

(Posted anonymously for obvious reasons. It's hard enough to find a job.)

John Bonham's Ghost said...

Zeppelin kicks ass. Listen to their live BBC sessions with headphones on. And before the haters pile on, yes I know they "borrowed" songs from American blues musicians. Doesn't matter...they were the best.

Anonymous said...

There's a lot of good research out there on stress, you should look into it.

The kinds of stresses we face in modern life are different than those we faced as hunter gatherers. In particular, hunter gatherers tended to face intense stresses for short periods, such as having to run from a lion. Whereas modern humans tend to face chronic, low-grade stresses such as having to deal with a shitty job and lousy boss. We're not designed for the latter case.

beowulf said...

"Why didn't I like Led Zep as much in the 1970s as I do now? Black Dog is awesome!"

A better question is, why is the Zeppelin song Houses of the Holy not on their album Houses of the Holy?

MQ said...

Steve's tendency to ascribe all human malfunctions to "disease" for naive 'evolutionary' reasons is pure silliness. (We've seen it with homosexuality as well). The human mind is an extremely complex mechanism; like all complex mechanisms it has design constraints and cannot be optimized for all circumstances.

The point is not some generalized kind of "stress" but the specific kinds of stress that occur in cities. One kind of city-related stress that was not in our primary evolutionary environment is the situation of being surrounded by complete strangers at almost all times. Humans were meant for sociality with a known and familiar community.

Anonymous said...

Leaving aside the precise reasons, it's likely that city life is less healthful for most people than rural or suburban life.

So the "new urbanist" ("anti-sprawl," "pro-density," "Matt Yglesias-type") advocates owe us some explanations.

"Why," we must ask them, "do you want to damage the health of children by forcing their parents into unhealthy overcrowded inner cities?"

smead jolley said...

OK, here's a stupid question: how would you know whether it's city life itself, or having to be around co-workers in an office, that causes the stress?

Dahlia said...

Jason Malloy has written more about schizophrenia than anyone, as far as I'm aware, in the Steveosphere.

Howard Hughes said...

"Leaving aside the precise reasons, it's likely that city life is less healthful for most people than rural or suburban life."
Urban life is less healthy and more fun. Like a lot of things.

Kylie said...

"Why didn't I like Led Zep as much in the 1970s as I do now? Black Dog is awesome!"

Apparently, you're not just getting funnier, your taste in music is getting better.

Or maybe you're just getting funnier and this is the latest example of it.

Regardless, I think Led Zeppelin and Pink Floyd are the two bands from the fabulous 60s whose music will stand the test of time. The reps of most of the other groups have to do less with their music and more with their image and hype.

As for stress, recently, I went from my small town to to spend a week in the big city. The shopping was fine and fun but the rest wasn't. Traffic was horrible, commutes took 50% longer than they do here and for all the amenities that come with my girlfriend's condo, she has to keep her blinds closed all the time and wedge a board between her front door and stairs (per a policeman's suggestions) to discourage home invasion. She lives in an affluent area so I'm guessing the refusal or inability on the part of police to racially profile is a factor. She'd be better off in a gated community but of course, she doesn't see that.


I don't even have to lock my door and I can have coffee on my patio, enjoying the trees, birds and wildlife, 7 months of the year.

We're both high-strung people but I'm not surprised that she's totally stressed out and I'm so relaxed. Being committed to and invested in an urban way of life, she doesn't see how unhealthy it is for her.

I was overcome with gratitude at being back home, away from all that noise, concrete and vibrance.

Svigor said...

Men ain't meant to be all squashed up together in vertical build-ups.

Zep, it's so hard to pick a favorite. No Quarter gets no love. I have a good Tool cover of No Quarter. I think In The Evening might be my favorite Zep tune.

Best band you've never heard of: Kyuss. Touch of Zep there, maybe.

jz said...

I don't have time now to follow the original publication, so will chime in anecdotally. My grandmother, mother, and sister have schizophrenia and were/are all Wisonsin dairy farmer wives/daughters.**

Agree strongly with Country Mouse above, who believes that early-stage young schizophrenics are drawn to the city for its disconnectedness......and government assistance.

I strongly disagree that city living is more stressful than rural living. City living is cushy.

**and my husband claims I have schizophrenia too.

Svigor said...

The kinds of stresses we face in modern life are different than those we faced as hunter gatherers. In particular, hunter gatherers tended to face intense stresses for short periods, such as having to run from a lion. Whereas modern humans tend to face chronic, low-grade stresses such as having to deal with a shitty job and lousy boss. We're not designed for the latter case.

In a big cat attack, assuming you survive, there are all kinds of endorphins and lovely chemicals dumped into the body, too, no?

So grinding, low-grade stress doesn't get you high either.

On the other hand, I think the mind generally does a good job of coping with "background" stress and finding a "new normal" or whatever. That's been my experience. The situation doesn't change, but it stops causing stress.

Anonymous said...

Well, urban dwellers are better off than small town folk on one mental health metric: big city suicide rates are lower than small town suicide rates.

Svigor said...

And before the haters pile on, yes I know they "borrowed" songs from American blues musicians. Doesn't matter...they were the best.

A lot of non-creative types make a big fuss over "originality." Actual creative people know putting out a good product towers over "originality," which is mostly a chimera.

Actually, that's not fair. A lot of the less-creative creative types seem to make a big fuss, too. And a lot of good creative people seem to avoid thinking about it.

Has to be said...

Urban life selects for intelligence. In fact, the single best predictor for a group's IQ is the number of generations the ancestors of that group had lived in cities.

But this selection has costs. The brain gets challenged; sometime it breaks.

Has to be said...

The kinds of stresses we face in modern life are different than those we faced as hunter gatherers. In particular, hunter gatherers tended to face intense stresses for short periods, such as having to run from a lion. Whereas modern humans tend to face chronic, low-grade stresses such as having to deal with a shitty job and lousy boss. We're not designed for the latter case.

Primitive human had plenty of chronic, low grade stresses. Like, "do I have enough food to last through the winter?"

Anonymous said...

"The body is built to handle acute stresses much better than chronic stress. For acute stress, a burst of adrenaline gives us the energy to run from the tiger or whatever temporary danger we need to deal with. Chronic stress fires up the same fight-or-flight response, but we don't have anywhere to go with it, so it wears us down and we get sick.'

You don't think that historically farmers, no matter their acreage, and all the rural folk whose livelihoods are tied in to the success of those farmers, endure "chronic stress," worried as they must constantly be about the vagaries of weather and other variables on their crops?

Talk to people whose families relied on the land about "worry, about sleeplessness, about stress.

Anonymous said...

"Stress" is the diagnosis when doctors/researchers, don't know the cause.

I'd rather they say, "We don't know what causes this."

Anonymous said...

There does seem to be some kind of mental instability, which Hans Eysenck called psychoticism, underlying "schizophrenia" and "manic depression" and probably some other pseudo-scientific categorizations of human behaviour. But whether or not it manifests itself in a psychotic break from reality might really just come down to stress. It's a rather boring explanation but it seems at least plausible to me.


Sounds pretty plausible to me. It fits pretty well, too, with the evidence that some forms of madness are culturally conditioned.

-Osvaldo M.

Kylie said...

"OK, here's a stupid question: how would you know whether it's city life itself, or having to be around co-workers in an office, that causes the stress?"

I would imagine some test could be conducted comparing the stress levels of city residents who work in city offices and suburban residents who work in those "office parks" in outlying suburban areas. Much as I hate the city, I find those office parks attractive with the space surrounding them and their grounds so attractively landscaped. If you have to work in an office, I'd think that'd be the way to go.

Anonymous said...

"All you have to do is avoid letting everyone see how crazy you are,"

Especially if you're not really crazy. A young guy I've known for 15 years just got diagnosed "bi-polar" and discharged from the Army, probably based on some mil questionnaire or assessment.

It's BS, but his confidence is shaken. I want to ask, why did you let them put a label on you? Nowadays anyone can get a label.

Dan Kurt said...

re:"The types of disorders known as...'shell-shock,'...first appeared about the time artillery bombardment and trench warfare developed.

Interestingly, we (at least males in general) are well adapted to heat-of-battle situations. Psychological trauma isn't really associated with bloody battles, but with sitting around helplessly, wondering if the next shell...will take you out." David F.

Actually, artillery bombardment in WWI and sometimes in WWII was not too stressful for the soldiers on the receiving end in the trenches as they were usually in dugouts many meters below the surface and had multiple exits. Fuze technology was primitive in WWI and in WWII instantaneous and air burst fuses were the rage. As long as one was in a deep shelter, one generally was safe. The Japs rode out the intense bombardments of Iwo Jima and Pelieu in their deep shelters as our Marines found out with so much pain.

The only exception was in WWI when the Germans had the opportunity to use against the Allies their 420 mm and 305 mm artillery to root out defenders in their warrens.

What really stressed the soldiers on both sides was the Maxim gun. Read: Command or Control?: Command, Training and Tactics in the British and German Armies, 1888-1918, Martin Samuels, ISBN-10: 0714642142.

Anonymous said...

So the "new urbanist" ("anti-sprawl," "pro-density," "Matt Yglesias-type") advocates owe us some explanations.

New urbanists want to make urban 'neighborhoods' where everybody does know everybody. Maybe they can't do that, but that's their goal.

-Osvaldo M.

elvisd said...

"Why didn't I like Led Zep as much in the 1970s as I do now?"

Probably because of the reason so many other people do. Time. In the '70s, you were expected to be part of the Eric Clapton cult (which continues-go to any guitar store, and there's always some picture shrine of him) for his "virtuosity". I can't think of a more inappropriate tag, but that word was always tossed.
Eventually, once there was time for the smoke to clear, people realized how much more there had been to LZ and Jimmy Page: the alternative tunings, the amazing production by Page, the genre-busting experiments, the reggae, celtic, folk, indian, funk excursions, and on and on. When you compare the two guitar heroes, Page's sloppiness-and he could get sloppy-seems pretty minor compared to the creative depth he and the band had. Clapton, Beck, and the rest of the generation just don't hold up as well.

Anonymous said...

"Sounds pretty plausible to me. It fits pretty well, too, with the evidence that some forms of madness are culturally conditioned.'

And, what, pray tell, might cause stress hormones and the endocrine system to be so "underperforming"? It's gotten us this far, after all, so it must be pretty highly evolved.

You need to ask yourself what stresses the body. Toxins? Diet? Viruses? Bacteria? Fungi? Other environmental factors? Constant noise? No light? Too much light?

Just a blanket "stress" from cultural pressures? Ach.

Anonymous said...

"Did they correct for religiousness as a variable here?

It is very difficult for me to imagine that religious people and atheists* do not respond [radically] differently to "social stress".

And it is also very difficult for me to imagine that there is not a vast gap in religiousness between rural folk and city folk.

*Although maybe I should make explicit the distinction between the "classically" religious -versus- the zealots in the pagan religion of atheism."


Ah, the smug religious @sshole. Nice. You can't "imagine" because you already think you know the answer. Why bother asking then?

Atheists are grossly UNDER-represented in prisons. You'd think if they had a problem handling stress, a certain percentage of them might, you know, get violent. Like the religious folk do. Oh, of course, those religious folk in prison "aren't true Christians" (the classic no true Scotsman fallacy).

I don't know what the stats are for stress and schizophrenia, but most of the atheists I know aren't zealots (this is pure psychological projection on the part of religious zealots combined with the fact that they know few atheists in real life). Not having to stress out over the fate of a soul they don't believe they have, gives atheists a stress-free alternative to getting on with the rest of their lives. Religion offers itself as the "solution" to the very fears it created in the first place.

But, you can't "imagine" how that could be, so for you this is incomprehensible. Literally. If the solution isn't God then you don't think there is a solution. But bad things happen anyway, necessitating a huge complex system of denial, evasion, rationalization, and blame shifting in order to keep Faith intact. Sounds stressful to me.

Udolpho.com said...

"But this selection has costs. The brain gets challenged; sometime it breaks."

An important thing to keep in mind in this part of the Internet where some people appear to operate under the impression that more IQ is more better. I think there is both a cost to very high IQ, and an additional cost when the IQ "spread" gets too wide.

Anonymous said...

1. There is some sort of danger
2. The danger is unpredictable and there isn't any way to fight or flee; the subject feels helpless.


A perfect description of public school.

dearieme said...

Schizophrenia will be found to be caused by genes or germs because practically everything is caused by genes or germs.

Dutch Boy said...

Stress can potentiate drug abuse which is a big inducer of schizophrenia.

Ray Sawhill said...

City living may have come along relatively recently in human history, but not nearly as recently as suburban living American-style. U.S.-style automobile suburbs have only been around since after WWII. Some people may enjoy it and even take it for granted, but in historical and anthropologocal terms, it's one seriously weird and unusual way of organizing societies.

spacehabitats said...

"Stress" is such a garbage can variable, I'm surprised that any serious scientist would employ it as an explanation for anything.
"Schizophrenia" is likewise a cluster of various syndromes that resemble one another rather than a discrete disease entity.

Garbage can x garbage can = confusion squared.

Cities tend to have great ethnic diversity and demographic volatility (turnover) than rural areas. Maybe genetically susceptible populations are "infected" by "carriers" who are resistant.

Until the underlying genotypes are better defined, it will be very difficult to draw any useful conclusions from the epidemiological data.

Ray Sawhill said...

Cities don't have to be congested or full of high rises. Central Paris has very few tall buildings. I just got back from a week in Berlin's Prenzlauer Berg neighborhood, where the streets are cobblestone, cafes are everywhere, and the housing is four or five stories tall. It was one of the most relaxing and stress-free trips I've ever taken.

Y'all should really check out Leon Krier, a new classicist architect who's also an architecture-and-urbanism theorist. He's an advocate of trad cities and also argues that buildings shouldn't go higher than five stories.

Anonymous said...

Stress can potentiate drug abuse which is a big inducer of schizophrenia.

Drug abuse can also potentiate stress (even if it seems that the tress goes away) which is a big inducer of schizophrenia.

Anonymous said...

Guys, we don't need to think NYC, Paris, London, Philly, Chicago, Hong Kong, in order to think "city."

Sure, living in a 400 sq ft. apt in NYC, traveling crazy freeways in LA, hearing sirens in the night beneath your apt. window in Chicago--yes, unpleasant things.

However, these "stressful" inconveniences aren't found in a town of 50,000, yet schiz is.

Dr. Sane said...

In Europic populations schizophrenia occurs 1.4x more often in males than females. As 1.4 is the square root of 2 doesn't this suggest a significant genetic component in the causation, or am I nuts?

Average Joe said...

Couldn't it be a combination of stress and infection? Stress weakens the immune system which makes the body more vulnerable to infection.

Randall H said...

Stress pulls the genetic trigger.

There is evidence that schizophrenics often have relatives who, if they do not succumb to schizophrenia, are often incredibly talented and creative. A number of schizophrenics also are, prior to succumbing, and sometimes after, if they can recover. These are the suspected reasons why this disorder persists in the gene pool. If you have 4 grandkids, 3 incredibly talented, 1 a schizo in an institution, the other 3 of superior talent can often more than make up for the fact that 1 turned out to be a bad apple.

Clayton said...

The recent article in Nature where they were able to turn stem cells into schizophrenic neurons by culturing from schizophrenic fibroblasts, as well as the evidence of the mutations being on the MHC part of chromosome six, argue that there is an infectious agent involved. Infection is easier as the density goes up.

agnostic said...

"City living may have come along relatively recently in human history, but not nearly as recently as suburban living American-style. U.S.-style automobile suburbs have only been around since after WWII. "

Nah, they're more of a return to low-density, non-hierarchical, human-scale, green-filled villages from the less stratified agrarian societies or pastoralist and agro-pastoralist societies.

If suburbs were more outta-whack with human nature, we'd see more maladaptive behavior and social breakdown there than in larger cities. Of course we see the opposite.

agnostic said...

"Guys, we don't need to think NYC, Paris, London, Philly, Chicago, Hong Kong, in order to think "city.""

Click on the link that Steve gave. The study looked at three levels of density: rural as the baseline, provincial city, and capital.

Although the capital, i.e. largest, cities were the worst, the provincial cities were still worse than rural areas -- about 1.5 times the risk of schizophrenia compared to rural areas.

Anonymous said...

"the other 3 of superior talent can often more than make up for the fact that 1 turned out to be a bad apple."

Ummm, "superior talent" makes up for the fitness loss of the "bad apple"? Maybe you just didn't finish your thought?

It's offspring who survive to child-bearing age themselves that count.

"Superior talent" is nice but only if the genes that produce that superior talent get passed along to the next generation. No offspring? No surviving genes for "superior talent." Too few offspring? Trouble for those genes.

If those three "superior talents" produce only three kids, they are down three in the genetic race.
If they produce 6 offspring, they break even for the survival of their genes.

To offset the loss of fit offspring by the "bad apple",those three "superiors" have to produce kids, enough kids to break even for themselves plus the one "bad apple." That's 8 kids that need to be produced by three offspring just to break even.

It matters not that they are superior in talent. They have to reproduce in abundance.

There is no "offset" without sufficient reproductive fitness.

_______________

David Davenport said...

COunting how many posts it takes to bring the jews into this.

... because it is a simple explanation for a wide range of dysfunctional behavior

There you are.

/////////////////////

Ah, the smug religious @sshole. Nice. You can't "imagine" because you already think you know the answer. Why bother asking then?

... are grossly UNDER-represented in prisons. You'd think if they had a problem handling stress, a certain percentage of them might, you know, get violent. Like the religious folk do.


Compare to:

...The difference is that faith-based leftist tend to be a self-created angry hateful group much more than their traditional religious counterparts.

Moreso than traditional religious conservatives, leftist are bound to experience more failures and frustration by tying their religious impulses to manifestly futile causes in this world. ...

Ray Sawhill said...

"Nah, they're more of a return to low-density, non-hierarchical, human-scale, green-filled villages from the less stratified agrarian societies or pastoralist and agro-pastoralist societies."

That's a spectacularly ill-informed argument totry to make. Not a bad description of traditional villages. But the post-war American suburbs? They're incredibly hierarchical, top-down and inorganic. Subdivisions are often created by one developer, and are meant to sit higher or lower on the prestige scale compared to each other. Zoning keeps shopping, industry and residential functions separate. There's a hierarchy of road scales, from feeders to cul de sacs. You generally can't walk anywhere useful. They're deliberately designed to make you use your car.

Traditional village

http://www.oldukphotos.com/graphics/England%20Photos/Isle%20of%20Man,%20Onchan%20Village%201920%27s.jpg

Postwar US suburb

http://cache.thephoenix.com/secure/uploadedImages/The_Phoenix/News/This_Just_In/TJI_post_war_main.jpg

It's certainly OK to say you like postwar US suburbs and it certainly makes sense to argue that some of them have been successful in some ways. Hey, some people really do like eating Pringles more than eating real food. No point in denying that. But they're some of the most highly engineered environments on earth.

Steve Wood said...

Humans were meant for sociality with a known and familiar community.

At last an explanation for the popularity of Facebook!

big city suicide rates are lower than small town suicide rates.

Are you referring to the US, and, if so, did you control for race? Whites have a higher suicide rate than blacks. The rural population is whiter. Hence ...

Much as I hate the city, I find those office parks attractive with the space surrounding them and their grounds so attractively landscaped. If you have to work in an office, I'd think that'd be the way to go.

I used to think that way until I worked in one. They are pretty to look at but boring to be in 8+ hours a day. There is nothing to do in an office park but work and nothing to look at that is not work-related. Also, it's oppressive to be in a completely controlled, corporate environment all the time. There is literally nowhere to go where you aren't under your employer's (or his surrogate's) watchful eye unless you drive somewhere at lunch, and lunchtime traffic in office park-heavy areas is as brutal as rush hour traffic in the city.

Working in an office park is like working in a mill in an old-school mill town, only you have Friday's and Chili's instead corner bars.

Then again, I'm one who believes that Office Space was a documentary, so perhaps I'm not the most objective observer.

If suburbs were more outta-whack with human nature, we'd see more maladaptive behavior and social breakdown there than in larger cities. Of course we see the opposite.

That would only be true if the population were randomly distributed between city and suburb. It's more likely that socially destructive types are drawn to/stuck in the cities and largely kept out of the suburbs by economic segregation and the greater difficulty of getting away with destructive behavior in suburbia.

agnostic said...

Well, you didn't deny that post-war American suburbs, compared to larger cities, show less social disfunction, more trust and civic spirit, lower crime, less disease, more green spaces, less human eyesores (prostitutes, homeless, drunks / addicts, etc.), and so on.

Because humans flourish better in suburbs than cities, they must be closer to the range of environments that we adapted to throughout our history.

By "hierarchical," I meant more in the sense of gross, visible inequality. The social class hierarchy is a lot flatter in the burbs than in the city. And that's reflected in the buildings, too: more similar in size in the burbs, more skyscrapers in cities.

It's true that you can't walk to most businesses in the burbs, but that's not the only destination for walking. I remember people walking all over -- to see friends, say Hi to neighbors, to go to the park or to school, to just get out and enjoy the green scenery, and so on.

Cars are great too -- they put us back in touch with our animal husbanding ways (admittedly that will only feel in-touch-with-nature for people with pastoralist backgrounds). They're like our cattle or horses. We give them names, sings songs about them like herders do for their livestock, pat or stroke them when they look great, occasionally use them as beasts of burden but more often as a way to take us to exciting far-off places. We even corral them in the garage.

Tod said...

Saints, scholars, and schizophrenics: mental illness in rural Ireland By Nancy Scheper-Hughes; as the link shows schizophrenia was about 3 times more common in Eire than in England. Ireland is very rural country.

Anonymous said...

R.D. Laing said that world's 2 leading medical geneticists had agreed with him out that there was no evidence for genetic causation. people continue to kid themselves (like Eysenk did) that they have found evidence, but as Steven Rose says the claims are later quietly withdrawn.

I think the it's fetal stress that explains the city data. IE Working women in urban areas not eating properly while pregnant.

Ray Sawhill said...

"Well, you didn't deny that post-war American suburbs, compared to larger cities, show less social disfunction, more trust and civic spirit, lower crime, less disease, more green spaces, less human eyesores (prostitutes, homeless, drunks / addicts, etc.), and so on."

But isn't a huuuuuge reason for this the fact that there are -- by definition -- no poor sections in suburbs? Plus, in the 'burbs, single adults are hard to come by. I'd hazard a guess that, because schizophrenia tends to hit people around the age of 20, many adult schizophrenics are single.

FWIW, I'd take factors like these as much more powerfully explanatory than anything having to do with the 'burbs, their kinda-sorta resemblance to traditional villages, and evolutionary history.

"Because humans flourish better in suburbs than cities ..."

In what sense? Or senses? It's certainly not true culturally or intellectually (although that may change, what with the internet). The 'burbs tend to be very convenient breeding grounds and nurseries for some folks during their child-raising years ... But it's very common for these same folks, once the kids are out of the house, to move someplace a lot more "real" -- the countryside, an old village, an exciting downtown.

Not an Atheist said...

In re: the possibility of an infectious agent - y'all are aware that stress wreaks havoc with the immune system, right?!?

Anonymous said...

Living in a big DIVERSE city is stressful.

David said...

>COunting how many posts it takes to bring the jews into this.<

By my count, you were post # 27. Congratulations.

You will be tickled pink to know I've racked my brain and can't find occasion to fault-find Jews in this story.

Country Mouse raises a good point. Cities are probably more self-selected than countrysides are. While some retiring cockneys aspire to the country, it's quite plausible that a larger number of aspirationals heads for or remains in Big Apples, at least historically. That (self-selection) would seem to make a chicken-and-egg out of any causal explanation we might infer from this study.

Urban life ~ IQ Proof? said...

Urban life selects for intelligence. In fact, the single best predictor for a group's IQ is the number of generations the ancestors of that group had lived in cities.

Any citation?

I have noticed some Jewish and NE Asians (esp Chinese) friends have loved high density apartment highrise urban living while displaying an irrational fear or dislike of the more bucolic life.

This seems the very opposite of most gentile Europeans.

Blacks also seem to prefer the urban life. Hispanics - hard to say one way or the other as they start diffusing into rural red states.

agnostic said...

"But isn't a huuuuuge reason for this the fact that there are -- by definition -- no poor sections in suburbs?"

It's probably not poverty per se, as poor rural areas don't have a higher rate of crazy homeless people, prostitutes, violent and property crime, disease, etc., compared to cities.

Even urban poverty didn't produce so much degeneracy among Jews and Chinese when they first came here.

I think the lack of vileness in the burbs is more related to the trust, solidarity / cohesiveness, and willingness to band together for group defense.

That is, suburbanites were better at keeping the unwanted out of their neighborhoods because they were more socially functional, whereas the more socially dysfunctional city-dwellers couldn't band together to keep the trash away.

"In what sense? Or senses? It's certainly not true culturally or intellectually (although that may change, what with the internet)."

In the Darwinian sense. They feel more natural than large cities, they make you more healthy, and as you point out they are better for marrying and raising a family.

Los Angeles was probably the most culturally influential place in America from the 1960s through the '80s, and it was pretty spread-out and not walkable -- more like a really large collection of suburban neighborhoods.

Silicon Valley is not located in the New Urbanist-approved city of San Francisco but in the more suburban places in the Bay area. And they've been the most influential intellectually as far as science, math, and tech goes.

As for intellectual leader in the arts & humanities -- there it would seem that the urban centers were the most responsible for Marxism, psychoanalysis, postmodernism, etc. I.e., the concentration of elite schools in the Bos-Wash corridor.

agnostic said...

And even with L.A., we'd have to take into account how many of the big cultural players were living in suburbanish areas, and just making trips into the denser and more urban hubs.

I don't know about that, but my impression is that they live in the more burbsy places, and zoom in-and-out of the dense spots to hold a meeting, hammer out a contract, play a gig, or act in a movie.

Get Off My Lawn! said...

That is, suburbanites were better at keeping the unwanted out of their neighborhoods because they were more socially functional, whereas the more socially dysfunctional city-dwellers couldn't band together to keep the trash away.

Or, Occam says, suburbs generally function better and have less social pathology than cities simply because they are richer. Land costs, zoning laws, limited public transportation and geographic distances all work to keep them that way by making them inaccessible to poor people. Even rich city neighborhoods do not have that ability (although Manhattan comes close these days ... as is, as Steve has discussed many time, quite tranquil and non-pathological).

On the other hand, poor suburbs can be very dysfunctional indeed.

Anonymous said...

Does working for a large corporation cause mental problems?
Corporations are not healthy places. These places can be very anti-human.

Anonymous said...

"Humans were meant for sociality with a known and familiar community"

Exactly, now we have to go to work in large anonymous corporations with people we don't even know and have to do in many instances mundane, but detailed work very quickly. We spend more time with people we don't know than our spouse. There is something not natural about it.

When I was growing up I thought corporations would be cool places to work. Was I wrong. Offices are worse than grade school. I don't know what is better an office or a modern factory in the US. If I have to work in one I think I would choose the factory, not a chicken factory though. I was in a Ford plant in the80's and it seemed pretty nice.

David said...

>1. There is some sort of danger
2. The danger is unpredictable and there isn't any way to fight or flee; the subject feels helpless.

A perfect description of public school.<

A perfect description of life.

Assistant Village Idiot said...

And of course, there's always the cats, especially the litter boxes. More contact with cat poop, cat hair, and cat air in the city, I'd think.

http://schizophrenia.com/prevention/cats.html

Anonymous said...

http://search.comcast.net/?cat=web&con=homepage&form_submit=1&q=cochran%2Bewald&top_SearchSubmit=

Anonymous said...

http://news.smh.com.au/breaking-news-world/schizophrenia-link-to-infection-20100915-15bdp.html

http://www.slate.com/blogs/thewrongstuff/2010/09/09/stress_doesn_t_cause_ulers_or_how_to_win_a_nobel_prize_in_one_easy_lesson_barry_marshall_on_being_right.html