Conventional Medicine/Functional Medicine

I've had it.  I have just had it.  Go ahead, diagnose me, nod your heads, make a note in my chart.  Call it noncompliance or transference, depending on the initials behind your name.  Shake your head this time, make another note.  But I have had it.

An Emergency Room Story

We took a friend to the ER.  She takes a complicated med regime with risk of stroke and had the kind of vague warning signs that begin those if only... stories.  She felt *dreadful!!*, an 8 out of 10, and knew that something was desperately wrong.

It turns out her BP was elevated, but evidently not ER worthy.  And *dreadful!!* is not a symptom on a diagnostic protocol.  So the doc (resident?) focused on the headache.  Never mind that it was a 3 out of 10, and she insisted her headache was not her complaint.  He knew what questions he was supposed to ask, which didn't include questions on a 1 to 10 scale about just how **full systems dreadful!!** she felt.  In any case, he hadn't got to the part of the book where they teach you to listen to the answers.

So he gave her a med for the headache, then immediately a med for the side effects that the first med always causes.  Forty-five minutes later, the headache was down from 3 to 2, but the second med was not adequate, and she needed a third med for the jerking legs caused by the first med.

Eventually the doctor/resident's supervisor came in.  This doctor did know how to listen.  She listened even to what was not being said, the rising anxieties and suppressed rage of everybody in the room.  So she asked some more questions, and decided maybe there was a reason for the headache.  They did a CAT scan, which revealed nothing.  So she recommended my friend discontinue the BP med she had started last week, because that med could account for all the vague stroke warning signs that brought us there.  And they were on a roll in ER, having seen three people that day with side effects from this particular BP med.

On the other hand, it could be, and this is what my sick friend really believes, and I am sure she is right, it was a genuine hypertensive incident caused by the interaction of yet another med she takes and some processed chicken she ate for lunch, immediately before she started to feel dreadful.

Modern Medicine Sucks

Yes, I know.  The ER is best reserved for heart attack and stab wound.  But that is where Urgent Care sends people with stroke symptoms.  And you know very well, in any doctor's office, prescribing medicine for the side effects caused by the medicine prescribed for the side effects caused by something else again is standard clinical practice.

It's not just the health care delivery system that is failing.  "Modern" medicine itself has failed me, failed you, failed a whole lot of us, with a whole lot of different diagnoses, including a whole lot of people who even get paid to practice it.

You all know this.  It's just that it's impolite to say it, hypomanic if the person who says it has a mood disorder, paranoid if the person who says it has a psychotic disorder, impolite if the person who says it has thus far dodged the DSM, impolitic if it's your job.  But there it is.  The paradigm is screwed up.

Paradigm: A worldview underlying the theories and methodology of a particular scientific subject.

Here is the short version:

Conventional medicine = Your [fill in the body part] is sick.  Take your medicine.

Functional medicine = Your body heals itself.  Live, so as to be healthy.

Applying The Paradigms

Now let's look at the longer version.  Here is your body:


Lovely.  Of course it's lovely.  And God saw everything that he had made, and behold, it was very good.

Next, here is not your body, but rather a diagnostic tree.  When you don't feel so well, the doctor uses this tree to locate your problem:


This is how a diagnostic tree works:

Conventional Medicine:

You feel dreadful.  So you go to the doctor, during regular office hours, if at all possible.  You tell the doctor how you feel.  The doctor wonders, What system inside this body is causing these symptoms?

So he/she elicits more information about symptoms, takes some measurements, runs some tests to determine which limb up there in the tree is out of order.  Is it the metabolic limb?  Endocrine limb?  Cardiovascular?  Pulmonary?

Next, the doctor sends you to the specialist in that limb, otherwise known as a system.  Doesn't matter which system, same paradigm.  Let's say the symptoms and the tests lead to the conclusion, it's psychiatric.  (We could do this same exercise with the cardiovascular system.  But this is Prozac Monologues...)  Is it mood disorder, psychotic disorder, anxiety disorder?

Then, which twig?  And finally, which treatment is purported to work best to make the symptoms go away on the particular twig your doctor has identified?

God help you if the doctor gets the twig wrong.  Because if you take the medicine that works well (or is purported to work well) for the next twig over, then another limb might pick up a hatchet and chop the sick twig or branch or limb or even the whole trunk right down. 

The thing is, the meds are dumb.  They don't know they are supposed to fix just that one little twig.  It is the rule, not the exception, that the med will also do  something to a different system, maybe several.  Let's just hope it's not something too dreadful.

Functional Medicine:

You feel dreadful.  So you go to the doctor.  You tell the doctor how you feel.  The doctor wonders, What has caused the body, which is designed to balance itself, to malfunction?

In functional medicine, the doctor pays as much attention to the roots as to the limbs.  The tree takes in nutrients, water, air, energy, experiences, toxins from the ground and the air.  It processes the environment through its cells and structures.  It is designed to absorb input, produce energy, rid itself of waste, grow, differentiate, reproduce -- function.  If the body is not thriving, functional medicine looks both to the environmental input and to the individual processing for the source of the disruption. 

Functional medicine is anchored by an examination of the core clinical imbalances that underlie various disease conditions. Those imbalances arise as environmental inputs such as diet, nutrients (including air and water), exercise, and trauma are processed by one’s body, mind, and spirit through a unique set of genetic predispositions, attitudes, and beliefs.

The fundamental physiological processes include communication, both outside and inside the cell; bioenergetics, or the transformation of food into energy; replication, repair, and maintenance of structural integrity, from the cellular to the whole body level; elimination of waste; protection and defense; and transport and circulation.

The core clinical imbalances that arise from malfunctions within this complex system include:
  • Hormonal and neurotransmitter imbalances
  • Oxidation-reduction imbalances and mitochondropathy
  • Detoxification and biotransformational imbalances
  • Immune imbalances
  • Inflammatory imbalances
  • Digestive, absorptive, and microbiological imbalances
  • Structural imbalances from cellular membrane function to the musculoskeletal system

Different Questions Lead To Different Treatment

The italics above are quoted from The Institute for Functional Medicine.  Here is the next paragraph, on the difference between how conventional and functional medicine solve problems:

Imbalances such as these are the precursors to the signs and symptoms by which we detect and label (diagnose) organ system disease. Improving balance – in the patient’s environmental inputs and in the body’s fundamental physiological processes – is the precursor to restoring health and it involves much more than treating the symptoms. Functional medicine is dedicated to improving the management of complex, chronic disease by intervening at multiple levels to address these core clinical imbalances and to restore each patient’s functionality and health.

Functional medicine is about the relationship between parts, relationships between macro/big and micro/little (systems and cells), the relationships between the systems themselves (cardiovascular, neurological...) and the relationships between the whole body and what is acting upon it.

There is nothing weird about functional medicine, nothing foreign to what anybody learns in medical school.  It's just that it notices what people forgot from that one hour in med school on nutrition, one hour on circadian rhythms, one hour on the connection between one system and another.  They forgot because after that one hour, conventional medicine never expected them to ask a question or listen to an answer about it again.

To become a functional medicine doctor, you learn conventional medicine and then learn to notice how it all connects.

Do-It-Yourself Functional Medicine

People in recovery are figuring this stuff out on our own.

Back To BDNF, Serotonin and Cognitive Remediation

So once upon a time, some brain scientists noticed that people with depression generally have lower serotonin levels than people without depression.  The conventional medicine solution: squirt some more serotonin into those synapses.

It didn't work near so well as we all were taught to believe.  Okay, so it worked very well for the pharmaceutical companies.  One out of every ten people in the United States of America is taking an antidepressant right now.  Ca-ching.  It's just, it didn't work so well for the people with depression.

Now the tune has changed.  Serotonin increases BDNF.  BDNF is the real hero.  Since SSRIs cause so many side effects, and they don't really work so well, and the patents have expired anyway, let's skip the serotonin squirting and find a different pill to stimulate more BDNF.

The National Institute on Mental Health (NIMH) has figured out there is something wrong with this approach, and won't fund it anymore.

Meanwhile, while you are waiting for the next miracle drug, which will be a long time coming, because the pharmaceutical companies have lost interest in antidepressants, you should know there are lots and lots and lots of things that improve BDNF production and at the same time improve the functioning of every other system.

Try aerobic exercise like walking, swimming, bike riding, mental exercise like sudoku and computer brain games, learning a new skill like a musical instrument or language or drawing, losing weight, eliminating refined sugar and diet soft drinks, eating leafy greens, fruits and fish, falling in love.  These things do not come in pill form and don't make anybody any money.  It's just that they make us healthy. 

Notice that these interventions replace toxins with healthy input.  That is functional medicine.

Here Comes An Opinion About Government Spending

Go back and reread that of ways to stimulate production of BDNF, absolutely essential for learning.  Then think about the cuts in your local school board budget.  Were they by chance funded by cutting physical education, sports, music, languages, and by placing snack machines in the schools?


The doctor's office is not the only place where our brains go bad.  Schools themselves are making us stupid.

More To Come On Cognition and Functional Medicine

Lots of topics web out from Getting My Brain Back.  Next up, mitochondria...


photo of emergency room by Thierry Geoffroy and used under the Creative CommonsAttribution-Share Alike 3.0 Unported license
photo of tablets, medical waste by Pöllö and used under the Creative Commons Attribution 3.0 Unported license
L'arbre de Vie by Raphaël Toussaint is used under the GNU Free Documentation License
graphic of tree with roots created by Vectorink and used under the Creative Commons Attribution 3.0 Unported license
flair from facebook
graphic of Brunnian link in public domain
photo of fruits and vegetables from Pike Place Market by Eric Hunt and used under the terms of the GNU Free Documentation License
photo of Bb school trumpet by Roy Benson and used under the terms of the GNU Free Documentation License

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

 

Cognitive Deficits -- on the way to Getting My Brain Back

The speaker at our monthly NAMI meeting was tall, mid-60's, military bearing, a former ER doc who did a couple tours of duty in Iraq.  You know the type.  Only, a little less of that ER doc -- I'll call it self-assurance.

He showed us slides of the work he used to do, the before shots (which we really did not want to see) and the after shots of young people, kids he patched together at the medic stations.  He told us about the sticky dark trail running from the helicopter pad to the table, and what made it sticky dark.

His passion for his work lit the room.  We listened to stories of kids for whom he had after shots.  There weren't always after shots.

He told us about TBI's, traumatic brain injuries and PTSD and how war does damage to brains.

He was taking a break after two tours of duty, back in an ER state-side when he had the stroke.

Now it became a different story.

Stroke -- The Brain Is Part Of The Body

They told him it would be a long recovery.  Two months later, he was astounded at how long it was taking.  They told him again, it would be a long recovery.  Six months later, the frustration overwhelmed him.  His body was back, the use of his limbs, his balance, more or less.  But his brain wasn't.  And the rehab people said, This is good.  Rehab has begun.

See, we know a stroke is a physical event, something that happens inside the body.  But still we have trouble thinking of the brain as the body.  We have trouble thinking of the functions of the brain, like thinking, as physical functions.  The injured body has to rehabilitate.  We know that.  Doesn't the brain just come along for the ride?

But thinking is done by a body, the part of the body called the brain.  Thinking is a physical process, electrical charges tracing a pathway from one cell to the next, within an organ of the body called the brain.  And when the brain is injured, it has trouble performing its physical functions, like thinking.

Cognitive Deficits

This emergency medicine doctor with battle front experience can't work anymore.  He used the phrase cognitive deficits.

To illustrate, he told us about the work of an emergency room doctor.  When somebody comes into ER with a potential heart attack, there is a protocol.  There are 17 steps to this protocol.  [It might be 23 -- I wasn't taking notes.]  He told us the first step.  Check.  Then he told us the second.  The second step requires a certain mathematical calculation.  He told us what needs to be calculated, the ratio between two measurements.  [I didn't write them down.]  He knows how to do the calculation.  He can do it in 18 minutes.  The whole process is still in there, inside his brain.

The thing is, this entire 17 step protocol has to be done in 93 seconds.

So he can't work as an ER doc anymore.  His job is to do rehab for his cognitive deficits.  In rehab he is learning how to connect all the bits that are still in there.  His brain is finding new pathways around damaged areas to turn all those bits into coherent and accessible thoughts.

And I thought -- That's it!  That's my swiss cheese brain!

My Swiss Cheese Brain

I am told, now that I have lost half of my cognitive functioning, I am still smarter than 80% of the people in the room.  Well okay, between 10 and 11:30 on alternate Wednesday mornings.

All the bits are in there.  If only I could connect the dots.  I wander inside this brain like the hallways of Hogwarts, wondering what's behind those locked doors, getting caught on moving staircases that take me to places I shouldn't be, sitting cross-legged on the floor in front of the Room of Requirement, desperately requiring entrance, but not a clue how to get in.

Sometimes all the bits taunt me.  They light up like little Christmas tree lights, blink off and on.  But if I grab one, the whole chain goes out.  Other times, all of a sudden, it's back, my brain.  I can get it to take me exactly where I want to go.

You don't notice.  You don't see the day spent on a paragraph, the week that is lost when the wall will not yield.  It hurts to write.  But I don't know who else to be, if not a writer.

Brain Damage

I have been writing about this stuff for years now.  Listening to somebody recovering from stroke, it finally hit me, brain damage.  I have brain damage.  The source is not the same.  A stroke kills brain cells through oxygen deprivation.  Trauma kills brain cells through chemistry, a surge of catecholamines, depression of thyroid function and hypoxia... an outpouring of other neurotransmitters, neuropeptides, and hormones... heightened catecholamine endorphin secretion with eventual depletion... the secretion of corticotrophin releasing hormone (CRH), adrenocorticotrophic hormone (ACTH) and cortisol... always more cortisol...

All of which really screws your hippocampus, seat of memory.  Here is the source of my cognitive deficits.  They say that, unlike cancer or a broken bone, there is no picture of depression.  Actually, that is not true.  MRI's show that anxiety and mood disorders damage and shrink the hippocampus.  They do have the pictures.  It is real.  It is brain damage.



Traumatic Brain Injuries, Post Traumatic Stress Disorder and severe depression all do the same brain damage.  They look the same.  By that, I mean the same MRI's.  They act the same.  By that I mean the same dysfunctions.  And, what do you know, they respond to the same treatments.  [I wrote about this in more detail back on March 28, 2010, one of my most frequently viewed posts.]

You can rehabilitate brains damaged by TBI's, PTSD and depression, just as you can rehabilitate brains damaged by stroke.  Just like stroke, some damage is reversible, some is not.  And just like stroke, expect it to take a long time.

A Long Recovery

A friend who has been my mentor through this life transition of mine told me, Yes, your brain will come back.  Give it five years.

So then my brain did its half-full/half-empty thing.

Five years -- that takes the pressure off.  I can give myself a break, and give myself time.  I can have hope.  Maybe my brain will be brilliant like my friend's brain again.

Five years -- my career really is over.  I will be too old to go back.  There is no reclaiming what I lost.  The presenter will never work in the ER again, and I will never be Diocesan Ministry Developer again.

Both.

I do tend to focus on the half empty part.

But my brain stretches out to as healthy as I can imagine, if only for a moment --

So I will do something else, instead.

to be continued...

photo of army doctor during training in Baghdad in public domain, (not the speaker referred to in this post)
flair by facebook
reproduction of hippocampus from Gray's Anatomy in public domain
fresco of The Visitation from the 14th century, Museo Matris Domini in Bergamo Italy

Summer Reading Picks from Prozac Monologues -- Repeat

The following is a repeat.  I tweaked it a bit and added book jackets.  If you click on a book jacket, you will go to a fuller description of the book at Amazon.com.  Ditto if you click on the title in the text.

Summer Reading Picks from Prozac Monologues -- June 17, 2010

Last winter I did the blog piece on movies for surviving the family holiday scene.  With or without family issues, here come my picks for summer reading.  This is an all purpose list, for normals and the mentally interesting alike, and just for fun.   Books to take to the beach -- or the backyard, should the beach be out of reach.

The following is my opinion.  Strongly-held, but my opinion.  Feel free to have your own.  That's what comments are for.

I asked friends for their input in two categories: lovable loonies and alternate worlds -- fiction, unless they could make a very compelling case otherwise.  Now I have a new reading list, too.

Lovable Loonies

We begin with lovable loonies.  My all-time number one favorite book, perfect for beach, book club, hospital bed, you name it, is Lamb: The Gospel According to Biff, Christ's Childhood Pal by Christopher MooreYou know, there were other gospels that didn't make the original cut.  I don't think this one would have, either.  Nevertheless, it had me at this sentence: The first time I saw the man who would save the world, he was sitting near the central well in Nazareth with a lizard hanging out of his mouth.  It seems Joshua (Jesus) was entertaining his little brother, who kept smashing the lizard's head with a rock, whereupon the future savior of the world would put it in his mouth, bring it back to life, and hand it back to his little brother.  Practice for later.  This gospel fills in the missing years of Jesus' life and explains the invention of cappuccino, judo and grace.  A loonier evangelist you could not find.  So that's number one.

Another Christopher Moore pick, though out of season, is The Stupidest Angel: A Heartwarming Tale of Christmas Terror.  It reintroduces a character from Lamb.  And boy, is he stupid.  The lovable loony is the sheriff's wife, a former actress who played a Xena-type warrior and never quite got out of character.  In a sub-plot and nod to O'Henry, she quits her meds to save up for her husband's Christmas present, a bong, while the sheriff/husband/recovering druggie plants an acre of pot to buy her a sword.

Actually, the whole purpose of this blog piece is to get more people to read my second favorite book, Lucky Dog by Mark Barrowcliffe -- a talking dog named Reg who helps a helpless loser win at poker -- the helpless loser being the only one who can understand what Reg is saying, of course.  After first meeting him, Dave goes on meds.  So Reg gives Dave the silent treatment, because his feelings are hurt .  Notice the running theme, meds.  This is a Prozac Monologues list, after all.  Eventually Dave misses Reg's conversation, quits his meds and figures out that Reg gives him an advantage at the gaming table.  It's all about smell.  You've got the mob, a rich old lady, a love interest, the world from a dog's point of smell and redemptionWhat more could you want for summer reading?

A friend reminded me of Kurt Vonnegut -- whom I already started rereading a few months ago.  Vonnegut makes reference to his lovable loony, Eliot Rosewater in a couple of books.  Rosewater gets his own book in God Bless You, Mr. RosewaterMaybe he has a touch of psychosis.  Maybe he is a hopeless idealist.  Maybe he just needs to say no.  But he is indeed lovable and a volunteer fireman.  Bonus loony: Kilgore Trout.

Crossover Category -- Lovable Loonies in Alternate Worlds

Also in the lovable loony category is The Hitchhiker's Guide to the Universe by Douglas Adams.  Couldn't we all use a book with the words Don't Panic on the cover?  Hitchhiker's Guide is the first of a triology with five books.  I think the second volume, The Restaurant at the End of the Universe is where I learned that every planet in the universe has a drink called gin and tonic.  You make it differently on every planet.  But there you are.  You can get the perfect beverage to accompany your summer reading, assuming the ingredients don't mess with your meds, on any planet in the universe.

I just started The Eyre Affair by Jasper Fforde.  Yes, I spelled his name correctly.  Another friend, a bookophile who knows loony recommends it.  It is the first of Fforde's loony alternate reality series, starring Special Operative Thursday Next, a literary detective who is chasing down the evil Acheron Hades who has stolen... It's a Lost in Austen/Inkheart kind of alternate reality, blurring the boundaries between the world of normals and the many worlds of books.  But today I am going back to the library to check out the original Jane Eyre.  Okay, okay -- I've never gotten around to it, just seen the movie version.  What with Fforde bending time and plot, I can tell I will miss stuff if I don't know the original.

Alternate Worlds

Hitchhiker's Guide and The Eyre Affair are my segue into alternate worlds.  I was heartbroken when we got to the end of the Harry Potter series by J.K. Rowling and lost that annual Hogwarts fix with its witches and wizards, port keys, Marauder's Map and all the rest.  According to a Face Book quiz, if I were a Hogwarts teacher, I would be Remus Lupin.  I agree -- the mostly depressed but occasionally dangerous one.  We never saw him do any real damage.  Sounds like BPII to me.  Last year I reread all seven books in preparation for the seventh movie.  This year, I am rewatching the movies to prepare for the eighth.  Bring on the popcorn!

Another friend fave and mine, too, is The Wrinkle in Time series by Madeline L'Engle.  These are cross-over youth/adult sci-fi, but you don't have to be a sci-fi fan to appreciate them.  One summer vacation/road trip, my six-year-old listened to Wrinkle on tape.  Every time we stopped for lunch, he wanted to discuss it.  Every time he got to the end, he started again at the beginning, and I was happy to listen with him.  I wonder if this was the root of his vocation as a philosopher.  The misfits are the heroes who save the planet from IT, the force that wants to eliminate unhappiness by eliminating deviance in the universe.  (I suspect that IT really just wants to get rid of deviance.  The unhappiness thing is just part of the sales pitch.)  In the first volume Meg figures out, same and equal are NOT the same thing.  Mitochondria play a major role in the second volume.  I'll write about mitochondria later this year.  Bonus: it turns out that It was a dark and stormy night is a great way to start a book, after all.

Michael Chabon rewrites history in The Yiddish Policemen's Union.  Imagine that at the end of World War II, Jewish people went to Alaska instead of Israel.  Fifty years later, Alaska is about to revert to the United States.  Enter your basic hapless detective.  Combine a murder mystery, political intrigue, orthodox Jewish mobsters, chess and a red calf.  Shake vigorously.  Serve on the rocks.

Chabon provides another alternate world in a tale of two Jewish adventurerers, Gentlemen of the Road.  Set in 10th century Khazaria, two con men/bodyguards/swashbucklers star in a dime store novel with elegant prose, inadvertently fighting for justice and the rightful heir to the Khazarian throne.

Not all alternate worlds are fantastical.  Like Gentlemen of the Road, books set in real times and places can sweep you up so that you leave your own world and enter the author's.  The day my mother left her third husband, the good stepfather, separating hers and theirs from his, I postponed going crazy by moving to China via Pearl Buck's The Good EarthSeventy years after it won a Pulitzer Prize, Oprah made it a Book Club pick.

Lately I have been living in nineteenth century England.  Jane Austen's biggest hit is Pride and Prejudice.  I haven't tried the graphic novel nor the sequels it inspired, including one with zombies.  You're on your own there.  Currently I am doing the Bronte sisters.  Emily Bronte wrote Wuthering Heights.  That link takes to you the edition that is easy to read in bed -- whatever that means.  I mentioned Jane Eyre by Charlotte Bronte above.  It has inspired the same kind of take-offs as Pride and Prejudice.  All of them have been made into multiple movies and mini-series, if you want to extend your reading experience into other media.

Rounding out our alternate world category, Ellis Peters takes us to a Benedictine monastery in twelfth century England, in the midst of a civil war.  Cadfael is a second career monk, a crusader turned herbalist and forensic scientist detective. The series starts with A Morbid Taste for Bones and goes on for nineteen more volumes -- God bless Ellis Peters.  This series has also been filmed, with Derek Jacobi as Cadfael.

Nonfiction Anyway

Douglas Adams and Hebrew poetry have both inspired me through the years.  If they tell you three, then they add a fourth.  I told you I had two categories.  So here is a third -- compelling nonfiction.  These two are on my own to read list:

The first is friend-recommended The Spirit Catches You and You Fall Down by Anne Fadiman. It is a tragic story of the clash between two cultures, that of the Hmong and that of Western medicine. The parents say Baby Lia Lee's soul is outside her body, captured by an evil spirit.  She needs a shaman.  The doctors say she has epilepsy.  She needs medication.  The doctors win.  The results are not good.  I haven't been reading biographies of people who live with mental illness lately.  But I might make an exception for this one.

The second and last is Invictus: Nelson Mandela and The Game That Made a Nation by John Carlin.  This edition has pictures from the movie.  The original edition is titled Playing the Enemy: Nelson Mandela and the Game That Made a Nation.  Combine the typical sports narrative structure: loser team triumphs, with that incredible, grace-filled moment in human history: oppressed people triumph and don't wreck vengeance on the oppressors.

Memoirs, Anyone?

So there are more than enough books to fill out my local library's summer reading club requirements.  I'm thinking of an autumn post with a list of mental illness memoirs: Kay Jamison, Elizabeth Wurtzel, etc.  Recommendations?

What are you reading this summer?  Enjoy.

photo of umbrella by Molku, who placed it in the public domain
book jackets by amazon.com
illustration of popcorn by digitalart used by permission 

Getting My Brain Back -- Neuroplasticity and Friends.

No, You Don't Already Have All Your Brain Cells

When we were kids they told us we already had all the brain cells we ever would have, that these brain cells would die off over the course of our lifetime, and if we killed them off early, we'd go senile.

Bummer.

I doubt this warning ever really kept anybody home from the kegger.

And as it happens, it is not true.  For those who survived the drive home, our brains were already hard at work, repairing the damage. 

Neuroplasticity

Neuroplasticity is the vocabulary word for the day.  It refers to the brain's ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.

BDNF

Think of neuroplasticity as the road repair function inside your head.  BDNF is the crew, a protein that helps the brain grow new brain cells and new connections between the brain cells.  BDNF is one of my very favorite brain things, even if I can never remember whether the D or the N comes first.  I will be writing more about it in the weeks to come. 

Epigenetics

Okay, one more vocabulary word for the day, epigenetics.  This word is about the nature/nurture debate.  Do you have a mental illness because you lost the genetic roll of the dice, or because a hurricane happened later?

Answer: Yes.

Evidently there are on/off switches installed in your genes.  After your DNA was poured, it still wasn't set.  Experiences after conception and into your life can determine which way the genes express themselves.

A few paragraphs above, I said your brain was already at work, repairing the damage you did to it at the kegger.  BDNF was patching holes.  Epigenetics means that unfortunately, the brain was also already at work, setting that damage in place.  Some of the substances consumed that night turned the switch in the direction you did not want it to go, especially if your roll of the genetic dice was already iffy.

Good News/Bad News

So your brain isn't finished forming.  And you have some control over what happens next.  Not absolute control.  But some control.

I tend to write about the bad news, how things go from bad to worse.  That's because I started this research trying to figure out what the hell happened.

But last month, I wrote a book report.  You may not have noticed.  But that was rather extraordinary.  Something new is happening.  I will be writing more about that in my new series, Getting My Brain Back.

Meanwhile, May is graduation month.  And graduation makes me think of Shel Silverstein.  Poetry, inspiration, you know.  Listen to the mustn't's, child; listen to the don't's...  But that poem isn't about neuroplasticity.  This one is.  Sort of.  Enjoy.



photo of Oktgoberfest at Fort Benning by Donna Hyatt, a US Army employee, and in the public domain
photo of sink hole by FEMA employee and in the public domain
flair by facebook

The Future is Bright -- For Whom?

The Future is Bright for Psychopharmocology Breakthroughs --

Okay, I'll bite.

I subscribe to an online journal Psychiatric Times.  Or at least, I have access to the articles for which there is no charge.  I don't get paid for this, you know.  Anyway, I get emails that link to the articles of the week.

So that was the subject line on the email dated 4/21/11, The Future is Bright for Psychopharmocology Breakthroughs.

This I'd like to know about.

Inside the email was a link to Novel Treatment Avenues for Bipolar Depression: Going Beyond Lithium, by Roger S. McIntyre and Danielle S. Cha.

This I'd really like to know about.

The article was not what I had been led to believe.  But I learned a lot, will share some of that with you, and explore the miscommunication at the end. 

Treating Bipolar Disorder Part IV -- Summing Up

Intending to review Ellen Frank's Treating Bipolar Disorder, I spent most of April describing the treatment itself, Interpersonal Social Rhythms Therapy, IPSRT.

Part I laid the foundation in work done on the relationship between circadian rhythms (our interior physiological clocks) and mood disorders.

Part II outlined Frank's Social Zeitgeber Theory and the treatment that proceeds logically from it, a process of establishing regular daily rhythms that set our interior clocks and keep them running on time. (Zeitgeber means timekeeper.)

Part III explained how work on interpersonal issues helps people reduce stressors and prevent disruptions to their social rhythms.

This last post will pull together my appreciation, my reservations and my hopes for future directions.

Social Zeitgeber Theory

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