BOTOX AND DEPRESSION

BOTOX AND DEPRESSION

A while back scientists "discovered" Botox as a treatment for Migraine's. Now Botox is being touted as a treatment for depression. Since I have suffered both migraine's and depression, I think it's time I said bye bye to my laugh lines!

PSYCHIC CONNECTION: BI-POLAR & PMS

Psychic Connection: Bi-Polar & PMS

One Sunday as I walked down Larchmont to the Farmers Market, two men walking in the opposite direction passed by me. Just after passing by, one of the men doubled back and approached me. He was of east indian descent and wore a turban and a business suit. "Your face is so beautiful" he exclaimed, "you have three points of happiness, here, here and here" he said gesturing toward my forehead. Our eyes locked and he gazed directly into mine. "There are two men in your life" he said "One younger who is more trouble than he is worth and the other your age and will bring you much happiness". For a moment I knew he was right and then just as I was falling...I snapped out it. He was so compelling that I almost didn't realize the street psychic scam. One more minute and he would have had me be giving him money to tell me more. He was that good, but not quite.

I will always remember a friend who used a fake psychic rap that went "I know about those dreams you've been having". And almost anyone he said it too would say "Oh my god, how did you know that?". One woman was so frightened that she became convinced he was actually demonic.

Another time, just for a lark, I told a group at a party that I could read palms. One by one I sat with each person, I held their palm in mine, sat quietly, looked at them intently and free associated some generalities about a fictional future. I read five palms before guilt overcame me and I confessed that I was just pretending. The problem was, everyone was so captivated that they refused to believe my disclaimer. I felt bad that my mojo was so strong that I could not undo what I had done.

Which brings me to my point (a little long on the intro, i know, i know):

Point 1: Until recently, a mental disorder first known as manic-depressive and later renamed bi-polar" was a rare but serious (and devastating) disease effecting 1-2% of the population (some estimated up to 6%). Alternating episodes of mania and depression were equally destructive. Lithium was the solution, leveling out the intensity of the cycles and allowing sufferers to lead a normal (albeit sleepy) life.

Point 2: I have struggled with mood swings my entire life, mostly characterized by temperamental outbursts and an occasional crying jag. My mother said I was "born without patience". I have been known to be artistic, painting and writing, etc. But none of this interfered with my life enough to be labeled "bi-polar". Maybe thin-skinned, maybe opinionated, maybe passionate, but not manic-depressive.

Point 3: After yet another breakup in a life-long series of failed romances, I decided that enough was enough. I went to my general practitioner and said "my PMS effects almost three weeks out of every month, I only have about 4 or 5 good days a month, my friends find me intolerable and my boyfriend says he can't take my moods anymore". She frowned at that last part, thinking perhaps that maybe I should just get another boyfriend (not a bad point), but after asking a few other questions suggested trying a low dosage of prozac for what might be PMDD instead of PMS. I agreed.

Point 4: After consultation with a psychiatrist, I tried prozac at various dosages, then switched to zoloft and then to cymbalta. Each worked initially and then seemed to be less and less effective. On these various anti-depressants I did feel better, calmer and even more insightful. Those close to me saw a new me, a me with a little more light in my heart and a lot less uncontrolled anger.

Point 5: One day, one of these outbursts was the straw that broke the camels back (wrong time, wrong place, wrong people) and I found that my job was in jeopardy. It was a serious wake up call and I marched back to my shrink to say "help!". She said "the anti-depressants seem to follow the same pattern with you, I think it is time to try a mood stabilizer". A have never felt such magical words--mood stabilizer...it sounded like actually the magic bullet I sought...literally "just what the doctor ordered".

Point 6: I started my new medication, Lamictal, that day. And then, just doing my due diligence, I hit the text books. There it was, Lamictal (initially developed to treat epilepsy) had been re-purposed to treat (drum-roll please): bi-polar disorder. The doc had used a more palatable term for me "just try this little mood stabilizer my dear". Had she said "you are bi-polar" I would have told HER she was crazy. On the other hand...my moods...stabilized (darn it). In other words, wouldn't you know, it worked.

Point 7: That week I came across a two page color ad in an LA Times insert for a website called "IsItReallyDepression.com?". NOTE: This is where the "psychic connection" comes in (pay attention!). The ad said something like: do you talk too fast? does your mind race? is your shopping out of control? If you said yes to some of these questions you might be bi-polar!!!" Just like the victims of my "psychic friends", I couldn't help noticing that 90% of woman might say yes to those questions. And much more disturbing: they were targeting the market of woman taking anti-depressants and channeling that market toward a class of drugs that, in the past, would have only been prescribed for 1-2% of the population!

Point 8: Here it is again the "1-2 punch" in the drug industry. 1) Reinvent an illness (call it a mood stabilizer instead of bi-polar, or stretch the definition of bi-polar to include almost everybody); and 2) repurpose a drug to sell it to another audience.

fin

THIS IS YOUR BRAIN ON STRESS

This is Your Brain on Stress - Can Your Brain Chemistry Make You Smarter?

The question I am fascinated by lately: do antidepressants work by promoting neurogenesis? From everything I have read, I was confident I understood how anti-depressents worked—they just got the brain to produce and absorb more of the chemical serotonin and “voila”. Or as Lehrer describes the theory “sadness is simply a shortage of chemical happiness”.

Until a few weeks ago, I had never heard of “neurogenesis” before. I also held the following beliefs: first, I remember learning that we don’t grow new brain cells (but that we do have zillions more than we’d ever need); second, I thought it was kind of obvious that drinking and drugs “killed” brain cells; third, you don’t have to read medical journals to figure that stress isn’t good for you.

However, I never put any of these concepts/questions/ assumptions into a context. That is, until I read Jonah Lehrer’s article “The Reinvention of the Self”. The article, although nine dense pages, blew me away. Until reading this article I was not familiar with the work of Professor Elizabeth Gould.

In this article I learned that my first (incorrect) assumption above was the dominant medical paradigm (so I don’t feel so dumb for thinking that). That “brain cells—unlike every other cell in our body—don’t divide. They don’t die, and they are never reborn.” was what was taught in medical schools.

If I hadn’t read this article I probably would have continued to believe that. When I read about neurogenesis (the process of creating new brain cells) I thought I had found a physiological answer to the question I posed in "Pushing the Envelope"…is depression really carving a deep channel in my brain that gets deeper and deeper with each bout OR is that just metaphor? But the answer held a twist.

Her research focuses on the effect of stress on the brain, which was not exactly in line with what I’m curious about, however…there it was: a hypothesis which would explain one of the blank spots in depression research. On Prozac, brains grow more cells. Under the influence of untreated depression, brains actually shrink.

I found some incredible pictures of this effect on another web site, Psycheducation.org. It is true afterall, a picture does say a thousand words!

DYING IS FINE, BUT DEATH OH BABY

When my grandmother moved into assisted living, she had to get rid of a lot of her belongings. One of the more precious of these was her constant companion, her television. My father tells me that she cried when they took it away.

That poignant story stays with me as a guide for living my life. As I notice my attachments, I try to let go, all along knowing that with or without attachment I can’t avoid the inevitable aging, and loss and finally death. But perhaps, perhaps, I can find acceptance and peace as I go through these stages.

I grasp desperately at hopeful research. I hang on every word that offers hope of maintaining a youthful brain as I age. Even if the jury is still out, and we don’t know for sure whether each bout of depression causes a “trench” in our brains to grow ever deeper… I still operate on that assumption. Along the same lines, out of a nagging fear that I will become stuck in my ways (even if I have medicinally escaped being stuck in depression).

My mother sent me an article that inspired hope, the lead went like this “A 21-year study published in the New England Journal of Medicine in 2003 found that performing one such activity-playing Risk or Scrabble, for example-just once a week is associated with a 7 percent reduced risk of dementia, including Alzheimer's. Performing more activities more frequently may cut risk as much as 63 percent”. Scrabble anyone?

I have my own way of attacking the problem. I CHANGE MY PATTERNS. I am determined to not get stuck in a rut, to become set in my ways, etc. etc. I get up on the other side of the bed, I try (unsuccessfully) to write with my left hand. I change the route I drive to work.

I strive to fill my brain up with as much information as it can hold. It seems like more just self-indulgence, more of an obligation. Kind of a "why am I here anyway” type of deal (is that a vestige of my religious impulse?). So I turn off the TV, and read a book, I tune the radio to NPR and listen intently in my car. I study topics that interest me and write about them to see if what goes in can indeed come back out.

TANGENT: Many moons ago, as I paged through a fabulous book "Four Arguments for the Elimination of Television", my brother-in-law walked by and quipped "Good book, 2 and 4 are true, but 1 and 3, I don't think so". Ever gullible, I looked up and said "really"? One look at Mr. Sarcasm answered that question. Ha ha.

But back to brain development. Another troubling thought: maybe this gradual inflexibility of the mind is analogous to the same in the body.

There is a point in the development of an embryo where the cells are undifferentiated but at some significant juncture, they begin to specialize. They then lose some of their magic properties. Suddenly the embryo can only be female, suddenly one cell can only become a brain cell and another can only become an arm or a foot, etc.

This concept, which was just another fact to memorize back when I was studying embryology, is now a hot topic in medical research and, for that matter, in politics. Enter the stem cell!

TANGENT: Speaking of embryology… My favorite expression from my embryology studies, which I quipped an untold number of times over the years, was “Ontology Recapitulates Phylogeny”. The expression refers to a debatable phenomenon, that the developing human embryo sort of reenacts the stages of evolution. Thus early on in its development, the human embryo actually has gills (like frogs and fish) and then later that same embryo resembles nothing else if not a pig! Anyway, true or not, I used that expression as a badge of my educated status (aren’t I smart!).

I must have said that dozens of times until one day…I actually heard what I was saying. I started to really ponder its meaning. What on earth does “Ontology” (the study of existence, often in the context of the existence of god) have to do with Phylogeny (the study of evolutionary relatedness)???.

And the answer was….I had been using the wrong word all these years. The correct word was Ontogeny not Ontology. Much to my relief, the internet was full of anecdotes and explanations of others with the same confusion (814 hits to the misquote).

But back to these cells…could it be that the timers that turn off everything else, will turn off my ability to learn? In fact, haven’t they already turned much of it off? Basically, even though new exciting research points to the fact that our brains really do continue to develop (even “grow” new brain cells, etc.)…I probably will never learn Calculus. Even stronger, I probably can’t learn Calculus.

It is fun, even enlivening, to argue about this…especially because if you find evidence that you can learn “X” then it seems like you are close to proving that you aren’t going to die. Yes my brain is still flexible, yes, yes, I am developing, I’m not aging, I’m not going to die. Whooo hoooo! Oh please don’t pop my bubble.

TANGENT: I wrote about this topic from another angle (in These Are the Good Old Days"

But still….in the end, even if I beat the odds, have a better quality of life, write a novel, run a marathon, paint a masterpiece….at 70, play scrabble every day, won’t I still cry when they take away my television set? Of course I will.

LOVE SONG TO J. ELI LILLY

Love Song to J. Eli Lilly - Brain Chemistry Meets the Alphabet

LBJ took the IRT down to 4th street USA When he got there, what did he see? The youth of America on LSD. LBJ, IRT, USA, LSD LSD, LBJ, FBI, CIA Initials, Hair Soundtrack

I thought I was suffering from PMS and then they said no, the DSM said it was probably PMDD and they gave me an SSRI. Luckily I don't have OCD or PTSS, but if I did the same pill would do the trick! I think I'm developing a new illness...acronym-itis!

Initially developed to combat depression, the mysteries of the SSRI's are still being uncovered. But something went wrong, less than a decade into production, the media, the facts, or both, had transformed Eli Lily's cash cow from a "depression miracle cure" to a "columbine-esque-suicide-causing" wild card.

Obviously action was required. To solve the problem, Lily had to do two things: 1) create a new illness that the same product could treat ("PMDD" (which sounded an awful lot like PMS but now required drug therapy)) and 2) rename the product (Prozac became Sarafam).

Thus on July 6, 2000 Eli Lilly announced the FDA approval of Sarafem(fluoxetine hydrochloride) for the treatment of premenstrual dysphoric disorder (PMDD).

After initial marketing success with PMDD, Lily found more "diseases" that responded to SSRI treatment: OCD, Anxiety, Post-Tramatic Stress, Panic Attacks, etc. etc. etc.

That is when the fun began. We need a name for the 1-2 punch of "invent an illness" "rename a drug".

Coming soon: the "new" mood stabilizers