Let’s assume that valence/salience proves correct.
This would allow use to re-target our understanding of these conditions to issues with either an imbalance of valence and/or salience targets, or lack of a target altogether.
A common form of depression, “Habenular depression”, would indicate that a salience signal was not being processed in the habenula. This lack of “how much” disables the generation of valence (“Want/don’t want”) as valence is generated as a derivative of salience.
Anxieties represent the opposite, a generation of a high salience signal, but a disabled valence signal being generated. Very high how much, but no “want/don’t want”. Anxieties are the lack of ability to create a behavioral choice, It’s the feeling of uncertainty due to lack of valence generation. These are expensive, and brains have a mechanism to clear the state of these decision centers by disabling the salience signal to them.
I’m not sure that “motivation” is anything other than the generation of a strong valence signal. This seems to be the primary target of most electrical stimulation methods, they simply hijack one side of the valence calculation model to invoke a particular point in the decision tree.
From a treatment perspective, we need to first determine if the issue is lack of salience signal or lack of appropriately strong valence to counter all of the other valence signals coming in from different areas. Once we’ve determined this, salience can be addressed by providing agonism to the signal in the brain stem. This is probably why “dopamine” seems to be the answer for everything, it’s role as the global salience signal is fundamental to the generation of any non-templated valence response.
For valence, the issue is that we aren’t generating a strong enough signal to overcome competing signals. This smells like the dentate gyrus might be a really good target here. Figuring out how to either suppress competing valence signals or boost our desired signal should be effective under this framework. I’m curious what TMS targeted toward various nuclei in the hypothalamic area could do here. Can we manipulate the valence template to produce more/less effects? This would be an interesting way to prove out this model.
From an externally driven standpoint, we need to create artificial salience when it doesn’t exist. This would require either an intense external social bind, or figuring out how to commit intensely to a specific concept, and building other behavior off of that. When we look at zealots, they never lack motivation because they always have a high valence calculation base to draw from. Figuring out what someone does really want, or artificially inducing that seems like an effective path here.
This also has an interesting commentary on depression and social stability in general, when societies provide a less powerful social bind (artificial valence) we tend to notice a rise in depression rates in those societies. This is something I need to look into over the next few days, if there’s a correlation between the “division” within a society and depression/anxiety etiologies.