Daily Archives: October 14, 2017

Brain Chemical Abnormalities Identified in Early Stage Psychosis

High levels of glycine and glutamate are seen in early stage psychosis. These interact with the NMDA receptor which is implicated in psychosis.

https://www.technologynetworks.com/neuroscience/news/brain-chemical-abnormalities-identified-in-early-stage-psychosis-293166

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A new study of young people experiencing a first episode of psychosis reports elevations in the brain chemicals glutamate and glycine. Published in Biological Psychiatry, the study led by Dr. Dost Öngür of Harvard Medical School provides the first ever measurement of glycine levels in patients with psychotic disorders.

Abnormal brain activity in psychotic disorders, such as schizophrenia and bipolar disorder, is thought to stem in part from impaired function of the NMDA receptor. Glutamate and glycine activate the receptor, which is an important mediator of brain signaling for processes such as learning and memory. According to Dr. Öngür, the findings may serve as a marker in the development of future treatments aimed at restoring function of NMDA receptors.

Reliable detection of glycine in the human brain has previously been very challenging — if not impossible — with conventional techniques, as an overlapping signal interferes with its detection. But first author Dr. Sang-Young Kim and colleagues applied a new method of the brain imaging technique called MR spectroscopy to suppress the interfering signal and reveal the hidden glycine signal.

Glycine levels were higher in 46 patients with first-episode psychosis, compared with 50 healthy participants. “Our findings suggest that glycine abnormalities may play a role in the earliest phases of psychotic disorders,” said Dr. Öngür. The researchers also measured increased glutamate levels in patients, which lines up with strong support for elevated glutamate reported in other studies of first-episode psychosis. The elevations in glutamate and glycine indicate that NMDA receptors receive abnormal stimulation in psychotic disorders.

The increased glycine level was the opposite of what the authors expected to find — researchers have actually tried raising glycine levels in patients to compensate for the underperforming NMDA receptors. The new findings revealing higher levels early on in the disease might help to explain why glycine supplementation hasn’t worked as well as researchers hoped.

“This study supports the notion of different developmental phases in the biology of schizophrenia. These phases might require somewhat different treatments,” said Dr. John Krystal, Editor of Biological Psychiatry.

This article has been republished from materials provided by Elsevier. Note: material may have been edited for length and content. For further information, please contact the cited source.

Reference

In Vivo Brain Glycine and Glutamate Concentrations in Patients with First-Episode Psychosis Measured by Echo-Time-Averaged Proton MR Spectroscopy at 4 Tesla,” by Sang-Young Kim, Marc J. Kaufman, Bruce M. Cohen, J. Eric Jensen, Joseph T. Coyle, Fei Du and Dost Öngür. Biological Psychiatry (http://dx.doi.org/10.1016/j.biopsych.2017.08.022).


Depression is a physical illness which could be treated with anti-inflammatory drugs, scientists suggest

I’ve posted this before, but it is so important that I am posting it again! Depression, a physical illness due to inflammation, able to be treated by anti inflammatory drugs!

http://www.telegraph.co.uk/science/2017/09/08/depression-physical-illness-could-treated-anti-inflammatory/

Around one in 13 people in Britain suffers from anxiety or depression and last year the NHS issued 64.7 million prescriptions for antidepressants, double the amount given out a decade ago.

Current treatment is largely centred around restoring mood-boosting chemicals in the brain, such as serotonin, but experts now think an overactive immune system triggers inflammation throughout the entire body, sparking feelings of hopelessness, unhappiness and fatigue.

It may be a symptom of the immune system failing to switch off after a trauma or illness, and is a similar to the low mood people often experience when they are fighting a virus, like flu.

A raft of recent papers, and unexpected results from clinical trials, have shown that treating inflammation seems to alleviate depression.

Likewise when doctors give drugs to boost the immune system to fight illness it is often accompanied by depressive mood – in the same way as how many people feel down after a vaccination.

Professor Ed Bullmore, Head of the Department of Psychiatry at the University of Cambridge, believes a new field of ‘immuno-neurology’ is on the horizon.

“It’s pretty clear that inflammation can cause depression,” he told a briefing in London to coincide with this week’s Academy of Medical Sciences FORUM annual lecture which has brought together government the NHS and academics to discuss the issue.

“In relation to mood, beyond reasonable doubt, there is a very robust association between inflammation and depressive symptoms.  We give people a vaccination and they will become depressed. Vaccine clinics could always predict it, but they could never explain it.

“The question is does the inflammation drive the depression or vice versa or is it just a coincidence?

“In experimental medicine studies if you treat a healthy individual with an inflammatory drug, like interferon, a substantial percentage of those people will become depressed. So we think there is good enough evidence for a causal effect.”

Advice | Natural ways to reduce inflammation

Dr Kelly Brogan, author of A Mind of Your Own points to lifestyle changes with a natural anti-inflammatory effect that can help improve your mood:

Exercise — Depression can result from chronic ongoing stress and exercise acts like a biological insurance plan against the bodily effects of stress. 20 minutes, three times a week or more of anything that gets you sweaty is all that’s needed.

Diet — Eliminate processed foods, especially sugar and refined carbohydrates which may increase inflammation in the body. Eat plenty of natural foods including fruits and vegetables, pastured animal products and eggs and wild fish.

Meditate — Meditation stimulates the expression of genes that are powerfully anti-inflammatory. Just ten minutes a day of mindfulness, deep breathing or gratitude journaling can help mood.

Scientists at Cambridge and the Wellcome Trust are hoping to begin trials next year to test whether anti-inflammatory drugs could switch off depression.

“There is evidence to suggest it should work,” added Prof Bullmore.

The immune system triggers an inflammatory response when it feels it is under threat, sparking wide-ranging changes in the body such as increasing red blood cells, in anticipation that it may need to heal a wound soon.

Scientists believe that associated depression may have brought an evolutionary benefit to our ancestors. If an ill or wounded tribal member became depressed and withdrawn it would prevent a disease being passed on.

However a link has taken so long to establish because until recently scientists believed the brain was entirely cut off from the immune system, trapped behind a ‘Berlin Wall’ known as the blood brain barrier.

But recent studies have shown that nerve cells in the brain are linked to immune function and one can have an impact on the other. Around 60 per cent of people referred to cardiologists with chest pain do not have a heart problem but are suffering from anxiety.

Figures also show that around 30 per cent of people suffering from inflammatory diseases such as rheumatoid arthritis are depressed – more than four times higher than the normal population.

Likewise people who are depressed after a heart attack are much more likely to suffer a second one, while the lifespan for people with cancer is hugely reduced for people with mental illness.

“You can’t separate the mind from the body,” said Prof Sir Robert Lechler, President of the Academy of Medical Sciences.

“The immune system does produce behaviour. You’re not just a little bit miserable if you’ve got a long term condition, there is a real mechanistic connection between the mind, the nervous system and the immune system.

“Our model of healthcare is outdated. We have a separation. Mental healthcare is delivered by mental health professionals, psychiatrists, mental health nurses and so on, often in separate premises from where physical health care is delivered and that is simply wrong and we need to find ways to ever more closely integrate and train amphibious healthcare professionals who can straddle this divide.”

Research has also shown that people who have suffered severe emotional trauma in their past have inflammatory markers in their body, suggesting their immune system is constantly firing, as if always on guard against abuse.

Numbers to call

Samaritans are available 24 hours a day, 365 days a year. If you need a response immediately, it’s best to call on the phone. This number is FREE to call: ☎ 116 123 (UK) 116 123 (ROI)

MIND, the mental health charity: Website0300 123 3393

Rethink Mental Illness: Website0300 5000 927

Dr Alan Carson, Reader in Neuropsychiatry, at the University of Edinburgh, said: “All psychiatric and neurological disorders are based in brain and brain is not static but structurally and functionally responsive to a range of biological, psychological and social issues.

“Yet institutionally we use an outmoded code which separates brain disorders into psychiatric ‘f’ codes and neurological ‘g’ codes which holds back both scientific and clinical progress.”

Stephen Buckley, Head of Information at mental health charity Mind, said more research was vital to pick apart the various causes of depression and find new treatments.

“We must acknowledge a wide range of potential causes and treatments,”  he said. “For many people, long term physical illness can cause mental health problems, such as depression. This could be because of the impact of living with the illness, the pain and discomfort or side effects of medication, among many other reasons.

“We also need to look at people’s broader experiences, their lives and other challenges they face – such as a lack of access to services, experience of abuse or trauma, poor housing and exclusion, to ensure everyone with a mental health problem gets the support they need.”

One promising treatment for depression on the horizon is the use of electrical stimulation to change the signals between the brain and the immune system.

Prof Kevin Tracey, President and CEO, of the US Feinstein Institute for Medical Research, discovered that the brain controls production of a deadly inflammatory chemical called TNF, which if released in high doses can be fatal, causing people to, literally, die of shock.

He has recently developed a electrical device which reproduces the connection and switches off the chemical. Three quarters of patients with rheumatoid arthritis recovered following trials.

“This is the tip of the iceberg of a new field called bio-electric medicine,” he said.

“This is a new way of thinking about medicine. We’re using electrons to replace drugs. This will not replace all drugs. But there will be many drugs that are either too expensive, too toxic which may be replaced by these devices.”


Ketamine Rapidly Reduced Suicidal Thoughts in People with Depression

I’ve posted about Ketamine before, but this meta analysis really shows the anti suicide and antidepressant effect of Ketamine! Wow!

https://www.bbrfoundation.org/content/ketamine-rapidly-reduced-suicidal-thoughts-people-depression

A single dose of ketamine, the anesthetic drug that has been found to have fast-acting antidepressant effects, can significantly reduce suicidal thoughts in patients with depression for up to a week, according to a new analysis.

The findings, published online October 3, 2017 in the American Journal of Psychiatry, come from data on 167 patients who participated in any of 10 previous studies on ketamine’s effects. All of the patients studied received a single dose of the drug or a control drug, administered intravenously. This “meta-analysis” – a study of multiple other studies – suggests that the drug not only reduces patients’ overall depression; it also appears to be particularly effective at countering suicidal thoughts.

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A new analysis of data from 10 studies finds that a single dose of intravenous ketamine reduces suicidal thoughts within one day of treatment. The drug’s beneficial effects on suicidal thoughts generally persist at least one week after treatment.

Ketamine’s use as an antidepressant is experimental. Scientists have discovered that low doses of the drug can relieve symptoms of depression within hours. Because ketamine is an old drug and is no longer protected by patent, it is unlikely to be tested in large clinical trials that are required for FDA approval. But researchers note that it can be particularly effective as a rapid antidepressant and can rapidly reduce suicidal thinking. Multiple research efforts are devoted to inventing a ketamine-like drug that has its antidepressant potency but lacks its side effects.

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A single IV dose of ketamine significantly reduces suicidal thoughts within a day of depression treatment.

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In the current study, researchers led by 2016 Young Investigator Samuel T. Wilkinson, M.D., at Yale School of Medicine, collected and analyzed data from past studies with the goal of better understanding ketamine’s acute effects on patients who are experiencing significant thoughts of suicide. The research team also included grantees Michael H. Bloch, M.D., M.S., a 2013 and 2009 Young Investigator at Yale University; Sanjay J. Mathew, M.D., a 2009 Independent Investigator and 2006 and 2001 Young Investigator at Baylor College of Medicine; James W. Murrough, M.D., Ph.D., a 2009 Young Investigator at Icahn School of Medicine at Mount Sinai; Adriana Feder, M.D., a 2015 Independent Investigator and 2002 Young Investigator at Icahn School of Medicine at Mount Sinai; Carlos A. Zarate, Jr., M.D., the winner of the 2011 Bipolar Mood Disorders Award at the National Institute of Mental Health, a 2005 Independent Investigator and 1996 Young Investigator; and Gerard Sanacora, M.D., Ph.D., a 2014 Distinguished Investigator, 2007 Independent Investigator and a 2001 and 1999 Young Investigator at Yale School of Medicine.

Participants in the 10 studies included in the new analysis had been diagnosed with a range of psychiatric conditions, including major depression and bipolar disorder. Dr. Wilkinson and his colleagues focused on those participants who reported suicidal thoughts at the time of their trial. They analyzed ketamine’s effects upon both suicidal thoughts and scores on standard clinical depression scales, comparing patients’ responses to the drug to those of patients in control groups who received either saline or the anesthetic midazolam as a placebo.

The team found that both suicidal thoughts and overall depression were relieved significantly by ketamine; more than half were free of suicidal thoughts within 24 hours of their treatment. These benefits persisted for up to a week—the latest time point considered in the analysis.

Overall, those whose depression diminished the most experienced the greatest reductions in suicidal thoughts, but the researchers found that ketamine’s effects on suicidal ideation were significant even after controlling for changes in depression severity. This means the drug’s effects on this critical aspect of depression may be partially independent from its effects on mood, they say. This will undoubtedly be the focus of future research.


The Job That Never Starts Is Starting!!

Happy Saturday, y’all!  Well I finally got the news.  The contract is signed and I have an official, set in stone, start date for my job of this coming Tuesday.  Le Sigh . . . I guess I’m relieved because I’ve been having every flavor of financial stress, worrying about losing my humble home, envisioning myself homeless and living in my car, trying out suicide plans, super fun stuff!!  It’s been, shall we say, crazy making?!  But as you know, I have very mixed feelings about working a full-time job after not doing it for almost four years.  I have a very great fear that I won’t be able to do it, stamina-wise, or that I won’t be able to do it, brains-wise.  Ah, fear.  You bitch.  Here is another chance for me to feel the fear and do it anyway.  Isn’t it something how life gives us these chances to rise above?  I’d rather not, I’d rather stay in my cocoon of safe existence, but life has other plans for me apparently.  So, three more days of relative calm, and then KA-BOOM!  I’m off to work.

Hope everyone had a good week, hope your drugs are working, hope you are working if that is in your best interests, and I hope the sky is blue where you are.  Let me know how you are in the comments, will ya?  Peach out!


Filed under: Bipolar, Bipolar and Anxiety, Bipolar and Crazy, Bipolar and Stress, Bipolar and Work, Bipolar Disorder, Psychology, Psychology Shmyshmology Tagged: Bipolar, Blogging, Mental Health, Mental Illness, Psychology, Reader

Emma and the Leaky Gut

While this may sound like a new Judy Blume novel, it’s really just my latest batch of experiments.

In August, when I met with my Case Manager, I was a bit weepy about the verdict of my pulmonologist (Obesity is the root cause of everything), trying and getting sick on a ketogenic diet, and the increasing pain in my knee.  Depression had trundled out the “Hopeless” cart, and I had climbed in.

My Case Manager is a lovely, up-beat, supportive darling, so when she suggested I see a hospital dietitian I felt instant betrayal.  Visions of scales and tape measures goose-stepped through my brain.  But, she asked me to think of this dietitian as someone I might add to my small support system—someone I could talk to and have on my side.  Framed that way, I agreed to meet with her.

In the meantime, I had been visiting my chiropractor for my knee and recurring TMJ.  Over the summer, she heard all about Dr. Obesity, my binge eating disorder, and all my other mental and physical woes.  For good measure, I came down with bronchitis a few weeks ago.  Along with prescribing additional protein powder to my morning shake while I’m sick, she also wondered if I might not have a Leaky Gut.

Basically, this syndrome is caused by a loosey-goosey gut allowing too much junk to pass into the blood stream, setting off an immune response that never shuts down.  Chronic inflammation of the gut follows.  Treatment involves getting rid of foods that irritate the gut and adding foods that soothe and heal it.  Dr. Ash has a quick take on Leaky Gut here.

Being sick with bronchitis turned out to be the perfect time to implement these changes.  Since I’m already lactose intolerant and get a gut ache eating bread, going dairy and gluten free was a no-brainer.  I can add bone broth to my gluten-free chicken noodle soup, eat a little kefir as a snack, and alternate my Breathe Easy tea with a variety of kombucha teas.  And my gut has stopped aching all the time.

I started to wonder:  What if obesity isn’t just a cause, but also a symptom?  What if Binge Eating Disorder isn’t just a mental illness, but also has a physical component?

These are the questions I took with me to the dietitian.

Emma is a sweet, young, cheerful professional, but had no answers.  She had heard of Leaky Gut, but knew nothing about it.  She knew about Binge Eating Disorder, but knew nothing about that either.  However, she was absolutely willing to learn.  She took all the information I brought with me and made copies for herself.  Our weekly sessions focus on what I want and my goals, not weight loss.  She is, as my Case Manager predicted, a wonderful addition to my support team.

My bad knee and intermittent TMJ turned out to be arthritis, no big surprise since my dad was a Bionic Man of joint replacements and—you know—that obesity thing making everything worse.  Whenever I think of arthritis, Mammie from Gone With The Wind pops into my head.

Arthritis waits in its web, swooping in after an injury.  An opportunistic little shithead.

Oh, well I’ll think about that tomorrow.  I have sauerkraut and wild salmon to eat now.  And tomorrow is another day.

Finding my vulnerability

vulnerability-quote

“I found it much easier to stand up for other people who may not be able to advocate for themselves than allowing others to help me.  When I finally reached rock bottom and I said those words to my sister, “Help me.  Please help me.”  It was the most vulnerable moment of my adult life.”   Montana Jail Journal- January 18, 2013

In my opinion mental wellness has a lot to do with personal growth.  I know it sounds trite to say, but I was on an expedited train of personal growth while I sat in a small jail cell in Montana because of an under-treated mental illness.  I just didn’t know it. Sometimes when the only thing one can do is think, read and write personal growth opportunities are abundant.

I’ve been reading Brene Brown’s most recent book, “Braving the Wilderness: The Quest for True Belonging and the Courage to Stand Alone”.  I’ve been fascinated with her work and all the many lessons I’m gaining as I read and digest each chapter. I was pleased with myself that I had actually been practicing some of what she suggested.  Having been in pure survival mode from bipolar disorder for many years to finally being well enough to embark upon self-reflection and personal growth is making me very happy.

She writes a great deal about belonging.  It seems like a paradox to talk about standing alone, braving a wilderness and belonging.  But this quote kind of sums it up–

“Because true belonging only happens when we present our authentic, imperfect selves to the world, our sense of belonging can never be greater than our level of self-acceptance.” 

This statement rang so loud to me.  All the people who live with a mental illness who are living in shame at this very moment came to my mind.  I’ve been there, I know what that’s like to not have self-acceptance, and therefore not belong.  I’ve felt like an outcast with the people who were closest to me.  When you blame yourself for having a mental illness it’s kind of hard to experience a deep level of self-acceptance.

As I’m blessed to experience a time of peaceful knowing, I keep thinking about all the people who need to hear, “you have a mental illness and it’s not your fault.”  When I sat in an Idaho psychiatric hospital and I let those words resonate inside of me, I could feel the shift in me emotionally.

Self-acceptance is something people pay a lot of money to get.  But it’s really not anything you can buy.  It comes from within.  It’s an internal, quiet voice of strength that tells you you’re okay.  It also means that we accept all of who we are–all our life experiences.

This is something very difficult to do when handed the additional challenge of having a mental health condition.  Think about it-if you’re fighting depression the last thing on your mind is accepting yourself.  But here’s the catch, when we accept our experience for what it is it can actually help us to heal faster.  And certainly if not to heal, than to have the energy to fight depression.

Funny thing is…I can read Brene Brown’s quote and smile.  I have experienced it and believe it is true.

Reading her book prompted me to watch her Ted Talk on Vulnerability.  I could probably watch it 100 times and still learn something.  But this whole idea of vulnerability peaked my interest.  Because as much I hated jail, it was a time in my life when I asked for help.  I was extremely vulnerable.

Yet, though I had a long journey ahead of me, those three weeks in jail changed my life.  I was learning to embrace vulnerability.

There is much of Brene Brown’s research that can really be applied to understanding why it’s so difficult to eliminate the self-stigma of mental illness.  I hope to take a deeper look at that and write about it on a future blog.  Until then, check out Brene Brown’s work.  It’s very enlightening.

 

 

 

 

 

 


“Will You Still Love Me If I …”

I had the TV on for background noise yesterday while I was working on a cake. If I am alone and not at the computer I have to have something on, whether it is the radio or the TV. I leave it on the same station that I watch the news on and it just …