Tag Archives: psychiatry

of schizophrenic mice and men

here is some exciting new research on schizophrenia, which i found through changeseeker. the full text is at psycport; i’ve added a few links and comments.

new research from the northwestern university feinberg school of medicine has revealed how schizophrenia works in the brain and provided a fresh opportunity for treatment. in a new, genetically engineered mouse model [which was pioneered by the good people at johns hopkins], scientists have discovered the disease symptoms are triggered by a low level of a brain protein necessary for neurons to talk to one another.

in human and mouse brains, kalirin [named after the multiple-handed hindu goddess kali for its ability to interact with numerous other proteins] is the brain protein needed to build the dense network of highways, called dendritic spines, which allow information to flow from one neuron to another. northwestern scientists have found that without adequate kalirin, the frontal cortex of the brain of a person with schizophrenia only has a few narrow roads. the information from neurons gets jammed up like rush hour traffic on an interstate highway squeezed to a single lane.

“without enough pathways, the information takes much longer to travel between neurons and much of it will never arrive,” said peter penzes, assistant professor of physiology at the feinberg school. he is senior author of a paper reporting the findings published in a recent issue of the proceedings of the national academy of science. michael cahill, a feinberg doctoral student in neuroscience, is the lead author.

“this discovery opens a new direction for treating the devastating cognitive symptoms of schizophrenia,” penzes said. “there is currently no treatment for that. it suggests that if you can stimulate and amplify the activity of the protein kalirin that remains in the brain, perhaps we can help the symptoms.”

currently the only drug treatment for schizophrenia is an antipsychotic. “the drugs address the hallucinations and calm down the patient, but they don’t improve their working memory (the ability of the brain to temporarily store and manage information required for complex mental tasks such as learning and reasoning) or their ability to think or their social behavior,” penzes said. “so you end up with patients who still can’t integrate into society. many attempt suicide.”

here is a study on the effect of the use of antipsychotics, particularly clozapine, by people with schizophrenia.

the following is an excerpt from an article which reviews the literature on suicide and suicide prevention of people with schizophrenia, where the suicide rate is anywhere from 5% to 29%:

mann et al. [250] reviewed the literature and identified a number of strategies that are effective in the prevention of suicide such as education and awareness programs for the general public, primary care providers and other gatekeepers, screening for individuals at high risk, and providing treatment using pharmacotherapy and psychotherapy. in particular, the prevention of suicide in schizophrenia should include providing proper information for the family members of the patient in the hope of reducing their hostility toward the patient. in addition, continuity of care after suicide attempts, restricting access to lethal methods and media reporting guidelines are important strategies to prevent suicide. since it is such a strong predictor of future suicide, preventing and reducing attempted suicide in schizophrenia may have a positive long-term impact.

june 2009 buddhist carnival

kuan yin in the grassfor those of you who are not familiar with this blog, every 15th of the month i post a collection of posts about buddhist topics.  it all started as a contribution to blog carnival in november 2007.  over time, i emancipated myself from blog carnival but the name remains.  blog carnivals are themed “readers digests” of the blogosphere.

so – what do we have today?

a poem – wu!

first link, as always, a poem.  this is from an article on philip whalen’s poetry at the poetry foundation.  here’s a little teaser

unless i ask i am not alive
until i find out who is asking
i am only half alive and there is only

wu!
(an ingrown toenail?)

growing up buddhist

jaimal, author of saltwater buddha, a book that looks at the spiritual side of surfing, had an interesting article in the buddhist magazine tricycle a while ago about growing up in a hippie family

my rebellion was characterized by a nuanced differentiation strategy of the karl rove variety: i framed my parents as flaky new age hippies with buddhist leanings-the spirit rock type. i sneered at my mom’s angel books and my dad’s yoga guru, who changed his name every few months. meanwhile, i would break free of their fluffiness and be the real deal. i would become a northern california buddhist without a trace of hippiness, an endeavor that i now realize could be compared to living in france and shunning cheese.

the full article is here.

decency is the absence of strategy

william harryman, who has contributed much to this carnival, had an interesting little tidbit on his friendfeed the other day from chögyam trungpa rinpoche:

it is of utmost importance to realize that the warrior’s approach should be simple-minded sometimes, very simple and straightforward. that makes it very beautiful: you having nothing up your sleeve; therefore a sense of genuineness comes through. that is decency.

gay men, straight women, non-duality and kuan yin

here is a reference to some research that points out the similarity between certain functions  in the brains of gay men and straight women.  the author then makes a noteworthy connection between this finding and androgyny in buddhism:

one of the most revered figures in buddhism, avalokiteshvara is often seen as androgynous. in the form of avalokiteshvara this bodhisattva is seen as a man but when referred to as guan yin (kuan yin/kannon) he/she is seen as a woman. this makes total sense to me as avalokiteshvara/guan yin is seen as the bodhisattva of compassion and thus seems perfectly natural as that compassion is spread to all beings equally regardless of gender and sexual orientation.

avalokiteshvara/kuan yin is literally the embodiment of non-duality in regards to sexuality.

the rest of this article is here, on the buddhist blog.

dr. monster and buddhism as a religion

an interesting article at god knows what on the history behind the religious aspects of japanese buddhism today, as describedin this excerpt:

the day-to-day life of buddhist priests of all sects was filled with the performance of exorcisms, funerals, distributing healing charms, and spells for rain. many of these rituals were for intended for apotropiac purposes, banishing monsters, limiting their negative effects, or transforming the curses of ancestors and kami into blessings.

(what might surprise people is that with the removal of certain rituals like ‘spells for rain’ this description still largely applies to the day-to-day life of buddhist priests and monks in most buddhist countries, including japan.)

western, eastern and psychiatric buddhism

buddhism.about.com brings up a number of worthwhile points in response to our own douglas todd, religion writer at the vancouver sun:

douglas todd of the vancouver sun (see also “we’re cool!“) has another interesting commentary, this time on buddhism and psychiatry. he notes that for the past several years all manner of prominent buddhists and prominent psychiatrists and psychologists have been coming up with buddhist-related practices to promote good mental health hygiene.

todd makes two points. one, he says, the psychotherapists don’t acknowledge that “ideals such as compassion, respecting human dignity, overcoming negative emotions and practicing awareness” are also found in judaism, christianity and islam. “practicing loving kindness, for instance, is the central teaching of jesus and the church.”

generosity

genkaku is one of my favourite buddhist writers; my husband and i have been following him for years.  his words are always light and full of common sense.  here he talks about generosity:

in buddhism, there is a suggestion that its followers engage in “dana” or giving/generosity. on the face of it, it sounds very much like dropping a buck in the christian plate during sunday services. and there’s nothing wrong with that either — donating to monks or nuns or beggars or institutions that uphold a convincing direction or faith.

but today i wonder if the most profound act of generosity does not lie in this: to offer yourself as best you can.

it’s a little tricky, since in order to offer yourself, you would first have to know who you were.

always maintain a joyful mind

linda lewis offers the lojong slogan: always maintain a joyfulmind and reflects:

when we are sick or in debt or experiencing loss or difficulties, we know from experience that neither complaining nor blaming helps.  we know that despair only solidifies the problem.  that is why sakyong mipham rinpoche advises us “to practice more when we have difficulties, and to practice more when we have life changes.”

then, rather than emoting and over-loading others with our latest greatest drama, we face the music, and are better able to deal with our troubles.  as mipham rinpoche also says, “some problems can be solved by talking…but some things are solved by not talking. that’s called practice.”

meditation practice

c4chaos explains his algorithmic approach to meditation:

step 1: focus out – i focus on the sensations of the breath. i note the sensation of the “rising” and “falling” of the abdomen. when attention wanders i note it and then gently go back to noting the sensation of the rising and falling. sooner or later awareness shifts or deepens.

if i feel a sense of deep relaxation, i proceed to step 2.

if i feel a sense of vibrations or waves, i proceed to step 3.

step 2: focus on rest – i focus on the restful sensations of the body and note it as “relaxed.” i then place some attention on the darkness/brightness in front of my closed eyes and note it as “blank.” i alternate between noting “relaxed” and “blank.” then i let go… sooner or later awareness shifts or deepens.

if concentration is poor and keeps wavering, i go back to step 1.

if i feel a sense of vibrations or waves, i proceed to step 3.

step 3: focus on change – i focus on the vibratory/wave sensations. i note it as “flow”, “expansion”, “contraction”, and “gone.” from here i just let go, ride out and surrender to the vibratory sensations while noting it as best as i can.  sooner or later awareness shifts and the vibratory sensations disappear.

if concentration is poor and keeps wavering, i go back to step 1.

if i feel a sense of deep relaxation, i proceed to step 2.

that’s it. simple as pie

that’s it for this month.  see you back on july 15!

image by mags

the depressing (side) effects of antidepressants

the following is a guest post by kat sanders, who regularly blogs at MRI technician schools. she welcomes your comments and questions at her email address: katsanders2 at gmail.com.

the opinions expressed in this post are kat sanders’ – i personally don’t take as strong a stance as kat, mainly because, as i say time and time again, psychoactive drugs have different effects depending on dosage, circumstances and who takes them. i don’t think we are at a point (yet) where we can say that there is “a” truth about any psychoactive drug, antidepressants or otherwise. similarly, while i obviously think that psychotherapy is useful, and that it’s a good idea to try it before, while or after taking antidepressants, like anything else, it’s not a magic pill that works for everyone.

having said that, i think kat offers good points for discussion.

have you taken antidepressants? have they worked?

here’s kat’s article:

the depressing side (effects) of anti-depressants

life has its ups and downs, and while we’re all able to enjoy the ups, most of us are unable to handle the downs. some of us bounce back to normalcy soon enough; but for the others, they sink into a mire of depression from which there seems to be no escape. when this situation continues for a while, they are taken to see a psychiatrist and prescribed anti-depressants. the truth about these drugs is that while they may have a calming and uplifting effect in the short term, they’re not advisable after a period of time because:

  • they have been proved in clinical trials to work only 50 percent of the time.
  • they cause you to gain weight. while the initial increase is not much, you do tend to put on a lot of weight over a period of time.
  • they are likely to cause a relapse when you continue to take them over a period of time. so there’s a high probability that you will slip back into depression just when you think you’re getting better.
  • they cause sexual dysfunction, mostly in women. you feel yourself losing interest in sex and anything related to it. relationships suffer as a result of this side effect and your depression worsens.
  • they cause some people to experience insomnia, intense somnolence, and other sleep disorders
  • they cause you to feel tired all the time. the fatigue prevents you from doing any worthwhile work.
  • they may also cause nausea and diarrhea.
  • they increase anxiety.
  • they cause you to fee mentally dull and uninterested in anything.

we need to realize that depression is something that cannot be managed only with anti-depressants. it’s an emotion, one that is brought on by a set of circumstances and that affects us mentally. instead of resorting to drugs, we need to understand the reason for our sadness and attempt to resolve it. that’s the only way we to treat depression – face it head on and tackle the underlying reason for it. anti-depressants must be used only for a certain time during which we need to find the strength to deal with the problem and get over it.

the problem with anti-depressants is that they cannot be stopped cold turkey, because when they are, they bring on the same symptoms as those caused by long-term usage. the dosage needs to be minimized and the patients weaned off them as slowly as possible. it’s not advisable to discontinue anti-depressants without consulting your medical practitioner.

the definition of addiction

in the last few weeks, a radio interview and two articles have encouraged me to again look at the nature of addiction. one of them is a discussion we are having on this blog here about alcohol use and art, with contributions by danish composer skovgaard danielsen and zen practitioner and painter eden maxwell. another was an article by trisha gura about chocolate addiction. the radio interview was with dr. gabor mate, well known for his work in our inner city, vancouver’s downtown eastside, as well as on stress and ADD.

so let’s look at some definitions of addiction.

cynthia jane collins in her book the recovery spiral has an interesting definition:

if we habitually or compulsively – with or without awareness or intention – use any activity, substance or person[s] to move us away from our true selves, we are practicing addictive behaviours.

gerald g. may proposes that

addiction is any compulsive, habitual behaviour that limits the freedom of human desire.

ben furman and tapani ahola, two scandinavian therapists known the world over for their imaginative work with therapeutic conversations once playfully gave addictions a name: “the muluttaja”. it derives from fascist times in finland and personifies the idea of “oppression and tyranny.”

virginia satir, one of north america’s foremost “elder” in family therapy, and another of my favourite models for therapy, talks of addiction as a coping mechanism for a rule that says, “i can’t feel what i feel.”

aviel goodman of the minnesota institute of psychiatry, who writes quite a bit about sexual addictions says that

addiction designates a process whereby a behavior, that can function both to produce pleasure and to provide escape from internal discomfort, is employed in a pattern characterized by (1) recurrent failure to control the behaviour (powerlessness) and (2) continuation of the behaviour despite significant negative consequences (unmanageability).

finally, gabor mate, whose absolutely fantastic book, in the realm of hungry ghosts: close encounters with addiction has this to say:

in the english language, addiction has two overlapping but distinct meanings. in our day, it most commonly refers to

a dysfunctional dependence on drugs or on behaviours such as gambling or sex or eating.

surprisingly, that meaning is only about a hundred years old. for centuries before then … addiction referred simply to an activity that one was passionate about …

in the words of a consensus statement by addiction experts in 2001, addiction is a “chronic neurobiological disease … characterized by behaviours that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving” …

the issue is not the quantity or even the frequency but the impact …

he then gives his own definition:

addiction involves:
1. compulsive engagement with the behaviour, a preoccupation with it;
2. impaired control over the behaviour;
3. persistence or relapse despite evidence of harm; and
4. dissatisfaction, irritability or intense craving when the object – be it a drug, activity or other goal – is not immediately available.

he concludes his chapter, “what is addiction?” by saying

we need to avoid the trap of believing that addiction can be reduced to the action of brain chemicals or nerve circuits or any other kind of neurobiological, psychological or sociological data … addiction is a complex condition … we need to view it simultaneously from many different angles … to get anywhere near a complete picture we must keep shaking the kaleidoscope to see what other patterns emerge.

now my question to you – those of you who have experience with addiction, either personally, through friends or family, or professionally: what do you think of these definitions? do they define addiction? or do you have another definition that works better for you?

vancouver events at this year’s mental health week

this week is national mental health week in canada. like last year, i’ll dedicate all my posts this week to mental health. (in a way, all my posts are about mental health but this week we’ll just be a bit more explicit, ok?)

today a roundup of mental health events happening in and around vancouver this week.

movies and psychiatry – may 5th
the depiction of mental illness in film. a multi-media mental health awareness week event, presented by dr. harry karlinsky. a clinical professor at the university of british columbia, founding director of the award-winning frames of mind mental health film series and festival film critic for the canadian psychiatric association. dr. karlinsky will provide a historical overview of the depiction of mental health issues within the world of cinema. he will also explore how the practice of psychiatry can be influenced by concepts first introduced in popular movies. various film and video clips will be utilized throughout the forum to illustrate key points. date: may 5th, time: 7:00pm – 8:30pm, and location: douglas college, 700 royal avenue, new westminster room: 2201. enquiries: 604-523-1072.

***

improving your life-work balance – wednesday may 7, 7-9:30 pm.

organized by the canadian mental health association, vancouver/burnaby branch.

in this interactive workshop, we’ll discuss what life-work imbalance is, how it impacts your life, the different ways that you can improve your own life-work balance and spend more time doing what you love. you’ll leave the workshop with an action plan for improving your life-work balance.

admission is $10.00 at the door, cash only please.
location:
alan emmott building
6650 southoaks crescent
burnaby, bc

***

turning grief into action – dealing with teen suicide

when jude platzer’s 15-year-old son josh committed suicide in 1999, her future became clear.

the vancouver resident, overwhelmed with emotion, jumped into action and adopted an advocacy role to help raise awareness about teen suicide and prevent other families from going through what hers had.

this week, as part of national mental health week (may 5-11), platzer will speak at the canadian mental health association north and west vancouver branch’s health lecture series on wednesday, may 7 at john braithwaite community centre at 7 p.m. for more information, go here.

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face value by the youth theatre action group
a play about teenagers dealing with mental health issues, addiction and prostitution. may 6th-8th at the roundhouse community centre. there are two matinee shows on may 7th and 8th at 1:15 p.m. evening shows are may 6th, 7th, 8th at 7:30 p.m. all shows will take place at the roundhouse community centre in vancouver. more info here.

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public education series on addiction
at the pacific spirit community health centre on west 43rd. all are welcome to come to this free drop-in group. every friday from 9:30 to 11:30. this friday, may 9: chemicals and the body. more info here.

for a full list of events put on by the canadian mental health association in british columbia, go here.