Chapter 12. Psychopathology: The Biology of Behavioral Disorders

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By Gary Stix  Many people with bipolar disorder have a strong attraction to marijuana. A 2019 review of 53 studies found that almost a quarter of a combined sample of 51,756 individuals with the condition used cannabis or had a problematic pattern of consumption (cannabis use disorder), compared with 2 to 7 percent in the general population—and an earlier study placed usage estimates still higher. Cannabis and bipolar disorder do not go particularly well together. Consumption may increase manic and psychotic symptoms, and there may be a greater risk of suicide. But can the allure of cannabis be explained as a mere form of substance misuse? Why are people with bipolar disorder so attracted to marijuana? Could they be getting any possible benefit from it? Alannah Miranda of the University of California, San Diego, is a postdoctoral scholar working with U.C.S.D. psychiatry professors William Perry and Arpi Minassian to explore these questions. Miranda presented her and her colleagues’ unpublished work at this year’s giant Society for Neuroscience conference, which attracted more than 24,000 people earlier this month. She talked to Scientific American about what she discovered in this continuing study, which has been funded by the National Institute on Drug Abuse. [An edited transcript of the interview follows.] Tell me about what you’re studying. I’m researching the effects of cannabis on cognition in people with bipolar disorder. People with bipolar disorder report that it’s helping alleviate some of their symptoms in terms of issues related to memory, attention, focus and anxiety. © 2022 Scientific American,

Keyword: Schizophrenia; Drug Abuse
Link ID: 28569 - Posted: 11.30.2022

Hannah Devlin Science correspondent Scientists claim to have found the first direct evidence that people with depression have a reduced capacity for releasing serotonin in the brain. The findings from a brain-imaging study reignite a debate within psychiatry over the so-called serotonin hypothesis of depression and challenge the conclusions of an influential review published in July that found “no clear evidence” that low serotonin levels are responsible. The latest work, led by scientists at Imperial College London, suggested that people with depression have a decreased serotonin response. “This is the first direct evidence that the release of serotonin is blunted in the brains of people with depression,” said Prof Oliver Howes, a consultant psychiatrist based at Imperial College and King’s College London, and a co-author. “People have been debating this question for 60 years, but it’s all been based on indirect measures. So this is a really important step.” The serotonin hypothesis arose from evidence from postmortem brains and blood samples that suggested a serotonin deficit could be involved in depression. The theory provides a plausible biological mechanism for how the main class of antidepressant drugs, selective serotonin reuptake inhibitors (SSRIs), are effective, and is why the brain chemical is sometimes referred to as a “happy hormone”. However, there is not yet conclusive evidence that serotonin abnormalities are the underlying cause of depression and resolving this question is seen as crucial to providing better treatments. The latest paper adds weight to the view that serotonin plays a role and demonstrates a new brain imaging technique that could pave the way to a better understanding of why SSRI drugs fail to help an estimated 10% to 30% of patients. “It’s the closest anyone has been able to get so far,” said Howes. “It’s hard to measure these transmitters in the brains of living people. We can’t put a pipette in there and take a sample. This is the closest we’re likely to come.” © 2022 Guardian News & Media Limited o

Keyword: Depression
Link ID: 28541 - Posted: 11.05.2022

By Leo Sands Psilocybin, the active hallucinogen found in psychedelic mushrooms — also known as “magic mushrooms” — can effectively alleviate a severe bout of depression when administered in a single dose and combined with talk therapy, a new clinical study found. Adults with depression who were administered a single 25-miligram dose of psilocybin were more likely to experience significant improvements in their mental health — both immediately and for up to three months — than others who were randomly assigned smaller doses of the same drug, said the peer-reviewed study, which was published Wednesday in the New England Journal of Medicine. “There’s something about the psychedelic experience that leads to a rapid resolution of depression symptoms,” said James Rucker, a consultant psychiatrist at King’s College London who worked on the trial. “We don’t really know what that is at the moment, but it’s very different to standard antidepressants.” The trial’s findings could be an encouraging sign for the 16 million Americans estimated each year by the Centers for Disease Control and Prevention to have depression, many of whom struggle to find treatments that work for them. Its authors hope the study — which was relatively small, with just 79 participants receiving the 25 mg dose — will pave the way for eventual regulatory approval of psilocybin by the Food and Drug Administration for use as a drug against depression. The new study randomly assigned 233 adults with depression three doses of psilocybin — 25 mg, 10 mg and 1 mg — across 22 sites in 10 countries. The authors found that the group given the largest dose recorded the most significant improvements in their depression, both immediately and for several weeks after.

Keyword: Depression; Drug Abuse
Link ID: 28540 - Posted: 11.05.2022

Jon Hamilton Computer games designed to boost self-esteem appear to prolong the antidepressant benefits of the mind-bending anesthetic ketamine. A recent study of 154 people found that those who played games featuring smiling faces and positive messages remained free of depression up to three months after a ketamine infusion, a team reports in the American Journal of Psychiatry. People who got ketamine alone tended to relapse after a week or two. The results are important because "we need new approaches that help people get feeling better faster and help them stay feeling better," says Rebecca Price, an author of the study and an associate professor of psychiatry and psychology at the University of Pittsburgh. Established drugs like Prozac and Zoloft can take weeks to ease depression, and don't work for every patient. Ketamine can offer immediate relief, but the effects often fade after a few days or weeks. "And then returning for infusions over and over to keep that relief going can end up being really burdensome and costly," Price says, "and just isn't accessible to all patients." So Price and a team of researchers wanted to find a way to make ketamine's antidepressant effects last longer. They decided to focus on a common symptom of depression: low self-esteem and self-loathing. The team drew on research suggesting that ketamine temporarily causes certain brain areas to enter a state in which they form lots of new connections. During this period, the brain seems to be more receptive to learning and change. "So we tried to use that window of opportunity just after ketamine to strengthen associations specifically between the idea of me, myself, and positive information and attributes," Price says. © 2022 npr

Keyword: Depression; Drug Abuse
Link ID: 28535 - Posted: 11.02.2022

By Jyoti Madhusoodanan Q: I recently started taking an S.S.R.I. antidepressant, but I have been confused about whether it’s safe to drink alcohol. Some internet sources say it’s fine, others say to avoid drinking completely. Help! For many health care providers who treat anxiety and depression, the concern about whether it’s safe — or even advised — to drink alcohol while taking an antidepressant is a common one. “Patients tell me all the time, ‘I’m going to be drinking with friends tonight, so I skipped a dose,’” said Dr. Sarah Ramsay Andrews, a psychiatrist at the Johns Hopkins University School of Medicine. But skipping a dose is never a good idea, said Dr. Jody Glance, an addiction medicine specialist at the University of Pittsburgh Medical Center Western Behavioral Health — even if you’re going out for cocktails with friends. “When people stop taking their medicines for a day or two, they often don’t resume, and that can lead to a relapse of anxiety or depression.” Besides, she added, how safe it is to drink while on antidepressants depends on the kind of antidepressant you’re taking — and for most people taking selective serotonin reuptake inhibitors (or S.S.R.I.s), an occasional drink likely won’t do much harm. There are, however, caveats to keep in mind. S.S.R.I. medications — which include citalopram (Celexa), sertraline (Zoloft) and escitalopram (Lexapro) — are the most commonly prescribed class of antidepressants. They are typically used to help treat depression, and can also be effective for other conditions like anxiety, obsessive compulsive disorder, certain phobias and even premenstrual dysphoric disorder. They work by increasing the levels of the brain chemical serotonin — which is thought to influence your mood and emotions, among other things — by blocking its removal after it carries messages in the brain. But unlike many other medications used to treat mood disorders — like the anxiety medication alprazolam (Xanax) or the tricyclic antidepressant amitriptyline (Elavil) — S.S.R.I.s are less likely to interact with alcohol than other kinds of drugs, Dr. Glance said. © 2022 The New York Times Company

Keyword: Depression; Drug Abuse
Link ID: 28517 - Posted: 10.19.2022

Jon Hamilton Drugs like magic mushrooms and LSD can act as powerful and long-lasting antidepressants. But they also tend to produce mind-bending side-effects that limit their use. Now, scientists report in the journal Nature that they have created drugs based on LSD that seem to relieve anxiety and depression – in mice – without inducing the usual hallucinations. "We found our compounds had essentially the same antidepressant activity as psychedelic drugs," says Dr. Bryan Roth, an author of the study and a professor of pharmacology at UNC Chapel Hill School of Medicine. But, he says, "they had no psychedelic drug-like actions at all." The discovery could eventually lead to medications for depression and anxiety that work better, work faster, have fewer side effects, and last longer. The success is just the latest involving tripless versions of psychedelic drugs. One previous effort created a hallucination-free variant of ibogaine, which is made from the root bark of a shrubby plant native to Central Africa known as the iboga tree. "It's very encouraging to see multiple groups approach this problem in different ways and come up with very similar solutions," says David E. Olson, a chemical neuroscientist at the University of California, Davis, who led the ibogaine project. The new drug comes from a large team of scientists who did not start out looking for an antidepressant. They had been building a virtual library of 75 million molecules that include an unusual structure found in a number of drugs, including the psychedelics psilocybin and LSD, a migraine drug (ergotamine), and cancer drugs including vincristine. The team decided to focus on molecules that affect the brain's serotonin system, which is involved in regulating a person's mood. But they still weren't looking for an antidepressant. Roth recalls that during one meeting, someone asked, "What are we looking for here anyway? And I said, well, if nothing else, we'll have the world's greatest psychedelic drugs." © 2022 npr

Keyword: Depression; Drug Abuse
Link ID: 28502 - Posted: 10.05.2022

Daniel Merino & Josjan Zijlmans As research into psychedelics and their medical uses makes a comeback, scientists are having to deal with the legacy – both scientific and social – of a 40-year nearly total freeze on psychedelics research. In this episode of “The Conversation Weekly” podcast, we speak with three experts about the early rise and fall of psychedelics in Western science and culture, how the mystical and often vague language of the ‘60s and '70s still pervades research today and what it’s like to actually run clinical trials using psilocybin. According to a poll done in the summer of 2022, nearly 30% of U.S. residents have tried at least one psychedelic drug in their lifetime. Whether from personal experience, hearing about the experiences of friends or widespread depictions in the media, many people will have either tried to describe a psychedelic trip or heard someone else describe one. The language commonly used in these descriptions is, for lack of a better word, often quite trippy. “A key function of the ego is to identify differentiation,” says Robin Carhart-Harris, a neurologist and psychologist at the University of California, San Francisco, and one of the world’s leading psychedelics researchers. “And when that function breaks down, it’s replaced with a sense of de-differentiation, a sense of unity, like everything is interconnected in a web of relationships. That’s not nothingness, it’s sort of everythingness.” Many psychedelics researchers use an approach called “the mystical framework” to assess psychedelic experiences. Researchers who use this framework give participants in psychedelics studies a survey as a way to define and categorize the experience. The survey asks participants to rate how strongly they felt certain phenomena during their trip, including feelings like the “certainty of encounter with ultimate reality (in the sense of being able to 'know’ and ‘see’ what is really real at some point during your experience).” © 2010–2022, The Conversation US, Inc.

Keyword: Depression; Drug Abuse
Link ID: 28496 - Posted: 10.01.2022

Perspective by Steven Petrow A few weeks ago, I mentioned to a friend that I was interested in learning more about psychedelics, especially how they might help me with depression and anxiety. That’s a broad category of plant medicines including psilocybin (“magic”) mushrooms, MDMA (ecstasy), DMT (Dimitri or the Businessman’s Trip), ketamine (“special K”) and some others. I’d been hesitant to be open about my search, because I’m old enough to remember the warnings about “bad trips” that scramble your brain. Imagine my surprise when my friend told me he’d recently taken his first “trip,” which he described as life-changing. I asked him — a real estate developer living in Northern California, married with kids — why he decided to try a psychedelic substance. “My work felt increasingly stale and meaningless,” he explained to me over a beer. “Despite a massive amount of reflection and coaching around how to break the rut, I felt as though I was still off track.” He and the others who have used these medicines spoke on the condition of anonymity because most of these psychedelics are Schedule I substances, meaning they are illegal to manufacture, buy, possess or distribute. When I confided my interest in psychedelics to a few other friends, several said they had tried the drugs and experienced several benefits: from easing anxiety to finding spiritual insights to combating depression and, among some with cancer, helping to reduce the fear of dying. They are hardly outliers. According to a new YouGovAmerica study, “one in four Americans say they’ve tried at least one psychedelic drug,” amounting to some 72 million U.S. adults. (The study included the medicines mentioned earlier, plus LSD, mescaline and salvia.) Was I missing a beat by not getting onboard?

Keyword: Depression; Drug Abuse
Link ID: 28463 - Posted: 09.07.2022

By Matt Richtel This article examines the increase in anxiety, depression, self harm and suicide among U.S. adolescents. Parents and teenagers dealing with these issues can find resources here. One morning in the fall of 2017, Renae Smith, a high school freshman on Long Island, N.Y., could not get out of bed, overwhelmed at the prospect of going to school. In the following days, her anxiety mounted into despair. “I should have been happy,” she later wrote. “But I cried, screamed and begged the universe or whatever godly power to take away the pain of a thousand men that was trapped inside my head.” Intervention for her depression and anxiety came not from the divine but from the pharmaceutical industry. The following spring, a psychiatrist prescribed Prozac. The medication offered a reprieve from her suffering, but the effect dissipated, so she was prescribed an additional antidepressant, Effexor. A medication cascade had begun. During 2021, the year she graduated, she was prescribed seven drugs. These included one for seizures and migraines — she experienced neither, but the drug can be also used to stabilize mood — and another to dull the side effects of the other medications, although it is used mainly for schizophrenia. She felt better some days but deeply sad on others. Her senior yearbook photo shows her smiling broadly, “but I felt terrible that day,” said Ms. Smith, who is now 19 and attends a local community college. “I’ve gotten good at wearing a mask.” She had come to exemplify a medical practice common among her generation: the simultaneous use of multiple heavy-duty psychiatric drugs. Psychiatrists and other clinicians emphasize that psychiatric drugs, properly prescribed, can be vital in stabilizing adolescents and saving the lives of suicidal teens. But, these experts caution, such medications are too readily doled out, often as an easy alternative to therapy that families cannot afford or find, or aren’t interested in. © 2022 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 28450 - Posted: 08.27.2022

By Andrew Jacobs A small study on the therapeutic effects of using psychedelics to treat alcohol use disorder found that just two doses of psilocybin magic mushrooms paired with psychotherapy led to an 83 percent decline in heavy drinking among the participants. Those given a placebo reduced their alcohol intake by 51 percent. By the end of the eight-month trial, nearly half of those who received psilocybin had stopped drinking entirely compared with about a quarter of those given the placebo, according to the researchers. The study, published Wednesday in JAMA Psychiatry, is the latest in a cascade of new research exploring the benefits of mind-altering compounds to treat a range of mental health problems, from depression, anxiety and post-traumatic stress disorder to the existential dread experienced by the terminally ill. Although most psychedelics remain illegal under federal law, the Food and Drug Administration is weighing potential therapeutic uses for compounds like psilocybin, LSD and MDMA, the drug better known as Ecstasy. Dr. Michael Bogenschutz, director at NYU Langone Center for Psychedelic Medicine and the study’s lead investigator, said the findings offered hope for the nearly 15 million Americans who struggle with excessive drinking — roughly 5 percent of all adults. Excessive alcohol use kills an estimated 140,000 people each year. “These are exciting results,” Dr. Bogenschutz said. “Alcohol use disorder is a serious public health problem, and the effects of currently available treatments and medications tend to be small.” The double-blind randomized trial followed 93 participants for 32 weeks and divided them into two groups: One received psilocybin and the other a placebo in the form of antihistamine pills. The participants, all of whom struggled with excessive drinking, also took part in 12 therapy sessions that began several weeks before they received their first doses and continued for a month after the final dose. The psilocybin dosage was determined according to participants’ weight, and their heart rate and blood pressure were monitored during the eight-hour sessions. © 2022 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 28448 - Posted: 08.27.2022

Adam Miller · CBC News · A new analysis of the cause of depression has seemingly upended what we know about this common condition and challenged the use of antidepressants. But it may also leave patients with more questions than answers as the science evolves. A systematic umbrella review of 17 studies published in Molecular Psychology on July 20 looked at the decades-old theory that depression is caused by low serotonin, and found there was "no consistent evidence" of "an association between serotonin and depression." The theory that depression is caused by a chemical imbalance in the brain has been around since the 1960s. But for years, many experts have doubted this, feeling it oversimplified a complex condition. "The serotonin theory is very old and has been very popular since the '90s, when the pharmaceutical industry started promoting it," said Dr. Joanna Moncrieff, a psychiatry professor at University College London and lead author of the study. "But since about 2005, probably a bit before then, there's been sort of rumours that actually the evidence isn't very strong, or it's inconsistent. Some studies are positive, some studies are negative, but no one's really got that evidence together anywhere." Moncrieff and her team set out to challenge the serotonin theory in a systematic review of available research. They also went a step further in their conclusion by suggesting that antidepressants are ineffective at treating depression — and have largely worked as a placebo. ©2022 CBC/Radio-Canada.

Keyword: Depression
Link ID: 28434 - Posted: 08.13.2022

By Sarah Wild In 2015, psychiatrist Mark Horowitz tried to come off his antidepressants. He reduced his dosage by a set proportion over the course of several months, which is much longer than what the United Kingdom’s guidelines recommended. But in the process of tapering, he experienced a storm of new symptoms, including anxiety, dizziness, and bouts of insomnia. “I’d wake in the morning, feeling like I was being chased by an animal on the edge of a cliff,” he says. Ultimately, he felt he had no choice but to go back on his medication. As it happened, Horowitz had recently completed a Ph.D. on the neurobiology of antidepressants. During his training, he recalls, his professors had told him that stopping antidepressants was fairly easy. Their view was supported by the scientific literature, which had found that any withdrawal symptoms were minor and faded quickly. Experiences such as Horowitz’s were considered an anomaly. But a series of widely reported studies published over the past seven years suggest that discontinuation symptoms are common and can be severe, including everything from panic attacks and flu-like symptoms to electric shock sensations in the head. The longer people remain on antidepressants and the higher their dose, the more likely they are to experience withdrawal symptoms. Each year, millions of people begin taking antidepressants. They have been shown to help anxiety sufferers feel calmer and lift the moods of those with severe depression and balance their emotions. For many, the intervention is lifesaving. Yet even today, few physicians inform their patients about the potential difficulties of coming off the medication. Most national guidelines suggest a slow taper, but there is little to no guidance on precisely how to do this. Patients who experience intense withdrawal symptoms may end up remaining on antidepressants or turning to online peer support groups for help.

Keyword: Depression
Link ID: 28414 - Posted: 07.30.2022

Ismaeel Yunusa Taking oxycodone at the same time as certain selective serotonin reuptake inhibitors (SSRIs), a commonly prescribed class of antidepressant, can increase the risk of opioid overdose, according to a study my colleagues and I published. Doctors prescribe the opioid oxycodone to treat moderate to severe pain after surgeries and injuries or certain conditions like cancer. Opioids are also a common drug of abuse. In the U.S., over 70% of drug overdose deaths in 2019 involved an opioid. Because many patients with depression also experience chronic pain, opioids are often coprescribed with antidepressants like SSRIs. Prior research has shown that certain SSRIs, namely fluoxetine (Prozac or Sarafem) and paroxetine (Paxil, Pexeva or Brisdelle), can strongly inhibit a liver enzyme crucial to the proper breakdown of drugs in the body, including oxycodone. The resulting increased concentration of oxycodone in the blood may lead to accidental overdose. To see whether different types of SSRIs might affect a patient’s risk of overdosing on oxycodone, my colleagues and I examined data from three large U.S. health insurance claims databases. We included over 2 million adults who began taking oxycodone while using SSRIs between 2000 and 2020. The average age of the group was around 50, and a little over 72% were women. A little over 30% were taking the SSRIs paroxetine and fluoxetine. We found that patients taking paroxetine or fluoxetine had a 23% higher risk of overdosing on oxycodone than those using other SSRIs. © 2010–2022, The Conversation US, Inc.

Keyword: Depression; Drug Abuse
Link ID: 28413 - Posted: 07.30.2022

By Chris Vognar Sign up for the Watching newsletter, for Times subscribers only. Streaming TV and movie recommendations from critic Margaret Lyons and friends. Get it in your inbox. In late 2012, the best-selling author and journalist Michael Pollan (“The Omnivore’s Dilemma”) was at a dinner party in Berkeley, Calif. Among his fellow diners was a prominent developmental psychiatrist, in her 60s, who spoke at some length about a recent LSD trip. This pricked up Pollan’s ears. His first thought, as he shared during a recent video interview: “People like that are taking LSD?” The psychiatrist went on to explain that the drug gave her a better understanding of the way children think. “Her hypothesis,” Pollan said, “was that the effects of psychedelics, LSD in that case, give us a taste of what child consciousness would be like — this kind of 360-degree taking-in of information, not particularly focused, fascinated by everything.” Pollan had already heard about clinical trials in which doctors were giving cancer patients psilocybin to help them deal with their fear of death. Now, he was really curious about psychedelic therapy. That curiosity became an article in The New Yorker (“The Trip Treatment,” 2015). The article became a book, “How to Change Your Mind” (2019). And now the book has become a four-part Netflix series of the same name, which debuted Tuesday. Pollan is an executive producer (along with the Oscar-winning filmmaker Alex Gibney) and the primary on-camera presence. A thoughtful and wide-ranging look at psychedelic therapy, the series is grounded in accounts of their centuries-long sacramental use and of their uneasy history in modern society, especially in the United States. In particular, it focuses on four substances — LSD, mescaline, MDMA (known as Ecstasy or Molly) and psilocybin (the active ingredient in magic mushrooms) — and the ways in which they are being used to treat patients with maladies including post-traumatic stress disorder, addiction, depression, anxiety and obsessive-compulsive disorder. © 2022 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 28401 - Posted: 07.16.2022

By Claudia Wallis Age is the single biggest risk factor for dementia, with the odds doubling about every five years after age 65. But many things influence those odds for a given individual. Genetic vulnerability is a contributor, as are so-called modifiable risk factors such as smoking, cardiovascular disease, social isolation, and impaired hearing and vision. Certain mental conditions, particularly depression and schizophrenia, have also been linked to dementia. But because depression can itself be a sign of cognitive decline, the causality has been a bit muddy. Earlier this year an analysis of data from New Zealand provided the most convincing evidence to date linking many kinds of mental illness with dementia. That study raises important questions about the reasons for this increased risk and what could be done to reduce it. The study looked at the health records of 1.7 million New Zealanders born between 1928 and 1967 covering a 30-year period ending in mid-2018. It found that those with a diagnosed mental disorder—such as anxiety disorders, depression or bipolar disorder—had four times the rate of ultimately developing dementia compared with people without such a diagnosis. For those with a psychosis such as schizophrenia, it was six times the rate. Among people who developed dementia, those with a psychiatric disorder were affected 5.6 years earlier, on average. The study did not examine biological, social or other reasons for the increased risk, but research on dementia points to several possible explanations. “There might be shared genetic risk factors,” suggests psychologist Leah Richmond-Rakerd of the University of Michigan, lead author of the study. Recent studies have found some overlap in genetic markers associated with Alzheimer's disease and those linked to bipolar disorder and to major depression. Long-term use of psychiatric medications could also be playing a role in dementia, but Richmond-Rakerd and her co-authors do not think it is a major contributor. © 2022 Scientific American,

Keyword: Schizophrenia; Alzheimers
Link ID: 28391 - Posted: 07.12.2022

By Joshua C. Kendall About 40 years ago, Daniel Bergner’s younger brother, Bob, then 21 and a college dropout, had a psychotic break. He became delusional; he was convinced that he might be the messiah and that he could cure their grandfather’s Alzheimer’s disease. Worn down by insomnia, Bob was also neglecting his personal hygiene. Out of desperation, the brothers’ parents arranged to have Bob committed to a locked psychiatric unit, where he was soon pumped up on a heavy dose of Haldol, an antipsychotic medication. Shortly after Bob was hospitalized, their father handed Daniel a popular book by the late Ronald Fieve — first published in 1975— on mood disorders. According to this prominent psychopharmacologist, psychiatry was undergoing “a third revolution,” which was leading to new and highly effective drug cures for major mental disorders, including schizophrenia, bipolar disorder, and major depression. This book, notes Daniel Bergner in “The Mind and the Moon: My Brother’s Story, The Science of Our Brains, and the Search for Our Psyches,” gave his parents hope that his brother’s condition could be treated. “It was as if they had ingested the book’s sentences and elevated its paragraphs to articles of faith,” he writes. “They were immediate converts.” As Bergner, a contributing writer for The New York Times Magazine, emphasizes in his moving narrative, the chief claim contained in that bestseller of yesteryear — that mental illnesses are diseases for which there exist chemical cures — ended up gaining a lot of traction. But Bergner himself has long harbored reservations about such biological reductionism.

Keyword: Schizophrenia; Depression
Link ID: 28389 - Posted: 07.12.2022

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