Showing posts with label amygdala. Show all posts
Showing posts with label amygdala. Show all posts

Anxiety My Old Friend - Will I Let It Kill Me?

Anxiety and stress are not the same thing.

Stress is a physiological experience in the face of a change in the internal or external system. It has its plusses and minuses. A little bit of stress over something you can do something about [I need to make that doctor's appointment] provides motivation to get it done and satisfaction (a nice hit of dopamine) once you do it.

via GIPHY

On the other hand, chronic stress that cannot be resolved [I never knew when he would explode] exhausts every resource the body has to maintain homeostasis/balance. And that's not good.

Anxiety describes the negative thoughts and feelings that accompany stress.

via GIPHY

It's not the only feeling that could accompany stress. When faced with changes like a new job, a challenging ski slope, or a date with the person of your dreams, you might also feel excitement.

via GIPHY

Or maybe not. "Good" change and "bad" change are labels we apply from our own perspective. As far as the body goes, they don't really figure in. The physiological response is the same.

Consider a winding mountain road in a snowstorm. Some people default to excitement. [That would be Colorado-raised me.] Some people default to anxiety. [That would be my California-born wife.] The people who can't help but default to it have an anxiety disorder. These are my people.

Anxiety Defined

Anxiety is the intense, excessive, persistent worry, fear, or dread about everyday situations, present, future, and imagined future. It's a normal enough experience. It becomes a disorder when "intense" tilts over into "excessive" to the point of interfering with daily activities.

Insert side comment here: People who have a mental illness, whether social anxiety disorder, depression, or schizophrenia, are not a different kind of people. Almost every symptom of a mental illness is a "normal" experience - shared by people who do not have a mental illness. These experiences do not need to be diagnosed or treated, until they pile up and become so intrusive that they become unmanageable, until they interfere with daily activities.

The physical manifestations of anxiety include fast heart rate, heavy breathing, sweating, and fatigue. How do we get from a thought to a heart rate? The brain - that's how.

Anxiety in the brain


Anxiety involves an interaction of three different parts of the brain in particular.

It begins when the amygdala senses a threat. The job of the amygdala is to leap into action at the sign of a threat. The amygdala initiates a sequence that releases adrenaline and cortisol to gear the body up to address the threat. As with the body's response to other stress, these hormones cause the faster heart rate and heavy breathing. Blood flow increases to the limbs to prepare it for action, and away from the digestive system - when your life is in danger, lunch can wait.

The prefrontal cortex, the "thinking" part of the brain, provides information and interpretation that mitigate or support the threat. [That's a garter snake, not a rattler. It's harmless.]

The anterior cingulate cortex sorts through the sense of threat and the additional information to find patterns and determine whether the current situation is a big deal or not. It tells the amygdala whether to calm down or GET MORE EXCITED!

The difference between anxiety and anxiety disorder

When there is a threat, the amygdala goes into action. When the threat goes away, what is supposed to happen is that the amygdala and all its downstream partners stand down. The body returns to its pre-threat state.

When the threat is chronic or, even worse, unpredictable, then these systems do not stand down. They just keep pumping out that cortisol.

In the brain, the amygdala increases in size.

Under constant assault from cortisol, the hippocampus (memory and emotion) and prefrontal cortex shrink. The hippocampus gets stuck on negative memories and emotions. [I call this the little time machine inside my brain. It plays the worst of my past on an unending loop.]

The connection between the amygdala and the prefrontal cortex that could moderate the fear goes down.

In other words, the brain changes. It changes in a way that reinforces the the problematic pattern, raising the risk for depression and dementia. Yuk!

Everybody gets anxious is not a helpful thing to say to a person with Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, Post-Traumatic Stress Disorder, or Social Anxiety Disorder. These are real things. They have tipped past the experiences of everybody. And a warm bath or deep breathing do not fix them.

Healing the problematic pattern may take many forms: distancing from the chronic stressors, medication, a variety of modalities in psychotherapy, even therapy dogs.

At ProzacMonologues.com I like to focus on what is happening inside the brain, to help me remember that my issues are not mere thoughts. They are experienced in my body. Here's an article with much more detail about the sympathetic and parasympathetic nerve systems and how they function.

A physical therapist friend, encouraging me to take a leave of absence to deal with my tattered brain, once told me, It's just like a broken bone. It takes time to heal.

I do wish it healed as easily as that broken foot is healing. But these issues do respond to treatment. If your anxiety interferes with your life, you don't have to suffer alone!


photo by author
Red Green Show meme from imgur on Pinterest

Getting My Brain Back -- I'm Still Excited by BDNF

Learning has been fundamental to my mental health recovery. It started with this blog itself. I wanted to know What the hell happened to my brain?!!! So I read the research and used ProzacMonologues.com to keep track of my notes.

For a while I added piano to my recovery regimen. Not for music therapy, but for brain development. Okay, I didn't keep at it. I can sort of play Desperado. But it did get me a few more miles down the road.

Lately I am learning a new language. Five minutes a day of Irish on Duolingo -- I don't expect to be fluent any time this decade. I don't need to be fluent. For those five minutes a day, I am building my brain.

Which is always a good thing.

I did a search in my blog for BDNF. And found something I wrote in 2011, right after I wrote that review of Ellen Frank's Treating Bipolar Disorder. Now you, kind reader, have no idea the struggle it took back then to write these paragraphs. I am proud of it both for the accomplishment and for the content itself. I present it to you again:

Getting My Brain Back -- In Praise of BDNF


Frazzled Cafe and Ruby Wax - Yes, I am a Fan


Ruby Wax is the founder of Frazzled Cafe, a peer support group for anyone who is overwhelmed by the stresses of modern life. As Ruby says, our brains just don't have the bandwidth. If that describes you, check it out. But bring your own coffee. The meetings moved online, a Zoom meeting on account of... you know.

Ruby is an American-born long time television personality in Britain and comedienne whose career pivoted when mental illness caught up with her. She went back to school to study the brain and got a masters from Oxford on mindfulness based therapy. Since then she has written books, toured, lectured, using her prodigious brain and her comic chops to entertain and educate about brain health.

How to Stay Sane

Shock, rage, fear, despair, depression, hopelessness, apathy, or even how about - drinking the kool-aid, surrender. Do we have a better choice?

Robin Chance, behavioral specialist and therapist, did a little therapy for the nation three years ago with her article, How to stay sane if Trump is driving you insane: Advice from a therapist. She offered a better choice.

Two questions: (1) How do we integrate this crisis into our understanding of the world? and (2) what do we do now? Now that the crisis of three years ago is our new normal, it seems time to revisit her words.

Giving Thanks for John McManamy

John McManamy was my introduction to the concept of expert patient, a mental illness educator with lived experience and serious chops, research-wise.

Our relationship began not long after Prozac Monologues, the blog began in 2009, with a skunk. How on earth did I find his tale of too-close-but-thankfully-not-the-worst-sort-of-too-close encounter with a skunk? Probably I googled amygdala. That tells who John is right there. You want to know about amygdala? John will tell you a story about a skunk.

The Brain Science of Caffeine

It's Pumpkin Spice Latte Season -- what better time to pour a cup of Caffeine: Neurological and Psychiatric Implications? It's the next up in my PsychiatricTimes.com Appreciation Month.

Sergi Ferré, MD, PhD offers this continuing education course for doctors and other health care providers. The goal of this activity is to provide an understanding of the mechanisms involved in the innervating effects of caffeine and the impact that caffeine may have on psychiatric disorders.

So settle in to learn about your favorite beverage.

Disclaimer: Though I have read the thing many times and looked up many big words, I cannot honestly say that I have satisfied all of the learning goals. Specifically, I cannot:
  • Explain the adenosine-dependent modulation of striatal dopamine and glutamate neurotransmission
nor
  • Describe the adenosine-dependent modulation of glutamate neurotransmission in the amygdala.
Good thing I don't need the grade.

Nevertheless, I gleaned a few fun facts which I will share with you.

Caffeine is the most commonly consumed psychotropic drug in the world, used primarily for its psychostimulant properties on the central nervous system. Yes, I think we already knew that, but it's nice to begin with a softball.

How To Tame Your Mind -- Ruby Wax

It's like training a dragon, only harder.

Ruby Wax nails depression: when your personality leaves town, and suddenly you are filled with cement.

She nails the problem: our brains don't have the band width for the 21st century.  Nobody's brain does.  Yours doesn't, either.

And she nails the solution: learning how to apply the brakes.

Raccoons Respect My Piss

I don't know that for a fact.  Actually, the piss in question is John McManamy's piss.  And he has the experience to back his claim.


Nor do I have any recollection of how I discovered McManamy's blog, Knowledge is Necessity, and from there, his enormous set of resources at McMan's Depression and Bipolar Web.  But as it happens, my entry into McMan World was Skunk -- the blog piece from August, 2009 that inspired his new book's title, Raccoons Respect My Piss, available in kindle format and now in paperback.


Since I asked John's permission to steal Skunk, which I guess means I didn't steal it, we have become what I call blogmates.  He most graciously gave me a leg up in this business, plugging Prozac Monologues in its infancy on his own blog.  Since then, we often find we are captured by the same curiosities at the same time -- as he puts it, God, neurons and everything between.

Project Implicit and the State of One's Soul

Remember, Dumbledore said to Harry, It is our choices that show what we truly are.

Project Implicit

So did you do the homework?  Did you try any of the Implicit Association Tests?  Do you still want to read my blog?

This is how they describe what they are doing:

Project Implicit represents a collaborative research effort between researchers at Harvard University, the University of Virginia, and University of Washington. While the particular purposes of each study vary considerably, most studies available at Project Implicit examine thoughts and feelings that exist either outside of conscious awareness or outside of conscious control. The primary goals of Project Implicit are to provide a safe, secure, and well-designed virtual environment to investigate psychological issues and, at the same time, provide visitors and participants with an experience that is both educational and engaging.

The variety of topics include attitudes toward age, race, disability, ethnicity, mental illness and others.  The tests are constructed to bypass thought, commitment, decision.  They dive deeper into what is known as the lizard brain, the part that evolved before reason, and that simply reacts, by setting one to tasks that have to be accomplished faster than the thinking part of the brain thinks.

Project Implicit is well aware that we may not like what we find in the lizard brain. I don't care for what I find in mine.  But it is important information, for two reasons.

Trayvon Martin and Soul-Searching - Not Gonna Happen



Two things struck me about this message.

The first was the more widely quoted, If I had a son, he would look like Trayvon Martin.  There is a photoshopped poster circulating on Facebook, Trayvon included in the Obama family photo.  It brought to mind immediately the young men I know who look like Trayvon.  I don't want to write their names, fearing, like O-lan from The Good Earth, that to speak such praise as they deserve would tempt the jealous gods to do them harm.

Their mothers are among my closest friends.  I can hardly speak of Trayvon Martin in their midst.  What it must mean to be the mother of a fine young African American man.

The second was a minor note, a hidden note, one that will be forgotten, was forgotten as soon as it was said, All of us have to do some soul-searching.

We Do Not Search Our Souls

Of all the words that this shooting has birthed, all the pundits and opinions, soul-searching is not among them.

Recovery In Progress -- My First NAMI Convention

Dr. Ken Duckworth's job at the Ask A Doctor about PTSD session was to make some opening remarks and then let people ask their questions.  He rattled off a list of treatments and said, The good news about PTSD is, we know what causes it -- trauma that was not able to be processed adequately.  The bad news is, the treatments just don't work so well.

Short and to the point.  Actually, I am not so negative (right this very minute, anyway) about treatment as Dr. Duckworth, because I am not looking for the magic med anymore.  I know about recovery.

Recovery is about collecting tools and pulling them out when the occasion requires.  I will illustrate.  But first the setting...

Last week I attended my first NAMI (National Alliance on Mental Illness) Convention in Chicago -- 2300+ people who have mental illnesses, family members, advocates, volunteers and caregivers, with a few scientists thrown in for good measure.  As a friend said to prepare me, A NAMI Convention has a certain kind of energy.  Yes, it does.

I have been to big conventions before, used to be a legislator (called Deputy) for the Episcopal Church, which gathers 8-10,000 or so Deputies, Bishops, exhibitors, visitors, volunteers and the like every three years.  I stopped doing that when I figured out that every three years General Convention tripped my hypomania and was followed hard on by a depressive episode.

So this was my largest gathering in some time, with plenaries, workshops, symposia, networking and ask-a-doctor sessions, drumming, theater, yoga and talent show, internet cafe and peer counselors, exhibitors, book sales and an information booth which was the best hidden spot of the whole damn Chicago Hilton.

You can expect a number of blogposts out of this event, including dueling comments between me and fellow blogger John McManamy.  Now that we have finally shared a beer, does that make us blogmates?  I began writing this piece in the hotel room, late after the last gasp, the rawest of my posts to come.

I knew it was a mistake to make Ask-The-Doctor-About-PTSD the last thing I attended.  It's just, that was the schedule.  Most helpful take-away: The brain is simply not designed to metabolize certain experiences.  PTSD is the result of incompletely metabolized traumas.  Bottom line, it is a normal response to an abnormal event or series of events.

The brain keeps trying to metabolize these unprocessed events/memories/emotions/bodily sensations.  They lurk beneath the surface, waiting for the next opportunity to emerge, when triggered by some reminder.


Oh, I was triggered, alright.  The last question of the day was about a particular symptom I don't talk about and religiously avoid.  I left the room reliving it, dizzy and disconnected.

Walking out, I heard the voice of my therapist, who once ended a session saying, The things we have talked about today probably have triggered your past traumas, and you will be dealing with the effects after you leave.  So how are you going to take care of yourself today?

Time to pull out that toolbox.

The Ask-A-Doctor doctor listed half a dozen treatment modalities for PTSD: meds, support groups, EMDR (Eye Movement Desensitization and Reprocessing), sleep regulation and aerobic exercise.  He mentioned Prazocin for nightmares.

First off, pop my anti-anxiety rescue med, put on my walking shoes and go get some aerobic exercise.  Work off that negative energy.

Just outside the door was Grant Park.  An art exhibit diverted me from my aerobics.  But art is good, very good.  Change the channel -- that's Cognitive Behavioral Therapy 101.


I stood still and drank in paintings inspired by water.  Not this painting, actually, which is exhibited just down the street.  But I thought of it.

Water is good.  It evens out the emotional turmoil. -- So says my other therapist, the one who does eastern-based energy work.  You see, when even the doctors acknowledge that western treatments (they don't call them western, because they don't speak of there being any other treatments) work poorly, I am not going to limit my tool box to only half the planet, especially not the more rigid half.

I spoke with the artist about perspective.  He paints on a flat surface, so doesn't think it matters which side is up.  I breathed into the here and now.  Thich Nhat Hanh taught me here and now.  But here and now is my worst subject.  And somebody interrupted to talk about showings and art business.  There were too many people -- had to reduce stimulation.


My energy therapist would recommend grounding.  I headed back to the gardens, flowers, trees, dirt, all good, all grounding.  Eating is good for grounding, too.  Maybe I should eat something.

From Alcoholics Anonymous: HALT = pay attention to when you are Hungry/Anxious/Lonely/Tired.  No, a martini is not in the recovery toolbox.

So I bought my inner child a strawberry ice cream -- a drippy cone instead of my usual adult cup.  Sugar isn't really the best choice, but it was red and a gift to my inner child.  Then I head off to find some meat.  Meat feeds the first chakra.  First chakra is about safety.  PTSD is about the amygdala is about safety is about the first chakra.

Still I was struggling.  I don't just have my own pain; I suck up the pain of every person with whom I have spent the last three days.  All those stories -- how can there be such a world?  How can I live in such a world?

I picked up my whole personal Book of Traumas, the traumas that never got resolved, that get retriggered today when I try to resolve them in therapy, the distrust I try to pretend does not exist toward the people who try to help me but they end up retriggering the traumas I can't resolve because they never seem to address that they are retriggering them and my retriggered shame prevents me from telling them and I truly believe the result will be retrauma anyway.

There are exceptions to that negative thought.  List the exceptions -- Cognitive Behavioral Therapy 102.  But how do I know who is for real...?

So I head back to the convention, walk over the train tracks.  And there is another trigger, another overpass, another trip to Chicago, another episode, another long time ago.  How quickly is that train traveling?  How far away?  How fast does a body fall that far?  How to time the collision of the two?  Velocity problems were the one thing that defeated me in high school math.

But I am not in the right spot anyway.  Geometry I got.  I need to be right -- there -- where -- a woman is pushing a baby stroller.

Oh.  Okay.  Not tonight.  I have an Iron Rule.  In a world filled with trauma, to the extent that it lies within my power, I will not cause trauma.  A two-year-old is sitting where my demon would call me.  The two-year-old wins.

God bless the internet that led me to David Conroy some years ago.  The first sentence of his book Out of the Nightmare brought sense out of the chaos that compounded the pain of my suicidal symptoms.  Suicide is not chosen; it happens when pain exceeds resources for coping with pain.

Tonight my pain was painful.  But I have survived worse, much worse.  And tonight my resources are many.  Tonight the thought was more than a mosquito, but it wasn't a tiger.  I do not underestimate the lethality of this disease.  One in five people with bipolar II do not survive it.  Tonight, I am still of the four.

I know people freak out over the suicidal ideation part of mental illnesses.  I apologize to my friends for causing them pain by bringing up the subject -- even though my need to protect you from this pain adds to my own.  I try not to bring it up, except with people who know what I am talking about.  But this is one of the tools in the Recovery Toolbox.  Those who do know what I am talking about need this tool.  And this post is for us.

Ironically, the state of the art treatment for people who have a lot of suicidal ideation and behavior, people with a diagnosis of Borderline Personality Disorder, is Dialactical Behavioral Therapy, radical acceptance.  Starting, not ending, but starting with acceptance even of that symptom that freaks out so many of you.

Yes, sometimes I have those thoughts.  They are well-worn grooves in my neurological pathways.  Any number of things will trip the cascade that leads there, including things you might not imagine, a cold sunny day, my doctor suggesting a new medication, an overpass.  These are not reasons.  Suicide is not about reasons.  These are triggers of neurological pathways that have a current of their own.

It is what it is.  Those five words sum up Dialectical Behavioral Therapy, an offshoot of CBT.  They were the chorus sung by one of the players in the lunchtime drama troupe.  Saturday night, I repeated them to myself.  Often when that thought appears, somewhere between a mosquito and a tiger, I say, There it is again.  That's all.  Mindfulness.  The thought doesn't have to freak me out, doesn't have to freak you out.  It is what it is.  Move on.


As I crossed the overpass, I felt a draw, a pull toward the hotel.  It was an energy, a spiritual energy on the side of life, two thousand people in that building, rooting for me, for my life, for one another, for you.  One of them even blowing a didgeridoo, accompanied by a flute, to be followed later by another who whistled Somewhere Over The Rainbow, all spiritual energy on the side of life.

The wisdom is ancient.  Two are better than one, because they have a good reward for their toil.  For if they fall, one will lift up the other; but woe to one who is alone and falls and does not have another to help.  Again, if two lie together, they keep warm; but how can one keep warm alone?  And though one might prevail against another, two will withstand one.  A threefold cord is not quickly broken.  [Ecclesiastes 4:9-12, New Revised Standard Version]

So that is my first report of my first NAMI Convention, the most confusing and most compassionate experience I have ever had with 2300 people.


(Find your local NAMI Chapter here.)

photo of toolbox by Per Erik Strandberg and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
General Convention Seal for the Episcopal Church in public domain
Olaus Magnus's Sea Orm, 1555 in public domain
Water Lilies by Claude Monet, 1906, in public domain
photo of Grant Park in Chicago by Alan Scott Walker and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
root chakra by Muladhara Chakra and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
photo of Chicago Orange Line by Daniel Schwen and used under the Creative Commons Attribution-Share Alike 2.5 Generic license
photo of Coal Creek Falls by Walter Siegmund and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
fresco at the Karlskirche in Vienna by Johann Michael Rottmayr, in public domain
book covers by amazon.com

Habit and the Stages of Change


I have been writing for several weeks now about this mass of electrical activity inside our brains, dendrites and nerve endings, meeting at synapses, passing their spark from one neuron to the next, creating -- what?  A wink, a whisper, a sensation, the next big brainstorm.

Most of these connections could be called, in the widest sense, habits.  By habits, I mean that pathways get used over and over, form patterns, become familiar, channel us to certain outcomes.  Most bypass the cortex, requiring no decision.  Like breathing, smelling, salivating at the cinnamon.
 
Most of the remainder are still automatic.  But with effort, they can be brought to consciousness where the cortex could interfere, and a decision made.  Like blinking.  Or picking up the cookie.

What if you don't want to pick up the cookie?  Okay, you really do want to pick up the cookie.  What if you want to not pick up the cookie anyway? 

How Do You Change A Habit?


You're gonna take more than one step.

Last week, I put some numbers out there, the Wahls diet.  Nine cups a day of vegetables and fruits.  I broke it down for you: 3 cups leafy greens, 3 cups cruciferous veggies, 3 cups intensely colored.

This food plan helped Dr. Terry Wahls reverse her secondary progressive MS and get up out of her wheelchair.  It could help you reduce your symptoms of heart disease, lung disease, asthma, hypertension, depression, obesity, bipolar disorder, diabetes, Alzheimer's or Parkinson's.

If you have, or are tending toward any of these chronic diseases, you have already heard your doctor/mother/spouse tell you that you need to improve your diet.  Dr. Wahl's book, Minding My Mitochondria tells you just how much and why. 

Nine cups a day of vegetables and fruits:

3 cups leafy greens
3 cups cruciferous veggies
3 cups intensely colored

Stages Of Change 

So there is your canyon.  Here are the steps, more than one.  Several, in fact.  The steps are known as the Stages of Change.



The Stages of Change model appears all over the place lately.  This article from the journal American Family Physician uses the Stages to help physicians help their patients, something more effective than Just do it.  A Youtube search yields results for addiction recovery counselors, life coach trainers, weight loss clinics.


Different sites number the stages differently.  Some say Precontemplation is Stage 0.  Some give Relapse its own number.  Some add Transcendence, whatever that is -- said the priest who gets cynical when quasi-religious language gets used for the purposes of self-improvement.  Whatever we are supposed to transcend, evidently it is not our desire to improve ourselves. -- But I digress.


I like this site, which is the source of the graphic above, even if the author does use that word Transcendence that made me twitchy there for a minute before I got back on track.  It works through the stages from the perspective of the person who is making the change, not the person who wants somebody else to change. 


Crossing Canyons/Building Bridges In My Brain 


Dr. Wahls calls it a diet.  I don't diet.  Who wants to DIE-t?   Each chocolate chip cookie left on the plate represents a little death.  A diet is a temporary interruption.  When it ends, you go back to your life.  But there is nothing temporary about the nutritional needs of my mitochondria, without whom there would be no life.


I'm into changing my brain.  In that mass of electrical wiring, some potentially healthy pathways are blocked by the detritus of dead dendrites.  Other destructive pathways are carved into canyons of well-worn automatic responses. 


Changing my brain will take time.  It is taking decades.  It will take at least another blogpost. 


And The Word Became Flesh 


Question: What do the Stages of Change have to do with Prozac Monologues? 


Answer: Words.  The Stages of Change use language to shape the brain.


Language is one kind of pathway from neuron to neuron.  It connects electrical impulses from the autonomic systems, the olfactory nerve, the amygdala, through the hippocampus (memory and emotion) and the anterior cingulate cortex (pattern seeking) and into the frontal cortex (conscious thought).

Language is how all this electrical activity gets turned into meaning.  It is where the brain and the mind become one. 

The Stages of Change include a process of changing our patterned thinking about food.  And thinking is how we move from one stage to the next. 

Dr. Wahls' writes about synergy, how exercise and diet work together to heal her myelin and reduce the symptoms of her MS.  I'm thinking the same process works for changing habits, particularly food habits.  Each new behavior reinforces the preceding thought that moved you to the new stage.  That repeated behavior patterns the thought that will move you to the next stage. 

Meanwhile, what you are eating while you are trying to make any change matters.  Your mitochondria need the right materials to build the dendrites that form the new pathways.  Like lunch for the road crew.

So don't try to skip stages.  And don't skip broccoli.

One of these days I will write my own food autobiography, my trip through these stages.

photo of Women Working at a Bell Telephone Switchboard from the National Archives and Records Administration and in the public domain
photos of Hatherton Canal in Staffordshire by Roger Kidd, Coal Creek Falls by Walter Siegmund, Glen Canyon by Sascha BrückJeff Kubina used under the Creative Commons Attribution-Share Alike 3.0 Unported license.
Stages of Change graphic was created by Todd Atkins, who placed it in the public domain

Getting My Brain Back -- In Praise of BDNF


Here is the star of Getting My Brain Back, the Neuron. I've got lots of neurons. So do you. They are our friends and we need to take care of them, so they take care of us. BDNF, brain-derived neurotrophic factor will help us do that. How BDNF is giving me my brain back is our story for the day.  But first...

Preface

Did you notice? I wrote a book report in April. If you are a regular reader, I guess that is obvious. Let me try again.

I read a book. Not just the one by Agatha Christie. Maybe you still don't get it. Never mind. Here is the story.

Introducing Neuron, The Brain Cell

 

PTSD: The State of Treatment

This is the second part of a series on Post Traumatic Brain Syndrome.  Let me recap last week and expand on what we know about the neurobiological mechanisms (how the brain works) of PTSD, and then discuss treatment strategies.

When something stressful happens, the brain prepares the body for action.  The hypothalamus, pituitary gland, amygdala, locus ceruleus and opioid system all release hormones to speed up respiration, raise blood pressure, reduce sensitivity to pain, all useful conditions for the proverbial fight or flight.

Under normal stressors, as soon as these hormones are released, feedback systems go into operation.  The hypothalamus tells everybody else that their job is done and they can back off.

These hormones, especially cortisol, damage brain structures, notably the hippocampus, whose job is to regulate emotion and to perform the "that was then, this is now" function.  I named it that, and am very proud of it.  My own brain has almost no "that was then, this is now" function.  Pretty much zip.

PTSD and the DSM: Science and Politics -- Again

Several weeks of what I call "swiss cheese brain" interrupted my series on PTSD.  Now with a couple posts in reserve and a two week cushion, I am trying again.  To get us back on the same page, here is a (tweaked) reprint of March 28, a history of the issue in the Diagnostic Statistical Manual and current context, to be followed by PTSD: The State of Treatment, and then PTSD: Hope for Prevention.

With the ongoing war in Iraq, Post Traumatic Stress Disorder -- PTSD is much in the news nowadays.  We can expect that to continue.

Nancy Andreasen, author of The Broken Brain, traces the social history of this mental illness in a 2004 American Journal of Psychiatry article.  The features of what we call PTSD have long been noted in the annuls of warfare.  More recently, in World War I it was called shell shock, and those who had it were shot for cowardice in the face of the enemy.  In World War II it was recognized as a mental illness and called battle fatigue.  Afflicted soldiers were removed from the front and given counseling designed to return them to battle within the week -- though there is one infamous story about General Troglodyte Patton who, while touring a hospital, cursed and slapped one such soldier for his "cowardice."

The DSM I, from the post-WWII era, recognized battle fatigue as Gross Stress Disorder.  It was removed from the DSM II in the early 1960s , when U.S. society was not regularly confronted with this cost of war.

Thanksgiving and the Anterior Cingulate Cortex


Did anybody decompensate at your Thanksgiving Day feast, when there were no pearl onions in cream sauce, notwithstanding the fact that nobody has ever eaten a single pearl onion in cream sauce, since Great grandma Libby died forty-five years ago?

Was it you?

I think I figured it out. Unfortunately, this flash of brilliance came to me yesterday morning, in my hypomanic surge that prepared me for my speed pie-making. Not in time for you to prevent the scene by preparing said onions.

Somebody's anterior cingulate cortex blew a fuse.

Of course, I don't know for sure. It is one more hypothesis that I would like to test in that Million Dollar fMRI machine that I am not getting for Christmas. But here is the hypothesis:

The bad economy, the fear-mongering health care debate, the single-payer stillbirth, the war in Afghanistan, global warning -- your anterior cingulate cortex (ACC) is doing all that it can to calm your amygdala. That is one of its jobs, partnered with the prefrontal cortex, to exercise executive function over your amygdala, which is convinced that you are about to die and is sending out messages to your adrenal gland, telling it non-stop to keep pumping out those glucocorticoids that are destroying your hippocampus, not to mention your heart. The amygdala must be brought under control! So your ACC has plenty of work to do already, and needs for you to help out by deep breathing. And yoga. And crystals.

But it also has another job, which is to detect abnormalities in patterns. You know those games where you are supposed to find five details that differ in two nearly identical pictures? That's a job for the ACC. But what with global warming and all that other stuff (and we still don't have any snow in Iowa the day after Thanksgiving, so my amygdala keeps telling my ACC, "I do so need to worry"), when somebody's ACC detected a variation in the Thanksgiving feast day table, i.e., the missing pearl onions, that was just one thing too many. And it blew a fuse, releasing the amygdala from its cage. And this time, the amygdala did not send out the message to freeze. It came out fighting.

So now you know. Or would know, if somebody who does own an fMRI machine would construct the experiment. Any takers?

Skunk!

I have found a new blog to follow, Knowledge is Necessity: Musings on Mental Health by John McManamy. I think we are up to similar enterprises. John also has another website, McMan's Depression and Bipolar Web, which is to mood disorders what Jerod Poore's Crazy Meds is to neurological pharmaceuticals. Read the blog for musings, the others for information.

Meanwhile, here is the link to "Skunk," John's blow by blow of an encounter between the amygdalas of two mammals, a lesson in the amygdala that is more artful than Mother Amygdala from this blog, July 28, 2009. An added feature is the lesson in how to address the presence of this particular mammal in your house. Enjoy!

And thanks to John for his work.

Mother Amygdala, Have Mercy Upon Us

Once upon a time I wanted to be a neurosurgeon. But I had this idiotic fear of science class -- it was in the water that they gave to girls in the 1950s. So I headed in another direction. Still I am fascinated by the brain, and will keep sharing the stuff that I learn about it. Today's topic is the amygdala.

Ah, the amygdala, the reptilian brain. It is among the oldest parts of the human brain, regulating memory, emotion and fear. The amygdala associates a strong emotional reaction with a piece of information to imprint that information in your memory. You remember best what you associate with strong emotion. If you walk under a tree in the tropics and a poisonous snake falls on top of you, it is highly beneficial from an evolutionary perspective to remember that tree where those poisonous snakes linger. That's when the amygdala is your friend.

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