Chapter 12. Psychopathology: The Biology of Behavioral Disorders

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By Christina Caron In recent years, the vagus nerve has become an object of fascination, especially on social media. The vagal nerve fibers, which run from the brain to the abdomen, have been anointed by some influencers as the key to reducing anxiety, regulating the nervous system and helping the body to relax. TikTok videos with the hashtag “#vagusnerve” have been viewed more than 64 million times and there are nearly 70,000 posts with the hashtag on Instagram. Some of the most popular ones feature simple hacks to “tone” or “reset” the vagus nerve, in which people plunge their faces into ice water baths or lie on their backs with ice packs on their chests. There are also neck and ear massages, eye exercises and deep-breathing techniques. Now, wellness companies have capitalized on the trend, offering products like “vagus massage oil,” vibrating bracelets and pillow mists, that claim to stimulate the nerve, but that have not been endorsed by the scientific community. Researchers who study the vagus nerve say that stimulating it with electrodes can potentially help improve mood and alleviate symptoms in those who suffer from treatment-resistant depression, among other ailments. But are there other ways to activate the vagus nerve? Who would benefit most from doing so? And what exactly is the vagus nerve, anyway? Here’s a look at what we know so far. The term “vagus nerve” is actually shorthand for thousands of fibers. They are organized into two bundles that run from the brain stem down through each side of the neck and into the torso, branching outward to touch our internal organs, said Dr. Kevin J. Tracey, a neurosurgeon and president of the Feinstein Institutes for Medical Research, Northwell Health’s research center in New York. Imagine something akin to a tree, whose limbs interact with nearly every organ system in the body. (The word “vagus” means “wandering” in Latin.) The vagus nerve picks up information about how the organs are functioning and also sends information from the brain stem back to the body, helping to control digestion, heart rate, voice, mood and the immune system. For those reasons, the vagus nerve — the longest of the 12 cranial nerves — is sometimes referred to as an “information superhighway.” Dr. Tracey compared it to a trans-Atlantic cable. “It’s not a mishmash of signals,” he said. “Every signal has a specific job.” © 2022 The New York Times Company

Keyword: Depression; Stress
Link ID: 28361 - Posted: 06.09.2022

By Ernesto Londoño TIJUANA, Mexico — Plumes of incense swirled through the dimly lit living room as seven women took turns explaining what drove them to sign up for a weekend of psychedelic therapy at a villa in northern Mexico with sweeping ocean views. A former U.S. Marine said she hoped to connect with the spirit of her mother, who killed herself 11 years ago. An Army veteran said she had been sexually assaulted by a relative as a child. A handful of veterans said they had been sexually assaulted by fellow service members. The wife of a Navy bomb disposal expert choked up as she lamented that years of unrelenting combat missions had turned her husband into an absent, dysfunctional father. Kristine Bostwick, 38, a former Navy corpsman, said she hoped that putting her mind through ceremonies with mind-altering substances would help her make peace with the end of a turbulent marriage and perhaps ease the migraines that had become a daily torment. “I want to reset my brain from the bottom up,” she said during the introductory session of a recent three-day retreat, wiping away tears. “My kids deserve it. I deserve it.” A growing body of research into the therapeutic benefits of psychedelic therapy has generated enthusiasm among some psychiatrists and venture capitalists. Measures to decriminalize psychedelics, fund research into their healing potential and establish frameworks for their medicinal use have been passed with bipartisan support in city councils and state legislatures across the United States in recent years. Much of the expanding appeal of such treatments has been driven by veterans of America’s wars in Afghanistan and Iraq. Having turned to experimental therapies to treat post-traumatic stress disorder, traumatic brain injuries, addiction and depression, many former military members have become effusive advocates for a wider embrace of psychedelics. © 2022 The New York Times Company

Keyword: Stress; Drug Abuse
Link ID: 28338 - Posted: 05.25.2022

By Daniel Bergner Caroline Mazel-Carlton began hearing voices when she was in day care. Mornings, by the time she was in middle school, a bowl of oatmeal awaited her for breakfast next to a white saucer of colorful pills. Her voices remained vibrant. They weren’t within her head; they spoke and screamed from outside her skull. They belonged to beings she could not see. The voice who had been with her longest warned of catastrophes coming for her family in Zionsville, a town north of Indianapolis, calamities tied in some unspecified way to TV images from the gulf war: fighter planes, flashes in the sky, explosions on the ground, luminous and all-consuming. A woman’s voice castigated her at school, telling her that her clothes smelled and that she had better keep her hand down, no matter that she knew the answers to the teacher’s questions. Another voice tracked her every move, its tone faintly mocking. “She’s getting out of bed now; oh, she’s walking down the hall now.” Her mix of psychotropic pills shifted, expanded: antipsychotics, mood stabilizers, an antidepressant, a benzodiazepine for anxiety, a stimulant for attention deficit. The pileup of drugs was typical; people hearing voices or having other hallucinations rarely wind up on just one medication. Multiple chemicals are prescribed, often more than one similar antipsychotic simultaneously, in an attempt to quell the psyche. This article is adapted from “The Mind and the Moon: My Brother’s Story, the Science of Our Brains, and the Search for Our Psyches,” published this month by Ecco. At most, for Mazel-Carlton, the antipsychotics sometimes succeeded in reducing her voices to a wall of sound. This could feel more assaultive than hearing them separately. The antipsychotics caused obesity — 50 pounds of new weight — and the feeling that she was losing control of her forearms and her neck. Her hands quivered and seemed to want to flap-paddle the air. To the isolation caused by the difference of her mind, the drugs added isolation from severe side effects. Her agitation and self-disgust, her terror of being barely human, drove her to twist clusters of her hair around her fingers, to yank hard. Patches of bare scalp crept into view. Classmates taunted, asking why she shook and was going bald, calling her “fat-ass” and “crackhead.” © 2022 The New York Times Company

Keyword: Schizophrenia
Link ID: 28331 - Posted: 05.18.2022

By Natasha Gilbert In May of 2018, Tabitha Bird spent a memorable day with her eldest son at a comic book convention in London. Later that evening, after she made sure that her two younger kids were safely tucked up in bed, Bird gathered every sleeping tablet, antidepressant, anti-anxiety med and ibuprofen pill she could find and walked out of the house. She drove to a nearby store where she bought a big bottle of water and some acetaminophen. Then she stopped in an empty industrial park and began to take the lot. Bird woke up from a coma four days later. The 47-year-old, from a town in West Sussex in the UK, now attributes her suicide attempt and the depression leading up to it to perimenopause — the time in most women’s lives when menstrual cycles become irregular and fertility wanes. During this transition, many women experience a suite of changes, including hot flashes, disrupted sleep and mood swings. Some breeze through perimenopause with little difficulty, but many — about 45 percent to 68 percent — experience depression, symptoms of which can include low mood, a loss of interest in things and even thoughts of suicide. Women with a history of depression, like Bird — who also suffered with it while pregnant — are the most vulnerable. During perimenopause, they are twice as likely to experience debilitating full-blown depressive disorder than women who haven’t had past episodes. As researchers probe for reasons why some women fall prey to depression at this time and others don’t, a leading candidate has emerged: widely fluctuating levels of the sex hormone estrogen. Estrogen directs fertility, but mounting research shows that it also holds sway on parts of the brain involved in regulating emotion and stress. © 2022 Annual Reviews

Keyword: Depression; Hormones & Behavior
Link ID: 28329 - Posted: 05.18.2022

Ellen Phiddian Tricyclic antidepressants have long been known to have more than one purpose: among other things, they can alleviate pain – particularly nerve pain. Recent research has finally established why these tricyclic antidepressants (TCAs) can help with nerve pain. The discovery could lead to the rapid development of pain relief medications that don’t include the side effects of TCAs. Nerve pain comes from a variety of sources – including cancer, diabetes, trauma, multiple sclerosis, and infections. These treatments could address a range of different types of nerve pain. It turns out the drugs inhibit a key protein in our nerves, called an N-type calcium channel. These N-type calcium channels are shaped like tiny gates, allowing positively charged calcium ions, or Ca2+, through them. This helps with the transmission of pain signals in the body. Researchers have long been keen to find things that “close” the gate of these calcium channels because that’s likely to have analgesic effects. Adjunct Professor Peter Duggan, a researcher with the CSIRO and senior collaborator on the project, says that he and his colleagues initially stumbled across TCAs from a very different direction: they were investigating the toxins of venomous marine cone snails. “A few of the components in that toxin are actually painkillers and they block these calcium ion channels very, very effectively,” says Duggan. The cone snail toxin has the potential to be very dangerous to people, as well as needing to be administered in an impractical way, so the researchers started looking at similar compounds that might have some of the same properties.

Keyword: Pain & Touch; Depression
Link ID: 28312 - Posted: 05.04.2022

By Melinda Wenner Moyer The more popular antidepressants become, the more questions they raise. The drugs are one of the most widely prescribed types of medications in the United States, with more than one out of eight Americans over 18 having recently taken them, according to a survey from the Centers for Disease Control and Prevention. Yet we know very little about how well antidepressants work over the long term, and especially how they affect overall quality of life, experts say. Most clinical drug trials have followed people taking antidepressants for only eight to 12 weeks, so it’s unclear what happens when patients take them for longer than that, said Gemma Lewis, a research psychologist at University College London who studies the causes, treatment and prevention of depression and anxiety. “We definitely need longer follow-ups of people who are using or are not using antidepressants, to see what the long-term outcomes are,” Dr. Lewis said. A study published yesterday in the journal PLoS One aimed to close this knowledge gap by comparing, over the course of two years, the changes in quality of life reported by Americans with depression who took antidepressants versus the changes reported by those with the same diagnosis who did not take the medications. The study included people who took all types of antidepressants, including selective serotonin reuptake inhibitors like Prozac, serotonin-norepinephrine reuptake inhibitors like Effexor and older antidepressants such as clomipramine and phenelzine. Researchers assessed both mental and physical quality of life with a survey that asked questions about subjects’ physical health, energy levels, mood, pain and ability to perform daily activities, among other things. The paper found no significant differences in the changes in quality of life reported by the two groups, which suggests that antidepressant drugs may not improve long-term quality of life. Both groups reported slight increases in the mental aspects of quality of life over time, and slight drops in their physical quality of life. But the study is imperfect, researchers say, and it certainly doesn’t settle the debate over the effectiveness of these drugs. © 2022 The New York Times Company

Keyword: Depression
Link ID: 28301 - Posted: 04.27.2022

By Linda Searing Already known to help ease depression, regular exercise may also help prevent it, with people who exercised just half the recommended weekly amount lowering their risk for depression by 18 percent, according to research published in the journal JAMA Psychiatry. However, those who were more active, meeting at least the minimum recommended physical activity level, reduced their risk for depression by 25 percent, compared with inactive people. The findings stem from the analysis of data from 15 studies, involving 191,130 adults who were tracked for at least three years. Those who met activity guidelines did at least 150 minutes a week of moderate-intensity activity, such as brisk walking, as recommended in the Physical Activity Guidelines for Americans. Mental health experts note that nearly 10 percent of American adults struggle with some form of depression each year. Antidepressant medication and talk therapy are commonly prescribed treatments, but exercise is also considered an effective treatment. Exercise sparks the brain’s release of endorphins, sometimes referred to as feel-good hormones. It can also quiet the mind, quelling the cycle of negative thoughts that often accompany depression, and can help reduce stress, improve sleep and boost self-esteem. Urging doctors to encourage their patients to increase their physical activity, the researchers wrote that the study’s findings suggest “significant mental health benefits from being physically active, even at levels below the public health recommendations.” If less-active participants in the study had exercised more, they say, 11.5 percent of depression cases could have been prevented.

Keyword: Depression
Link ID: 28300 - Posted: 04.27.2022

Diana Kwon Susannah Cahalan was 24 years old when her world turned upside down. Cahalan was living a busy life as a news reporter at the New York Post when she suddenly began experiencing sensitivity to light, numbness in her limbs, and an unsettling feeling that something was not quite right in her body and her brain. One day at work, she found herself inexplicably going from crying hysterically to skipping giddily down a hall. After a seizure landed her in the hospital, her condition rapidly worsened. She started having delusions and hallucinations, believing that her father was a murderer, that she was being secretly recorded, and that she could age people using her mind. In a matter of weeks, walking, speaking, and swallowing became difficult. She eventually became immobile and unresponsive, lying in her hospital bed in a catatonic state. Despite her worsening condition, dozens of specialists from various fields—psychiatry, neurology, internal medicine—couldn’t figure out what was wrong. Numerous blood tests and brain scans failed to generate answers. To many who saw her, Cahalan’s condition looked indistinguishable from mental illnesses such as bipolar disorder or schizophrenia, in which people can experience delusions and hallucinations that make it difficult for them to distinguish what’s real and what’s not. It wasn’t until a neurologist asked Cahalan to draw a clock that the problem became clear. Cahalan had drawn all the numbers on just one side of the clock face, indicating that there was a problem in the functioning of one half of her brain. A brain biopsy confirmed what the doctor had suspected. Cahalan had anti-NMDAR encephalitis, a rare autoimmune disease in which the body produces antibodies that attack the NMDA receptor, a protein found throughout the brain. The condition had only been discovered in the early 2000s, just a few years prior to Cahalan’s diagnosis, by neurologist Josep Dalmau, then at the University of Pennsylvania. This diagnosis was much-needed good news for sufferers of the mysterious condition—their disease was treatable. After receiving immunotherapy, Cahalan was able to fully recover. © 1986–2022 The Scientist.

Keyword: Schizophrenia; Neuroimmunology
Link ID: 28289 - Posted: 04.20.2022

By Andrew Jacobs Psychedelic compounds like LSD, Ecstasy and psilocybin mushrooms have shown significant promise in treating a range of mental health disorders, with participants in clinical studies often describing tremendous progress taming the demons of post-traumatic stress disorder, or finding unexpected calm and clarity as they face a terminal illness. But exactly how psychedelics might therapeutically rewire the mind remains an enigma. A group of neuroscientists in London thought advanced neuroimaging technology that peered deep into the brain might provide some answers. They included 43 people with severe depression in a study sponsored by Imperial College London, and gave them either psilocybin, the active ingredient in magic mushrooms, or a conventional antidepressant; the participants were not told which one they would receive. Functional magnetic resonance imaging, which captures metabolic function, took two snapshots of their brain activity — the day before receiving the first dose and then roughly three weeks after the final one. What they found, according to a study published Monday in the journal Nature Medicine, was illuminating, both figuratively and literally. Over the course of three weeks, participants who had been given the antidepressant escitalopram reported mild improvement in their symptoms, and the scans continued to suggest the stubborn, telltale signs of a mind hobbled by major depressive disorder. Neural activity was constrained within certain regions of the brain, a reflection of the rigid thought patterns that can trap those with depression in a negative feedback loop of pessimism and despair. By contrast, the participants given psilocybin therapy reported a rapid and sustained improvement in their depression, and the scans showed flourishes of neural activity across large swaths of the brain that persisted for the three weeks. That heightened connectivity, they said, resembled the cognitive agility of a healthy brain that, for example, can toggle between a morning bout of melancholia, a stressful day at work and an evening of unencumbered revelry with friends. © 2022 The New York Times Company

Keyword: Depression; Drug Abuse
Link ID: 28283 - Posted: 04.13.2022

By Lenny Bernstein Researchers have found variations in a small number of genes that appear to dramatically increase the likelihood of developing schizophrenia in some people. The interplay of a wide array of other genes is implicated for most people with schizophrenia, a severe brain disorder characterized by hallucinations, delusions and inability to function. But for some who possess mutations in the 10 genes identified in the new study, published Wednesday in the journal Nature, the likelihood of developing the disease can be 10, 20 and even 50 times greater. The discovery could one day lead to advances in diagnosis of, and therapy for, the disease, according to the lead author of the study, Tarjinder Singh, of the Broad Institute at MIT and Harvard, which led an effort that involved years of work by dozens of research institutions worldwide. “This is the biological clue that leads to better therapies,” Singh said in an interview. “But the key thing is, we haven’t had any meaningful clues for the longest time.” Ken Duckworth, chief medical officer for the National Alliance on Mental Illness, a nationwide advocacy group, said the study is an important development in the neuroscience that underlies schizophrenia. But he said it is difficult to predict how soon such basic research would pay off for people living with the disease. “This is a big step forward for science that may pay a long-term return for people with schizophrenia and the people who live with them,” Duckworth said. But, he said, “if this is a 17-inning game and they’ve gotten us from the first to the second inning, how does this help someone today?” Less than 1 percent of the U.S. population is believed to have schizophrenia, which is generally treated with an array of powerful antipsychotic medications. The disease reduces life expectancy by about 15 years, according to the new research. Scientists have long recognized a hereditary component to the disease, along with other factors such as environment. The work of isolating these genes could not have been accomplished even 10 or 15 years ago, Singh said, before the sequencing of the human genome and the spread of technology that allows such genetic detective work to be conducted in laboratories around the world. © 1996-2022 The Washington Post

Keyword: Schizophrenia; Genes & Behavior
Link ID: 28274 - Posted: 04.09.2022

By Ingrid K. Williams This article is part of a limited series on artificial intelligence’s potential to solve everyday problems. Imagine a test as quick and easy as having your temperature taken or your blood pressure measured that could reliably identify an anxiety disorder or predict an impending depressive relapse. Health care providers have many tools to gauge a patient’s physical condition, yet no reliable biomarkers — objective indicators of medical states observed from outside the patient — for assessing mental health. But some artificial intelligence researchers now believe that the sound of your voice might be the key to understanding your mental state — and A.I. is perfectly suited to detect such changes, which are difficult, if not impossible, to perceive otherwise. The result is a set of apps and online tools designed to track your mental status, as well as programs that deliver real-time mental health assessments to telehealth and call-center providers. Psychologists have long known that certain mental health issues can be detected by listening not only to what a person says but how they say it, said Maria Espinola, a psychologist and assistant professor at the University of Cincinnati College of Medicine. With depressed patients, Dr. Espinola said, “their speech is generally more monotone, flatter and softer. They also have a reduced pitch range and lower volume. They take more pauses. They stop more often.” Patients with anxiety feel more tension in their bodies, which can also change the way their voice sounds, she said. “They tend to speak faster. They have more difficulty breathing.” Today, these types of vocal features are being leveraged by machine learning researchers to predict depression and anxiety, as well as other mental illnesses like schizophrenia and post-traumatic stress disorder. The use of deep-learning algorithms can uncover additional patterns and characteristics, as captured in short voice recordings, that might not be evident even to trained experts. © 2022 The New York Times Company

Keyword: Depression; Schizophrenia
Link ID: 28271 - Posted: 04.06.2022

April Dembosky Most of the time, the voices in Keris Myrick's head don't bother her. They stay in the background or say nice things. But sometimes they get loud and mean – like when a deadly pandemic descended on the world and shut down society as we know it. "It's when things go really, really fast and they seem overwhelmingly disastrous. That's when it happens," says Myrick, who was diagnosed with schizophrenia 25 years ago. "The attacking voices were calling me stupid ... I literally had a meltdown right here in my house. Just lost it." She was able to calm herself down and quiet the voices, and as the pandemic wore on, she kept them at bay by keeping busy: She works for a foundation, hosts a podcast and wrote a children's book. She was able to manage, but she worried about others like her. "People with schizophrenia were not actually deemed as 'the priority vulnerable population' to be served or to be addressed in the same way as people who had other chronic health conditions and who were over a certain age," Myrick says. "So we kind of got left out." This omission occurred even as new data published in JAMA Psychiatry showed that people with schizophrenia are nearly three times more likely to die from COVID-19 than the general population. Their risk of death from the virus is greater than for people with diabetes, heart disease or any other condition aside from age. "People's initial reaction to this was one of disbelief," says Katlyn Nemani, a New York University School of Medicine neuropsychiatrist and the study's lead author. © 2022 npr

Keyword: Schizophrenia
Link ID: 28255 - Posted: 03.26.2022

By Ellen Barry After more than a decade of argument, psychiatry’s most powerful body in the United States added a new disorder this week to its diagnostic manual: prolonged grief. The decision marks an end to a long debate within the field of mental health, steering researchers and clinicians to view intense grief as a target for medical treatment, at a moment when many Americans are overwhelmed by loss. The new diagnosis, prolonged grief disorder, was designed to apply to a narrow slice of the population who are incapacitated, pining and ruminating a year after a loss, and unable to return to previous activities. Its inclusion in the Diagnostic and Statistical Manual of Mental Disorders means that clinicians can now bill insurance companies for treating people for the condition. It will most likely open a stream of funding for research into treatments — naltrexone, a drug used to help treat addiction, is currently in clinical trials as a form of grief therapy — and set off a competition for approval of medicines by the Food and Drug Administration. Since the 1990s, a number of researchers have argued that intense forms of grief should be classified as a mental illness, saying that society tends to accept the suffering of bereaved people as natural and that it fails to steer them toward treatment that could help. A diagnosis, they hope, will allow clinicians to aid a part of the population that has, throughout history, withdrawn into isolation after terrible losses. “They were the widows who wore black for the rest of their lives, who withdrew from social contacts and lived the rest of their lives in memory of the husband or wife who they had lost,” said Dr. Paul S. Appelbaum, who is chair of the steering committee overseeing revisions to the fifth edition of the D.S.M. © 2022 The New York Times Company

Keyword: Depression; Emotions
Link ID: 28247 - Posted: 03.19.2022

By Linda Searing Depression affects about 280 million people worldwide, including about 5 percent of all adults, according to data from the World Health Organization and a report from the World Psychiatric Association Commission, an international research group. The commission describes depression as “one of the leading causes of avoidable suffering and premature mortality in the world” and labels it a neglected global health crisis. FAQ: What to know about the omicron variant of the coronavirus In the United States, an estimated 21 million adults, or about 8 percent of those 18 and older, are living with depression, according to the National Institute of Mental Health. In addition, the Centers for Disease Control and Prevention note that roughly 11 percent of all physician office visits and emergency department visits are related to depression. Though most everyone feels sad or gloomy from time to time, depression — what the medical world refers to as depressive disorder or major depression — goes beyond simple mood fluctuations. Rather, such feelings as sadness, hopelessness or low self-worth, loss of interest in usual activities, sleep problems and lack of energy persist for two weeks or more, interfering with a person’s everyday life. Genetics, chemical changes in the brain and stressful events are among factors believed to be responsible for depressive episodes. Left untreated, depression can have devastating effects. But treatment — which may include such approaches as talk therapy, medication, exercise, light therapy or acupuncture — can ease symptoms and help prevent a recurrence. However, the World Psychiatric Association Commission report, published in the Lancet, notes that about half of people suffering from depression in high-income countries are not diagnosed or treated, a number that increases to as much as 90 percent of those with depression who live in low- and middle-income countries. © 1996-2022 The Washington Post

Keyword: Depression
Link ID: 28224 - Posted: 03.02.2022

By Ellen Barry A new book by Dr. Thomas P. Insel, who for 13 years ran the United States’ foremost mental health research institution, begins with a sort of confession. During his tenure as the “nation’s psychiatrist,” he helped allocate $20 billion in federal funds and sharply shifted the focus of the National Institute of Mental Health away from behavioral research and toward neuroscience and genetics. “I should have been able to help us bend the curves for death and disability,” Dr. Insel writes. “But I didn’t.” Dr. Insel, 70, who left N.I.M.H. in 2015, calls the advances in neuroscience of the last 20 years “spectacular” — but in the very first pages of his new book, he says that, for the most part, they haven’t yet benefited patients. His book, “Healing: Our Path From Mental Illness to Mental Health,” is not an indictment of the science to which he devoted much of his adult life. Instead, it chronicles failures in virtually every other element of our mental health system, including the ineffective delivery of care, the gutting of community health services and the reliance on police and jails for crisis services. It also calls out a paradox: that the United States, a country that leads the world in spending on medical research, also stands out for its dismal outcomes in people with mental illnesses. Indeed, over the last three decades, even as the government invested billions of dollars in better understanding the brain, by some measures, those outcomes have deteriorated. The country’s long spell without breakthrough treatments can be attributed, in part, to the complexity of the brain. Dr. Insel rose through the ranks at a time of optimism that advances in neurobiology would lead to new treatments, and as head of N.I.M.H., as he put it, he “bet big on genomics.” But 20 years later, he said the role that genes play in schizophrenia and bipolar disorder has proven to be extraordinarily complex. “Each of those variants that have been discovered just account for a tiny, tiny amount of risk, so in aggregate, they’re probably significant, but you have to put a hundred of them together,” he said. “So we started doing bigger and bigger studies to find smaller and smaller effects.” © 2022 The New York Times Company

Keyword: Depression; Schizophrenia
Link ID: 28214 - Posted: 02.23.2022

By Christina Caron After 10 years of marriage, Ree, 42, and her husband were ready to call it quits. Even their therapist had given up, she said, in part because her husband “was so closed off, just unable to open up.” “We loved each other a lot and we were very compatible, however, we didn’t know how to deal with conflict,” Ree said. She was often anxious about their relationship and could be “a little neurotic at times,” but the more she pushed her husband to connect, the more withdrawn he became. Their sex life suffered. Then a friend suggested that they try the illegal drug MDMA, popularly known as Ecstasy or Molly. For Ree — who, along with her husband, requested anonymity to speak about drug use, and is referred to by a nickname — the answer was an “immediate no.” MDMA, long associated with rave culture, is currently categorized as a Schedule I drug — meaning it has a high potential for abuse and no accepted medical use in the United States. “We are about as strait-laced as you can come,” she said. “We’re not people who break laws or do drugs.” Six months later, after reading “How to Change Your Mind,” the best-selling book by Michael Pollan that details his transformative experience with psychedelics, Ree reconsidered. And that’s how they found themselves in a secluded area of Utah at a large, rented house with a beautiful view of the mountains to trip on MDMA with five other couples. In recent years, clinical trials have shown that MDMA, when combined with talk therapy, can bring relief to those suffering from post-traumatic stress disorder, a finding that has elevated MDMA’s reputation from party drug to potential therapeutic. Some couples, drawn to the drug’s ability to produce feelings of empathy, trust and compassion, have started using unregulated MDMA on their own in an effort to help them reconnect, improve communication and have better sex. © 2022 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 28192 - Posted: 02.09.2022

ByElizabeth Pennisi The trillions of bacteria in and on our bodies can bolster our health and contribute to disease, but just which microbes are the key actors has been elusive. Now, a study involving thousands of people in Finland has identified a potential microbial culprit in some cases of depression. The finding, which emerged from a study of how genetics and diet affect the microbiome, “is really solid proof that this association could have major clinical importance,” says Jack Gilbert, a microbial ecologist at the University of California, San Diego, who was not involved with the work. Researchers are finding ever more links between brain conditions and gut microbes. People with autism and mood disorders, for example, have deficits of certain key bacteria in their guts. Whether those microbial deficits actually help cause the disorders is unclear, but the findings have spawned a rush to harness gut microbes and the substances they produce as possible treatments for a variety of brain disorders. Indeed, researchers recently reported in Frontiers in Psychiatry that fecal transplants improved symptoms in two depressed patients. Guillaume Méric didn’t set out to find microbes that cause depression. A microbial bioinformatician at the Baker Heart & Diabetes Institute, he and his colleagues were analyzing data from a large health and lifestyle study from Finland. Part of a 40-year effort to track down underlying causes of chronic disease in Finnish people, the 2002 study assessed the genetic makeup of 6000 participants, identified their gut microbes, and compiled extensive data about their diets, lifestyles, prescription drug use, and health. Researchers tracked the health of participants until 2018. Méric and his colleagues combed the data for clues to how a person’s diet and genetics affect the microbiome. “There have been very few studies that have examined [all these factors] in such detail,” Gilbert says. Two sections of the human genome seemed to strongly influence which microbes are present in the gut, the researchers report this week in Nature Genetics. One contains the gene for digesting the milk sugar lactose, and the other helps specify blood type. (A second study, also published today in Nature Genetics, identified the same genetic loci by analyzing the relationship between the genomes and gut microbes of 7700 people in the Netherlands.) © 2022 American Association for the Advancement of Science.

Keyword: Depression; Obesity
Link ID: 28188 - Posted: 02.05.2022

ByRobert F. Service More than 50 years after the Summer of Love, psychedelics are again the rage. This time the love comes from doctors beginning to embrace psychedelics such as LSD and psilocybin to treat depression, substance abuse, and other serious mental health conditions. But because the drugs cause hallucinations, their medical use requires intensive monitoring by clinicians. That drives up treatment costs, making psychedelics impractical for widespread therapeutic use. In recent years, researchers have begun to tweak psychedelics’ chemical structures, aiming to make analogs that retain medical usefulness but don’t cause hallucinations. Now, researchers report in Science they’ve teased apart the molecular interactions responsible for psychedelics’ antidepressive effects from those that cause hallucinations. They used that knowledge to make new compounds that appear to activate brain cellular circuits that help relieve depression without triggering a closely related pathway involved in hallucinations. So far, the compounds have only been studied in mice. But if such psychedelic analogs work in humans, they could spawn new families of pharmaceuticals. “This work is going to generate a lot of interest,” says Bryan Roth, a pharmacologist at the University of North Carolina School of Medicine, whose lab is also seeking nonhallucinogenic psychedelic analogs. The need is profound. Mental or neurological disorders are estimated to affect roughly one-quarter of U.S. adults every year, and therapies often don’t work. LSD, psilocybin (the main ingredient in magic mushrooms), and other psychedelics might do better. Studies have shown a single dose of psilocybin can offer relief from depression for months at a time, and last year, a clinical trial of 3,4-methylenedioxymethamphetamine, or ecstasy, showed it can alleviate posttraumatic stress disorder. © 2022 American Association for the Advancement of Science.

Keyword: Depression; Drug Abuse
Link ID: 28177 - Posted: 01.29.2022

By Emily Witt In the fall of 1972, a psychiatrist named Salvador Roquet travelled from his home in Mexico City to the Maryland Psychiatric Research Center, an institution largely funded by the United States government, to give a presentation on an ongoing experiment. For several years, Roquet had been running a series of group-therapy sessions: over the course of eight or nine hours, his staff would administer psilocybin mushrooms, morning-glory seeds, peyote cacti, and the herb datura to small groups of patients. He would then orchestrate what he called a “sensory overload show,” with lights, sounds, and images from violent or erotic movies. The idea was to push the patients through an extreme experience to a psycho-spiritual rebirth. One of the participants, an American psychology professor, described the session as a “descent into hell.” But Roquet wanted to give his patients smooth landings, and so, eventually, he added a common hospital anesthetic called ketamine hydrochloride. He found that, given as the other drugs were wearing off, it alleviated the anxiety brought on by these punishing ordeals. Clinicians at the Maryland Psychiatric Research Center had been studying LSD and other psychedelics since the early nineteen-fifties, beginning at a related institution, the Spring Grove Hospital Center. But ketamine was new: it was first synthesized in 1962, by a researcher named Calvin Stevens, who did consulting work for the pharmaceutical company Parke-Davis. (Stevens had been looking for a less volatile alternative to phencyclidine, better known as PCP.) Two years later, a doctor named Edward Domino conducted the first human trials of ketamine, with men incarcerated at Jackson State Prison, in Michigan, serving as his subjects. At higher doses, Domino noticed, ketamine knocked people out, but at lower ones it produced odd psychoactive effects on otherwise lucid patients. Parke-Davis wanted to avoid characterizing the drug as psychedelic, and Domino’s wife suggested the term “dissociative anesthetic” to describe the way it seemed to separate the mind from the body even as the mind retained consciousness. The F.D.A. approved ketamine as an anesthetic in 1970, and Parke-Davis began marketing it under the brand name Ketalar. It was widely used by the U.S. military during the Vietnam War, and remains a standard anesthetic in emergency rooms around the world. © 2021 Condé Nast.

Keyword: Depression; Drug Abuse
Link ID: 28132 - Posted: 12.31.2021

By Vanessa Barbara JUIZ DE FORA, Brazil — My first encounter with ketamine did not go well. A lifelong depressive — I picked up the habit of despairing sadness in early adulthood, and it remained faithfully with me — I’d turned to a more experimental form of treatment: ketamine infusions, in which a kindly anesthesiologist funnels the drug into a sad person’s veins for around 50 minutes and hopes it perks her up. Forty-five minutes into my first session, I rather anxiously asked my partner, who was in the room with me, if our 3-year-old daughter was fine. He decided it was the perfect time for a joke. Our daughter, he answered, was safe at home — and as a matter of fact, he added, she was already a very independent 15-year-old. I panicked. While under the strong, dissociative effect of the drug, patients sometimes enter what’s called a k-hole, in which their sense of time and space is distorted or eliminated. In that state of oblivion, I found it entirely plausible that my daughter was not a toddler anymore, but a strong-willed teenager. I became very distressed. My heartbeat accelerated. The anesthesiologist hurriedly ended the session as my partner said: “I’m kidding! Sorry! She’s still 3!” It was an inauspicious start, but I was determined to make the best of it. Ketamine, long used as an anesthetic but better known as an illegal party drug and, of course, a horse tranquilizer, has in recent years been gaining traction as an antidepressant. People have written enthusiastic accounts of their experiences, and researchers and psychiatrists, in a cascade of studies, have pointed to its possible benefits, not least the speed with which it can alleviate symptoms. Today, hundreds of clinics around the world provide infusions to people who have found little, if any, improvement with other treatments. That’s where I come in. Over the years, apart from the good old psychotropic medications, I have tried several types of talk therapy, meditation, acupuncture, singing lessons, bungee jumping and transcranial magnetic stimulation. (I still have sweet memories of the woodpecker sounds tapped into my brain.) © 2021 The New York Times Company

Keyword: Depression; Drug Abuse
Link ID: 28130 - Posted: 12.29.2021