The Evolving Science of Mind

Back in June, I added three books to my burgeoning bookshelves and went on to  post briefly about one of them titled Brainwashed - the Seductive Appeal of Mindless Neuroscience written by Sally Satel and Scott O. Lilienfeld.

Shortly afterwards, David Brooks of the New York Times wrote a review of Brainwashed as well as commentary titled "Beyond the Brain" [June 17, 2013]  noting, "It’s a pattern as old as time. Somebody makes an important scientific breakthrough, which explains a piece of the world. But then people get caught up in the excitement of this breakthrough and try to use it to explain everything." 

Well, I thought, perhaps I should stop pressing for an fMRI for my family member and rely instead on proven testing as provided by a local neuropsychologist who in June spent six hours going through the testing and then interpreting the results to recommend next steps.  He argued that fMRI's do not yet yield enough information to make formal diagnoses to take treatment to the next step.

Now along comes today's (Sunday, September 8, 2013, The Sunday Review, page 12) New York Times with a piece titled "The New Science of Mind" by Eric R. Kandel who is, according to the italicized information, "....a professor of the Mortimer B. Zuckerman Mind Brain Behavior Institute at Columbia, a senior investigator at the Howard Hughes Medical Institute and a recipient of the 2000 Nobel Prize in Physiology or Medicine, and [if that isn't enough] the author of "The Age of Insight: The Quest to Understand the Unconscious in Art, Mind and Brain, From Vienna 1900 to the Present." 

Dr. Kandel provides an in-depth discussion not only on the biological basis and reported potential treatment of depression but also on the broader concept of the Science of Mind.

He points to the outcome of studies by Professor Helen Mayberg of Emory University and others of neural circuitry that has become disordered:  one can treat a person more effectively with either an antidepressant or Cognitive Behavioral Therapy depending on whether or not certain areas of the brain seen in the fMRI are more or less active.

Pause here.........  Really!?!

Kandel goes on to highlight four areas about the biology of mental disorders.  The biology of mental disorders?  So many of us who have family members with one mental disorder or another have been arguing, as Dr. Kandel writes, that "....mental disorders are biological in nature, that people are not responsible for having schizophrenia or depression, and that individual biology and genetics make significant contributions."

Those four areas in this discussion are:
1 - "Neural circuits disturbed by psychiatric disorders are likely to be very complex...."
2 - "....We can identify specific, measurable markers of a mental disorder, and those biomarkers can predict the outcome of two different treatments:  psychotherapy and medication"
3 - "Psychotherapy is a biological treatment, a brain therapy.  It produces lasting, detectable physical changes to our brain, much as learning does."
4 - "The effects of psychotherapy can be studied empirically."

Kandel also incorporates a discussion of the important contributions of genetics - a topic that is being addressed more frequently by many.  In fact a succinct summary of what happens in each of us appears in a New York Times book review by David Quammen about George Johnson's The Cancer Chronicles.  Simply taking a look at mitosis and entropy as explained by Johnson, Mr. Quammen describes what happens within our cells every day.  

So what is the conclusion here?  It's one that continues to be argued about by psychologists, psychiatrists, theoreticians, and philosophers among others.  [From the Kandel piece]:  "....This new science of mind is based on the principle that our mind and our brain are inseparable.... Our mind is a set of operations carried out by our brain.  [And further], the same principle of unity applies to mental disorders."

My conclusion is that we still remain quite far from the day when one can receive effective personalized treatment for their brain disorder whether that brain disorder/malfunction causes, for example, anorexia or bulimia, schizophrenia, depression, obsessive compulsive disorder, anxiety, borderline personality disorder [ a misnomer], and manic-depressive disorder (bipolar disorder) -- or two or more of these at the same time. 

And as a closing caveat I think it's important for family members, myself included, to recognize based on the genetics piece that we are all different, that our brains have evolved as we've grown dependent on our experiences, our genetics, our environment, and as well on the unique brain pruning process that occurs for each of us [will try to find a succinct link to describe this fascinating process].  Consequently what works as treatment for one person or even a few people might not work for others.  The science of all of this is young and each person with a brain disorder must be evaluated independently and perhaps by more than one psychiatrist/psychologist before a course of treatment is adopted.  Likewise, it's important to revisit that treatment and/or therapist  if progress is not being made.

A link between diet soda and depression

The United States Department of Agriculture announced on Friday a proposal for "new standards to provide healthy food options in schools."

Note that this is a proposal and there is a call for the public's input, and a web address is provided in the news release.  So, the announcement does not necessarily mean a fait accomplit although the soft drink lobby is quite powerful.

Among the proposals is the availability of diet sodas for high school students and the choice of one diet soda each day for lunch.

At the same time, neuroscientists and presumably some members of the public are aware that an NIH study released in January reported a link between diet soda and depression!  Among the media reporting this was US News and World Report.

Earlier on my blog I wrote about the potential dangers of aspartame, an artificial sweetener found in many versions of diet soda.  I was surprised to find that the Mayo Clinic has actually addressed the question that I raised about phenylalanine.  

Here's a Mayo Clinic response to the question of phenylalanine,a substance found in diet soda.  Short answer - it can be harmful.

Today (March 14, 2013) another article that appears in the Huffington Post, this one by Dr.  Joseph Mercola titled Aspartame Pathway reports on the toxicity of another substance that appears when aspartame is broken down by the human body -  methanol.  From the article:  "Methanol acts as a Trojan horse: It's carried into susceptible tissues in your body, like your brain and bone marrow, where the alcohol dehydrogenase (ADH) enzyme converts it into formaldehyde, which wreaks havoc with sensitive proteins and DNA."

I hope more parents and the general public will become more aware of research that is uncovering links between aspartame and brain circuit disorders.  Perhaps in the meantime, if one wants a coca-cola, one might want to lobby their Costco or whatever to bring coca-cola that is bottled in Mexico (with cane sugar) to their locale.  Perhaps other soda manufacturers might want to return to real sugar, as well.

Yes, real sugar as well as sodas can be harmful, too, taken in excess.  In fact, studies have shown that some people became addicted to sugar when it first became widely available in our country in the 1800's.

Moderation is the key in all things.

BPD and ED - a view from the trenches by Evelyn Sharnov in Psychology Today

Warning:  as I write below, this links to a very powerful and potentially triggering article.  The thing is, it's real.

Powerful and very real is this story - In Extremis Part One - by Evelyn Sharnov that was just posted on  the Psychology Today website blog.

Here's the link if the above highlighted title link doesn't work.
http://www.psychologytoday.com/blog/notes-the-frontline/201206/in-extremis-part-one

I want to highlight two very important points:

First, that she acknowledges what so many baffled parents have struggled with:

"A borderline personality disorder sometimes forms in response to triggers like abuse or abandonment, real or perceived—but not always. The origins of the disorder are a mystery at its core."

And, second, that this illness is treatable and must be addressed as soon as possible for the person affected.

An excellent book just out is by Francis Mark Mondimore, M.D. and Patrick Kelly, M.D. titled Borderline Personality Disorder:  New Reasons for Hope (A Johns Hopkins Press Health Book, 2011).

I reviewed this extremely informative book here.

I know it's hard to hang in there with someone who is fighting this what I believe at its basis is a  biological brain disorder.  And, as illustrated in the story, Annie also has an eating disorder - a common combination.  But as Laura Collins relates in her talk  - powerful with terrific visuals to accompany the text - she presented at the International Conference on Eating Disorders in Austin this past May 2012, we must not forget that, again, these are biologically based illnesses of the brain and not willful behaviors and for that reason the people who are overwhelmed by these illnesses need our help, not our abandonment nor our disdain.

Using the brain to treat the brain

I still remember the first time I saw the movie "Carrie"  For years, I have been skeptical about a human's ability to direct her/his brain power to accomplish telekinesis.  However, recently more and more articles have been appearing about the brain's ability to do something similar as research delves into finding ways for those severely wounded to use their artificial limbs more productively.

What if a person could turn that brain power into a healing energy source for themselves?  What if, indeed, a person could be taught to use their brain power to treat their eating disorder behaviors or better yet what lies behind that behavior?

Imagine if  a servicewoman or man, who returns from combat with PTSD, could use this technology to eventually retrain their brain to heal.

I don't think this is so far-fetched since for at least five years I've been reading reports and studies that illustrate how a person can train themselves to go to thought B rather than thought A in order to interrupt a harmful behavior.  I began to pay more attention to this idea while taking NAMI's free 12-week Family to Family Course back in 2007 when I learned about work done in addiction studies that was being applied to brain disorders.

So now comes news of companies in San Jose - NeuroSky - and San Francisco - Emotiv Systems, Inc. - which offer headsets and software designed to "empower" users to do things like control a computer with their thoughts or play a game called "Mind Labyrinth" "....which grants players access to 52 different levels of an ancient temple as their relaxation grows deeper."

You can find more information in an article that appears in today's (Tuesday, May 29, 2012) Wall Street Journal in Section B, pp. 1-5.

This news is very exciting.  There are, according to the article, "1,700 developers working with NeuroSky's technology, .... making mindcontrolled computer games for the company's $129 MindWave Mobile headset."  Others believe that these games will further the efforts to improve mental health.

This will take time, of course, and one needs to be wary of a silver bullet approach.  But what a possibility!!!!

Addictions

No, I'm not going to write about ED, although I believe that once those behaviors identified as eating disorders, whatever they are, become entrenched, the person is addicted to them.  Which is why an eating disorder truly is, for a host of reasons, a medical emergency needing immediate attention and treatment.

Instead, I continue to be intrigued by the path I am taking in my reading.  Having read the Immortal Life of Henrietta Lacks by Rebecca Skloot and then a book I posted about here earlier, The Emperor of All Maladies, by Siddhartha Mukhurjee,  I've just become acquainted with the writing of  Dr. Abraham Verghese, who is the author of the acclaimed book, Cutting for Stone.  Dr. Verghese took time out from his life as a professor of medicine to study and then be graduated from the Iowa Writers' Workshop.  We readers are all very lucky, I think.  Having finished Cutting for Stone this week, I looked him up and learned that he has written two other books -- My Own Country and The Tennis Partner.  So I ordered the books and they arrived today.

Not one to allow a book to pass unexamined even if I'm still reading another one, I picked up The Tennis Partner and read the prologue.  And, there it was again:  another viewpoint from another person in medicine who believes that alcoholism and drug addictions truly are diseases that are biologically based disorders of the forebrain.  In addition, the medical doctor speaking to David Smith, an intern addicted to cocaine and the subject of the book, notes on page 5 of the prologue that, "....you have a disease, like diabetes.  And just like a diabetic taking insulin and monitoring blood sugars, every day for the rest of your life, you will need to monitor and treat your disease."  Add eating disorders to this list.

[And here's an article from the New York Times on the subject of addictions, looking at what goes on in the brain.  This article is particularly important, I think, because the author also notes the prevalence of these behaviors in connection with other brain disorders.]

If only this philosophy would make it into federal and state laws and on into the regulations governing insurance companies so that all brain disorders would be treated equitably, without regard to cost and with knowledge of the time it will take to help the person develop new behaviors and the means to avoid old behaviors.  For many, it'll take several attempts before the demon is brought under control and then, as noted, the person will indeed "....need to monitor and treat your disease"...."every day for the rest of your life."

Now back to the book I'm currently reading, which is Bitter Pills - Inside the Hazardous World of Legal Drugs by Stephen Fried.

"Addictive Personality? You Might be a Leader"

I love titles like this one which enticed me to read a New York Times opinion piece this past Sunday morning (July 24, 2011, "Sunday Review", p. 4) at breakfast.  Written by David J. Linden, a professor of neuroscience at Johns Hopkins University School of Medicine as well as author of a book with the startling title, The Compass of Pleasure: How Our Brains Make Fatty Foods, Orgasm, Exercise, Marijuana, Generosity, Vodka, Learning and Gambling Feel So Good.

[I have now (7/28) received the book and the chapter "Feed Me" is one of the best easily understood descriptions of why we get hungry or the reverse that I have read.  As usual, I flipped through the book and looked at the index when I opened the package.] 

One of the sentences highlighted in the New York Times article is, "Traits that make us crave pleasure also contribute to creativity and risk-taking."

Traits and States was a topic at the National Eating Disorder Association's meeting last Fall.   I wrote a piece reflecting on this topic.   Traits are those pieces of us that can be maligned and at the same time raved about, depending on the behavior that comes along with them.  While working at the University of Arizona, I participated in a fascinating job evaluation in which I was asked to look at my traits and qualities and write about the positives and negatives and how these affected my performance.  I learned so much about myself.  I also learned to be grateful for traits that I used to believe were detrimental.  I came to value my behavior better, too.  The affirmations course I took about this time underscored my ability to get ahead.

David Linden takes this positive outlook when he notes that ...."the psychological profile of a compelling leader - think of tech pioneers like Jeff Bezos, Larry Ellison, and Steven P. Jobs - is also that of the compulsive risk-taker, someone with a high degree of novelty-seeking behavior.  In short , what we seek in leaders is often the same kind of personality type that is found in addicts, whether they are dependent on gambling, alcohol, sex or drugs."

Wow!  novel approach here.  Then he delves into the functions of the brain related to pleasure and reward.  Timely, for sure.

He also looks at the medial forebrain pleasure circuit and the role of dopamine in the seeking of rewards.  What could be classified, after all, as a reward?  Well, for starters food.  If one is hungry, one eats.  One gets pleasure from taste and the responses of the body to food.  As a runner-turned-hiker, I can tell you that water is right up there when I'm out in the desert and getting low in the fluids I'm carrying.  He also touches on the point that Dr. Ryan in her lecture noted (in an earlier post here) that one can get pleasure even thinking about things like gambling. 

Dr. Linden, however, proposes that those who have an addictive personality crave things and at the same time actually like them less.  Sounds counter-intuitive.  He also provides a clear (current) explanation about why some become addicts and others do not.  Genes "....account", he says, "for 40 to 60 percent of the variation in the risk for addiction" and that there is "...no one 'addiction gene'."  Their dopamine response is attenuated.  In other words they need higher and then higher levels of stimulation to obtain the same level of pleasure that others gain in moderation. 

Linden goes on to list a few famous addicts; it'd be interesting to learn how many others there are with an "addictive personality" who channel their risk-taking solely into "legal" pursuits.  Must be quite a few, actually.  He counsels search committees to "...look for someone with an attenuated dopamine function:  someone who is never satisfied with the status quo, someone who wants the feeling of success more than others - but likes it less."

Having read this piece, I will read his book.  Surely there are some who get quite a good "high" out of this kind of achievement and who have learned to moderate their behavior so they can continue feeling good about what they are doing..... Or who love the high, continue to go after it, and like what they are doing? ....  or not?

A Teenager's Brain

Newsweek Magazine has just published another article in the December 16, 2010 issue written by Russ Juskalian about the teenage brain, this one titled "The Kids Can't Help It."  As research continues about the vulnerability of the brain during the maturation process, I hope that more parents will read this information or learn it from their pediatrician or from others to learn how to facilitate their child's journey to adulthood.