Posts tagged Neuroscience
Posts tagged Neuroscience
[Article of Interest] Unmasking the agony: Combat troops turn to art therapy
By Bill Briggs, NBC News contributor
The skull’s left corner is gone, leaving a jagged, diagonal edge drenched in red. The eyes are black and frantic. All of it resembles the Iraqi man who, in his final minute alive, stared up at Maj. Jeff Hall.
For five years, that face tortured Hall, once a sharp Army leader later shoved to his own ragged edge. Not long ago, a woman handed Hall a blank mask, brushes and paints. She asked him to see what may emerge on the surface.
“That image, seared into my mind, began leaking out of me,” said Hall, one of hundreds of active-duty troops who have created masks as part of an art therapy program at Walter Reed National Military Medical Center. “I almost needed to regurgitate it. To be honest, it helped me let it go.”
Many more masks, some resembling Hall’s violent creation, some depicting abstract demons, adorn walls at the National Intrepid Center of Excellence (NICOE) on the Walter Reed campus.
They reveal scars once carried and cloaked inside the minds of men and women back from war — troops diagnosed with mild brain injuries and secondary psychological issues, including post-combat stress.
Hall, 43, who titled his mask “The Shock of Death,” served a pair of year-long tours in Iraq spanning 2003 to 2005. Ultimately haunted by violent events he saw and survived in Iraq, including the loss of friends, Hall eventually contemplated suicide and became more isolated. His commander noticed Hall’s behavioral changes and guided him into counseling in 2008. Two years later, Hall was invited to seek treatment for a traumatic brain injury at then-new NICOE, a Department of Defense facility offering research, education and treatment focused on TBIs and psychological health.
When service members initially enter the art-therapy studio, their faces often are blank and unyielding, hiding unwelcome war souvenirs within — the mental cargo they’ve lugged home but can’t shake. On their masks, they expose that secret turmoil: vulnerabilities, anger, grief or, often, fragmented identities.
“It’s intense. They get really invested in this. It becomes very meaningful for them,” said Melissa Walker, an art therapist who coordinates the masks program at NICOE.
Participants at NICOE must be active-duty troops who are dealing with a combination of TBI and psychological health concerns. Typically, they are referred by their primary health care provider or their commander. A designated team at NICOE determines which service members are most appropriate to receive treatment there. Attendees participate for four weeks. Art therapy is just one of the tools offered and the service members usually make one mask — done during their first week at the center.
“I tell them: ‘Don’t worry about the finished product; worry about what you are symbolizing in the mask.’ That makes it more powerful to them. It gives them a way to express to us, visually, what they’re going through,” Walker said. “It’s a little less intimidating then handing them a blank piece of paper.”
Art therapy has become a staple in the treatment of a wide array of traumas, from child abuse to PTSD. Making art can help people unlock dark emotions or memories that they can’t yet vocalize, pulling those buried anxieties from their subconscious and placing them onto a canvass or into a lump of clay, said Donna Betts, a professor in the art therapy program at George Washington University.
As a patients’ pieces are taking shape, art therapists help them talk about what they believe they are trying to express in their creations, Betts said.
“It’s especially effective in the treatment of trauma in service members. When trauma is experienced, it tends to be stored in the nonverbal part of the brain,” Betts said. “This is why so many of them can’t even put into words what they’ve been through. Art therapy helps them retell their story through art. It translate that trauma from the nonverbal part of the brain to the verbal part so they can start dealing with it.
“They then become more aware of the trauma. This is where that healing starts to take place.”
After the paint is dabbed and stroked at NICOE, many of those papier-mache masks offer chilling accounts of what it is like to live inside the minds of combat veterans.
One brown face with the mouth agape and with bloodshot eyes upturned is squeezed by a metal clamp that reads “TBI” on the left and “PTSD” on the right.
Another mask is coated by small chunks of amber bark — two tiny holes remain for eyes — symbolizing the outer camouflage the maker felt is necessary to blend back into the civilian world.
Some masks show mouths locked or sewn closed, whispering of an inability to speak of what they’ve witnessed. Many are divided down the middle — for example, one displays part of an American flag on the left and a skull on the right.
“There is a split sense of self. They feel like they’re one person when they’re deployed and one person when they return home,” Walker said. “Or, they do a really strong, warrior exterior with a vulnerable inside but they don’t feel like they can express that.”
The troops who come to NICOE for therapy can take their masks home. But many purposely leave them to hang from the walls to speak to — and perhaps even soothe — incoming troops trying to cope with the same thoughts and impulses.
The creations give service members a format “to say what they can’t say out loud — because it’s too painful or because we just don’t feel like anybody really wants to hear it,” said Hall, who remains on active duty, stationed at Rock Island Arsenal in northwestern Illinois.
“I absolutely believe it is a method to calm your mind.”
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[Article of Interest] Invitation to a Dialogue: Benefits of Talk Therapy
By Larry S. Sandberg
To the Editor [of the New York Times]:
We tend to divide treatments for mental illness into “psychological” approaches and “biological” ones; the former typically involve “talk therapy” and the latter medication. But this either-or way of thinking obscures the fact that talk therapy affects the brain and is no less biological than pills.
Numerous findings over the last two decades demonstrate how talk therapy alters the brain. Disabling conditions like clinical depression and anxiety can be treated effectively by understanding distorted patterns of thought, becoming aware of emotional conflicts that have not been conscious, or practicing new behaviors. Talk therapy is a potent treatment for serious mental disorders and not simply for the “worried well,” as it is sometimes characterized.
These conditions can also be treated with medication, either alone or in combination with talk therapy. Whereas the effects of medication tend to go away once the medication is stopped, the benefits of talk therapy can be enduring because of the significant changes that take place not only in the “mind” but in the “brain,” too. This is a real-life example of what the Nobel laureate Eric Kandel has discovered: learning affects the ways in which the brain forms new connections.
Why does this matter? It is important that the public know that talk therapy is an important tool in the healing process precisely because of its powerful effects on the brain. Medication, which is lifesaving for many, tends to be overprescribed. Rather than being introduced as part of a comprehensive treatment that includes psychotherapy, it is often used in its place. We should be aware of the cultural trends that devalue psychotherapy and the listening healer and the unintended consequences that may ensue.
[Article of Interest] Childhood Depression May Be Tied to Later Heart Risk
For these kids, obesity, smoking and inactivity more likely in adolescence, preliminary research shows
Teens who were depressed as children are more likely to be obese, to smoke and to be sedentary, a new study finds.
The findings suggest that depression during childhood can increase the risk of heart problems later in life, according to the researchers.
The study included more than 500 children who were followed from ages 9 to 16. There were three groups: those diagnosed with depression as children, their depression-free siblings and a control group of unrelated youngsters with no history of depression.
Twenty-two percent of the kids who were depressed at age 9 were obese at age 16, the study found. “Only 17 percent of their siblings were obese, and the obesity rate was 11 percent in the unrelated children who never had been depressed,” study first author Robert Carney, a professor of psychiatry at Washington University School of Medicine in St. Louis, said in a university news release.
The researchers found similar patterns when they looked at smoking and physical activity.
”A third of those who were depressed as children had become daily smokers, compared to 13 percent of their nondepressed siblings and only 2.5 percent of the control group,” Carney said.
Teens who had been depressed as children were the least physically active, their siblings were a bit more active and those in the control group were the most active, according to the study, which is scheduled for presentation Friday at the annual meeting of the American Psychosomatic Society in Miami. Although the study showed an association between childhood depression and obesity, smoking habits and inactivity later in life, it did not prove a cause-and-effect relationship.
These findings are cause for concern because “a number of recent studies have shown that when adolescents have these cardiac risk factors, they’re much more likely to develop heart disease as adults and even to have a shorter lifespan,” Carney said.
”Active smokers as adolescents are twice as likely to die by the age of 55 than nonsmokers, and we see similar risks with obesity, so finding this link between childhood depression and these risk factors suggests that we need to very closely monitor young people who have been depressed,” he said.
Note: Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.
[Article of Interest] People with Mental Illness at Highly Increased Risk of Being Murder Victims
Risk highest among those with substance use disorders
People with mental disorders have a highly increased risk of being victims of homicide, a large study published today on bmj.com suggests. The perpetration of homicide by people with mental disorders has received much attention, but their risk of being victims of homicide has rarely been examined. Yet such information may help develop more effective strategies for improving the safety and health of people with mental illness.
So a team of researchers from Sweden and the USA assessed mental disorders and homicides across the entire population of Swedish adults between 2001 and 2008. Mental disorders were grouped into the following categories: substance use disorder; schizophrenia; mood disorders including bipolar disorder and depression; anxiety disorders and personality disorders. Results were adjusted for several factors such as sex, age, marital status, educational level, employment status and income. Of 7,253,516 adults in the study, 141 (22%) out of 615 homicidal deaths were among people with mental disorders.
After adjusting for several factors, the results show that people with any mental disorder were at a fivefold increased risk of homicidal death, relative to people without mental disorders. The risk was highest among those with substance use disorders (approximately ninefold), but was also increased among those with personality disorders ((3.2fold), depression (2.6fold), anxiety disorders (2.2fold), or schizophrenia (1.8fold) and did not seem to be explained by substance use.
One explanation for the findings may be that those with mental disorders are more likely to live in high deprivation neighbourhoods, which have higher homicide rates, say the authors. They may also be in closer contact with other mentally ill people and be less aware of their safety risks owing to symptoms of the underlying illness. They suggest that interventions to reduce these risks “should include collaborations between mental health clinics and the criminal justice system to develop personal safety and conflict management skills among people with mental illness.” Improved housing, financial stability, and substance abuse treatment may also reduce vulnerability to violent crime, they add. A key implication of these new findings is that clinicians should assess risk for the full array of adverse outcomes that may befall people with mental health problems, say Roger Webb and colleagues at the University of Manchester, in an accompanying editorial. This would include being a victim of violence as well as committing it, abuse and bullying, suicidal behaviour, accidental drug overdoses, and other major adverse events linked with intoxication or impulsivity.
These risks go together, and people with mental illness, as well as their families, should receive advice on avoiding various types of harm, they suggest. They acknowledge that some important questions remain unanswered, but suggest that national mental health strategies “should reflect the broad nature of safety concerns in mental healthcare, while antistigma campaigns among the public should aim to counter fear of mentally ill people with sympathy for the risks they face.”
“Mental disorders and vulnerability to homicidal death: Swedish nationwide cohort study”, Casey Crump et al. BMJ. 2013;346:f557 doi:10.1136/bmj.f557
Editorial: “Risk of people with mental illnesses dying by homicide”, Roger Webb et al. BMJ. 2013;345:f1336 doi: 10.1136/bmj.f1336
[Article of Interest] Edward Deeds, Outsider Artist, Leaves Behind Hauntingly Innocent Drawings From Mental Institution
By Priscilla Frank
”The artist really should be lost to history, and certainly these drawings should,” said curator Tom Parker of his upcoming exhibition. The works in question are by Edward Deeds, a mental patient at Missouri State Hospital for almost 40 years. The show, entitled, “Talisman of the Ward: The Album of Drawings by Edward Deeds,” presents 30 works by the outsider artist.
Deeds, who was diagnosed with dementia praecox and schizophrenia, was committed to a mental institution in 1936. Beyond this fact we know little about his condition, personality or life, although the curator sees all he needs to in Deeds’ artwork. “The images have one fabulous clue on every page,” Parker explained to the Huffington Post. “State Lunatic Asylum, written on the paper by the hospital. One poetic detail which encapsulates everything you need to know about the artist and his circumstance.”
The artist’s drawings, crafted on the official hospital stationary, radiate a remarkable innocence given the circumstances of their creation. Whimsical lions, wide-eyed characters and vintage vehicles comprise a pictorial land far beyond the mental facility walls. The only reminder of Deeds’ dark reality is recurrence of the letters “ECT,” a likely acronym for the controversial shock treatment known as electroconvulsive therapy.
At the time of Deeds’ death he gave his collection of drawings to his mother, who then passed them to her other son, who stored them in his attic. Years later, the drawings were tossed out to a curbside junk pile and were discovered by a 14-year-old boy who became fascinated with them. He kept the works safe for 36 years.
The precious drawings, both unpretentious and cryptic, present an idyllic vision from a mysterious perspective. The story of their creation and survival is as magnetic as the raw emotion in his innocent crayon strokes.
“Talisman of the Ward: The Album of Drawings by Edward Deeds” will show from January 10 until February 9, 2013 at Hirschl & Adler Modern.
[Article of Interest] Side Effects of Mental Illness Drugs Cause Sudden Death
by Kerri Knox, RN
Schizophrenia is a scary and difficult chronic mental illness- both for the person and for their family who all have to live with the diagnosis. In most cases, antipsychotic medications need to be taken forever to control the disturbing symptoms. But rarely is anyone told that these medications not only double the risk of sudden cardiac death, but also put the sufferer at risk for several other chronic illnesses as well.
The severe mental condition that has been termed schizophrenia is NOT the ‘multiple personality disorder’ that many think of when they hear the term, but is a different mental illness characterized by bizarre behaviors like paranoia, hearing voices, and having hallucinations. It is often acquired after a stressful life event and occurs swiftly and unpredictably in what is known as a ‘psychotic break’. This is devastating for the patient and their family who suddenly have to live with a diagnosis of mental illness. And that is just the first step in a life filled with doctors, hospitals, medications and psychiatrists- with little hope to ever really have a normal life again.
Schizophrenia and a handful of medications forever
There is no ‘cure’, in traditional medicine, for Psychosis; and a prescription for one or more ‘antipsychotics’ with names like Haldol and Risperdal, along with a cocktail of other drugs often prescribed for anxiety, depression and sleep are frequently on the menu. But what these people are rarely, if ever, told about are the long term side effects of these drugs. While doctors are ever prescribing anticholesterol ‘statins’, aspirin and blood pressure medications in order to achieve a 1 - 2% reduction in heart disease, they are knowingly giving schizophrenic individuals, who generally get their first psychotic break as a teenager or young adult, a shortened lifespan from the medications that they are prescribing.
In the research available on these drugs, it is well known that Sudden Cardiac Death is a ‘side effect’ of antipsychotic medications. In fact, these medications DOUBLE the risk of sudden cardiac death. In the beginning, however, it does not give them the “heart disease” of clogged arteries that we associate with heart attacks. The immediate risk of antipsychotics is that they give sufferers a high risk for a very specific disorder called ‘Prolonged Q-T interval’.
Prolonged Q-T Interval gets its name from the prolonged time that it takes for the electrical activity of the heart to return to normal after each heartbeat. But this extra time isn’t measured in minutes or seconds, but in hundredths of a second- making it difficult to diagnose. But this extra millisecond can have the devastating consequence of putting the taker of these medications into an abnormal cardiac rhythm called Ventricular Fibrillation- which will quickly lead to death without immediate emergency care. And this will come on without pain, shortness of breath or any of the other ‘warning signs’ of a heart attack because it is not clogged arteries that are the problem, but the electrical system that is the primary problem.
Even worse, antipychotics don’t just put people into your vanilla, standard everyday Ventricular Fibrillation that generally responds well to the dramatic ‘paddles on the chest, everybody get away from the patient and shock them’ type of defibrillation that you see on television. It actually puts them into a very specific TYPE of Ventricular Fibrillation called Torsades de Pointes, that doesn’t change to a normal rhythm with the shocks and heart starting medications that are the ‘standard protocol’ for restarting the heart. Instead, ‘Torsades’ requires an immediate infusion of intravenous magnesium. As hospitals and emergency rooms have magnesium at hand, this shouldn’t be such a hard thing to do; but unfortunately, Torsades de Pointes is fairly rare and is difficult to recognize, so in many cases it is not even considered until the shocks and CPR are not working- and by then it is often too late for the magnesium to be effective.
But wait, there’s more…
Not only do antipsychotics double the risk of deadly heart rhythms, but they ALSO increase the risk of getting diabetes, high blood pressure, high cholesterol and obesity- which are risk factors for ‘regular’ heart disease complete with clogged arteries, angioplasty and open heart surgery. Fortunately, true psychosis is rare- so doctors don’t prescribe these dangerous medications unless they are absolutely necessary… right?
Unfortunately, this is not the case at all. In fact, over 200,000 people in the US are newly diagnosed each year and hundreds of thousands of prescriptions for antipsychotics are written every year. They are being given to adolescents, children and even preschoolers as young as two years old. Most of these are prescribed by primary physicians without the child having even had an evaluation by a psychiatrist. And almost half were written, not for schizophrenia as they are intended, but for ADD and ADHD for which the drugs have never even been tested!
"Rates of (doctor’s office) visits that resulted in a psychotropic prescription increased from 3.4 percent in 1994-1995 to 8.3 percent in 2000-2001. By 2001, one out of ten office visits by adolescent males resulted in a prescription for a psychotropic medication." Trends in the use of psychotropic medications among adolescents, 1994 to 2001.
So, while researchers who study the cardiac death risk profile of antipsychotic drugs are advocating “sharp reductions” in the use of these agents- doctors are ignoring this advice and are steadily increasing the number of antipsychotic drugs prescribed each year. These patients, who are often children and teens without true schizophrenia, will somehow have to deal with several chronic health conditions that will not only shorten their lives, but decrease the quality of a life already made more difficult by mental illness.
The creators of the Serious Mental Illness blog invite you to submit your visual art, music, photography, crafts, video work, poetry, collage, or short fiction to Art from the Edge.
Art from the Edge, a virtual gallery and resource center, is dedicated to art created in and about extreme mental states. It is an open and public world wide forum for artists to share their visual and written works and their personal stories with all those interested in the connection between creativity and “edge” states.
Much like art, which exists in a multitude of mediums and forms of expression, there are a plurality of “edge” states that inspire the artists who harbor them. For this reason, we leave the term completely open to our community’s interpretation, knowing from research and experience that this state could be driven by psychosis or trauma, or an altered state induced by drugs. It could be the offshoot of extreme depression or grief, or the aftermath of a spiritual or mystical state of consciousness.
Ultimately, we are interested in the artist’s individual experience and in his or her sense of what it is that drove the creative act.
[Video of Interest] Simon Kyaga - Genius and Madness
Simon Kyaga, MD, of the Karolinska Institute in Stockholm, and colleagues conducted a nested case-control study that included 1,173,763 participants enrolled in the Swedish total population registries. The researchers compared patients diagnosed with psychiatric disorders and their healthy relatives to the general population. Scientific and artistic occupations were defined as creative professions. These included dancers, photographers, researchers and authors, for example. Diagnoses of psychiatric disorders were based on the International Classification of Diseases.
In this study, those in overall creative professions were not more likely to have psychiatric disorders, with the exception of bipolar disorder. However, authors were more than twice as likely as controls to have schizophrenia (OR=2.09; 95% CI, 1.35-3.23) and bipolar disorder (OR=2.21; 95% CI, 1.50-3.26). This population was also more likely to be diagnosed with unipolar depression (OR=1.54; 95% CI, 1.30-1.81), anxiety disorders (OR=1.38; 95%CI, 1.03-1.86), alcohol abuse (OR=1.47; 95% CI, 1.25-1.74), drug abuse (OR=1.53; 95% CI, 1.09-2.16) and to commit suicide (OR=1.49; 95% CI, 1.08-2.05).
Consistent with their earlier research, Kyaga and colleagues found that first-degree relatives of patients with schizophrenia, bipolar disorder, anorexia nervosa and, to a lesser degree, autism were significantly overrepresented in creative professions.
According to the researchers, the results have important clinical implications: “If one takes the view that certain phenomena associated with the patient’s illness are beneficial, it opens the way for a new approach to treatment,” Kyaga said in a press release. “In that case, the doctor and patient must come to an agreement on what is to be treated, and at what cost. In psychiatry and medicine generally there has been a tradition to see the disease in black-and-white terms and to endeavor to treat the patient by removing everything regarded as morbid.”
[Blog Post of Interest] The Big Chill: Psychiatric Medications Now Are on Trial For Murder
By Michael Cornwall, Ph.D. on Mad in America
Excerpt: The Canadian judge in the first North American criminal trial to find Prozac the sole cause of a murder ruled – “There is clear medical evidence that the Prozac affected his (defendant’s) behavior and judgment, thereby reducing his moral culpability.” Will those chilling words cause a small tremor in the writing hand of every prescriber of Prozac and other psychiatric medications from now on?
That Prozac verdict which is not going to be appealed by the District Attorney changes everything. The upcoming Utah Supreme Court trial where the court has already ruled that prescribers of psychiatric medications can be held responsible for the actions of their patients, adds to the huge shift in the landscape for anyone who prescribes.
Being an ex-drug-addict turned neuroscientist brings a unique insight into the physiological and phenomenological realities of addiction.
Excerpt: For 10 years I spun in and out of an addiction to opiates (and other drugs) that led to despair, crime, and the loss of everything I valued most—including my place in graduate school. After many failed attempts, I finally quit taking addictive drugs 30 years ago. I reentered grad school, got my PhD in developmental psychology, and became a professor at the University of Toronto, focusing on emotional and personality development. I studied these topics for 13 years, but I never quite understood my own personality development. I came to believe that my theories needed help from neuroscience, and that’s why I switched to research on the emotional brain—my focus for the past decade.
When I was in the throes of intense psychological addiction, my thoughts were continuously (and unpleasantly) drawn to drug imagery. It would be so great to have some now! How can I get some tonight?! But attraction to something you are just about to get feels marvelous. Dopamine-induced engagement turns into a headlong rush of triumph when the goal is finally accessible.
This perspective on the dual nature of attraction helps make sense of addiction. Unsated attraction can be a kind of torture, and addicts may seek drugs to put an end to that torture, more than for the modicum of pleasure drugs actually bestow.
The Inquiry into the ‘Schizophrenia’ Label Inquiry Panel would like to hear about your experience and thoughts about ‘schizophrenia’ or similar labels such as ‘psychosis’. We are particularly interested in hearing from:
people affected by the label ‘schizophrenia’ (or similar labels such as ‘psychosis’)
people given other ‘mental illness’ diagnoses
families, carers and friends of people diagnosed with ‘schizophrenia’ or ‘psychosis’
mental health workers and professionals, and
people interested in mental health issues
For more information, Click Here.
"Our study suggests that if people have a single genetic risk factor alone or a traumatic environment in very early childhood alone, they may not develop mental disorders like schizophrenia," says Guo-li Ming, M.D., Ph.D., professor of neurology and member of the Institute for Cell Engineering at the Johns Hopkins University School of Medicine.
"But the findings also suggest that someone who carries the genetic risk factor and experiences certain kinds of stress early in life may be more likely to develop the disease."
Excerpt from the Washington Post article: In our increasingly psychiatrized world, the first course is often to classify anything but routine happiness as a mental disorder, assume it is based on a broken brain or a chemical imbalance, and prescribe drugs or hospitalization; even electroshock is still performed.
The International Society for the Psychological Treatments of the Schizophrenias and Other Psychoses's list of the Top 20 papers on the psychological treatments of the schizophrenias and other psychoses:
Psychodynamic psychotherapy lasting for at least a year is effective and superior to shorter-term therapy for patients with complex mental disorders such as personality and chronic mental disorders.