Chapter 12. Psychopathology: The Biology of Behavioral Disorders

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By Laura Sanders Everyone knows that the brain influences the heart. Stressful thoughts can set the heart pounding, sometimes with such deep force that we worry people can hear it. Anxiety can trigger the irregular skittering of atrial fibrillation. In more extreme and rarer cases, emotional turmoil from a shock — the death of a loved one, a cancer diagnosis, an intense argument — can trigger a syndrome that mimics a heart attack. But not everyone knows that the heart talks back. Subscribe to Science News Powerful signals travel from the heart to the brain, affecting our perceptions, decisions and mental health. And the heart is not alone in talking back. Other organs also send mysterious signals to the brain in ways that scientists are just beginning to tease apart. A bodywide perspective that seeks to understand our biology and behavior is relatively new, leaving lots of big, basic questions. The complexities of brain-body interactions are “only matched by our ignorance of their organization,” says Peter Strick, a neuroscientist at the University of Pittsburgh. Exploring the relationships between the heart, other organs and the brain isn’t just fascinating anatomy. A deeper understanding of how we sense and use signals from inside our bodies — a growing field called interoception — may point to new treatments for disorders such as anxiety. “We have forgotten that interactions with the internal world are probably as important as interactions with the external world,” says cognitive neuroscientist Catherine Tallon-Baudry of École Normale Supérieure in Paris. © Society for Science & the Public 2000–2024.

Keyword: Emotions; Depression
Link ID: 29313 - Posted: 05.18.2024

By Christina Caron Antidepressants are among the most prescribed medications in the United States. This is, in part, because the number of people diagnosed with depression and anxiety has been on the rise, and prescriptions jumped sharply among some age groups during the pandemic. Despite the prevalence of these medications, some patients have “significant misconceptions” about how the drugs work, said Dr. Andrew J. Gerber, a psychiatrist and the president and medical director of Silver Hill Hospital in New Canaan, Conn. About 80 percent of antidepressants are prescribed by primary care doctors who have not had extensive training in managing mental illness. Dr. Paul Nestadt, an associate professor of psychiatry at the Johns Hopkins School of Medicine, said patients tell him, “‘You know, Doc, I’ve tried everything.’” But often, he said, “they never got to a good dose, or they were only on it for a week or two.” Here are some answers to frequently asked questions about antidepressants. How do antidepressants work? There are many types of antidepressants, and they all work a bit differently. In general, they initiate a change in the way brain cells — and different regions of the brain — communicate with one another, said Dr. Gerard Sanacora, a professor of psychiatry at the Yale School of Medicine. Clinical trials have shown that antidepressants are generally more effective with moderate, severe and chronic depression than with mild depression. Even then, it’s a modest effect when compared with placebo. © 2024 The New York Times Company

Keyword: Depression
Link ID: 29275 - Posted: 04.30.2024

By Nicole Rust We readily (and reasonably) accept that the causes of memory dysfunction, including Alzheimer’s disease, reside in the brain. The same is true for many problems with seeing, hearing and motor control. We acknowledge that understanding how the brain supports these functions is important for developing treatments for their corresponding dysfunctions, including blindness, deafness and Parkinson’s disease. Applying the analogous assertion to mood—that understanding how the brain supports mood is crucial for developing more effective treatments for mood disorders, such as depression—is more controversial. For brain researchers unfamiliar with the controversy, it can be befuddling. You might hear, “Mental disorders are psychological, not biological,” and wonder, what does that mean, exactly? Experts have diverse opinions on the matter, with paper titles ranging from “Brain disorders? Not really,” to “Brain disorders? Precisely.” Even though a remarkable 21 percent of adults in the United States will experience a mood disorder at some point in their lives, we do not fully understand what causes them, and existing treatments do not work for everyone. How can we best move toward an impactful understanding of mood and mood disorders, with the longer-term goal of helping these people? What, if anything, makes mood fundamentally different from, say, memory? The answer turns out to be complex and nuanced—here, I hope to unpack it. I also ask brain and mind researchers with diverse perspectives to chime in. Among contemporary brain and mind researchers, I have yet to find any whose position is driven by the notion that some force in the universe beyond the brain, like a nonmaterial soul, gives rise to mood. Rather, the researchers generally agree that our brains mediate all mental function. If everyone agrees that both memory and mood disorders follow from things that happen in the brain, why would the former but not the latter qualify as “brain disorders”? © 2024 Simons Foundation

Keyword: Depression; Learning & Memory
Link ID: 29251 - Posted: 04.11.2024

By Esther Landhuis When Angela Tang’s teenage son came down with a baffling illness, few households could have been better equipped to deal with it. The family lives in a wealthy Los Angeles suburb. Both parents are doctors — Tang in internal medicine, her husband in infectious disease — and their son, a straight-A student well-liked at school, had been cared for by the family’s pediatrician since birth. Still, the parents worried as their son’s symptoms appeared, seemingly out of the blue, in September 2018: He’d meticulously line up pencils in groups of five, recite prayers unrelentingly, make homework illegible as he had to erase or cross out every C, D, and F. Eating, too, became a chore. If he had a contaminating thought while taking a bite, he’d have to spit out the food, wash his mouth, and try again, but the new bite couldn’t have touched the old one. It got to the point where he could only eat mushy or semi-liquid foods carefully placed “in little aliquots on his plate, so that if one bite got contaminated,” it wouldn’t touch the others, Tang said. Before long, she and her husband were working around the clock just to get him through the day. In a panic, Tang consulted their pediatrician, and recalls the doctor asking an intriguing question: “Has he had any unusual infections recently — because you know about PANDAS, right?” At the time, Tang knew nothing about PANDAS. She had completed her own medical residency two years before the illness — short for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections — was first outlined in a 1998 paper. That publication detailed how a child’s behavior could change alarmingly after a strep infection, and may include symptoms of obsessive-compulsive behavior and tics. It has also stirred controversy: Many doctors hesitate to diagnose or treat the condition even today.

Keyword: OCD - Obsessive Compulsive Disorder; Neuroimmunology
Link ID: 29241 - Posted: 04.04.2024

By Charles Digges My default mode for writing term papers during my student days was the all-night slog, and I recall the giddy, slap-happy feeling that would steal over me as the sun rose. There was a quality of alert focus that came with it, as well as a gregariousness that would fuel bonding sessions with my other all-night companions. After we’d turned in the products of our midnight oil to our professors, we would all head out for pancakes. Then I’d go home and sleep the magic off. For years, I’d wondered if there was any basis for this temporary euphoria that I—though certainly not all my classmates—experienced after those sleepless nights. That I should feel so expansive and goofy after skipping sleep while many of them turned into drowsy grouches seemed to defy logic. Going without sleep isn’t supposed to be a good thing, especially for folks who experience depression, as I have. But it turns out this paradox has been the subject of inquiry for at least two centuries. In 1818, University of Leipzig psychiatrist Johann Christian August Heinroth was reportedly the first to suggest that partial or total sleep deprivation could be temporarily effective against “melancholia,” as depression was called in those days. He found this to be true only in a certain subset of patients—around 60 percent. More than a hundred years later, in the 1970s, evidence emerged that a “resynchronization” of disturbed circadian rhythms could be responsible for the improved moods of depressed patients after a night without sleep. And more recently, researchers have found that a neurotransmitter involved in reward known as dopamine may play a role in this effect, as may neuroplasticity—the nervous system’s ability to rearrange itself in response to stimuli. But the precise neural mechanisms responsible have remained unclear. © 2024 NautilusNext Inc.,

Keyword: Sleep; Depression
Link ID: 29220 - Posted: 03.28.2024

By David Adam The drug ketamine is enjoying a second life. First developed as an anaesthetic that was used widely by US battlefield surgeons during the Vietnam war, it is growing in popularity as a treatment for depression and other mental-health conditions. And this week, the drug got its highest-profile endorsement yet. In an interview with US journalist Don Lemon that was released online on Monday, Elon Musk, founder of SpaceX and head of social-media platform X (formerly Twitter), spoke about his own experiences of using the drug to manage what he called a “negative chemical state” similar to depression. Musk said he has a prescription for the drug from “a real doctor” and uses “a small amount once every other week or something like that”. His comments follow the fatal drowning of Friends actor Matthew Perry last October, an incident that an investigation blamed on the drug’s acute effects. It’s complicated. Approved as an anaesthetic by the US Food and Drug Administration in 1970, the drug was delivered intravenously to people undergoing surgery. Ketamine is often still given that way for depression. That requires supervision — typically people attend a private clinic and are monitored by an anaesthetist as well as the prescribing psychiatrist and members of the support staff. Because it’s long out of patent, there’s little commercial interest in developing new versions of the drug. Some companies are trying to package it into more-convenient oral lozenges, but that’s a challenging formulation. “The problem with ketamine is if you take it orally, by and large it doesn’t get through to the system because it’s got low bioavailability,” says Allan Young, a consultant psychiatrist at King’s College London who studies mood disorders.

Keyword: Depression; Drug Abuse
Link ID: 29210 - Posted: 03.23.2024

By Sara Reardon For the past few decades, scientists studying candidate antidepressant drugs have had a convenient animal test: how long a rodent dropped in water keeps swimming. Invented in 1977, the forced swim test (FST) hinged on the idea that a depressed animal would give up quickly. It seemed to work: Antidepressants and electroconvulsive therapy often made the animal try harder. The test remains popular, appearing in about 600 papers per year. But researchers have recently begun to question the assumption that the test really gauges depression and is a good predictor of human responses to drugs. Opposition to the test is snowballing, driven in part by concerns it is unnecessarily cruel given its spotty results. This month, following similar moves by the Australian government, the United Kingdom’s Home Office announced it would require U.K. researchers to justify the use of the test and would encourage other U.K. ministries that regulate animal research to “completely eliminate” it. Such changes add urgency to efforts to develop better animal tests of psychiatric drugs’ effects. Neurobiologist Anne Mallien of Heidelberg University, who studies the effects of the FST on rodents’ well-being, says she would love to have other options. “The thing is that alternatives are somewhat missing.” In the FST, researchers put a mouse or rat in a container of water, usually for about 5 minutes, and time how long it exerts itself before giving up and simply floating. Rodents will often swim longer when treated with psychiatric drugs. “But does that mean something for [human medicine]?” says neuroscientist Carole Morel at the Icahn School of Medicine at Mount Sinai. The rodents’ high stress levels could complicate the results, and an intelligent animal quickly learns that researchers will rescue it once it gives up.

Keyword: Depression; Animal Rights
Link ID: 29201 - Posted: 03.21.2024

By Elizabeth Landau Electroconvulsive therapy has a public relations problem. The treatment, which sends electric currents through the brain to induce a brief seizure, has barbaric, inhumane connotations — for example, it was portrayed as a sadistic punishment in the film One Flew Over the Cuckoo’s Nest. But for patients with depression that does not improve with medications, electroconvulsive therapy (ECT) can be highly effective. Studies have found that some 50% to 70% of patients with major depressive disorder see their symptoms improve after a course of ECT. In comparison, medications aimed at altering brain chemistry help only 10% to 40% of depression patients. Still, even after many decades of use, scientists don’t know how ECT alters the brain’s underlying biology. Bradley Voytek, a neuroscientist at the University of California, San Diego, said a psychiatrist once told him that the therapy “reboots the brain” — an explanation he found “really unsatisfying.” Recently, Voytek and his collaborators paired their research into the brain’s electrical patterns with patient data to explore why inducing seizures has antidepressant effects. In two studies published last fall, the researchers observed that ECT and a related seizure therapy increased the unstructured background noise hiding behind well-defined brain waves. Neuroscientists call this background noise “aperiodic activity.” The authors suggested that induced seizures might help restore the brain’s balance of excitation and inhibition, which could have an overall antidepressant effect. “Every time that I talk to someone who’s not in this field about this work they’re like, ‘They still do that? They still use electroshock? I thought that was just in horror movies,’” said Sydney Smith, a graduate student in neuroscience in Voytek’s lab and the first author of the new studies. “Dealing with the stigma around it has become even more of a motivation to figure out how it works.” © 2024 Simons Foundation.

Keyword: Depression; Attention
Link ID: 29199 - Posted: 03.19.2024

By Ben Seal When Oregon’s first psilocybin service center opened in June 2023, allowing those over 21 to take mind-altering mushrooms in a state-licensed facility, the psychedelic revival that had been unfolding over the past two decades entered an important new phase. Psilocybin is still illegal on the federal level. But now, as researchers explore the therapeutic potential of psilocybin and other psychedelics, including LSD and MDMA (also known as Molly or ecstasy), legal reform efforts are spreading across the country — raising tensions between state and federal laws. As a class, psychedelic drugs were outlawed in the United States by the Controlled Substances Act of 1970. The act designated psychedelics as Schedule I drugs — the most restrictive classification, indicating a high potential for abuse and no accepted medical use. That status limits research to federally approved scientific studies and restricts federal funding to research with “significant medical evidence of a therapeutic advantage.” Despite these limitations, researchers have demonstrated the potential of psychedelics in the treatment of post-traumatic stress disorder, major depressive disorder, anxiety and addiction. A 2020 systematic review of recent research found that psychedelics can lessen symptoms linked to a variety of mental health conditions. While that review found no serious, long-term adverse physical or psychological effects from ingesting psychedelics, more research is needed on the latter. Today, decades after research on the effects of hallucinogens on the brain was sidelined by the act, academic and cultural interest in psychedelics is on the rise. More than 60 percent of Americans now support regulated therapeutic use of psychedelics, while nearly half support decriminalization, and nearly 45 percent support spiritual and religious use. An estimated 5.5 million US adults use psychedelics each year.

Keyword: Depression; Drug Abuse
Link ID: 29189 - Posted: 03.16.2024

By Ellen Barry Twins are a bonanza for research psychologists. In a field perpetually seeking to tease out the effects of genetics, environment and life experience, they provide a natural controlled experiment as their paths diverge, subtly or dramatically, through adulthood. Take Dennis and Douglas. In high school, they were so alike that friends told them apart by the cars they drove, they told researchers in a study of twins in Virginia. Most of their childhood experiences were shared — except that Dennis endured an attempted molestation when he was 13. At 18, Douglas married his high school girlfriend. He raised three children and became deeply religious. Dennis cycled through short-term relationships and was twice divorced, plunging into bouts of despair after each split. By their 50s, Dennis had a history of major depression, and his brother did not. Why do twins, who share so many genetic and environmental inputs, diverge as adults in their experience of mental illness? On Wednesday, a team of researchers from the University of Iceland and Karolinska Institutet in Sweden reported new findings on the role played by childhood trauma. Their study of 25,252 adult twins in Sweden, published in JAMA Psychiatry, found that those who reported one or more trauma in childhood — physical or emotional neglect or abuse, rape, sexual abuse, hate crimes or witnessing domestic violence — were 2.4 times as likely to be diagnosed with a psychiatric illness as those who did not. If a person reported one or more of these experiences, the odds of being diagnosed with a mental illness climbed sharply, by 52 percent for each additional adverse experience. Among participants who reported three or more adverse experiences, nearly a quarter had a psychiatric diagnosis of depressive disorder, anxiety disorder, substance abuse disorder or stress disorder. © 2024 The New York Times Company

Keyword: Depression; Genes & Behavior
Link ID: 29184 - Posted: 03.07.2024

NIH-funded study shows prenatal mental health support is effective for women living in low-resource settings. Results from a large clinical trial funded by the National Institutes of Health show that an intervention for anxiety provided to pregnant women living in Pakistan significantly reduced the likelihood of the women developing moderate-to-severe anxiety, depression, or both six weeks after birth. The unique intervention was administered by non-specialized providers who had the equivalent of a bachelor’s degree in psychology—but no clinical experience. The results suggest this intervention could be an effective way to prevent the development of postpartum mental health challenges in women living in low-resource settings. “In low resource settings, it can be challenging for women to access mental health care due to a global shortage of trained mental health specialists,” said Joshua A. Gordon, M.D., Ph.D., Director of the National Institute of Mental Health, part of NIH. “This study shows that non-specialists could help to fill this gap, providing care to more women during this critical period." Led by Pamela J. Surkan, Ph.D., Sc.D.(link is external), of Johns Hopkins Bloomberg School of Public Health, Baltimore, the study was conducted in the Punjab Province of Pakistan between April 2019 and January 2022. Pregnant women with symptoms of at least mild anxiety were randomly assigned to receive either routine pregnancy care or a cognitive behavioral therapy (CBT)-based intervention called Happy Mother-Healthy Baby. The researchers assessed the participants (380 women in the CBT group and 375 women in the routine care group) for anxiety and depression six weeks after the birth of their child.

Keyword: Depression; Sexual Behavior
Link ID: 29165 - Posted: 02.27.2024

Ayana Archie The monthly rate of antidepressants being dispensed to young people increased about 64% more quickly during the coronavirus pandemic, according to a study published Monday in the journal Pediatrics. Researchers used the IQVIA Longitudinal Prescription Database to examine a sample of about 221 million prescriptions written for millions of Americans between the ages 12 to 25, and from 2016 to 2022. Researchers additionally separated the data into before and after March 2020, when the pandemic started. The increase was prominent among young women and girls. The monthly rate increased about 130% faster among 12- to 17-year-old girls, and about 57% faster among young women between the ages of 18 and 25. The study hypothesizes this jump could be due to high rates of depression or anxiety, better access to health care, due to things such as telehealth, or people's reliance on prescriptions because of long waitlists for therapy during the pandemic. The dataset includes prescriptions dispensed from "retail, mail-order, and long-term care pharmacies in the United States," the study says, not exclusive health care systems, such as Kaiser Permanente. Conversely, during the pandemic, the monthly antidepressant dispensing rate decreased for boys between the ages of 12 to 17 and did not change for young men between 18 and 25. Though, data shows more male adolescents were sent to the emergency room for suspected suicide attempts in early 2021, compared to early 2019. Between 2019 and 2021, male high school students also reported constantly feeling sad or hopeless more often, according to the researchers. © 2024 npr

Keyword: Depression
Link ID: 29164 - Posted: 02.27.2024

By Pam Belluck Jennifer Caldwell was active and energetic, working two jobs and taking care of her daughter and her parents, when she developed a bacterial infection that was followed by intense lightheadedness, fatigue and memory problems. That was nearly a decade ago, and she has since struggled with the condition known as myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS. Ms. Caldwell, 56, of Hillsborough, N.C., said she went from being able to ski, dance and work two jobs as a clinical research coordinator and a caterer to needing to stay in bed most of every day. “I haven’t been right since, and I haven’t worked a day since,” said Ms. Caldwell, whose symptoms include severe dizziness whenever her legs are not elevated. The condition has also “messed me up cognitively,” she said. “I can’t read something and comprehend it very well at all, I can’t remember new things. It’s kind of like being in a limbo state. That’s how I describe it, lost in limbo.” Seven years ago, the National Institutes of Health began a study of patients with ME/CFS, and Ms. Caldwell became one of 17 participants who engaged in a series of tests and evaluations of their blood, bodies and brains. Findings from the study, which was published on Wednesday in the journal Nature Communications, showed notable physiological differences in the immune system, cardio-respiratory function, gut microbiome and brain activity of the ME/CFS patients compared with a group of 21 healthy study participants. Medical experts said that even though the study was a snapshot of a small number of patients, it was valuable, partly because ME/CFS has long been dismissed or misdiagnosed. The findings confirm that “it’s biological, not psychological,” said Dr. Avindra Nath, the chief of infections of the nervous system at the National Institute of Neurological Disorders and Stroke, who led the study. © 2024 The New York Times Company

Keyword: Neuroimmunology; Depression
Link ID: 29157 - Posted: 02.22.2024

By Matt Richtel Growing numbers of children and adolescents are being prescribed multiple psychiatric drugs to take simultaneously, according to a new study by researchers at the University of Maryland. The phenomenon is increasing despite warnings that psychotropic drug combinations in young people have not been tested for safety or studied for their impact on the developing brain. The study, published Friday in JAMA Open Network, looked at the prescribing patterns among patients 17 or younger enrolled in Medicaid from 2015 to 2020 in a single U.S. state that the researchers declined to name. In this group, there was a 9.5 percent increase in the prevalence of “polypharmacy,” which the study defined as taking three or more different classes of psychiatric medications, including antidepressants, mood-stabilizing anticonvulsants, sedatives and drugs for A.D.H.D. and anxiety drugs. The study looked at only one state, but state data have been used in the past to explore this issue, in part because of the relative ease of gathering data from Medicaid, the health insurance program administered by states. At the same time, some research using nationally weighted samples have revealed the increasing prevalence of polypharmacy among young people. One recent paper drew data from the National Ambulatory Medical Care Survey and found that in 2015, 40.7 percent of people aged 2 to 24 in the United States who took a medication for A.D.H.D. also took a second psychiatric drug. That figure had risen from 26 percent in 2006. The latest data from the University of Maryland researchers show that, at least in one state, the practice continues to grow and “was significantly more likely among youths who were disabled or in foster care,” the new study noted. Mental health experts said that psychotropic medications can prove very helpful and that doctors have discretion to prescribe what they see fit. A concern among some experts is that many drugs used in frequently prescribed cocktails have not been approved for use in young people. And it is unclear how the simultaneous use of multiple psychotropic medications affects brain development long-term. © 2024 The New York Times Company

Keyword: Depression; Development of the Brain
Link ID: 29152 - Posted: 02.20.2024

Rhitu Chatterjee In recent years, there's been growing interest in psilocybin, the psychoactive ingredient in "magic mushrooms" or "shrooms" as a potentially beneficial therapy for mental health conditions. At the same time, drug busts of mushrooms went way up between 2017 and 2022, and the amount of the psychedelic substance seized by law enforcement more than tripled, according to a new study. "What I think the results indicate is that shroom availability has likely been increasing," says Joseph Palamar, an epidemiologist at NYU Langone Health and the main author of the new study published in the journal Drug and Alcohol Dependence. Sponsor Message The findings come at a time when there's a "psychedelic renaissance" happening in the country, says Dr. Joshua Siegel of Washington University in St. Louis, who wasn't involved in the new study. There's growing public and scientific interest in psychedelics' potential therapeutic effects on various mental and behavioral health issues, says Siegel, who also studies how psychedelics affect the human brain. At the same time, a small number of states have already decriminalized psychedelic drugs, and many more are looking into doing the same. The new study is "an important part of the bigger picture of where we are headed as a nation" with psychedelics, says Siegel. "It's important to understand what's happening in terms of the health care side of things. It's important to understand what's happening recreationally and legally." The new study found that the total amount of mushrooms seized by law enforcement across the country went from nearly 500 pounds in 2017 to more than 1,800 pounds in 2022. The largest amount (42.6% of total) seized was in the West, followed closely by the Midwest (41.8%). © 2024 npr

Keyword: Drug Abuse; Depression
Link ID: 29141 - Posted: 02.08.2024

By Ernesto Londoño Seizures of psychedelic mushrooms across the nation by law enforcement officials have increased significantly in recent years as attitudes regarding their use have grown more permissive, according to a government-funded study released Tuesday. Researchers found that law enforcement officials confiscated 844 kilos of mushrooms containing psilocybin in 2022, an increase of 273 percent from 2017. Psilocybin is the psychoactive component in the fungi commonly known as magic mushrooms. Officials at the National Institute on Drug Abuse, which commissioned the study, said that the increase in seizures of magic mushroom reflected rising use of the drugs, rather than an indication that counternarcotics officials were pursuing the substances more aggressively than before. The marketplace for magic mushrooms, which are illegal under federal law, has boomed in recent years as several clinical studies have shown that they may be effective as therapies to treat depression and other serious conditions. But many medical professionals say they worry that the hype surrounding psychedelics has moved faster than the science. Dr. Nora Volkow, the director of the N.I.D.A, said that preliminary clinical studies had shown that psychedelics might one day become an important tool for the treatment of psychiatric disorders, including addiction to other drugs. But she said she worried that many people were self-medicating with psychedelics. “Psychedelic drugs have been promoted as a potential cure for many health conditions without adequate research to support these claims,” Dr. Volkow said. “There are people who are very desperate for mental health care, and there are businesses that are very eager to make money by marketing substances as treatments or cures.” © 2024 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 29130 - Posted: 02.06.2024

Dawn Megli In late 2022, Sarah Gutilla's treatment-resistant depression had grown so severe that she was actively contemplating suicide. Raised in foster care, the 34-year-old's childhood was marked by physical violence, sexual abuse and drug use, leaving her with life-threatening mental scars. Out of desperation, her husband scraped together $600 for the first of six rounds of intravenous ketamine therapy at Ketamine Clinics Los Angeles, which administers the generic anesthetic for off-label uses such as treating depression. When Gutilla got into an Uber for the 75-mile ride to Los Angeles, it was the first time she had left her home in Llano, Calif., in two years. The results, she says, were instant. "The amount of relief I felt after the first treatment was what I think 'normal' is supposed to feel like," she says. "I've never felt so OK and so at peace." For-profit ketamine clinics have proliferated over the past few years, offering infusions for a wide array of mental health issues, including obsessive-compulsive disorder, depression and anxiety. Although the off-label use of ketamine hydrochloride, a Schedule III drug approved by the Food and Drug Administration as an anesthetic in 1970, was considered radical just a decade ago, now between 500 and 750 ketamine clinics have cropped up across the United States. Market analysis firm Grand View Research pegged industry revenues at $3.1 billion in 2022, and it projects them to more than double to $6.9 billion by 2030. Most insurance doesn't cover ketamine for mental health, so patients must pay out-of-pocket. While it's legal for doctors to prescribe ketamine, the FDA hasn't approved it for mental health treatment, which means that individual practitioners develop their own treatment protocols. The result is wide variability among providers, with some favoring gradual, low-dosage treatments while others advocate larger amounts that can induce hallucinations, as the drug is a psychedelic at the right doses. "Ketamine is the Wild West," says Dustin Robinson, the managing principal of Iter Investments, a venture capital firm specializing in hallucinogenic drug treatments. © 2024 npr

Keyword: Depression; Drug Abuse
Link ID: 29129 - Posted: 02.03.2024

By Sandra G. Boodman On the day after Christmas 2021, Abigail Aguilar, 18, and nearly three months pregnant, walked into her mother’s bedroom and in a flat, emotionless voice announced, “Mom, I’m going to slit my throat.” For weeks Quintina Sims had grappled with her daughter’s increasingly bizarre and frightening behavior. Aguilar had also been plagued by unremitting nausea, splitting headaches and weakness so severe her stepfather sometimes had to carry her to the bathroom. Doctors had largely brushed off her symptoms as the normal manifestations of early pregnancy. Aguilar’s threat triggered a cascade of events that would end in a hospital 130 miles south of her Kern County, Calif., home where doctors mobilized in an effort to discover what was making the previously healthy teenager so sick. After treatment after treatment failed, Sims, now 42, would be called upon to make what she called “the hardest decision of my life” — one that appears to have saved her daughter. Aguilar, who will turn 21 in a few weeks, is now working full time as a preschool teacher’s assistant and studying child development at a community college. She remembers very little of her harrowing six-week stay at Loma Linda University Medical Center, but says the months she spent recovering proved to be clarifying. “It made me realize that I had to value my life a lot more,” Aguilar said. “And I learned that my family was always going to be there for me.” An unexpected surprise In the fall of 2021, Aguilar, a recent high school graduate, was living with her grandparents in Los Angeles, working in a movie theater and going to college part time. In October, she discovered she was pregnant; the baby was due in July 2022. “It was a surprise,” she recalled. Aguilar, who was unmarried, struggled with what to do. She decided to have the baby, a decision her mother supported. “At first everything was fine,” Aguilar said.

Keyword: Schizophrenia; Hormones & Behavior
Link ID: 29112 - Posted: 01.23.2024

Ian Sample Science editor From Cain and Abel and the Brothers Karamazov to Cinderella, the warmth and support provided by siblings has hardly been taken for granted. Now, researchers have found that children who moan about their brothers and sisters may have good reason to complain: the more siblings teenagers have, the more it hits their happiness, they claim. A study of secondary schoolchildren in the US and China found that those from larger families had slightly poorer mental health than those from smaller families. The greatest impact was seen in families with multiple children born less than a year apart. Doug Downey, a professor of sociology at Ohio State University, said previous work in the field had revealed a mixed picture of positives and negatives for children with more siblings, adding that the latest results “were not a given”. The researchers asked 9,100 eighth graders in the US and 9,400 in China, with an average age of 14, a range of questions about their mental health, though the specific questions varied between the countries. In China, the teenagers with no siblings fared best for mental health. In the US, children who had no siblings or only one were found to have similar mental health. Overall, mental health was worse the more siblings the teenagers had, with greater impacts seen for teenagers with older siblings, and when brothers and sisters were closely spaced in age. Writing in the Journal of Family Issues, Downey and his colleagues argue that the findings are in line with the “resource dilution” explanation, the driving force behind the unwritten formula that states that the number of balls dropped rises, sometimes dramatically, with the number of siblings born. © 2024 Guardian News & Media Limited

Keyword: Depression; Development of the Brain
Link ID: 29101 - Posted: 01.16.2024

By Meryl Davids Landau When Brian Meyer received a Stage 4 prostate cancer diagnosis three years ago at age 62, he was determined to make the most of his remaining years. He immediately retired from a decades-long career in the grocery business and took every opportunity to hike, camp and — his all-time favorite — fish for salmon. Brian and his wife, Cheryl, regularly visited their two grown children and three grandsons and spent time with their many friends. But it was sometimes hard to keep his mind off his pain and the reality that life was nearing an end. “It tugs at the heart all the time,” Meyer, from Vancouver Island, British Columbia, said in August. A calm person by nature, he found his anxiety skyrocketing. By November, though, despite a new, highly aggressive liver cancer that shrank his prognosis to months or weeks, Meyer felt calm much of the time. The prime reason: a 25-milligram dose of the psychedelic drug psilocybin he had taken several months earlier, due to a Canadian program being watched elsewhere for the emotional benefits it may offer people nearing death. In mid-August, Meyer and nine other people with terminal cancers had gathered in two rooms, and there, lying on plush floor mats with blankets covering their bodies, their eyes covered by sleeping masks and music piped in over headphones, they swallowed the psilocybin capsules. The consciousness-altering drug, administered by the nonprofit Vancouver Island wellness center Roots to Thrive, set Meyer and the others on a six-hour journey of fantastical images and thoughts. The hope was that this “trip” would lead to lasting improvements in mood and lessen their angst around death. It was accompanied by weeks of Zoom group therapy sessions before and after, along with an in-person gathering the evening before for a medical clearance and the opportunity for participants and their spouses to meet in person.

Keyword: Drug Abuse; Stress
Link ID: 29100 - Posted: 01.16.2024