Chapter 12. Psychopathology: The Biology of Behavioral Disorders

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By BENEDICT CAREY LONDON — England is in the midst of a unique national experiment, the world’s most ambitious effort to treat depression, anxiety and other common mental illnesses. The rapidly growing initiative, which has gotten little publicity outside the country, offers virtually open-ended talk therapy free of charge at clinics throughout the country: in remote farming villages, industrial suburbs, isolated immigrant communities and high-end enclaves. The goal is to eventually create a system of primary care for mental health not just for England but for all of Britain. At a time when many nations are debating large-scale reforms to mental health care, researchers and policy makers are looking hard at England’s experience, sizing up both its popularity and its limitations. Mental health care systems vary widely across the Western world, but none have gone nearly so far to provide open-ended access to talk therapies backed by hard evidence. Experts say the English program is the first broad real-world test of treatments that have been studied mostly in carefully controlled lab conditions. The demand in the first several years has been so strong it has strained the program’s resources. According to the latest figures, the program now screens nearly a million people a year, and the number of adults in England who have recently received some mental health treatment has jumped to one in three from one in four and is expected to continue to grow. Mental health professionals also say the program has gone a long way to shrink the stigma of psychotherapy in a nation culturally steeped in stoicism. “You now actually hear young people say, ‘I might go and get some therapy for this,’” said Dr. Tim Kendall, the clinical director for mental health for the National Health Service. “You’d never, ever hear people in this country say that out in public before.” A recent widely shared video of three popular royals — Prince William, Prince Harry and Kate, Dutchess of Cambridge — discussing the importance of mental health care and the princes’ struggles after their mother’s death is another sign of the country’s growing openness about treatment. © 2017 The New York Times Company

Keyword: Depression
Link ID: 23876 - Posted: 07.25.2017

/ By Ed Cara Ariella Cohen had already made nearly a dozen visits in as many months to a Philadelphia emergency room when, in the winter of 2014, she once again grabbed her pre-packed overnight bag and rushed to the hospital with crippling intestinal pain. She didn’t have high expectations: At just 26, she and her family had seen close to 100 doctors and amassed hundreds of thousands of dollars in medical bills attempting to identify and treat the source of her pain, and she arrived with a long-ago memorized script of the many diagnoses she had received since her childhood. As she sat on a gurney, Cohen recalls calmly explaining her situation to the attending physician. Like so many times before, her body was in mutiny: The assembly line of muscles along her gut had frozen, and she had been constipated for months, with the resulting pain sometimes scorching her insides. That day it had become so horrendous that she collapsed, prompting two of her regular doctors, fearing that the stoppage might tear a hole in her lower intestine, to advise she go to the ER immediately. According to Cohen, the ER physician that day simply dismissed her symptoms without an examination. If anything was wrong, he implied, it was mental, not physical, and he refused to admit her. Later that winter, during a raging snowstorm, her agony came again, but despite calling ahead to the ER and being told she could see another physician, the same doctor came around again as she was being examined and told her to go home. Copyright 2017 Undark

Keyword: Depression
Link ID: 23875 - Posted: 07.25.2017

By Daisy Yuhas, When the shy, dark-haired boy met with clinicians for a full psychiatric evaluation two years ago, almost everything about him pointed to autism. W. had not spoken his first words until age 2. He was at least 4 before he could form sentences. As he got older, he was unable to make friends. He struggled to accept changes to his routine and maintain eye contact. And despite having an average intelligence quotient, he was unusually attached to objects; at age 11, he still lugged a bag of stuffed animals with him everywhere he went. But something else was clearly at work, too. “He had these things that he would call day dreams,” recalls Jennifer Foss-Feig, assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York. When she evaluated W., she noticed that he would often gaze into an empty corner of the room—particularly when he seemed to suspect that she wasn’t paying attention to him. (For privacy reasons, Foss-Feig declined to reveal anything but the child’s first initial.) Occasionally, he would speak to that space, as though someone else were there. His parents, she recalls, were worried. They explained to Foss-Feig that their son had what he called an “imaginary family.” But W.’s invisible playmates weren’t of the usual harmless variety that many children have; they seemed to be a dangerous distraction both at home and at school. On one occasion, he wandered through a busy parking lot, seemingly oblivious to the oncoming traffic. © 2017 Scientific America

Keyword: Autism; Schizophrenia
Link ID: 23874 - Posted: 07.25.2017

By Sharon Begley, STAT Lab mice whose brains were injected with cells from schizophrenia patients became afraid of strangers, slept fitfully, felt intense anxiety, struggled to remember new things, and showed other signs of the mental disorder, scientists reported on Thursday. The latest advance in “chimeras,” animals created by transplanting cells from one species into another, demonstrated the value of the technique, scientists not involved in the study said, but is likely to draw renewed attention to a controversial field that opponents see as deeply immoral and undermining the natural order. Under a 2015 moratorium, the National Institutes of Health does not fund research that transplants human stem cells into early embryos of other animals. When the NIH asked for public comment on lifting the moratorium, it received nearly 20,000 responses, almost all objecting to “grossly unethical research”; many mentioned Frankenstein. But the new study, in Cell Stem Cell, injected human cells into newborn mice, not embryos. It received funding from the NIH as well as private foundations, to unravel how brain development goes off the rails to cause schizophrenia. Although the prevailing idea has been that the devastating disease, which strikes some 1 percent of U.S. adults, is primarily caused by something going wrong with neurons, the scientists suspected the brain’s support cells, called glia. © 2017 Scientific American,

Keyword: Schizophrenia; Glia
Link ID: 23863 - Posted: 07.22.2017

By Jack Turban Fourteen-year-old Nicole, whose name I changed for her privacy, told her mother every day for years that she wanted to end her own life. Between suicide attempts were more psychiatric hospital visits than she or her mother could count. She refused to get out of bed, shower, or go to school, missing sixty school days in a single year. In one visit with her therapist, she admitted to praying every night that she would not wake up the next morning. After countless psychiatrists and psychotherapists were unable to improve her depression, her mother converted a bathroom cabinet into a locked safe, containing all of the sharp objects and pills in the house. Her parents were certain it was only a matter of time until Nicole killed herself. Today, a now seventeen-year-old Nicole greets me with a big smile. Her blonde hair is pulled back into a ponytail to reveal her bright blue eyes. She tells me she hasn’t missed a day of school and is preparing for college. Blushing, she lets me know that her first date is coming up, a prom date to be precise. For the first time in years, she is happy and wants to live. What happened to cause this dramatic change? In December, Nicole started infusions of a psychedelic drug called ketamine. Though she had failed to respond to endless medication trials for her depression (selective serotonin reuptake inhibitors, mirtazapine, topiramate, antipsychotics, and lithium to name just a few), ketamine cleared her depression within hours. The effect lasts about two weeks before she needs a new infusion. © 2017 Scientific America

Keyword: Depression; Development of the Brain
Link ID: 23850 - Posted: 07.19.2017

By Aaron Reuben, Jonathan Schaefer Most of us know at least one person who has struggled with a bout of debilitating mental illness. Despite their familiarity, however, these kinds of episodes are typically considered unusual, and even shameful. New research, from our lab and from others around the world, however, suggests mental illnesses are so common that almost everyone will develop at least one diagnosable mental disorder at some point in their lives. Most of these people will never receive treatment, and their relationships, job performance and life satisfaction will likely suffer. Meanwhile the few individuals who never seem to develop a disorder may offer psychology a new avenue of study, allowing researchers to ask what it takes to be abnormally, enduringly, mentally well. Epidemiologists have long known that, at any given point in time, roughly 20 to 25 percent of the population suffers from a mental illness, which means they experience psychological distress severe enough to impair functioning at work, school or in their relationships. Extensive national surveys, conducted from the mid-1990s through the early 2000s, suggested that a much higher percentage, close to half the population, would experience a mental illness at some point in their lives. These surveys were large, involving thousands of participants representative of the U.S. in age, sex, social class and ethnicity. They were also, however, retrospective, which means they relied on survey respondents’ accurate recollection of feelings and behaviors months, years and even decades in the past. Human memory is fallible, and modern science has demonstrated that people are notoriously inconsistent reporters about their own mental health history, leaving the final accuracy of these studies up for debate. Of further concern, up to a third of the people contacted by the national surveys failed to enroll in the studies. Follow-up tests suggested that these “nonresponders” tended to have worse mental health. © 2017 Scientific American

Keyword: Schizophrenia; Depression
Link ID: 23837 - Posted: 07.14.2017

Dean Burnett Antidepressants; the go-to treatment for depression, or generalised anxiety. It’s incredible when you think about it, the fact that you can have a debilitating mood disorder, take a few pills, and feel better. It’s unbelievable that medical science has progressed so far that we now fully understand how the human brain produces moods and other emotions, so can manipulate them with designer drugs. That’s right, it is unbelievable. Because it isn’t the case. The fact that antidepressants are now so common is something of a mixed blessing. On one hand, anything that helps reduce stigma and lets those afflicted know they aren’t alone can only be helpful. Depression is incredibly common, so this awareness can literally save many lives. On the other hand, familiarity does not automatically mean understanding. Nearly everyone has a smartphone these days, but how many people, if pushed, could construct a touchscreen? Not many, I’d wager. And so it is with depression and antidepressants. For all the coverage and opinion pieces produced about them, the details around how they work remain somewhat murky and elusive. Actually, in the case of antidepressants, it’s more a question of why they work, rather than how. Most antidepressants, from the earliest Trycyclics and Monamine Oxidase inhibitors, to the ubiquitous modern day selective serotonin reuptake inhibitors (SSRIs), work by increasing the levels of specific neurotransmitters in the brain, usually by preventing them from being broken down and reabsorbed into the neurons, meaning they linger in the synapses longer, causing more activity, so “compensating” for the reduced overall levels. Antidepressants make the remaining neurotransmitters work twice as hard, so overall activity is more “normal”, so to speak. © 2017 Guardian News and Media Limited

Keyword: Depression
Link ID: 23822 - Posted: 07.11.2017

Deborah Orr Most people know about SSRIs, the antidepressant drugs that stop the brain from re-absorbing too much of the serotonin we produce, to regulate mood, anxiety and happiness. And a lot of people know about these drugs first hand, for the simple reason that they have used them. Last year, according to NHS Digital, no fewer than 64.7m antidepressant prescriptions were given in England alone. In a decade, the number of prescriptions has doubled. On Tuesday I joined the throng, and popped my first Citalopram. It was quite a thing – not least because, like an idiot, I dropped my pill about 90 minutes before curtain up for the Royal Shakespeare Company’s production of The Tempest at the Barbican. That’s right. This isn’t just mental illness: this is metropolitan-elite mental illness. It was a pretty overwhelming theatrical experience. The first indication that something was up came as I approached my local tube station. I noticed that I was in a state of extreme dissociation, walking along looking as though I was entirely present in the world yet feeling completely detached from it. I had drifted into total mental autopilot. Luckily, I was able to recognise my fugue. It’s a symptom of my condition, which, as I’ve written before, is complex post-traumatic stress disorder. The drug-induced dissociation was more intense than I’m used to when it’s happening naturally. I use the word advisedly. Much of what is thought of as illness is actually an extreme and sensible protective reaction to unbearable interventions from outside the self. © 2017 Guardian News and Media Limited

Keyword: Depression; Attention
Link ID: 23818 - Posted: 07.09.2017

By Clare Wilson A patient-led movement is helping people taking psychiatric medicines to hack their dosing regimens so they can wean themselves off the drugs without any side effects. Now a Dutch website that sells kits to help people do this is about to launch an English-language site, triggering safety concerns among UK regulators and doctors. Some people find it impossible to stop taking certain antidepressants and anti-anxiety medicines such as valium because, unless the dose is reduced very gradually, they get severe mental and physical side-effects. The problem is these medicines aren’t sold in small enough tablets to allow for tapering. This has prompted some people to flout mainstream medical advice and use DIY methods for reducing their doses, such as grinding up tablets and dissolving them in water, or breaking open capsules of tiny beads and counting them out. The UK mental health charity Mind advises people who want to stop taking antidepressants of some techniques to try, but recommends they get advice from their doctor or pharmacist first. To help people taper their dose more easily, a Dutch medical charity, called Cinderella Therapeutics, creates personalised “tapering kits”, with precisely weighed out tablets in labelled packets that gradually reduce over several months. The website recommends people do this under medical supervision and must first receive a doctor’s prescription. © Copyright New Scientist Ltd.

Keyword: Depression
Link ID: 23817 - Posted: 07.09.2017

ByMaia Szalavitz George Sarlo is throwing cash at research into how drugs like magic mushrooms can help people overcome trauma like his own. Deep in the Mexican jungle, in a village so remote it's only accessible by boat, 74-year-old venture capitalist George Sarlo waited to meet his father. It was the fall of 2012, and Sarlo knew his quest seemed absurd. After all, his father had been dead for decades, and he had no connection to this region of rainforests and beaches and its indigenous peoples. As the financier watched a shaman prepare a ceremonial cup of bitter brown ayahuasca, he couldn't believe that he'd agreed to swallow this nauseating psychedelic brew for a second time. But he had traveled for 12 hours—via plane, boat, and finally on foot—to this primeval place, a newly-built gazebo-like wood platform without walls. He had expressed his intentions in a group therapy session in preparation; he had eaten a special, bland diet and even halted other medications. He also trusted his friend, Dr. Gabor Maté, a fellow Hungarian Holocaust survivor, who led the therapy and had arranged the trip. Maté is perhaps best known for his book, In the Realm of Hungry Ghosts, which explores his work with extremely traumatized injection drug users in Vancouver. He's been offering psychedelic therapy to trauma survivors since learning about the potential of ayahuasca in 2008.

Keyword: Drug Abuse; Stress
Link ID: 23798 - Posted: 07.01.2017

Martha Mills So, it turns out I’m getting better at depression. That isn’t to say I’ve stopped suffering it, or that it is any less debilitating when it sneaks up after a two-year hiatus and pile-drives me into a blistering agony of mental carpet burns topped with a patronising tousle of the bed-hair, like a nostalgic school bully. No, what’s “better” about me is spotting it and moving quicker through the self-blame method of diagnosis. We all have down days, and that’s what you hope these are. Only they stopped being a day or two of feeling blue that can be whiled away with the distraction of a conspiratorial sofa and questionable DVD collection, and have merged into weeks since you were last able to feel anything but disappointment on waking up, and the choice between showering or just smelling like a tramp’s undercarriage has gone beyond struggle into pure resignation. Being especially practised at denial, I decided that I, a mere mortal with a solid history of depressive episodes since childhood, could fake my way out of this oncoming tsunami of debilitating black fog using the advice that people who have never experienced depression trot out – an experiment that could surely only succeed [sidelong glance to camera]. I would improve my diet and exercise, force myself to take up hobbies, I would “soldier on until it passed” and thrust myself (reluctantly) into social situations. I even tried “looking on the bright side” but it turned out to just be glare on my TV. © 2017 Guardian News and Media Limited

Keyword: Depression
Link ID: 23795 - Posted: 07.01.2017

By Catherine Caruso, More than half of all opioid prescriptions in the United States are written for people with anxiety, depression, and other mood disorders, according to a new study that questions how pain is treated in this vulnerable population. People with mood disorders are at increased risk of abusing opioids, and yet they received many more prescriptions than the general population, according to an analysis of data from 2011 and 2013. “We’re handing this stuff out like candy,” said Dr. Brian Sites, of Dartmouth-Hitchcock Medical Center, the senior author of the study. Opioid prescribing in the U.S. quadrupled between 1999 and 2015, and during that time over 183,000 people died from overdoses related to prescription opioids, according to the CDC. Sites said more research is needed to understand whether opioids are being overprescribed to adults with mood disorders. “If you want to come up with social policy to address the need to decrease our out-of-control opioid prescribing, this would be the population you want to study, because they’re getting the bulk of the opioids, and then they are known to be at higher risk for the bad stuff,” he said. The study, published Monday in the Journal of the American Board of Family Medicine, tapped a U.S. health survey that gathered data from providers and facilities on prescription medications, health status, and basic demographics for about 51,000 adults. It found that 19 percent of the 38.6 million Americans with mood disorders use prescription opioids, compared to 5 percent of the general population — a difference that remained even when the researchers controlled for factors such as physical health, level of pain, age, sex and race. © 2017 Scientific American

Keyword: Depression; Drug Abuse
Link ID: 23779 - Posted: 06.27.2017

By JANE E. BRODY It’s perfectly normal for someone to feel anxious or depressed after receiving a diagnosis of a serious illness. But what if the reverse occurs and symptoms of anxiety or depression masquerade as an as-yet undiagnosed physical disorder? Or what if someone’s physical symptoms stem from a psychological problem? How long might it take before the true cause of the symptoms is uncovered and proper treatment begun? Psychiatric Times, a medical publication seen by some 50,000 psychiatrists each month, recently published a “partial listing” of 47 medical illnesses, ranging from cardiac arrhythmias to pancreatic cancer, that may first present as anxiety. Added to that was another “partial listing” of 30 categories of medications that may cause anxiety, including, ironically, popular antidepressants like selective serotonin reuptake inhibitors, or S.S.R.I.s. These lists were included in an article called “Managing Anxiety in the Medically Ill” meant to alert mental health practitioners to the possibility that some patients seeking treatment for anxiety or depression may have an underlying medical condition that must be addressed before any emotional symptoms are likely to resolve. Doctors who treat ailments like cardiac, endocrine or intestinal disorders would do well to read this article as well lest they do patients a serious disservice by not recognizing an emotional cause of physical symptoms or addressing the emotional components of a physical disease. © 2017 The New York Times Company

Keyword: Depression; Stress
Link ID: 23773 - Posted: 06.26.2017

Researchers have identified structural changes in two genes that increase the risk of developing Tourette syndrome, a neurological disorder characterized by involuntary motor and vocal tics. The study, published in the journal Neuron, was supported by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health. “Our study is the tip of the iceberg in understanding the complex biological mechanisms underlying this disorder. With recent advancements in genetic research, we are at the cusp of identifying many genes involved in Tourette syndrome,” said Jeremiah Scharf, M.D., Ph.D., assistant professor of neurology and psychiatry at Harvard Medical School and Massachusetts General Hospital, Boston, and co-corresponding author of the study. The research was part of an international collaboration co-led by Dr. Scharf; Giovanni Coppola, M.D., professor of psychiatry and neurology at the University of California, Los Angeles; Carol Mathews, M.D., professor of psychiatry at the University of Florida in Gainesville; and Peristera Paschou, Ph.D., associate professor in the department of biological sciences at Purdue University, West Lafayette, Indiana. The scientific team conducted genetic analyses on 2,434 individuals with Tourette syndrome and compared them to 4,093 controls, focusing on copy number variants, changes in the genetic code resulting in deletions or duplications in sections of genes. Their results determined that deletions in the NRXN1 gene or duplications in the CNTN6 gene were each associated with an increased risk of Tourette syndrome. In the study, approximately 1 in 100 people with Tourette syndrome carried one of those genetic variants.

Keyword: Tourettes; Genes & Behavior
Link ID: 23761 - Posted: 06.22.2017

/ By Joshua C. Kendall Dr. Joshua A. Gordon, the new director of the National Institute of Mental Health, took office in the final year of Barack Obama’s presidency. But he has this much in common with Obama’s successor: He has little patience for incremental reforms. As Gordon defines it, the job involves both advocating for the mental health needs of Americans and developing science to guide policymakers and clinicians. A 49-year-old psychiatrist who made his reputation as a brilliant researcher of mice with mutations that mimic human mental disorders, Gordon is convinced that radical changes are needed in the treatment of illnesses like schizophrenia. In an interview in his office at the NIMH campus in Bethesda, Maryland, he lamented that while modest improvements have been made in patient care over the last few decades, we don’t know enough about the brain to “even begin to imagine what the transformative treatments of tomorrow will be like.” Few psychiatrists would disagree that change is overdue. Take depression: Current approaches, which employ drugs like Prozac or cognitive-behavioral therapy, or a combination of the two, can relieve major symptoms in only some patients. The hope is that “precision medicine” — treatments targeted to the specific biological makeup of the patient — can do for psychiatry what scientists like Gordon’s Nobel Prize-winning mentors J. Michael Bishop and Harold E. Varmus did for cancer treatment a generation ago. Unfortunately, as Gordon is well aware, mental illness is particularly challenging in this regard. In contrast to many types of cancer, where one genetic mutation can cause unregulated cell growth, psychiatric diseases rarely stem from any single faulty gene; instead, they are typically rooted in a complex interplay of genetic, environmental, and cultural factors. Copyright 2017 Undark

Keyword: Depression; Schizophrenia
Link ID: 23751 - Posted: 06.17.2017

By Sam Wong Microdosing, the practice of regularly taking small amounts of psychedelic drugs to improve mood and performance, has been taking off over the past few years. But the fact that these drugs are illegal makes it difficult to research their effects and possible health consequences. There are no rigorous clinical trials to see whether microdosing works (see “Microdosers say tiny hits of LSD make your work and life better”). Instead, all we have are anecdotes from people like Janet Lai Chang, a digital marketer based in San Francisco. She will present her experience of microdosing at the Quantified Self conference in Amsterdam from 17 to 18 June. When did you start microdosing? I started in February 2016. I wanted to understand how my brain works and how it might work differently with the influence of psilocybin [the active ingredient in magic mushrooms]. What else did you hope to achieve? I had been struggling with a lot of social anxiety. It was really preventing me from advancing professionally. I was invited to give a talk at Harvard University and a TedX talk in California. I didn’t feel ready. I felt all this anxiety. I procrastinated until the last minute and then didn’t do it. It was one of my biggest regrets. What doses did you take? At first I was taking 0.2 grams of mushrooms every day, with a day or two off at the weekend. In August, I had a month off. From October to April, it was a few times a week. How did it affect you? I was less anxious, less depressed, more open, more extroverted. I was more present in the moment. It’s harder to get into the flow of the focused solo work that I’m normally really good at. But it’s good for the social aspect. © Copyright New Scientist Ltd.

Keyword: Depression; Drug Abuse
Link ID: 23743 - Posted: 06.15.2017

By ALEX WILLIAMS This past winter, Sarah Fader, a 37-year-old social media consultant in Brooklyn who has generalized anxiety disorder, texted a friend in Oregon about an impending visit, and when a quick response failed to materialize, she posted on Twitter to her 16,000-plus followers. “I don’t hear from my friend for a day — my thought, they don’t want to be my friend anymore,” she wrote, appending the hashtag #ThisIsWhatAnxietyFeelsLike. Thousands of people were soon offering up their own examples under the hashtag; some were retweeted more than 1,000 times. You might say Ms. Fader struck a nerve. “If you’re a human being living in 2017 and you’re not anxious,” she said on the telephone, “there’s something wrong with you.” It was 70 years ago that the poet W.H. Auden published “The Age of Anxiety,” a six-part verse framing modern humankind’s condition over the course of more than 100 pages, and now it seems we are too rattled to even sit down and read something that long (or as the internet would say, tl;dr). Anxiety has become our everyday argot, our thrumming lifeblood: not just on Twitter (the ur-anxious medium, with its constant updates), but also in blogger diaries, celebrity confessionals (Et tu, Beyoncé?), a hit Broadway show (“Dear Evan Hansen”), a magazine start-up (Anxy, a mental-health publication based in Berkeley, Calif.), buzzed-about television series (like “Maniac,” a coming Netflix series by Cary Fukunaga, the lauded “True Detective” director) and, defying our abbreviated attention spans, on bookshelves. With two new volumes analyzing the condition (“On Edge: A Journey Through Anxiety,” by Andrea Petersen, and “Hi, Anxiety,” by Kat Kinsman) following recent best-sellers by Scott Stossel (“My Age of Anxiety”) and Daniel Smith (“Monkey Mind”), the anxiety memoir has become a literary subgenre to rival the depression memoir, firmly established since William Styron’s “Darkness Visible” and Elizabeth Wurtzel’s “Prozac Nation” in the 1990s and continuing today with Daphne Merkin’s “This Close to Happy.” © 2017 The New York Times Company

Keyword: Depression; Stress
Link ID: 23732 - Posted: 06.12.2017

By JULIA FIERRO A few months ago, I gave a reading at a local bookstore. A small but enthusiastic crowd attended, and I confessed to the audience filled with emerging writers that I had, in my 20s and early 30s, stopped writing for eight years, and that I had accepted I’d never write again. Then someone asked, “How did you return to writing?” I decided to tell the truth: Zoloft. I began flipping light switches on and off (always in fives) in third grade. My frugal parents were aghast at the waste of electricity. I tried to explain. I had to flip the switches. Or else something bad would happen, to me, to them. We were all in danger — my younger brother, my school friends, even my pets. I assumed that my fears were rational and that my school friends were like me, worrying all the time. As my obsessions accumulated, the dread throbbed more insistently, and my rituals became more complex. I counted in fives all day at school, my teeth clicking in time so much my teacher grew annoyed by the sound, and when the last school bell rang, my jaw was sore. My nightly prayers became a chant I had to recite 20, then 50 and, later, 100 times. Now that I am a mother, it astounds me that I was able to hide my rituals from my family — but I felt I had no choice. As the daughter of an Italian immigrant who survived unimaginable horrors — poverty, plague, war, domestic violence, the death of his baby sister because of a lack of basic health care — I heard one word over and over again. “Forte.” Strength. Weakness or, to be more specific, showing or admitting to weakness, seemed both un-Italian and un-American. I was raised in a historic whaling village on Long Island. Every year our grade school class field-tripped to the town museum, where we heard stories about courageous Dutch and English settlers who harpooned and lanced whales before towing them ashore and using their flensing knives to cut blubber into long strips. The stories taught us that America was bedrocked with self-reliance and fortitude.

Keyword: Depression
Link ID: 23716 - Posted: 06.07.2017

By Helen Thomson Life is full of decisions, and sometimes it’s difficult to know if you’re making the right one. But a drug that blocks the rush of noradrenaline through your body can boost your confidence, and may also lead to new treatments for schizophrenia and obsessive compulsive disorder. How much we trust our decisions is governed by the process we use to assess our own behaviour and abilities, known as metacognition. Our judgements shape how we’ll behave in future. For example, if you play Frisbee and you think you played badly, you might be less likely to do it again, says Tobias Hauser at University College London. Having low confidence in our actions can play a part in mental health conditions. “We see many symptoms associated with poor metacognitive judgement in schizophrenia and OCD,” says Hauser. “In OCD, for instance, people may constantly go and check whether they’ve closed a door. They are poor at judging whether they have done something correctly or not.” Little is known about the neural underpinnings of metacognition, but it is likely to involve the prefrontal cortex and the hippocampus, two brain areas modulated by the chemicals dopamine and noradrenaline. To investigate, Hauser and his colleagues asked 40 people to take a drug that blocks dopamine or noradrenaline either before or after a placebo. Another 20 people received two doses of the placebo drug. Eighty minutes after receiving the second drug, the subjects performed a task in which they had to decide whether the overall motion of a burst of randomly moving dots was directed to the left or right. © Copyright New Scientist Ltd.

Keyword: OCD - Obsessive Compulsive Disorder
Link ID: 23705 - Posted: 06.03.2017

Sarah Marsh When depression takes hold of Helen it feels like she is drowning in a pool of water, unable to swim up to the world above. The 36-year-old former nurse has had mental health problems most of her life. No drugs, hospital stays or therapies have been able to help. Then one day, during yet another spell in hospital, her consultant told her about a psychiatrist treating patients with ketamine. The psychiatrist in question visited her to discuss using the drug. He warned there were no guarantees, but it had helped some patients. Since then Helen’s life has transformed. Sitting on a bench in the grounds of the hospital where her treatment began a year and a half ago, she lists everything she can do now that she could not before: take her kids to school, give them hugs, go on coffee dates. “I am managing my thoughts and that is what ketamine helps to do. It slows down my thought process so instead of being completely overwhelmed by all these immense negative thoughts and feelings … I can think, stop and breathe,” she says, nervously pulling her sleeves over her hands as she talks. She adds: “It’s still really hard but now there is a tiny fraction of a second where my thoughts are slow enough to think: ‘I can deal with this. I cannot give up.’”

Keyword: Depression; Drug Abuse
Link ID: 23697 - Posted: 06.02.2017