Daily Archives: November 18, 2016

Mental Illness in a Test Tube

The physical reasons for mental illness, for example syphilis can cause mental illness symptoms. Thyroid disease, hypo or hyper, can cause mood symptoms. And thiamine deficiency in alcoholics can cause mental illness symptoms, this ised to be known as alcoholic insanity.

Although there is no test yet to diagnose schizophrenia of bipolar disorder, they are working on it. The thing that caught my eye the most is that in people who are experiencing mania, uric acid levels are high, And giving them meds that lower their uric acid levels improves their symptom of mania. So is mania/bipolar disorder a form of neural gout? Fascinating.

Also depression is thought to be an autoimmune response to infection, as it has many similar symptoms, such as malaise, low energy, achiness all over, and low appetite as an infection.


The lack of objective medical tests in psychiatry is a common criticism of the field. According to some, being a doctor means using physical exams, lab work or imaging to evaluate patients. Indeed, oncologists can find a tumor on a CT scan. Cardiologists can diagnose a heart attack with blood tests or an electrocardiogram.

Despite public misconceptions, psychiatrists do much of the same. We use objective tests all the time to evaluate patients with mental illness. (And I don’t mean inkblots.)

Say a middle-aged man visits a doctor’s office because he’s been experiencing confusion and memory problems. His family says his speech sounds different. The man has become delusional about his neighbors, convinced they are poisoning his food. He has no other medical history, other than a rash on his genitals years before.

A century ago, doctors might have diagnosed him with “general paresis of the insane.” He might have been confined to an asylum and left in squalid conditions. Yet  today, we know this disorder by another name—neurosyphilis. It’s a neuropsychiatric disorder caused by the presence of bacteria that cause syphilis in the brain. We can send off a lab test to identify this disease, and penicillin often cures patients.

This is far from the only example. In the 19th century, a German neurologist named Carl Wernicke found a series of three patients—two of whom were alcoholics—who suffered from strange symptoms including impaired eye movements, confusion, and poor balance. Around the same time, a Russian psychiatrist named Sergei Korsakoff discovered that patients with chronic alcoholism sometimes developed peripheral neuropathy, memory impairment, and psychiatric disturbances. Both physicians published papers describing these disorders, and the overlapping conditions later came to be known as Wernicke-Korsakoff syndrome.

In the years following, medical professionals identified more and more patients with these findings. But no one knew what caused the symptoms. The syndrome was often referred to as “alcoholic insanity.” Decades of research and the Nobel Prize-winning work of Dr. Christiaan Eijkman helped identify a vitamin called thiamine,, the deficiency of which was eventually found to be the cause of these conditions. We now routinely treat alcoholic patients with thiamine to prevent Wernicke-Korsakoff syndrome, and scans like brain MRI help confirm the diagnosis.

In psychiatry, we use blood work and imaging every day to evaluate patients with symptoms of mental illness. A vegan suffering from crippling depression might have B12 deficiency, while a patient who abuses IV drugs with progressive delusions and aggression could have HIV encephalopathy. A college student with anxiety, palpitations, and sensitivity to heat would raise alarms for hyperthyroidism.

This is a common theme in the history of psychiatry. Disorders treated under the domain of mental illness cross over into the realm of other medical specialties once an underlying cause is discovered. A patient might seek treatment for mental health issues, but once a medical reason for these symptoms is found, other doctors often then assume their care. “We’ll take it from here,” our colleagues say.

So the purview of psychiatry has largely remained limited to diseases that defy explanation. Our specialty has been relegated to the medicine of the unknown. We can’t yet test your blood for schizophrenia. We’re unable to diagnose bipolar disorder on imaging. We’re left with the Diagnostic and Statistical Manual of Mental Disorders and its inherently subjective criteria for defining illness.

Over the coming decades, research into the brain will drive mental health diagnoses and treatment in new directions. Yet what happens to the field of psychiatry as we continue to discover the underlying causes of mental illness? Does its scope of practice shrink ever further? Does the specialty fade further into irrelevance?

For example, recent studies have found associations between mania and elevated uric acid levels in the blood. Giving medications (e.g., allopurinol) that lower serum uric acid for bipolar patients with mania has been found to improve treatment responses in randomized placebo-controlled trials. If this relationship were to be true, could bipolar disorder become another everyday medical condition, just like gout?

Scientists have taken similarly unique approaches towards tackling depression. Some have proposed that depression might be caused by autoimmune responses to infection, as depressed patients are often fatigued with low appetite and other symptoms commonly seen among infected patients. What’s more, depressed patients commonly have elevated inflammatory markers in their blood. Might depression one day be treated by autoimmune specialists? Could immunotherapies eventually cure the blues?

One day, we’ll find out and, depending on the answers, you may be visiting a different kind of doctor for your mental health. If you happen to see a psychiatrist though, don’t be surprised if we ask you to stop by the lab on your way out.

Removing the Option to Quit

Today is the first day that we have had actual Autumn-like weather.  It is dreary out, the days of sunshine prior are slowly erasing themselves from my memory, until it feels like every day for the past ten years has been this way.  This removal of hope that happens to me from time to time, it’s happening, and like I sometimes (but not always) do, this time I am refusing to give myself the option to quit on myself.

I have too much going for me to give up.  I can’t promise that the thoughts won’t sneak in, but for this moment and for at least today, I will not quit on myself.  I will keep plodding, one foot in front of the other, and I will come out victorious in the Spring, surviving and possibly even conquering this beast in my brain that seems to be so loud and demanding through the colder months.

Continuing on from my last post, that strategy of hunkering down and just slogging through it will remain, will keep on.  I am not going to detail the daily woes of life, because that gets me nowhere.  I accept that I am depressed, moving through a mixed cycle, cycling, paranoid, racing thoughts, nightmares, feeling unsafe, and avoiding most people, most places, most interactions.  I acknowledge and then I move forward.  Maybe tomorrow will be better, I really have no way of knowing for sure, but I can work my hardest to keep shuffling toward days filled with more sunlight and green carpets of grass and natural warmth on my skin.  I will not let today’s troubles swallow me whole, spitting me out to be useless and lying still on the carpet all day.

I will do the things I need to do, I will follow the lists, I will cherish my blessings, and I will persevere, because there is really no other acceptable answer.  Above all, remember that a simple kindness can be the push that gets a person through a hard day.  Don’t be shy, throw a pebble at my window.  I will likely be both surprised and grateful, and will almost certainly return the favor.

Filed under: Daily Tagged: anxiety, Bipolar, DBT, depression, dialectical behavior therapy, fear, panic, PTSD, SAD, safety, seasonal affective disorder, self harm, suicidal thoughts, suicide, suicide prevention

I Don’t Think This Is Working. . .

I am waiting for my tutoring student who has not shown up yet.  She also has not emailed me her paper like she was supposed to..   I think I will need to talk to the mom and see what is going on.   i’m going to stay here for a while and then call and see if she is planning on coming,  Otherwise I will leave if I can’t reach her.

I don’t have anything else planned for today so we will see what happens.  I don’t want to spend the day in bed again.  I will probably do some laundry once I get home and see how that works.

We are try8ig to prepare for Thanksgiving and get our plans in place for that.  Let the kids stay busy and  us get ready to  travel.  I don’t know what all we’re going to wind up buying for Christmas for the girls.  We have a few plans in mind but not many,  We will just have to look around and see what we can find.  WE have some  presents bought but not nearly enough.

I feel pretty good this morning.  The only thing is that my black pants all disappeared on me today,  I couldn’t find the ones that I usually wear with the top.I wanted to wear.  SO I may go out shopping for some of those or I may just ask for some for Christmas.  I can’t decide.  If I don’t do any more tutoring, I won’t have a reason to dress up very often and can make it until Christmas with what I have.  Sigh.

Donald Trump and Library Porn

I have never been so nervous to go to the library as I was this week.

I’ll tell you what I was there to get, but you have to keep it a secret.  Promise?  Pinky swear? (Everyone knows you can’t break a pinky swear – you get seven years of bad luck or you grow warts or something.  It’s unpleasant.  Don’t mess with pinky swears).

Okay. *deep breath*  I was there to get…

Books by Donald Trump.

WAIT! HOLD ON! Don’t unfollow me and threaten to burn down my house or dismember my childhood teddy bears!  I want to read his books because, like it or not, he is going to be our next president.  I want to read these books for the same reason I wanted to read The Audacity of Hope when President Obama was elected.  If someone’s going to be running my country, I would like to hear what he has to say.  I feel like that’s responsible.  Plus, how can I complain intelligently if I don’t even understand someone’s views?

Okay.  There’s my defense.  NOW you can unfollow me, but you don’t know where I live and also I’ve hidden my teddy bears.  So ha.

If you’re still reading, I will tell you about my library excursion.

Our country is oddly hateful of people who support Trump at the moment. I certainly didn’t want to be on the receiving end of this venom simply for checking out a library book.  It doesn’t mean I like him, people!  I don’t like him at all!  It means that I want to be an informed citizen!

I reserved the books ahead of time, so when I went in I could basically grab and dash.  I went to the shelf where the holds are reserved, and I immediately saw my books with a big label on the side that said, “HILLBORO.”  I quickly looked left and right – had anyone I know seen this?  Was anyone watching now?  I was alone.  Grab the books and run!  EEEEEEEEEP!

I grabbed the books but put the titles facing toward me so that no other library patrons would mistakenly think I’m a Trump fan.  Then I saw that there was “About the Author” picture on the back of the book.  Eeek!  There’s no escaping his ridiculous hair!  Quick!  Turn around a different book! Good news: the blue book had no picture on the back.  I put that one in the front.

I hurried over to the self-checkout so I would not have to admit to a librarian what I was reading.  I felt weird about being this shifty, like I was checking out porn or something.  This made me wonder – do they have porn at the library?  They sell magazines…can you check out a Playboy?  That seems pretty disgusting, but hey – it’s 2016.  We live in a weird world.  Our country just elected Donald Trump.  Library porn is pretty low on the list of global concerns.

I’ve checked out books on bipolar disorder a bazillion times.  I think I’ve probably had every library book on the topic checked out.  I never got all shifty about checking those out.  But reading up on the new leader of the free world?  How embarrassing!  Obviously that’s a dumb way to feel, but this is a mental illness blog.  LET ME FEEL MY FEELINGS!

Okay, so I was embarrassed about the book, but I did the self checkout and hustled out of the library like my coat was on fire (this is a phrase I’ve never quite understood, because everyone knows that if your coat is on fire you should stop, drop, and roll.  To clarify: I did not stop, drop, and roll with this book.  I left the library in a rushed manner).

Now I’m at home, and I’m getting ready to read my secret books that are so, so much less sexy than library porn.


It’s been a slog of a day.  I went Christmas shopping and grocery shopping and did well, but I fell asleep after I got back listening to the soundtrack for.”Ocean’s 11″.  I also dropped off my Wyatt Waters pictures to be framed and am looking forward to hanging them in my foyer.

Bob and I seem to be recovered from our argument the other day.  I’m feeling better about things but am interested in seeing what my counselor says next week on what to do if he backslides again.  I don’t think I’m asking too much to get affirmation for what all I do.  If he wants me to be happy just being a wife and mom (which is what he said during our discussion) he needs to make it easier for me to feel good having made the sacrifice for the kids.

I don’t think I’m being selfish categorizing it as a sacrifice.  I never wanted to quit working,  I didn’t want to work a job I hated and paying daycare when I could do something I loved.  And losing that was so hard on me.  I still don’t think he understands that.



Don’t The Moon Look Lonely

Shinin’ through the trees….