Saturday, August 25, 2007

My Theory of What Causes Crazy

The current treatment is to restrict the amount of dopamine available to the brain. This theory is 50 years old and all the treatments are variations of the same song. When LSD was discovered and seen to cause psychosis, researchers for a short time theorized that serotonin excess might be the problem, but they rejected the idea because amphetamines could also cause psychosis and that chemical was dopamine related and reassured them that their old treatments were effective. Hallucinogens affect the central nervous system by disrupting the neurotransmitter serotonin that serves as a filter of unimportant information from incoming sensory stimuli.

Researchers feel dopamine is a chemical messenger (whose effects can be mimicked by amphetamine and cocaine) that makes us happy - it is the pleasure chemical. Temporary elevation of dopamine levels often leads to an improvement in mood, alertness, improved libido, improved memory functions and perhaps even an enhancement in verbal fluency and creativity. It is the neurotransmitter that helps produce feelings of satisfaction and pleasure. Schizophrenics not in the throes of psychosis are said to be experiencing the negative symptoms: apathy, lack of emotion, poor or nonexistant social functioning, disorganized thoughts, difficulty concentrating and/or following instructions, difficulty completing tasks, and memory problems. The neuroleptics cut off the dopamine supply and then psychiatrists say the natural results of the deprivation are a symptom of the disease. One of the leading researchers of schizophrenia, Dr. Daniel R. Weinberger (Chief of the Clinical Brain Disorders Branch, Division of Intramural Research Programs, at the National Institute of Mental Health, National Institutes of Health. whose papers were cited a total of 2413 times, making him the second-most-cited scientist of the 1990s in schizophrenia) explains that there is too little dopamine in the prefrontal cortex in schizophrenia which then causes too much to be produced in the mesolimbic areas. This doesn't make sense to me - in no other part of the body can excess and deficiency coexist.

Sleep Disorders
Serotonin is daily moderated by melatonin which is produced when we sleep. Robert Whitaker, author of Mad in America is currently interviewing recovered schizophrenics and he says absolutely every single case admits to a period of sleeplessness prior to a psychic break. Mind Freedom, an organization of mental health survivors, has interviewed people and the sleep problem is recounted multiple times.

There is an episode of Star Trek in which the crew of the Enterprise was deprived of REM sleep because of some freaky space glitch. As a consequence of being dream deprived, they began to hallucinate when they were awake. Scientists like John Lilly and Jean Houston have proven this does indeed occur.

Small doses of sleep deprivation are familiar to everyone. The most common symptoms of sleep deprivation are inattention, staring, trembling hands, drooping eyelids, increased pain sensitivity and a reduced sense of well-being. Extreme sleep deprivation can lead to a seemingly psychotic state of paranoia and hallucinations in otherwise healthy people. Curiously, sleeping problems occur in almost all people with mental disorders, including those with Alzheimer's disease, depression and schizophrenia.

Animal studies show that sleep and dreaming (REM) sleep are necessary for survival. For example, while rats normally live for two to three years, those deprived of rapid eye movement (REM) sleep survive only about 5 weeks on average and rats deprived of all sleep stages live only about 3 weeks. Sleep deprived rats also develop abnormally low body temperatures and sores on their tail and paws. Scientists (H.P.Roffwarg, J.N. Muzio, W.C. Dement, 1966, Science 152, 604) feel that REM sleep must play an essential role in the development of the central nervous system because developing babies require proportionately greater amounts of REM sleep than a developed adult. In fact the brains of infant rats show significant abnormal development if they are deprived of REM sleep.

Researchers suggest that healthy people need not only an adequate amount but also the right kind of sleep just like they need an adequate amount of proper exercise. In adults non-rapid eye movement (NREM) and rapid eye movement (REM) sleep alternate cyclically throughout the night beginning with NREM sleep which lasts about 80 minutes followed by REM sleep which lasts about 10 minutes. Theorists suspect that REM sleep relaxes the mind and NREM sleep relaxes the body, and that most remembered dreams occur during REM sleep. It is during REM sleep that most brain areas show greatly increased blood flow, almost uniformly greater than 50% above the waking level and as great as nearly 200%. Brain temperatures rise during REM sleep. There are nerve cells in our brains which fire five to ten times more frequently during certain sleep stages than during wakefulness and it is likely that dreams are responsible for maintaining the central nervous system throughout the lifespan.

Incidentally, REM sleep also stimulates the brain regions used in learning. In an experiment, people taught a skill and then deprived of NREM sleep could recall what they had learned after sleeping while people deprived of REM sleep could not.

Sleeping patterns change in adolescence. Beginning in early adolescence there is a gradual decline in delta wave sleep. The decline may represent one of the earliest known indicators of the aging of the central nervous system and may be relevant to the appearance of schizophrenia in early adulthood. Sleeplessness and stress often go hand in hand.

Sleep is controlled by the conversion of serotonin to melatonin. The pineal gland located deep in the center of the brain stores serotonin that is chemically converted to melatonin and the melatonin is converted back to serotonin in daily cycles that determine the body clock. If melatonin is not produced, the serotonin goes into overload and causes psychosis.

Many people who take the over-the-counter melatonin have commented on an increase in the vividness and frequency of dream activity and have noted an increase in dream recall. Loss of dream recall is known to be a symptom in other problems. Researchers have found that 80% of depressed patients cannot recall dreams. It has been found that alcohol suppresses REM sleep, causing the body to make up this loss of REM by carrying it over to the waking stage. In an advanced stage, this waking stage hallucination may be the cause of delirium tremens. Researchers have found that people deprived on REM sleep for one night will have more REM dreams the following night. Perhaps our bodies quota of hallucinations must be supplied one way or another. "Dreaming permits each and every one of us to be quietly and safely insane every night of our lives." -William Dement

Psychotic episodes are the most frightening to the general public and of the most concern to psychiatrists. Psychosis is actually not so very uncommon and there are lots of medical and psychiatric causes of hallucinations besides schizophrenia. Some common causes include the following:

*Pellagra, which is the deficiency disease caused by a severe lack of niacin in the diet also is characterized by dementia.
*B-12 deficiency which also causes insomnia
*Fever, which can occur with almost any infection, frequently produces hallucinations in children and the elderly
*Intoxication or withdrawal from such drugs as amphetamines, LSD, cocaine/crack, heroin, psilocybin (magic mushrooms), PCP and alcohol
*Delirium or dementia
*Sensory deprivation such as blindness or deafness
*Lack of sleep and disruption of circadian rhythms
*Severe medical illness including liver failure, kidney failure, and brain cancer
*Various prescription drug reactions: Lariam, the commercial name for the anti-malarial drug mefloquine, withdrawal from excessive doses of barbiturates (sedative drugs commonly prescribed as sleeping pills), PCP used as human anaesthesia,Aldomet, Benadryl, Catapres, Celebrex, Cipro, Dexatrim, Elavil, Halcion, Inderal, Lanoxin, Procanbid, Sonata, Tagamet, Ultracet, Valium, Vioxx and withdrawal from neuroleptics

If schizophrenia were excess dopamine, the sufferer would be animated and the hallucinations would be glorious and euphoric rather than usually frightening. The current excess dopamine idea came about because the hallucinations were similar to amphetamine psychosis - amphetamines increase dopamine, hence dopamine is the problem. But who sleeps less than a "speed freak" thus creating an imbalance of serotonin/melatonin? The soporific effects of the antipsychotics is the reason they may appear to be effective; however, unfortunately the antipsychotics cause irreversible brain damage and frequent Parkinson's disease.

Deficiencies cause the human body many more problems than excess. The diseases of rickets, scurvy, beri–beri, pellagra, hypothyroidism, immune deficiencies and diabetes are all diseases in which the body does not manufacture enough of an essential element. Even the "excess cholesterol causes heart attacks" theory has come into question:

When I say “heart attack” what are your first thoughts in terms of causes? A good bet is that you will consider cholesterol levels, and immediately after that, diet. After a bit more thought, you might want to add stress induced by a job with too much pressure and responsibility, and finally—just maybe—you will consider the possibility of a genetic predisposition. These are all the causes we hear from the media are associated with heart disease, and indubitably there is a lot of research to back these claims up. However, and most astoundingly, research available since the 1960s and repeated several times since, also shows that all the above factors are actually minor causes of heart disease. The best single predictor of heart problems is indeed stress, but of an entirely different and still widely ignored type: the stress that comes not from doing too much or being under self-imposed pressure, but from being ordered around with little or no control over your destiny.

A study conducted among 17,000 British civil servants (and before that on a million employees of Bell Telephones in the 1960s) clearly shows that the status of a person’s job is the most reliable predictor of heart attack, more than obesity, smoking or high blood pressure (though these count as well, so don’t rush to get that triple cheeseburger just yet). High cholesterol is also a risk factor, but only in people that are genetically predisposed to it. It seems that your heart is by and large at the mercy of the size of your pay check.

The studies linking the pecking order on the job with heart problems found that what happens is that being ordered around diminishes your sense of control over your life, which causes stress mediated by the release of the hormone cortisol. High levels of cortisol not only create problems for your coronary arteries, but depress your immune response, so that you are also more likely to fall prey to an infection—which is not helped by the fact that the rise in cortisol is accompanied by a decrease in serotonin(ed note: did he mean melatonin?), meaning that you don’t sleep very well and you never feel rested.

Researchers have been able to explode another myth related to heart attacks: the idea that it is a disease of the rich, suffered by CEOs because of the high pressure they experience on their job for prolonged periods of time and the associated responsibilities of such a situation. Well, if you are a CEO and are planning on using that as an excuse to raise your bonus this year, forget it. While there are exceptions, the heart attack rate in this category is actually much lower than the population at large, presumably because these people are actually very much in control of what they are doing, since they are everybody else’s boss (and even when they “fail” they get to retire with a few extra million dollars in their bank accounts). This category becomes at risk—rather ironically—only after retirement, possibly because their new “relaxed” life style is actually associated with very little control. Taking it easy for someone used to issue orders and be in charge can be fatal, literally.

Human beings are primates, and evolutionary theory teaches us to expect something similar in our inter-specific cousins. Sure enough, studies on baboons have shown an increase in stress level and production of cortisol in males that join a new troop, because when they do so they find themselves at the bottom of the pecking order, with little control over availability of food and mates. The same is true for monkeys studied in zoos, where researchers found a nice inverse relationship between pecking order and the furring up of arties. Next time you see a monkey or ape, remember to empathize with their working conditions.

Amazingly, you can even demonstrate the effect experimentally on humans by dividing people into two groups, giving them the same tasks, but ordering around one group and empowering the other with self decision making. The latter group experiences lower levels of stress hormones, blood pressure and heart rate. - Dr. Massimo Pigliucci

Sometimes medicine takes a 180 degree turn such as the findings that giving too much liquid to distance runners may prove fatal or that bacteria causes stomach ulcers. "It is an observable fact that psychiatry, unlike any legitimate science, is a discipline in which two dissertations so incompatible that for either one to be valid the other must be incompetent nonsense can both be awarded Ph.D.s by the same department of the same university in the same year." William R. Harwood, Book reviewer on Amazon.

I once saw a program where the lecturer held up a five year old copy of the New England Journal of Medicine and said something to the effect that "we no longer believe 60% of what was printed here." How is it that the psychiatry business still keeps trying to ram that same round peg into that square hole after 50 years of dopamine suppression that continues to fail to fix the problem? Or would mild sedatives, removal from a stressful environment and a sleeping pill be less profitable than lifelong drugging?

9 Comments:

At 7:12 AM, Anonymous Anonymous said...

When researchers were studying LSD's serotonin surplus similarity to schizophrenia's psychosis, they were probably closer to the truth than when they switched to the amphetimine dopamine theory. Wouldn't it be a kick if they found out that it was a sleep disorder?

 
At 7:26 AM, Blogger liberated psych said...

Anon: that is what I think. The negative symptoms of schizophrenia rap bugs the hell out of me. Like when they say we crazies are antisocial and polls show that 85% of people do not want to associate with someone labelled mentally ill - and that was mentally ill in general - I bet it would be even higher if the public was asked about schizophenia specifically.

 
At 4:37 AM, Blogger Flimsy Sanity said...

Psychiatrists should probably be giving the depressed something that increases dopamine instead of serotonin. No wonder so many that take Paxil and Zoloft have psychotic reactions.

 
At 5:08 AM, Anonymous Anonymous said...

I think I read somewhere that sleep is to the mind what food is to the body.

 
At 8:11 PM, Anonymous Anonymous said...

So your theory is that schizophrenia is dreaming on the outside - while the person is awake?

Would it be presumptuous to say that REM sleep does not take place while sleeping but while awake?

 
At 8:17 PM, Anonymous Anonymous said...

I've taken Remeron as it increases REM sleep - but have also had intense reactions to it - like increased irritability and bursts of anger.

I'm not on any SSRI's but since I've been off, I've had the normal feelings of melancholy as opposed to the suicidal ideations from being off and then on SSRI's

I've noticed that sleep deprivation has been a cause for elevated stress levels and anxieties in myself. When presenting this fact to some psychiatrists, they seemed to ignore it and failed to treat the problem, which caused more sleep deprivation and increased symptoms.

 
At 4:49 AM, Blogger liberated psych said...

Hi Anonymouses,
Dreaming on the outside is a wonderful analogy.
I think most psycho drugs are way too harsh. I am not a doctor or a scientist, only an observer. For myself, I just take melatonin that is available over the counter. When I once asked the psych bunch for a sleeping aid, they gave me trazodone which was horrible. The psych world discounts sleep therapy because they already tried that, but when they did it, they would knock the person out for such a long time that they would get pneumonia. They just cannot be gentle. I am sorry I didn't answer sooner but I don't check this site very often.

 
At 10:17 AM, Blogger liberated psych said...

Dreaming (or REM sleep) switches your brain from producing serotonin to producing melatonin which kind of flushes the serotonin out of your system and rests your brain. Some serotonin is important but too much builds up and duplicates LSD type thinking which is as unrealistic as your dreams but exactly the opposite of a dream. I might have to research how this works a little better.

 
At 1:20 PM, Anonymous lipitor said...

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