Category: Neuropathology

Tripping in context

Let’s say you’re sitting at a bar. You’re 1.5 drinks in: confidence blows in the sail of your diaphragm, smiles are beginning to seep from your cheeks, and the voice in your head informs your sad, previously sober-self: What the hell – I really can achieve my goals, and I really do take myself too seriously, and thank the lord for alcohol! We have to do this more often, you mopey fuck!” As GABA floats across the lanes of your head-highways your brain – rather, you – find yourself settling into a disorganized and disinhibited state of bliss. Euphoria is too complicated a word for a feeling this normal. You’re calm once more.

You’re alone in that sense. Somehow your eyes receive some brainspace from your nose, which has utterly hijacked your experience with an awful perfume smell. An older woman 2 seats over is the hare to your tortoise and the current colonizer of your nostrils. You see that she is already a walking (sitting) vessel for a bottle of wine. She orders another. Some song that your dad really likes plays on the bar speakers as you peek down at her right ankle. No mistaking the Louis Vuitton purse at her side, nor the 3 prescription bottles inside of it. Your background in medicine, druggery, and institutionalization have taught you about privacy, but being medication savvy, 3/4 of a second is all you need: notice that the pill bottles all look fresh but bear different logos: St. Paul Corner Drug, CVS, Walgreens Pharmacy. Citizen-healthy-voter you shouldn’t peek, shouldn’t judge, so you look away and try to mind your drink. Hospital-you sees the after-image of the bottles in your mind’s eye. Amphetamine, Xanax, Prozac. Yet another rich lady with a gaggle of doctors. A gaggle of neuroses, sure, and based on her medication choices she’s well aware of her own difficulties. The problem is, these medications shouldn’t be prescribed together. Any legitimate care provider would know not to prescribe an antidepressant with a benzo with a stimulant anywhere other than a college basement. The bartender asks if you want another – in the 1/2 second before answering you have a moment of sadness for all the doctors who are persecuted for prescribing. Yeah, America, blame the doctors for your kids taking adderall. Keep blaming the doctors for Prozac being ineffective. Keep blaming a bunch of debt-laden medical students for doing their best to please you. And then jump onto the next miracle cure, why don’t ya, until the next miracle cure fucks you up. And fuck wine, you think to yourself loudly. You try to remember that there’s no need to be judgmental. Even though you won’t ever relate to this lady she’s ruined your state of mind, which honestly isn’t her fault. So much for the calm.

Then, Grandma-Glamorous yells something that actually resonates: GOSH, I MEAN FOR A MAJORITY OF PEOPLE WITHOUT MAJOR DEPRESSIVE DISORDER, NONE OF THESE ANTIDEPRESSANTS WORK ANY BETTER THAN LIFESTYLE CHANGES ! THEY SAID ON THE NEWS THAT THEY’RE USING THOSE MAGIC MUSHROOMS TO MAKE THE BLUES GO AWAY, HAVEN’T YOU HEARD? DOESN’T A LITTLE WOODSTOCK SOUND MORE FUN THAN WHINING? Fearfully, you almost glance down at her purse again to see if she’s carrying any tabs. She isn’t. What is this lady onto, anyways? She’s not like you: She’s never hallucinated (recreationally or clinically), she prefers medication over lifestyle changes, she drinks like a fish, and – despite her ability to rattle off study findings – appears completely medically irreverent. She’s also upper class and has uttered words supportive of the Trump administration. You wonder if she has a therapist and realize that it doesn’t really matter. She is a consumer and she wants what she wants what she wants. So how do these folks, abusive yet wary of all things prescription, come to love magic mushrooms?

What about the clinicians who are eager to publish? Their credibility requires that they not abuse medication, and that they be less wary of prescriptions. In fact, they must plunge headfirst into pharmacological interventions despite any wariness they experience. Their patients rely on it.

What about you? The nerdy, liberal-leaning undergrad? You have seen in your own body the disastrous effects of various prescription drugs. You’ve also seen in your own body the disastrous effects of various psychedelic drugs. You’ve also seen the benefits of both of these classes of drugs. So, let’s get serious.

What do psychedelics have to offer to the everyman? To the world of clinical psychiatry? Are psychedelics like psilocybin, LSD, or MDMA beneficial for mental health? Are they harmful for mental health? How do their effects differ between younger and older people? Between men and women? Are these drugs more effective for people with diagnosed illnesses? Less effective? Dangerous? If I have major depressive disorder, and medications aren’t working for me, should I ask the young fella at the bar if he knows where to buy some shrooms?

 

 

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Do you cry after caffeine intake?

I do. It’s weird

Coffee is a devilish drug with a tendency to cultivate dependence and craft caffeinated chains between itself and the user. As I type this I’m maybe a few ounces (probably 30-50mg of caffeine) into a cup of coffee &, as often happens, I started crying in what totaled to a brief 10-second spurt. Playing on my mental radio was a sudden dialogue with a formless stranger about how beautiful my cats are, how grateful for them, etc. An image of myself much older came to mind; I was seeing an old picture of the cats and hadn’t seen that old picture in some time and I was crying tears of gratitude.

This mental trip took place in less than 4-5 seconds, was profound, colorful, and detailed, and took me straight out of the room I was sitting in. There was a glowy feeling of being decades older and shown these gorgeous pictures of these gorgeous cats. It was less a thought process and more of a vision or fleeting headline on the newsreel of my frontal lobes.

It immediately passed and I felt funny for having had the experience yet again. Self aware, un-emotional, and nonreactive to what had just occurred. This type of thing occurs very often after coffee but it was quite some time before I realized that. I thought I was the type of person who had an early morning cry session, or a few chaotic ones (always of about 10-20 seconds maximum) but the link with caffeine became clear after a long period of daily journaling. Will post an excerpt soon but just wanted to leave this note here for myself later. With that said, I’m off to finish this coffee

Man’s best friend vs. Malignant Glioma

Easily the coolest research I’ve cut up & snorted in a while. 

It is commonplace to be forcefed research and ideas that are popular and meaningful. Neither popularity though meaning, however, make a given project or consideration in academia practical in the real world. In my experience it is rare to taste research and ideas that are practical. Past that point it is nearly impossible to come across research and ideas that are practical, simple, and clearly overlooked. A lovely bit of writing came up lately that seemed immediately worth reading, considering, and sharing. The fact that is is (all at once) so practical, so simple, and so clearly overlooked gripped me and hasn’t released my wandering, daydreaming self since the moment I printed this paper off some weeks ago. There’s always 10 motherfuckers out there trying to start a new conversation for every 1 team of people hoping to resolve, clean up, or challenge an old one. My response to this early quote was of feeling like these authors were bringing some serious love and professionalism to old conversations:

The framework of this study originated from the desire to explore and combine non-conventional modalities to overcome the limitations of conventional methodologies

It’s rude of me to be offering quotes without offering the paper. You probably won’t print it off and carry it with you for weeks (especially if you didn’t download the .pdf from the link above yet…….) but here’s a reminder of the title

The Effect of Pet Therapy and Artist Interactions on Quality of Life in Brain Tumor Patients: A Cross-Section of Art and Medicine in Dialog (published 2018)  

 

This paper is directly helpful to people. The authors explore the application of pet therapy and art therapy (or, more simply, pets and art) to health-related quality of life – HRQoL – in patients diagnosed with malignant gliomas. In laymen’s term a malignant glioma is a terminal brain tumor, with a median survival time of less than 2 years after diagnosis. This is notable given that many other diseases can be significantly slowed in their course or even eliminated with the best treatments available today. The early claim by the authors is that the traditional goals of medicine are survival and disease-free survival. They go on to assert that traditional medicine does not tend to the needs of those who will not survive and are disease-ridden or terminally ill, and that there are (presumably unexplored) means for improving HRQoL. Though there is perhaps an anecdotal, personal, or folk account for this shortcoming in traditional medicine we should not proceed in reading this paper without questioning this starting point. Many of us will have experiences in healthcare – from birth to the beyond – that are more wholesome, more forward-thinking, and already aware or attuned to the loving tools described in this paper. It would not serve the reader (in my opinion) to get ahead of themselves and act as if traditional medicine has never been aware of how art, pets, or ‘art therapy/pet therapy’ assist HRQoL, including during the process of dying.

With that said let’s stop with a few questions worth pondering. If they make any sense (or if they don’t), jot these down, carry them around, digest them, disagree with yourself, repeat. Google whatever doesn’t make sense. It’s worth it:

In this paper, we describe our unique study that was designed to address two critical questions: (1) can pet therapy in the outpatient setting help improve HRQoL of brain tumor patients? and (2) can patient’s facial expression be used as a proxy measure for their overall HRQoL?

Amygdala regulation

Ain’t easy. Especially on low sleep. I recently stumbled upon some literature describing the relationship between the prefrontal cortex and the limbic system. Specifically it went over the connections between the prefrontal cortex and the amygdalae. Will have to come back here & post the link(s) but wanted to jot this down here, as it’s timely & highly relevant to mood disorders.

Sleep is a fickle thing & it seems that quality and duration of sleep is related to one’s ability to keep their amygdala functioning well. The absence of good quality sleep of proper duration can lead one to experience impulsiveness, out-of-control distractibility and responsiveness to irrelevant stimuli, and immense irritability. Take it from me: the vast gulf between being contented & calm or being a murderous monster can be crossed, in part, by hitting the hay.