Group items tagged

The creators of the D.S.M. in the 1960s and ’70s “were real heroes at the time,” said Dr. Steven E. Hyman, a psychiatrist and neuroscientist at the Broad Institute and a former director at the National Institute of Mental Health. “They chose a model in which all psychiatric illnesses were represented as categories discontinuous with ‘normal.’ But this is totally wrong in a way they couldn’t have imagined. So in fact what they produced was an absolute scientific nightmare. Many people who get one diagnosis get five diagnoses, but they don’t have five diseases — they have one underlying condition.”

Decades of spending on neuroscience have taught scientists mostly what they do not know, undermining some of their most elemental assumptions. Genetic glitches that appear to increase the risk of schizophrenia in one person may predispose others to autism-like symptoms, or bipolar disorder. The mechanisms of the field’s most commonly used drugs — antidepressants like Prozac, and antipsychosis medications like Zyprexa — have revealed nothing about the causes of those disorders. And major drugmakers have scaled back psychiatric drug development, having virtually no new biological “targets” to shoot for.

Dr. Insel is one of a growing number of scientists who think that the field needs an entirely new paradigm for understanding mental disorders, though neither he nor anyone else knows exactly what it will look like.

Dr. Hyman, Dr. Insel and other experts said they hoped that the science of psychiatry would follow the direction of cancer research, which is moving from classifying tumors by where they occur in the body to characterizing them by their genetic and molecular signatures.

Dr. Insel said in the interview that his motivation was not to disparage the D.S.M. as a clinical tool, but to encourage researchers and especially outside reviewers who screen proposals for financing from his agency to disregard its categories and investigate the biological underpinnings of disorders instead.

The brain-development lag has huge implications for how we think about anxiety and how we treat it. It suggests that anxious adolescents may not be very responsive to psychotherapy that attempts to teach them to be unafraid, like cognitive behavior therapy

should also make us think twice — and then some — about the ever rising use of stimulants in young people, because these drugs may worsen anxiety and make it harder for teenagers to do what they are developmentally supposed to do: learn to be unafraid when it is appropriate

up to 20 percent of adolescents in the United States experience a diagnosable anxiety disorder, like generalized anxiety or panic attacks, probably resulting from a mix of genetic factors and environmental influences.

This isn’t to say that cognitive therapy is ineffective for teenagers, but that because of their relative difficulty in learning to be unafraid, it may not be the most effective treatment when used on its own.

Fear learning lies at the heart of anxiety and anxiety disorders. This primitive form of learning allows us to form associations between events and specific cues and environments that may predict danger.

once previously threatening cues or situations become safe, we have to be able to re-evaluate them and suppress our learned fear associations. People with anxiety disorders have trouble doing this and experience persistent fear in the absence of threat — better known as anxiety.

Dr. Casey discovered that adolescents had a much harder time “unlearning” the link between the colored square and the noise than children or adults did.

adolescents had trouble learning that a cue that was previously linked to something aversive was now neutral and “safe.” If you consider that adolescence is a time of exploration when young people develop greater autonomy, an enhanced capacity for fear and a more tenacious memory for threatening situations are adaptive and would confer survival advantage. In fact, the developmental gap between the amygdala and the prefrontal cortex that is described in humans has been found across mammalian species, suggesting that this is an evolutionary advantage.

As a psychiatrist, I’ve treated many adults with various anxiety disorders, nearly all of whom trace the origin of the problem to their teenage years. They typically report an uneventful childhood rudely interrupted by adolescent anxiety. For many, the anxiety was inexplicable and came out of nowhere.

prescription sales for stimulants increased more than fivefold between 2002 and 2012. This is of potential concern because it is well known from both human and animal studies that stimulants enhance learning and, in particular, fear conditioning.

When the researchers blocked the input to these neurons, the mice began moving during their sleep, just like someone with REM sleep behavior disorder.

Narcolepsy is characterized by suddenly falling asleep at any time during the day, even in mid-sentence. Cataplexy is a related illness in which people suddenly lose muscle tone and collapse.

They tested their hypothesis using a mouse model of narcolepsy in which cataplexic attacks could be triggered by chocolate. "We found that silencing the SLD-to-ventral medial medulla reduced the number of cataplexic bouts,"

The glycinergic neurons we have identified in the ventral medial medulla could be a good target for drug therapies for people with narcolepsy, cataplexy, or REM sleep behavior disorder,

"They were connected to neurons that control voluntary movements, but not those that control muscles in the eyes or internal organs. Importantly, they were inhibitory, meaning that they can prevent muscle movement when active."

"The glycinergic neurons we have identified in the ventral medial medulla could be a good target for drug therapies for people with narcolepsy, cataplexy, or REM sleep behavior disorder,"

The cerebrum has two halves, or hemispheres, that are further divided into four regions, or lobes. The frontal lobes, located behind the forehead, are involved with speech, thought, learning, emotion, and movement.

Behind them are the parietal lobes, which process sensory information such as touch, temperature, and pain.

At the rear of the brain are the occipital lobes, dealing with vision

Lastly, there are the temporal lobes, near the temples, which are involved with hearing and memory.

The second-largest part of the brain is the cerebellum, which sits beneath the back of the cerebrum.

diencephalon, located in the core of the brain. A complex of structures roughly the size of an apricot, its two major sections are the thalamus and hypothalamus

The brain is extremely sensitive and delicate, and so it requires maximum protection, which is provided by the hard bone of the skull and three tough membranes called meninges.

Want more proof that the brain is extraordinary? Look no further than the blood-brain barrier.

This led scientists to learn that the brain has an ingenious, protective layer. Called the blood-brain barrier, it’s made up of special, tightly bound cells that together function as a kind of semi-permeable gate throughout most of the organ. It keeps the brain environment safe and stable by preventing some toxins, pathogens, and other harmful substances from entering the brain through the bloodstream, while simultaneously allowing oxygen and vital nutrients to pass through.

One in five Americans suffers from some form of neurological damage, a wide-ranging list that includes stroke, epilepsy, and cerebral palsy, as well as dementia.

Alzheimer’s disease, which is characterized in part by a gradual progression of short-term memory loss, disorientation, and mood swings, is the most common cause of dementia. It is the sixth leading cause of death in the United States

50 million people suffer from Alzheimer’s or some form of dementia. While there are a handful of drugs available to mitigate Alzheimer’s symptoms, there is no cure.

Unfortunately, negative attitudes toward people who suffer from mental illness are widespread. The stigma attached to mental illness can create feelings of shame, embarrassment, and rejection, causing many people to suffer in silence.

In the United States, where anxiety disorders are the most common forms of mental illness, only about 40 percent of sufferers receive treatment. Anxiety disorders often stem from abnormalities in the brain’s hippocampus and prefrontal cortex.

Attention-deficit/hyperactivity disorder, or ADHD, is a mental health condition that also affects adults but is far more often diagnosed in children.

ADHD is characterized by hyperactivity and an inability to stay focused.

Depression is another common mental health condition. It is the leading cause of disability worldwide and is often accompanied by anxiety. Depression can be marked by an array of symptoms, including persistent sadness, irritability, and changes in appetite.

The good news is that in general, anxiety and depression are highly treatable through various medications—which help the brain use certain chemicals more efficiently—and through forms of therapy

This could stigmatise many highly engaged people for whom gaming is one of their main hobbies.

concerns about gaming addiction might reflect a moral panic instead of solid science.

there is no consensus on the definition of video game addiction, the essential symptoms or indicators, or the core features of the mental health condition.

What is currently missing is a body of studies where scientists preregister their methods and hypotheses prior to collecting data samples online.

we believe rigorous scientific research into gaming addiction is essential.

onic constipation, a functional bowel disorder, affects approximately 14% of adults worldwide [1]. Slow transit constipation (STC) is the major cause of chronic constipation which is characterized by markedly prolonged colonic transit time as a result of the colonic motility function disorde

Usually, patients with STC suffer from a common sense of abdominal pain, nausea, depression and sickness, which seriously influence their social ability and health-related quality of life [4–6

Current clinical treatments include cathartics, prokinetics and aggressive surgery which can increase bowel movement frequency to a certain degree.

However, pharmacological interventions is prone to drug dependency and relapse after drug withdrawal [3]

Surgical treatments such as subtotal colectomy and total colectomy in STC patients may adversely affect the quality of life due to the risk of postoperative diarrhea or incontinence, and result in a heavy healthcare burden

The enteric nervous system (ENS), located in the intestinal wall, regulates various functions including contraction of intestine, homeostasis and blood flow [10]. As the ‘second brain’, the ENS contains large amounts of neurons working independently from the central nervous system [11]. Researches have identified that STCs are mostly caused by disorders of the relevant nerves, especially the ENS [12,13].

McCallum et al. [35] found that gastric electrical stimulation in combination with pharmacological treatment could also enhance emptying in patients with gastroparesis. Especially, gastric electrical stimulation has been approved as a clinical therapy method for gastroparesis and obesity in European and American countries [36].

we employed pulse train stimulation and implanted electrodes at the proximal colon in dogs.

After CES treatment, we observed the colonic transit time of the sham treatment group was longer than that of CES treatment and control groups, and electrical stimulation significantly enhanced the colonic electromyogram (EMG) signal.

histopathology and TEM analysis showed increased ganglia and synaptic vesicles existing in the colon myenteric plexus of the CES treatment group as compared with that of the sham CES group

Our results suggested that CES might reduce the degeneration of the myenteric plexus neurons, thereby contributing to the therapeutic effect on STC beagles.

the defecating frequency and the feces characteristics of STC beagles returned to normal after CES treatment. The result indicated that CES could improve the symptoms of STC.

The colonic EMG signal was strongly promoted by CES

Especially, the colonic EMG signal of the beagles with STC was remarkably enhanced by CES (Figure 3), indicating that CES could not only improve the colonic content emptying, but also enhance the EMG signal to promote colonic motility.

Colonic electrical stimulation (CES), a valuable alternative for the treatment of STC, was reported to improve the colon motility by adjusting the bioelectrical activity in animal models or patients with STC [17]. However, little report focuses on the underlying nervous mechanism to normalize the delayed colonic emptying and relieve symptoms. We hypothesized that CES may also repair the disorders of the relevant nerves and then improve the colonic motility.

The first study regarding the CES to modulate colonic motility was performed by Hughes et al. [37]. Since then, many researchers employed short-pulse CES in canine descending colon or pig cecum [20,21,38]. Researchers also applied long-pulse CES to stimulate the colon of human or animals [39]

Recently, studies showed that the prokinetic effect of pulse train CES is better than that of short-pulse CES or long-pulse CES [25]

Our study indicated that CES could enhance the colonic motility, and then accelerate the colonic content emptying. Thereafter, we investigated the underlying mechanism and presumed that CES might improve the STC symptom through the repairment of the ENS.

The neuropathy in ENS is considered to be responsible for various kinds of disordered motility including STC and the related pathophysiologic symptoms [40]. In agreement with this view, our study discovered the decreased number of ganglia in the myenteric plexus, as well as the destruction of the enteric nerve axon terminals and synaptic vesicles in the sham CES group beagles

The present study proves that CES with pulse trains has curative effects on the colonic motility and content emptying in STC beagles. The up-regulation of intestinal nerve related proteins such as SYP, PGP9.5, CAD and S-100B in the colonic myenteric plexus suggests that CES might reduce the degeneration of the myenteric plexus neurons, thereby producing the therapeutic effect on STC beagles. Further investigation for the underlying mechanism of nerve regeneration is necessary to better understand how CES promotes the recovery of delayed colonic motility induced by STC.

Dory, voiced by comedian Ellen DeGeneres, suffers classic symptoms of anterograde amnesia, which is typically associated with damage to the hippocampus, the area of the brain involved in encoding memories.

the portrayal of the condition is spot on. She has difficulty remembering names and retaining new information, but her condition doesn’t affect her sense of identity.

it’s just a perfect example of the neuromyth

Jason Bourne, the amnesiac main character of this action flick, exhibits no trouble with short-term memories, but wakes up after suffering an unspecified injury to the brain with no recollection of who he is.

explaining that the “double conk” myth – the idea that someone can lose their identity after being hit in the head and regain it after a second blow or psychological trigger – is actually a conflation of two ideas.

Identity loss is more closely associated with psychogenic amnesia, an extremely rare and controversial diagnosis, whose origins, some experts believe, may be influenced by culture.

This sci-fi action film relies on the conceit that humans only use 10 per cent of their brains.

Sure, filmmakers may take artistic licence, she says, but the trouble is many people actually believe we only use a portion of our brains.

she notes that due to its success, the film may have inadvertently contributed to the stereotype of the autistic savant – the notion that people with autism excel in a specific area, which, in the case of Hoffman’s character, involved dealing in numbers. In reality, Spiers says, this is very rare.

The criteria used by the WHO are similar to those used to distinguish any addictive behavior—namely. that the behavior starts to take priority over a person’s life to the exclusion of behaviors essential to good health.

“But clinicians are approaching this behavior from an understanding of a disorder based on a continuum of normative, recreational and problematic use rather than from the setting or context of a unique, new culture.” Carras, for example, points out that gaming fulfills a participatory and social need for some.

2) He will say whatever feels most comfortable or good to him at any given time. He will lie a lot, and say totally different things to different people. Stop being surprised by this. While it’s important to pretend “good faith” and remind him of promises, as Bernie Sanders and others are doing, that’s for his supporters, so *they* can see the inconsistency as it comes. He won’t care. So if you’re trying to reconcile or analyze his words, don’t. It’s 100% not worth your time. Only pay attention to and address his actions.

3) You can influence him by making him feel good. There are already people like Bannon who appear ready to use him for their own ends. The GOP is excited to try. Watch them, not him.

4) Entitlement is a key aspect of the disorder. As we are already seeing, he will likely not observe traditional boundaries of the office. He has already stated that rules don’t apply to him. This particular attribute has huge implications for the presidency and it will be important for everyone who can to hold him to the same standards as previous presidents.

5) We should expect that he only cares about himself and those he views as extensions of himself, like his children. (People with NPD often can’t understand others as fully human or distinct.) He desires accumulation of wealth and power because it fills a hole.

He will have no qualms *at all* about stealing everything he can from the country, and he’ll be happy to help others do so, if they make him feel good. He won’t view it as stealing but rather as something he’s entitled to do. This is likely the only thing he will intentionally accomplish.

6) It’s very, very confusing for non-disordered people to experience a disordered person with NPD. While often intelligent, charismatic and charming, they do not reliably observe social conventions or demonstrate basic human empathy. It’s very common for non-disordered people to lower their own expectations and try to normalize the behavior. DO NOT DO THIS

7) People with NPD often recruit helpers, referred to in the literature as “enablers” when they allow or cover for bad behavior and “flying monkeys” when they perpetrate bad behavior

8) People with NPD often foster competition for sport in people they control. Expect lots of chaos, firings and recriminations. He will probably behave worst toward those closest to him, but that doesn’t mean (obviously) that his actions won’t have consequences for the rest of us. He will punish enemies.

9) Gaslighting — where someone tries to convince you that the reality you’ve experienced isn’t true — is real and torturous. He will gaslight, his followers will gaslight.

Learn the signs and find ways to stay focused on what you know to be true. Note: it is typically not helpful to argue with people who are attempting to gaslight. You will only confuse yourself. Just walk away.

10) Whenever possible, do not focus on the narcissist or give him attention. Unfortunately we can’t and shouldn’t ignore the president, but don’t circulate his tweets or laugh at him — you are enabling him and getting his word out.

Maurice discloses her Catholicism, and the reader is aware that prayer undergirds the therapy, but the book is about the therapy, not the prayer. Specifically, it is about the importance of choosing methods of treatment that are supported by scientific data. Applied behavioral analysis is all about data: its daily collection and interpretation. The method is empirical, hard-headed, and results-oriented.

on a deeper level, the book is profoundly religious, more religious perhaps than its author intended. In this reading of the book, autism is not only a developmental disorder afflicting particular individuals, but a metaphor for the spiritual condition of fallen man.

Maurice’s autistic daughter is indifferent to her mother

In this reading of the book, the mother is God, watching a child of his wander away from him into darkness: a heartbroken but also a determined God, determined at any cost to bring the child back

the mother doesn’t turn back, concedes nothing to the condition that has overtaken her daughter. There is no political correctness in Maurice’s attitude to autism; no nod to “neurodiversity.” Like the God in Donne’s sonnet, “Batter my heart, three-personed God,” she storms the walls of her daughter’s condition

Like God, she sets her sights high, commits both herself and her child to a demanding, sometimes painful therapy (life!), and receives back in the end a fully alive, loving, talking, and laughing child

the reader realizes that for God, the harrowing drama of recovery is never a singular, or even a twice-told tale, but a perennial one. Every child of his, every child of Adam and Eve, wanders away from him into darkness

we have an epidemic of autism, or “autism spectrum disorder,” which includes classic autism (Maurice’s children’s diagnosis); atypical autism, which exhibits some but not all of the defects of autism; and Asperger’s syndrome, which is much more common in boys than in girls and is characterized by average or above average language skills but impaired social skills.

At the same time, all around us, we have an epidemic of something else. On the street and in the office, at the dinner table and on a remote hiking trail, in line at the deli and pushing a stroller through the park, people go about their business bent over a small glowing screen, as if praying.

This latter epidemic, or experiment, has been going on long enough that people are beginning to worry about its effects.

for a comprehensive survey of the emerging situation on the ground, the interested reader might look at Sherry Turkle’s recent book, Reclaiming Conversation: The Power of Talk in a Digital Age.

she also describes in exhaustive, chilling detail the mostly horrifying effects recent technology has had on families and workplaces, educational institutions, friendships and romance.

many of the promises of technology have not only not been realized, they have backfired. If technology promised greater connection, it has delivered greater alienation. If it promised greater cohesion, it has led to greater fragmentation, both on a communal and individual level.

If thinking that the grass is always greener somewhere else used to be a marker of human foolishness and a temptation to be resisted, today it is simply a possibility to be checked out. The new phones, especially, turn out to be portable Pied Pipers, irresistibly pulling people away from the people in front of them and the tasks at hand.

all it takes is a single phone on a table, even if that phone is turned off, for the conversations in the room to fade in number, duration, and emotional depth.

an infinitely malleable screen isn’t an invitation to stability, but to restlessness

Current media, and the fear of missing out that they foster (a motivator now so common it has its own acronym, FOMO), drive lives of continual interruption and distraction, of virtual rather than real relationships, and of “little” rather than “big” talk

if you may be interrupted at any time, it makes sense, as a student explains to Turkle, to “keep things light.”

we are reaping deficits in emotional intelligence and empathy; loneliness, but also fears of unrehearsed conversations and intimacy; difficulties forming attachments but also difficulties tolerating solitude and boredom

consider the testimony of the faculty at a reputable middle school where Turkle is called in as a consultant

The teachers tell Turkle that their students don’t make eye contact or read body language, have trouble listening, and don’t seem interested in each other, all markers of autism spectrum disorder

Like much younger children, they engage in parallel play, usually on their phones. Like autistic savants, they can call up endless information on their phones, but have no larger context or overarching narrative in which to situate it

Students are so caught up in their phones, one teacher says, “they don’t know how to pay attention to class or to themselves or to another person or to look in each other’s eyes and see what is going on.

“It is as though they all have some signs of being on an Asperger’s spectrum. But that’s impossible. We are talking about a schoolwide problem.”

Can technology cause Asperger’

“It is not necessary to settle this debate to state the obvious. If we don’t look at our children and engage them in conversation, it is not surprising if they grow up awkward and withdrawn.”

In the protocols developed by Ivar Lovaas for treating autism spectrum disorder, every discrete trial in the therapy, every drill, every interaction with the child, however seemingly innocuous, is prefaced by this clear command: “Look at me!”

If absence of relationship is a defining feature of autism, connecting with the child is both the means and the whole goal of the therapy. Applied behavioral analysis does not concern itself with when exactly, how, or why a child becomes autistic, but tries instead to correct, do over, and even perhaps actually rewire what went wrong, by going back to the beginning

Eye contact—which we know is essential for brain development, emotional stability, and social fluency—is the indispensable prerequisite of the therapy, the sine qua non of everything that happens.

There are no shortcuts to this method; no medications or apps to speed things up; no machines that can do the work for us. This is work that only human beings can do

it must not only be started early and be sufficiently intensive, but it must also be carried out in large part by parents themselves. Parents must be trained and involved, so that the treatment carries over into the home and continues for most of the child’s waking hours.

there are foundational relationships that are templates for all other relationships, and for learning itself.

Maurice’s book, in other words, is not fundamentally the story of a child acquiring skills, though she acquires them perforce. It is the story of the restoration of a child’s relationship with her parents

it is also impossible to overstate the time and commitment that were required to bring it about, especially today, when we have so little time, and such a faltering, diminished capacity for sustained engagement with small children

The very qualities that such engagement requires, whether our children are sick or well, are the same qualities being bred out of us by technologies that condition us to crave stimulation and distraction, and by a culture that, through a perverse alchemy, has changed what was supposed to be the freedom to work anywhere into an obligation to work everywhere.

In this world of total work (the phrase is Josef Pieper’s), the work of helping another person become fully human may be work that is passing beyond our reach, as our priorities, and the technologies that enable and reinforce them, steadily unfit us for the work of raising our own young.

in Turkle’s book, as often as not, it is young people who are distressed because their parents are unreachable. Some of the most painful testimony in Reclaiming Conversation is the testimony of teenagers who hope to do things differently when they have children, who hope someday to learn to have a real conversation, and so o

it was an older generation that first fell under technology’s spell. At the middle school Turkle visits, as at many other schools across the country, it is the grown-ups who decide to give every child a computer and deliver all course content electronically, meaning that they require their students to work from the very medium that distracts them, a decision the grown-ups are unwilling to reverse, even as they lament its consequences.

we have approached what Turkle calls the robotic moment, when we will have made ourselves into the kind of people who are ready for what robots have to offer. When people give each other less, machines seem less inhuman.

robot babysitters may not seem so bad. The robots, at least, will be reliable!

If human conversations are endangered, what of prayer, a conversation like no other? All of the qualities that human conversation requires—patience and commitment, an ability to listen and a tolerance for aridity—prayer requires in greater measure.

this conversation—the Church exists to restore. Everything in the traditional Church is there to facilitate and nourish this relationship. Everything breathes, “Look at me!”

there is a second path to God, equally enjoined by the Church, and that is the way of charity to the neighbor, but not the neighbor in the abstract.

“Who is my neighbor?” a lawyer asks Jesus in the Gospel of Luke. Jesus’s answer is, the one you encounter on the way.

Virtue is either concrete or it is nothing. Man’s path to God, like Jesus’s path on the earth, always passes through what the Jesuit Jean Pierre de Caussade called “the sacrament of the present moment,” which we could equally call “the sacrament of the present person,” the way of the Incarnation, the way of humility, or the Way of the Cross.

The tradition of Zen Buddhism expresses the same idea in positive terms: Be here now.

Both of these privileged paths to God, equally dependent on a quality of undivided attention and real presence, are vulnerable to the distracting eye-candy of our technologies

Turkle is at pains to show that multitasking is a myth, that anyone trying to do more than one thing at a time is doing nothing well. We could also call what she was doing multi-relating, another temptation or illusion widespread in the digital age. Turkle’s book is full of people who are online at the same time that they are with friends, who are texting other potential partners while they are on dates, and so on.

This is the situation in which many people find themselves today: thinking that they are special to someone because of something that transpired, only to discover that the other person is spread so thin, the interaction was meaningless. There is a new kind of promiscuity in the world, in other words, that turns out to be as hurtful as the old kind.

Who can actually multitask and multi-relate? Who can love everyone without diluting or cheapening the quality of love given to each individual? Who can love everyone without fomenting insecurity and jealousy? Only God can do this.

When an individual needs to be healed of the effects of screens and machines, it is real presence that he needs: real people in a real world, ideally a world of God’s own making

Nature is restorative, but it is conversation itself, unfolding in real time, that strikes these boys with the force of revelation. More even than the physical vistas surrounding them on a wilderness hike, unrehearsed conversation opens up for them new territory, open-ended adventures. “It was like a stream,” one boy says, “very ongoing. It wouldn’t break apart.”

in the waters of baptism, the new man is born, restored to his true parent, and a conversation begins that over the course of his whole life reminds man of who he is, that he is loved, and that someone watches over him always.

Even if the Church could keep screens out of her sanctuaries, people strongly attached to them would still be people poorly positioned to take advantage of what the Church has to offer. Anxious people, unable to sit alone with their thoughts. Compulsive people, accustomed to checking their phones, on average, every five and a half minutes. As these behaviors increase in the Church, what is at stake is man’s relationship with truth itself.

The relationship between TBI and PTSD has garnered increased attention in recent years as studies have shown considerable overlap in risk factors and symptoms,

At 3 months, 77 participants, or 18 percent, had likely PTSD; at 6 months, 70 participants or 16 percent did. All subjects underwent brain imaging after injury.

"MRI studies conducted within two weeks of injury were used to measure volumes of key structures in the brain thought to be involved in PTSD,"

Specifically, smaller volume in brain regions called the cingulate cortex, the superior frontal cortex, and the insula predicted PTSD at 3 months.

Together, the findings suggest that a "brain reserve," or higher cortical volumes, may provide some resilience against PTSD.

When we learn something—even as simple as someone’s name—we form connections between neurons in the brain. These synapses create new circuits between nerve cells, essentially remapping the brain.

The sheer number of possible connections gives the brain unfathomable flexibility—each of the brain’s 100 billion nerve cells can have 10,000 connections to other nerve cells.

Huganir and his team discovered that when mice are exposed to traumatic events, the level of neuronal receptors for glutamate increases at synapses in the amygdala, the fear center of the brain, and encodes the fear associated with the memory. Removing those receptors, however, reduces the strength of these connections, essentially erasing the fear component of the trauma but leaving the memory.

Now Huganir and his lab are developing drugs that target those receptors. The hope is that inactivating the receptors could help people with post-traumatic stress syndrome by reducing the fear associated with a traumatic memory, while strengthening them could improve learning, particularly in people with cognitive dysfunction or Alzheimer’s disease.

Dementia (di-men-sha): A loss of brain function that can be caused by a variety of disorders affecting the brain. Symptoms include forgetfulness, impaired thinking and judgment, personality changes, agitation and loss of emotional control. Alzheimer’s disease, Huntington’s disease and inadequate blood flow to the brain can all cause dementia. Most types of dementia are irreversible.

Post-traumatic stress disorder (PTSD): A disorder in which your “fight or flight,” or stress, response stays switched on, even when you have nothing to flee or battle. The disorder usually develops after an emotional or physical trauma, such as a mugging, physical abuse or a natural disaster. Symptoms include nightmares, insomnia, angry outbursts, emotional numbness, and physical and emotional tension.

The Bloomberg article cites a July meta-analysis in the medical journal Lancet, which found a tenuous link between higher temperatures and suicides and mental illness. But the study deems the collective evidence of “low certainty” owing to inconsistent study findings, methodologies, measured variables and definitions.

“climate change might not necessarily increase mental health issues because people might adapt over time, meaning that higher temperatures could become normal and not be experienced as anomalous or extreme.”

yes. Before the media began reporting on putative temperature records—the scientific evidence for which is also weak—heat waves were treated as a normal part of summer. Uncomfortable, but figuratively nothing to sweat about.

according to a World Health Organization report last year, the very “awareness of climate change and extreme weather events and their impacts” may lead to a host of ills, including strained social relationships, anxiety, depression, intimate-partner violence, helplessness, suicidal behavior and alcohol and substance abuse.

A study in 2021 of 16- to 25-year-olds in 10 countries including the U.S. reported that 59% were very or extremely worried about climate change, and 84% were at least moderately worried

Forty-five percent claimed they were so worried that they struggled to function on a daily basis, the definition of an anxiety disorder.

“First and foremost, it is imperative that adults understand that youth climate anxiety (also referred to as eco-anxiety, solastalgia, eco-guilt or ecological grief) is an emotionally and cognitively functional response to real existential threats,” a May 10 editorial in the journal Nature explained. “Although feelings of powerlessness, grief and fear can be profoundly disruptive—particularly for young people unaccustomed to the depth and complexity of such feelings—it is important to acknowledge that this response is a rational one.”

These anxieties are no more rational than the threats from climate change are existential.

A more apt term for such fear is climate hypochondria.

The New Yorker magazine earlier this month published a 4,400-word piece titled “What to Do With Climate Emotions” by Jia Tolentino, a woman in the throes of such neurosis

Ms. Tolentino goes on to describe how climate therapists can help patients cope. “The goal is not to resolve the intrusive feeling and put it away” but, as one therapist advises her, “to aim for a middle ground of sustainable distress.” Even the climate left’s despair must be “sustainable.”

there’s nothing normal about climate anxiety, despite the left’s claims to the contrary.

Progressives may even use climate change to displace their other anxieties—for instance, about having children

Displacement is a maladaptive mechanism by which people redirect negative emotions from one thing to another

Climate hypochondriacs deserve to be treated with compassion, much like anyone who suffers from mental illness. They shouldn’t, however, expect everyone else to enable their neuroses.

The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms. A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.

This concerned me, but didn’t feel I was in the position to sound some kind of alarm back then. There was a team of about eight of us, and only one other person brought up the kinds of questions I had. Anyone who raised doubts ran the risk of being called a transphobe. 

I certainly saw this at the center. One of my jobs was to do intake for new patients and their families. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school. 

There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are. 

The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.

To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription. 

When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable. Our patients were told about some side effects, including sterility. But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor.

Many encounters with patients emphasized to me how little these young people understood the profound impacts changing gender would have on their bodies and minds. But the center downplayed the negative consequences, and emphasized the need for transition. As the center’s website said, “Left untreated, gender dysphoria has any number of consequences, from self-harm to suicide. But when you take away the gender dysphoria by allowing a child to be who he or she is, we’re noticing that goes away. The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.” 

Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).

Here’s an example. On Friday, May 1, 2020, a colleague emailed me about a 15-year-old male patient: “Oh dear. I am concerned that [the patient] does not understand what Bicalutamide does.” I responded: “I don’t think that we start anything honestly right now.”

Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects, and this patient experienced one of them: liver toxicity. He was sent to another unit of the hospital for evaluation and immediately taken off the drug. Afterward, his mother sent an electronic message to the Transgender Center saying that we were lucky her family was not the type to sue.

How little patients understood what they were getting into was illustrated by a call we received at the center in 2020 from a 17-year-old biological female patient who was on testosterone. She said she was bleeding from the vagina. In less than an hour she had soaked through an extra heavy pad, her jeans, and a towel she had wrapped around her waist. The nurse at the center told her to go to the emergency room right away.

when there was a dispute between the parents, it seemed the center always took the side of the affirming parent.

Other girls were disturbed by the effects of testosterone on their clitoris, which enlarges and grows into what looks like a microphallus, or a tiny penis. I counseled one patient whose enlarged clitoris now extended below her vulva, and it chafed and rubbed painfully in her jeans. I advised her to get the kind of compression undergarments worn by biological men who dress to pass as female. At the end of the call I thought to myself, “Wow, we hurt this kid.”

There are rare conditions in which babies are born with atypical genitalia—cases that call for sophisticated care and compassion. But clinics like the one where I worked are creating a whole cohort of kids with atypical genitals—and most of these teens haven’t even had sex yet. They had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist.

Being put on powerful doses of testosterone or estrogen—enough to try to trick your body into mimicking the opposite sex—-affects the rest of the body. I doubt that any parent who's ever consented to give their kid testosterone (a lifelong treatment) knows that they’re also possibly signing their kid up for blood pressure medication, cholesterol medication, and perhaps sleep apnea and diabetes. 

Besides teenage girls, another new group was referred to us: young people from the inpatient psychiatric unit, or the emergency department, of St. Louis Children’s Hospital. The mental health of these kids was deeply concerning—there were diagnoses like schizophrenia, PTSD, bipolar disorder, and more. Often they were already on a fistful of pharmaceuticals.

no matter how much suffering or pain a child had endured, or how little treatment and love they had received, our doctors viewed gender transition—even with all the expense and hardship it entailed—as the solution.

Another disturbing aspect of the center was its lack of regard for the rights of parents—and the extent to which doctors saw themselves as more informed decision-makers over the fate of these children.

We found out later this girl had had intercourse, and because testosterone thins the vaginal tissues, her vaginal canal had ripped open. She had to be sedated and given surgery to repair the damage. She wasn’t the only vaginal laceration case we heard about.

During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility. 

I left the clinic in November of last year because I could no longer participate in what was happening there. By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to “do no harm.” Instead, we are permanently harming the vulnerable patients in our care.

Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.

Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling.

For almost four years, I worked at The Washington University School of Medicine Division of Infectious Diseases with teens and young adults who were HIV positive. Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a transman, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt. 

The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus. 

All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children's Hospital, which had been established a year earlier. 

The idea that every human brain is mechanically perfect – with cruel or annihilating impulses somehow separate from it, as if repugnant thoughts were like stagnant water running through an infallibly reliable plumbing system – is silly but somehow comforting.

our potential for understanding that it’s all in our minds, and working out how individual minds can develop in a well-adjusted way, has never been greater. That, to me, gives great hope for the future.

working on more broadly applying [the therapy] to other forms of genetic hearing loss,” he said. But in contrast to VGLUT3 mutant mice, which are missing the protein entirely, humans with missense mutations expressed a defective transporter, making it unclear whether Lustig’s strategy could translate to human VGLUT3-linked deafness.

Taste and smell are two of the senses that have received less attention from gene therapy researchers—but that’s changing

In olfactory dysfunction, there are few curative therapies,

Treating the mice intra-nasally with gene therapy vectors carrying the wildtype Ift88 gene, researchers saw significant regrowth of nasal cilia, whereas control mice given empty vectors showed no regrowth. Treated mice almost doubled in weight compared to controls.

So far, no scientists have designed a gene therapy to target taste buds, but at least one team is tackling an important factor in taste: saliva. If a person’s saliva production drops below 50 percent of normal, “you get tooth decay and trouble swallowing,”

Scientists are also developing gene therapies for disorders involving touch—or at least pain-sensing—neurons, with one drug candidate

Wolfe envisions that someday pain treatment could be as simple as visiting the doctor every few months for a quick skin prick “wherever it hurts”—choosing between a variety of genes to get the best effect.

addition to neuroimaging techniques that can reveal regional brain activity, brain lesioning can also help shed light on the most important targets for a particular disorder. In brain lesioning, misfiring neurons or their connections are destroyed, most commonly using a heating probe inserted in the brain. Once the first patients are treated, data on effectiveness and side effects, in combination with continued neuroimaging, can help further focus the targets. Lesioning is an alternative to DBS in certain specific cases and can be effective, but it is irreversible, and any untoward effects can be permanent. Because the dose of DBS at the same site can be adjusted down if adverse effects emerge, it is considered to be a potentially safer alternative.

More and more of us are sedentary, spending most of our time indoors. We eat industrial food much altered from its natural sources, and there is reason for concern about how our changed eating habits are affecting our brain activity and our moods. We are deluged by an unprecedented overload of information and stimulation in this age of the Internet, email, mobile phones, and multimedia, all of which favor social isolation and certainly affect our emotional (and physical) health.

e we are gathering scientific evidence for the benefits of living close to nature, not simply for enjoying its beauty or getting spiritual sustenance but for keeping our brains and nervous systems in good working order.

It may seem baffling, but the explanation is simple: the human body was never designed for the modern postindustrial environment.”

I believ

Human beings evolved to thrive in natural environments and in bonded social groups. Few of us today can enjoy such a life and the emotional equilibrium it engenders, but our genetic predisposition for it has not changed.

Possibly, the deterioration of emotional well-being characteristic of contemporary urban life represents a cumulative effect of lifestyle changes that have been occurring over many years, an effect that is now suddenly obvious.

Not only do we suffer from nature deficit, we are experiencing information surfeit. Many people today spend much of their waking time surfing the Internet, texting and talking on mobile phones, attending to email, watching television, and being stimulated by other new media—experiences never available until now.

The allure of synthetic entertainment—television, the Internet—is eerily reminiscent of the false promise of industrial food. It seems like a distillation of the good aspects of a social life, always entertaining yet easy to abandon when it becomes tedious or challenging. But, like junk food, it is ultimately unsatisfying and potentially harmful. Our brains, genetically adapted to help us negotiate a successful course through complex, changing, and often hazardous natural environments, are suddenly confronted with an overload of information and stimulation independent of physical reality.