Chapter 16. Psychopathology: Biological Basis of Behavior Disorders

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By Concepción de León I hear some people have trouble with therapy, that it can take years for them to open up to their doctors, let alone cry or break down. Not me. Day one, I told my therapist, Amy Bernstein, “I’ll just tell you everything, and we’ll go from there.” I was assigned to her after revealing, during an initial interview to determine the appropriate therapist for my needs, that I’d been touched as a child. I hadn’t planned to bring it up at all, but I was asked directly, so I said, yes, you could say that. (At the time, I avoided the word “molested.”) And yes, it still crossed my mind. To be honest, what happened had always felt like such a small thing. Many others have had it much worse; I counted myself lucky for only having been touched in subtle ways — a male relative digging his hands in my tiny skirt pockets to “feel around for change”; another bringing his hand to my crotch when he thought I was asleep. These were two of a handful of men who violated me. Amy recommended books to help me understand what had happened, but I put them down after just a few pages, thinking, “This isn’t for me! My thing is too small.” But then, as tends to be the case with therapy, things got harder before they got better. I returned to one of the books Amy had recommended, “The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma,” by Bessel van der Kolk, to try to understand my visceral response to remembering. Dr. van der Kolk is a Boston-based psychiatrist who specializes in post-traumatic stress disorder and has worked with a broad range of clients, from veterans to sexual assault survivors. “The Body Keeps the Score” hinges on his idea that trauma is stored in the body and that, for therapy to be effective, it needs to take the physiological changes that occur into account. Trauma produces “a re-calibration of the brain’s alarm system, an increase in stress hormone activity” and, also, “compromises the brain area that communicates the physical, embodied feeling of being alive,” Mr. van der Kolk writes. For survivors of sexual assault and other traumas, the amygdala, which initiates the body’s fight or flight response system whenever it perceives danger, can remain activated long after the threat has subsided. In the present, survivors relive their traumas in the form of fragmented images, sounds and emotion that the brain can’t register as belonging to the past. Many people also experience dissociation, which can manifest as literal desensitization in parts of the body or the inability to describe physical sensations. © 2018 The New York Times Company

Keyword: Stress
Link ID: 25590 - Posted: 10.18.2018

By Jessica Wright Among the many things a woman is supposed to avoid when pregnant are antidepressants, particularly a subtype of the drugs that some studies have linked to an increased risk of autism and attention-deficit/hyperactivity disorder. Yet the evidence linking antidepressants to autism is thin. And untreated depression is dangerous for a mother and her child. Here we explain what scientists know about the link between antidepressants and autism. Does taking antidepressants during pregnancy increase the odds that your child will have autism? Maybe, but even if so, the risk is small. Several studies have looked at the health records of thousands of women for any boost in autism rates among the children of those who took antidepressants while pregnant. Some of these studies found up to a doubling of the odds of the women having a child with autism. However, because the initial risk of autism is small, this increase still adds up to a low absolute risk. More important, women who take antidepressants may have other traits that are responsible for the increased rates of autism in their children. Many studies that control for these traits conclude that there is no risk from the antidepressants themselves. © 1996-2018 The Washington Post

Keyword: Autism; Depression
Link ID: 25580 - Posted: 10.16.2018

By Wajahat Ali Ever since I was young, my mind has gotten stuck. I’ll be flooded with intrusive thoughts. An image or an idea will transform into a burning question — “What if I left the stove on?” “What if the door is unlocked?” “What if I lose control and do something violent?” This plays on an endless loop. To cope, I constantly seek reassurance by reviewing my actions, trying to replace my thoughts or using logic to undo what is utterly illogical. But all those efforts fail, instead energizing the thought, resurrecting it like a zombie on steroids, making it more vicious, resistant and cruel. That’s a snapshot of living life with obsessive-compulsive disorder, an anxiety disorder that afflicts nearly 2 percent of the population. With O.C.D., the brain misfires, causing it to malfunction and react to disturbing thoughts, images and ruminations. The sufferer tries to manage his anxiety with compulsive rituals, which include excessive double-checking, counting, repeating a prayer or mantra, and engaging in mental reassurances that give a short-term relief but ultimately become addictive crutches, fueling an endless cycle of torment. O.C.D. has often been misunderstood, undiagnosed and exploited as a set of amusing quirks for Hollywood characters. I wish my O.C.D. was as fun and lovable as depicted in “Monk.” It’s not. At one point in my life, I endured an endless stream of tormenting thoughts about sex, overwhelmed by visions of every vile variation, partnership and arrangement imaginable. They would make Caligula blush. When this happened, feelings of guilt, disgust and shame would inevitably begin to overwhelm me. Self-doubt bubbled up and asked: “What sick person could imagine such things? Surely, there must be something wrong with you?” Here I am, a somewhat intelligent, moral, responsible individual fully aware that the thoughts are irrational, but nonetheless I must perform ridiculous rituals to try to feel safe and achieve relief. I think of it as God’s sick joke. © 2018 The New York Times Company

Keyword: OCD - Obsessive Compulsive Disorder
Link ID: 25573 - Posted: 10.15.2018

By Daniel Barron Lisa Barlow, whose name I have changed to protect her privacy, is at her kitchen table in Washington DC when she realizes that each Sunday, fifteen passenger trains depart for New Haven, CT. She’s a successful copy editor and has a meeting in New Haven early Monday morning. She has no plans Sunday, so doesn’t care when she arrives or how long it takes. She travels coach so has thirty tickets to choose from: fifteen departures each with two price options. Should she choose the more-expensive flexible ticket over the locked-in value ticket? Does she want to leave earlier or later? Brunch in DC or lunch in New Haven? She can’t decide. She scrolls the screen up and down, up and down, faster and faster. Her eyes dart about the webpage. She feels a rising tension in her chest. Her breathing shortens. Her thoughts race in and out of her mind like the breath in her lungs. She touches her face and notices the telltale sign: it’s numb. She reaches into her pocket, where she safeguards a small pill for moments like these. A pharmacologic reset button. Barlow has had panic attacks since High School—the first over a social drama, the second after her science teacher told her that if she refused to dissect a pig, she’d amount to nothing. She suspects her attacks have something to do with her parents, whose difficult marriage often forced her to choose between them. This, a therapist explained, was an “impossible choice,” one with permanent consequences yet no clear answer. Now as an adult, when faced with a decision that has no clear answer—even something as simple as booking a train ticket—her brain is programmed to panic. © 2018 Scientific American

Keyword: Emotions; Learning & Memory
Link ID: 25569 - Posted: 10.12.2018

By Nicholas Bakalar Omega-3 supplements may help reduce anxiety symptoms, a review of studies has concluded. The analysis, in JAMA Network Open, concluded that people with clinically diagnosed anxiety disorders who took large doses of the supplement — up to 2,000 milligrams a day — benefited most. Researchers used data from 16 studies that compared omega-3 fatty acid supplements with placebo and three that did not use a placebo. Over all, omega-3 supplements were associated with significant relief from anxiety symptoms, but some groups benefited more than others. Omega-3 supplements did not ease anxiety levels in those without a clinical diagnosis of an anxiety disorder, on in adolescents under 18. And they were more strongly associated with reduced symptoms when the balance of two types of fatty acids in the supplement, EPA and DHA, was less than 60 percent EPA. The senior author, Dr. Yutaka Matsuoka, chief of health care research at the National Cancer Center in Japan, said that supplements may not be necessary. “Eating fatty fish that includes EPA and DHA is more natural. I recommend mackerel, Pacific saury, sardines, tuna or salmon.” In any case, he said, omega-3 is not a first-line treatment for anxiety, or a substitute for other evidence-based therapies. “But for patients who are not responsive to psychotherapies, omega-3 might be a promising alternative.” © 2018 The New York Times Company

Keyword: Stress
Link ID: 25564 - Posted: 10.12.2018

By Erin Blakemore Are you depressed? If you’re not sure, it’s no surprise. Perpetual sadness isn’t the only symptom. Anger, back pain, sleep disturbances and even indecisiveness could all be signs of depression. One in six adults will experience depression in their life, but you can’t get help if you’re not sure you need it. Your doctor can screen for depression, so it’s worth asking on your next visit. Isolation and social withdrawal are common among people with depression. But it’s still possible to seek help during these periods. If you can’t face the thought of visiting your doctor, you can find information and assistance on your computer or smartphone. Screening for Mental Health’s online screening program gives a brief survey. It then tells you whether your answers are consistent with depression and provides materials to bring to your next doctor’s visit and a list of resources. Although it’s not a formal diagnosis, it’s a place to start to seek help. Crisis Text Line can connect you with a trained crisis counselor who can take you from crisis to cool down, all via text. The service is free and confidential. It’s available to people experiencing any kind of crisis. Text HOME to 741741 to get started. The National Alliance on Mental Illness can also connect you to mental-health resources, including help for depression. Visit nami.org/Find-Support or call the NAMI Helpline, 800-950-NAMI, between 10 a.m. and 6 p.m. Eastern. © 1996-2018 The Washington Post

Keyword: Depression
Link ID: 25537 - Posted: 10.08.2018

By Benedict Carey Dr. Bernard J. Carroll, whose studies of severe depression gave psychiatry the closest thing it has to a “blood test” for a mental disorder, and who later became one of the field’s most relentless critics, helping to expose pervasive corruption in academic research, died on Sept. 10 at his home in Carmel, Calif. He was 77. His wife, Sylvia Carroll, said the cause was lung cancer. Dr. Carroll was all of 28 when he published a paper that seemed to herald a new age of psychiatry, one rooted in biology rather than Freudian theory. Trained both in endocrinology and psychiatry, he applied a test from that first specialty — the dexamethasone suppression test, or DST — to people with mood problems. The test measures the body’s ability to suppress its own surges of cortisol, a stress hormone. In a 1968 article in The British Medical Journal, Dr. Carroll announced that when the test was administered to people with the severest species of depression — a paralyzing gloom then called melancholia, or endogenous depression — their bodies were shown to have trouble suppressing the hormone. People with other kinds of mood disorders had normal scores. The test did not mean that failure to suppress cortisol caused depression, just that it was associated with it. “I thought of it as a confirmatory test, to support a diagnosis, not to make one,” Dr. Carroll, known as Barney, said, in a recent interview in his home, “and possibly as a way to monitor progress in treatment.” It didn’t happen. In 1980, experts revising psychiatry’s influential diagnostic manual eliminated distinctions in kinds of depression. Melancholia was lumped with many other mild and moderate conditions under the classification “major depressive disorder.” Soon after, modern antidepressants hit the market, and pharmaceutical companies paid top academics around the world to help interpret studies, massage data and promote their products. The field chased the drugs, and the money, and learned nothing about the biology of mental disorders. © 2018 The New York Times Company

Keyword: Depression
Link ID: 25531 - Posted: 10.05.2018

By Laura M. Holson Researchers from Johns Hopkins University have recommended that psilocybin, the active compound in hallucinogenic mushrooms, be reclassified for medical use, potentially paving the way for the psychedelic drug to one day treat depression and anxiety and help people stop smoking. The suggestion to reclassify psilocybin from a Schedule I drug, with no known medical benefit, to a Schedule IV drug, which is akin to prescription sleeping pills, was part of a review to assess the safety and abuse of medically administered psilocybin. Before the Food and Drug Administration can be petitioned to reclassify the drug, though, it has to clear extensive study and trials, which can take more than five years, the researchers wrote. The analysis was published in the October print issue of Neuropharmacology, a medical journal focused on neuroscience. The study comes as many Americans shift their attitudes toward the use of some illegal drugs. The widespread legalization of marijuana has helped demystify drug use, with many people now recognizing the medicinal benefits for those with anxiety, arthritis and other physical ailments. Psychedelics, like LSD and psilocybin, are illegal and not approved for medical or recreational use. But in recent years scientists and consumers have begun rethinking their use to combat depression and anxiety. “We are seeing a demographic shift, particularly among women,” said Matthew Johnson, an associate professor of psychiatry and behavioral sciences at Johns Hopkins and one of the study’s authors. Among the research he has conducted, he said, “we’ve had more females in our studies.” © 2018 The New York Times Company

Keyword: Depression
Link ID: 25530 - Posted: 10.04.2018

By Michael Shermer Anthony Bourdain (age 61). Kate Spade (55). Robin Williams (63). Aaron Swartz (26). Junior Seau (43). Alexander McQueen (40). Hunter S. Thompson (67). Kurt Cobain (27). Sylvia Plath (30). Ernest Hemingway (61). Alan Turing (41). Virginia Woolf (59). Vincent van Gogh (37). By the time you finish reading this list of notable people who died by suicide, somewhere in the world another person will have done the same, about one every 40 seconds (around 800,000 a year), making suicide the 10th leading cause of death in the U.S. Why? According to the prominent psychologist Jesse Bering of the University of Otago in New Zealand, in his authoritative book Suicidal: Why We Kill Ourselves (University of Chicago Press, 2018), “the specific issues leading any given person to become suicidal are as different, of course, as their DNA—involving chains of events that one expert calls ‘dizzying in their variety.’” Indeed, my short list above includes people with a diversity of ages, professions, personality and gender. Depression is commonly fingered in many suicide cases, yet most people suffering from depression do not kill themselves (only about 5 percent Bering says), and not all suicide victims were depressed. “Around 43 percent of the variability in suicidal behavior among the general population can be explained by genetics,” Bering reports, “while the remaining 57 percent is attributable to environmental factors.” Having a genetic predisposition for suicidality, coupled with a particular sequence of environmental assaults on one's will to live, leads some people to try to make the pain stop. In Bering's case, it first came as a closeted gay teenager “in an intolerant small Midwestern town” and later with unemployment at a status apex in his academic career (success can lead to unreasonably high standards for happiness, later crushed by the vicissitudes of life). Yet most oppressed gays and fallen academics don't want to kill themselves. “In the vast majority of cases, people kill themselves because of other people,” Bering adduces. “Social problems—especially a hypervigilant concern with what others think or will think of us if only they knew what we perceive to be some unpalatable truth—stoke a deadly fire.” © 2018 Scientific American

Keyword: Depression
Link ID: 25529 - Posted: 10.04.2018

Sarah Boseley Health editor Half of all those taking antidepressants experience withdrawal problems when they try to give them up and for millions of people in England, these are severe, according to a new review of the evidence commissioned by MPs. Guidance from the National Institute of Health and Care Excellence (Nice), which says withdrawal symptoms “are usually mild and self-limiting over about one week” urgently needs to be changed, say the review authors. Dr James Davies from the University of Roehampton and Prof John Read from the University of East London say the high rate of withdrawal symptoms may be part of the reason people are staying on the pills for longer. They cannot cope, so carry on taking the drugs, or their doctors assume they have relapsed and write another prescription. The review was commissioned by the all-party parliamentary group for prescribed drug dependence and follows a long debate about the Nice guidance, which critics say is out of date. Modern antidepressants of the SSRI class, such as Prozac (fluoxetine) and Seroxat (paroxetine), were marketed in part on their safety. People were unable to harm themselves by overdosing as they could on benzodiazepines like valium and stopping the drugs was said to be easier. There have been plenty of anecdotal accounts of withdrawal symptoms, which include dizziness, vertigo, nausea, insomnia, headaches, tiredness and difficulties concentrating. But the Nice guidance said in 2004 that the withdrawal symptoms were slight and short-lived and was re-adopted without further evidence in 2009. It is similar to the US guidance, which says symptoms usually resolve within one to two weeks. © 2018 Guardian News and Media Limited

Keyword: Depression
Link ID: 25524 - Posted: 10.03.2018

By Moises Velasquez-Manoff The man was 23 when the delusions came on. He became convinced that his thoughts were leaking out of his head and that other people could hear them. When he watched television, he thought the actors were signaling him, trying to communicate. He became irritable and anxious and couldn’t sleep. Dr. Tsuyoshi Miyaoka, a psychiatrist treating him at the Shimane University School of Medicine in Japan, eventually diagnosed paranoid schizophrenia. He then prescribed a series of antipsychotic drugs. None helped. The man’s symptoms were, in medical parlance, “treatment resistant.” A year later, the man’s condition worsened. He developed fatigue, fever and shortness of breath, and it turned out he had a cancer of the blood called acute myeloid leukemia. He’d need a bone-marrow transplant to survive. After the procedure came the miracle. The man’s delusions and paranoia almost completely disappeared. His schizophrenia seemingly vanished. Years later, “he is completely off all medication and shows no psychiatric symptoms,” Dr. Miyaoka told me in an email. Somehow the transplant cured the man’s schizophrenia. A bone-marrow transplant essentially reboots the immune system. Chemotherapy kills off your old white blood cells, and new ones sprout from the donor’s transplanted blood stem cells. It’s unwise to extrapolate too much from a single case study, and it’s possible it was the drugs the man took as part of the transplant procedure that helped him. But his recovery suggests that his immune system was somehow driving his psychiatric symptoms. At first glance, the idea seems bizarre — what does the immune system have to do with the brain? — but it jibes with a growing body of literature suggesting that the immune system is involved in psychiatric disorders from depression to bipolar disorder. © 2018 The New York Times Company

Keyword: Schizophrenia; Neuroimmunology
Link ID: 25512 - Posted: 10.01.2018

By Megan Thielking, Walk into Kalypso Wellness Centers in San Antonio, Texas, and you might be treated with one of five “proprietary blends” of ketamine. They’re not cheap—$495 per infusion—and not covered by insurance, but the company offers a “monthly” membership program to cut costs and advertises discounts for members of the military and first responders. Kalypso promotes ketamine, long used as an anesthetic during surgery and more recently as a club drug, as a treatment for more than two dozen conditions, including depression, chronic pain, and migraines. “Congratulations on resetting your life!!!” it cheerily tells patients on a form they’re handed after an infusion. Starting with just one office 19 months ago, Kalypso has expanded rapidly to meet surging patient demand for ketamine and now oversees two other Texas clinics and offices in North Carolina and New York. It recruits customers through online ads and radio spots, and even by visiting support groups for pain patients, people with depression, first responders, and grieving parents who have lost children. Advertisement “You name it, we’ve done it,” said clinic co-founder and anesthesiologist Dr. Bryan Clifton. An investigation by STAT shows that Kalypso’s sweeping claims are hardly uncommon in the booming ketamine treatment business. Dozens of free-standing clinics have opened across the U.S. in recent years to provide the drug to patients who are desperate for an effective therapy and hopeful ketamine can help. But the investigation found wide-ranging inconsistencies among clinics, from the screening of patients to the dose and frequency of infusions to the coordination with patients’ mental health providers. A number of clinics stray from recommendations issued last year by the American Psychiatric Association. © 2018 Scientific American

Keyword: Depression; Drug Abuse
Link ID: 25500 - Posted: 09.27.2018

Denis Campbell Health policy editor Eating junk food increases the risk of becoming depressed, a study has found, prompting calls for doctors to routinely give dietary advice to patients as part of their treatment for depression. In contrast, those who follow a traditional Mediterranean diet are much less likely to develop depression because the fish, fruit, nuts and vegetables that diet involves help protect against Britain’s commonest mental health problem, the research suggests. Published in the journal Molecular Psychiatry, the findings have come from an analysis by researchers from Britain, Spain and Australia who examined 41 previous studies on the links between diet and depression. “A pro-inflammatory diet can induce systemic inflammation, and this can directly increase the risk for depression,” said Dr Camille Lassale, the study’s lead author. Bad diet heightens the risk of depression to a significant extent, she added. The analysis found that foods containing a lot of fat or sugar, or was processed, lead to inflammation of not just the gut but the whole body, known as “systemic inflammation”. In that respect the impact of poor diet is like that of smoking, pollution, obesity and lack of exercise. © 2018 Guardian News and Media Limited

Keyword: Depression; Obesity
Link ID: 25494 - Posted: 09.26.2018

by Angie Seech When I first started doing research into the changes that occur in a woman’s brain during pregnancy and the postpartum, I continued to come across the name of Jodi Pawluski, Ph.D., a researcher in the field of perinatal mental health. After reading this amazing review paper, I reached out to Jodi and her colleagues to thank her for her important work. Since that one email, I’ve had the opportunity to thank her in person and spend some time talking with her about perinatal mental health. Besides being a wonderful person, she is truly passionate about what she does and about helping women. Just read some of her answers to my questions about her research and views on the present and future status of maternal mental health and I’m sure you’ll agree! What is your ultimate goal as a researcher in this field? This is such a great, but broad, question! My ultimate goal is to have policies change to incorporate the importance of maternal mental and physical health for the mother. I also want these policies to value, promote, and support research on the neurobiology of motherhood and maternal mental illness. There is so much more that we need to know, but without support and interest we, as scientists, clinicians, parents, can’t find answers to our many questions. What is your most important question? Or the question that you really want to find the answer to in your career? At the moment I am doing some really interesting work on how maternal antidepressant medication use, such as SSRIs, can affect the neurobiology of the mother and developing offspring, using rodent models. One of my goals is to find out why some women respond well to SSRIs, such as Prozac, during the perinatal period and why others don’t. This is an important question and ultimately will allow for more precise and effective treatments. During my career I hope that my research significantly contributes to understanding how maternal mental illness affects the maternal brain and contributes to find ways in which we can safely and effectively treat these diseases. 2018 © MOMMY BRAIN EDU |

Keyword: Sexual Behavior; Depression
Link ID: 25483 - Posted: 09.24.2018

By — Linda Searing More than 1 of every 3 college freshmen across the globe — 35 percent — show symptoms of one of the common mental-health disorders, according to new research published by the American Psychological Association. The research was based on World Health Organization data on 13,984 full-time freshman students from 19 colleges in eight countries — Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain and the United States. The two most common disorders found were major depression (affecting 21 percent of the students) and generalized anxiety disorder (19 percent). The students were also screened for panic disorder, mania, drug abuse and alcohol abuse or dependence. Although the study, published in the Journal of Abnormal Psychology, found that symptoms started years before college — generally at about age 14 — in most cases, the life changes and stresses that may occur as students enter their college years could exacerbate symptoms. The study’s authors, and other experts, say that to help manage their mental-health condition, students should check whether their campus counseling centers, or local psychologists, offer group or individual cognitive behavioral therapy, or CBT. But the lead author said that because the number of students needing mental-health treatment “far exceeds the resources of most [campus] counseling centers,” students and colleges should consider supplementing services with “Internet-based interventions” that studies have shown to be effective, including online CBT. © 1996-2018 The Washington Post

Keyword: Depression
Link ID: 25482 - Posted: 09.24.2018

Luke Watkin was in year eight at school and alone in a corridor when he first heard a strange noise. "I heard what sounded like a train brake, followed by a metal on metal noise. "It was just something completely out of the ordinary. It was a bit of a shock to the system, something I just couldn't understand or really process. "My experience at the time was quite terrifying." It was his first experience of the mental health condition, psychosis. Luke was 12 years old. He said it went on from noises to hearing words, hearing his name, to eventually hearing whole sentences "of it almost trying to talk to me". The main symptoms of psychosis are hallucinations and delusions and it can be caused by a specific mental health condition, such as schizophrenia, bipolar disorder or severe depression. It can also be triggered by traumatic experiences, stress, drugs, alcohol, as a side-effect of prescribed mediation or a physical condition such as a brain tumour. While it is not as common as depression - affecting fewer than one in every hundred - experts say it is important to recognise symptoms of psychosis early because early treatment can be more effective. People with psychosis have a higher than average risk of self-harm and suicide. The charity Rethink Mental Illness has surveyed 4,000 people and found more than half believe they wouldn't be able to identify the early symptoms. They are concerned that a general lack of awareness leads to young people not getting help early on - especially as the first episode of psychosis is most likely to happen between the ages of 18 and 24. More subtle early warning signs include withdrawing from friends, expressing strange beliefs, sudden changes in mood and confused thoughts. © 2018 BBC

Keyword: Schizophrenia
Link ID: 25462 - Posted: 09.18.2018

By Alan Jasanoff Disorders of the mind have meant different things to different people at different times. In Plato’s “Phaedrus,” Socrates extols divinely inspired madness in mystics, lovers, poets and prophets; he describes these disturbances as gifts of the gods, rather than maladies. Premodern Europeans more commonly despised the insane, but barely distinguished them from others their society rejected; madmen were imprisoned alongside beggars, blasphemers and prostitutes. Some modern cultures have notions of mental disorder that seem almost as strange to us; syndromes with names like latah, amok and zar defy traditional classifications of Western psychiatry and often call for spiritual rather than medical responses. Our own culture’s conception of the varieties of mental illness took shape first from a deck of cards curated by the pioneering German psychiatrist Emil Kraepelin over a century ago. Each of the cards contained an abstract of a patient’s medical history, and by grouping them according to similarities he observed among the cases, Kraepelin delineated for the first time some of the major categories physicians now use to diagnose psychiatric diseases. Since the 1980s, Kraepelin’s characterizations of psychosis, mania and depression have been virtually codified in the Diagnostic and Statistical Manual of Mental Disorders, the clinician’s bible for evaluating patients. Kraepelin was a staunch critic of psychoanalysis and passionate advocate for understanding mental phenomena in strictly biological terms — attitudes now also ascendant in psychiatric biomedicine. © 2018 The New York Times Company

Keyword: Schizophrenia
Link ID: 25461 - Posted: 09.18.2018

By Knvul Sheikh Humans and other mammals react to stressful situations through a series of well-orchestrated evolutionary adaptations. When faced with a predator looking for its next meal, or with worry of losing a job, our bodies release a cascade of stress hormones. Our heart rate spikes, breath quickens, muscles tense up and beads of sweat appear. This so-called “fight-or-flight” response served our ancestors well, but its continual activation in our modern-day lives comes with a cost. Scientists are starting to realize stress often exacerbates several diseases, including depression, diabetes, cardiovascular disease, HIV/AIDS and asthma. One theory is hoping to explain the link between stress and such widespread havoc by laying the blame on an unexpected source—the microscopic powerhouses inside each cell. Each of our cells contains hundreds of small bean-shaped mitochondria — subcellular structures, or organelles, that provide the energy needed for normal functioning. Mitochondria have their own circular genome with 37 genes. We inherit this mitochondrial DNA only from our mothers, so the makeup of the DNA’s code stays relatively consistent from one generation to the next. But our fight-or-flight response places extreme demands on the mitochondria. All of a sudden, they need to produce much more energy to fuel a faster heartbeat, expanding lungs and tensing muscles, which leaves them vulnerable to damage. Unlike DNA in the cell’s nucleus, though, mitochondria have limited repair mechanisms. And recent animal studies have shown chronic stress not only leads to mitochondrial damage in brain regions such as the hippocampus, hypothalamus and cortex, it also results in mitochondria releasing their DNA into the cell cytoplasm, and eventually into the blood. © 2018 Scientific American,

Keyword: Depression; Genes & Behavior
Link ID: 25448 - Posted: 09.14.2018

By Bernardo Kastrup, Edward F. Kelly A long-awaited resurgence in psychedelic research is now under way and some of its early results have been startling. Whereas most scientists expected the mind-boggling experiences of psychedelic states to correlate with increased brain activity,a landmark study from 2012 found the opposite to be the case. Writing in this magazine, neuroscientist Christof Koch expressed the community’s collective surprise. These unexpected findings have since been repeatedly confirmed with a variety of psychedelic agents and measures of brain activity (2013,2015,2016, 2017). Under the mainstream physicalist view that brain activity is, or somehow generates, the mind, the findings certainly seem counterintuitive: How can the richness of experience go up when brain activity goes down? Understandably, therefore, researchers have subsequently endeavored to find something in patterns of brain activity that reliably increases in psychedelic states. Alternatives include brain activity variability, functional coupling between different brain areas and, most recently, a property of brain activity variously labeled as “complexity,” “diversity,” “entropy” or “randomness”—terms viewed as approximately synonymous. The problem is that modern brain imaging techniques do detect clear spikes in raw brain activity when sleeping subjects dream even of dull things such as staring at a statue or clenching a hand. So why are only decreasesin brain activity conclusively seen when subjects undergo psychedelic experiences, instead of dreams? Given how difficult it is to find one biological basis for consciousness, how plausible is it that two fundamentally different mechanisms underlie conscious experience in the otherwise analogous psychedelic and dreaming states? © 2018 Scientific American

Keyword: Depression; Drug Abuse
Link ID: 25414 - Posted: 09.04.2018

Sarah Boseley Health editor Erica Avey, 27, microdosed on LSD for eight months, using an analogue that was legal in Germany, where she was living. “I started microdosing essentially because I was in a really depressed stage of my life. It was for mental health reasons – mood balancing, mood management. It was hard for me to leave my apartment and do normal things as a human being,” she said. Depression or sadness are very common reasons for starting; Avey was unusual only in that she could be open about it. Her workplace knew and thought it was fine. “As long as I wasn’t out of control or permanently high at work they were quite OK.” She took about 15 micrograms (a whole tab is 100 micrograms). “That was a good amount for me. Some people take as little as six,” she said. She adopted a popular protocol – one day on, three days off. It worked for her. “It definitely had the effect I wanted,” she said. “It lifted me out of a pretty deep depression. I’m still trying to wrap my head around what it has done to me in the long-term. I think it has changed me.” She had been “pretty negative”, she said, mindlessly going through social media, plagued with obsessive thoughts. “I’m able to be more mindful of my emotions. If I’m feeling sad, that’s OK. I don’t obsess anymore. I don’t dwell on it. I don’t get worked up about it.” © 2018 Guardian News and Media Limited

Keyword: Depression; Drug Abuse
Link ID: 25407 - Posted: 09.01.2018