“Your body is the life force power of some fifty trillion molecular geniuses [cells]. You and you alone choose moment by moment who and how you want to be in the world. I encourage you to pay attention to what is going on in your brain.”

Jill Bolte Taylor, PhD teaches us what to pay attention to by telling the story of her experience having a stroke. She vividly describes sensory losses, and cognitive impairments like losing the ability to read and do math. But with determination and good care she’s recovered so well she’s capable of writing a compelling autobiography. That story is now available.

“I take you on a very unusual journey into the step-by-step deterioration of my cognitive abilities, as viewed through the eyes of a scientist. As the hemorrhage in my brain grew
larger and larger, I relate the cognitive deficits I was experiencing to the underlying biology. As a neuroanatomist, I must say that I learned as much about my brain and how it functions during that stroke, as I had in all my years of academia.”

My Stroke of Insight: A Brain Scientist’s Personal Journey is an amazing recount of how she learned to live without abilities of her left hemisphere, and peace she found on the right. “Turn to the right” became a reminder to tap into those right hemispheric perceptions, to feel “fluid” and temporally still, as she regained cognitive skills like reading. Basic lessons relearned tempered with her academics gave her unusual insight into the brain’s processes. In My Stoke of Insight, she explains “simple science” that makes the book accessible to a wide audience, but without skimping on important details.

Stroke patients and their caregivers will benefit from this book, with tips on treatment and considerations for the person now in an “infant” state. With detailed depictions of her symptoms as she experienced a stroke, this book will teach all readers the warning signs in an amazing memoir likely to stay in memory.

She also passes along a catchy phone number to remember: 1-800-BrainBank, and the lyrics to a jingle she wrote and performed as its spokesperson, the Singin’ Scientist. Call!

Read more.

Back in the earlier days of psychotherapy, dream interpretation was an important focus of treatment. Those visions were explored as windows into the unconscious and the symbolic content containted the secrets to a deeper understanding of self and the keys to a improved life. But times have changed, and anyone interested in dream work now has to dig through a list hacks and para-professionals to find a credible therapist who does it. This weekend, the Washington Post published an interesting piece on the current state of dream interpretation, which covers the diversity of the technique from classic analysis to TV interpretation.

Still, there is bias against dreaming, agrees Clara Hill, a professor in the Psychology Department at the University of Maryland. Some of the bias comes from a lack of understanding dreamwork, particularly the aspects that sound a little paranormal.

I’ve never been a fan of dream interpretation, have never made it part of my work, and it has become less accepted in the current Evidence Based Practice movement. However, I do have colleagues that do a limited form of it and say that with the right client it can be a very powerful tool. Overall, I think that if the mix of therapist, client, and content are right, then it can certainly be helpful a helpful part of therapy.

Jane Pauley, who has bipolar disorder and is a passionate mental health advocate, is suing the New York Times for using her image in an advertising supplement for drug companies rather than what she believed would be an article on mental health issues.

Claiming that The New York Times duped her into granting an interview for what turned out to be a drug company-funded advertising supplement, Jane Pauley has sued the newspaper for fraud. In a lawsuit filed Tuesday in U.S. District Court, the 55-year-old broadcaster charges that she believed that the Times interview was for a news article on mental health issues, but that the story (accompanied by a full-page photo) ran in an October 2005 “special advertising supplement” promoting psychotherapeutic drugs sold by Eli Lilly and other pharmaceutical firms. Pauley, who in September 2004 disclosed her battle with bipolar disorder, alleges that the Times “duped” her into lending her name to its advertising gambit, according to the lawsuit.

The Smoking Gun has published the full legal document filed in the suit online; read more.

According to a news report today, in 2008, the U.S. government will publish a list of guidelines for phsyical exercise. Everyone knows that obesity is a growing problem in the country, as is a reduction in physical activity, and officials are hoping that a government intervention similar to the food pyramid will help slow or reverse the trend. The government already has several publications on exercise, but this one (like the food pyramid) will be updated regularly as scientific discovery continues.

The government already makes recommendations about exercise. The new pyramid, for example, recommends 30 minutes of daily physical activity, says 60 minutes is needed to prevent weight gain and 90 minutes may be needed to sustain weight loss. The surgeon general issued a report in the mid 1990s that contained recommendations on exercise. Officials said the new guidelines, however, would establish a process where the best science on physical activity would be routinely evaluated.

Overall, I definitely support a large policy statement on physical exercise, but I struggle to understand how it will have much of an effect on public behavior. It may raise awareness and give people easily accessible guidelines, but the motivation to change one’s lifestyle still has to occur, and an exercise pyramid will not be the answer.

According to researchers at The Australian National University in Canberra, spending time on therapeutic and educational web sites may be just as effective as regular visits to the psychotherapist.

Researchers studied a group of patients who were referred to two web sites: The MoodGYM and education site BluePages. The MoodGYM is a cognitive behavior therapy site dedicated to preventing depression by helping users to identify and overcome difficult emotions, and showing them how to develop good coping skills, in order to improve their mental health. BluePages is a depression education site, providing information about the symptoms of and treatments for depression.

After 12 months, users of both web sites reported improvement. Interestingly enough, the educational site BluePages proved to be more effective than the behavior-therapy site. BluePages users appeared “less likely to use actions that did not have an evidence basis,” researcher Helen Christensen said.

Perhaps the results are really have been shown to be the most effective means of treating depression. DeVries also believes willingness to use the web sites shows the kind of initiative needed to successfully treat depression. Someone who is visiting an educational site like BluePages is taking the necessary steps with their own self-care, which is a crucial step in successful treatment.

The researchers believe that the results indicate that Internet-based strategies—educational and therapeutic—can be as effective as in-office treatment. If that is the case, educational and treatment-focused sites could become useful tools in treating people in remote or rural areas for whom access to professional help is problematic. While it can’t replace individual psychotherapy or medication in all instances, the study does show that sites dedicated to education and treatment can be a valuable tool.

A team of New York scientists has found that clinically depressed people may have abnormalities in a region of the brain that regulates pleasure and reward - and the finding could ultimately lead to novel ways to treat the disease.

Dr. David Silbersweig and his colleagues at Weill Cornell Medical Center brought 22 people into the research laboratory to undergo brain scans while watching words come up on a monitor. Some words were positive, some negative and others neutral. The aim was to see if the depressed brain looked different in the region that governs reward when reading these words.

The results show that indeed it does. The scientists tested 10 depressed people who had not yet received treatment and 12 volunteers with no history of mental illness. One key characteristic of depression is that patients have a very hard time motivating themselves and enjoying things that once made them feel good. The brain scan measured blood oxygen changes in active brain regions. The color-coded statistical images allowed the researchers to determine which areas were most active in response to emotion-laden words.

The scientists found that the brains of non-depressed volunteers responded differently to positive and negative words, particularly in an area called the ventral striatum, a key reward center of the brain. Positive words like ‘rejoice’ and ’success’ triggered more activity in this region than negative words like ‘damaged’ and ‘useless’ or the neutral words. By comparison, those with depression had decreased activity in this brain region when reading the positive words. Silbersweig said that this finding, published in the latest issue of the American Journal of Psychiatry, suggests that the reward area is not reacting to positive stimuli in depressed people. The team also identified another region that differed in those diagnosed with depression: an area in the front of the brain that regulates self-awareness of emotion.

The SAMHSA Resource Center to Address Discrimination and Stigma (ADS Center) has produced a new fact sheet on mental health in the workplace. Mental Health, It’s Part of our Lives at Work details ways to disclose to an employer, risks and benefits and more. It provides links to American legal resources, and more information on employment issues.

Depression costs the economy 70 billion annually, according to The Wall Street Journal, and one in five in the office is vulnerable to some form of mental illness. I suggest you print a few extra copies of the PDF and leave them in the lunchroom. You are not alone; information helps all involved.

SAMHSA also offers free teleconferences, not online, but audio recordings archived for replay via a toll free number in the United States only (1-888-844-1786). They include more in-depth topics like Self-disclosure: The Public and Personal Effects of Revealing Mental Health Problems, Overcoming Barriers and the Stigma Associated With Mental Illness In Rural Communities, Transition to Adulthood: Strategies for Overcoming Stigma and Achieving Positive Outcomes for Young Adults, and many others geared specifically to groups such as older adults, African-Americans, Asian-Americans, and more, including culturally diverse American communities.

The fact sheet has relevance to workers in the rest of the world, too.

Direct download PDF.

A team of international scientists announced this week that it has found that embryonic stem cells may have potential use in the treatment of psychological disorders. The experiments conducted rodents showed that stem cells may offer a cure disorders such as depression, and potentially schizophrenia. Investment by the US National Institute of Health in this area could significantly speed up the research, which is currently delayed because of lack of political support by President Bush.

Drs. Miles Cunningham and Kim Kwang-soo at Harvard Medical School and Professor Kim Dong-wook at Yonsei University differentiated embryonic stem cells into nerve cells generating dopamine and serotonin and devised a model of psychiatric disease for applying the technology. The eighty animals involved in the experiment behaved as if they had taken anti-depressant medication.

Dopamine and serotonin are well-known neurotransmitters, or the chemicals playing a key role in relaying, amplifying and modulating electrical signals between brain cells - and which are known to also play a role in schizophrenia.

More experiments are progress, but it will take a long time to apply them to human beings.

A new initiative encouraging employers to improve the way they deal with mental health in the workplace has been launched by UK Health Minister Rosie Winterton.

The three year initiative, called ‘Action on Stigma’, urges employers to sign up to a set of anti-stigma principles - for example, demonstrating that they have made changes in their work environment and employment practices to ensure that people with mental health problems are treated fairly and equally with others.

Many employers who have taken part in projects to make their workplace culture more ‘mental health friendly’ have reported reduced staff turnover and sickness absences. Despite this:

Only about 20% of people with severe mental health problems are employed, compared to 65% of people with physical health problems and 75% for the whole adult population

Even for people with more common types of mental illness, such as depression, only about half are competitively employed

However, people with mental health problems have the highest ‘want to work rate’ with up to 90% wanting to work, compared to 52% for disabled people generally.

Although some of the principles are voluntary, adopting them will help public sector organisations, including local councils, government departments and hospitals, to meet the requirements of a new duty under the Disability Discrimination Act which comes into force in December 2006. This will require them to set out precisely how they intend to eliminate unlawful discrimination and promote equality of opportunity.

Anxiety disorders appear to be independently associated with several physical conditions, including thyroid disease, respiratory disease, arthritis and migraine headaches. Although depression has long been linked to physical illness, evidence supporting an association between anxiety disorders and physical health problems is more recent.

Anxiety disorders include panic disorder, agoraphobia, social phobia and obsessive-compulsive disorder. Studies have found that those with phobic anxiety may be more likely to experience sudden cardiac death, and rates of anxiety disorders are higher than expected in patients with thyroid disease, cancer, hypertension and several other conditions.

Dr. Jitender Sareen, from the University of Manitoba, Winnipeg, Canada, and colleagues explored the association between anxiety disorders and physical conditions in 4,181 adults who were part of the German Health Survey (GHS), conducted between 1997 and 1999. The survey assessed whether participants had any physical illnesses through a questionnaire asking about 44 particular conditions, a medical interview conducted by a primary care physician, blood pressure measurements and blood and urine samples. Psychiatric interviews were conducted by a psychologist or physician, who used criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to detect anxiety disorders. A quality of life survey—which measured factors such as physical functioning, pain and general health—was also administered, and to determine disability levels participants reported how many days of the past 30 they were unable to perform their usual daily activities.

Though the mechanisms of association between anxiety disorders and physical conditions remain unknown, several possibilities should be considered, according to the researchers. For example, the presence of an illness may cause worry and anxiety that eventually becomes serious enough to qualify as an anxiety disorder, the presence of an anxiety disorders could trigger biological processes that contribute to illness or a third condition, such as a substance abuse disorder, could be linked to both.

The other day Jennifer wrote about engineering autism, including, “even environmental factors such as television watching could play a role in child developing autism.” A new research study finds a relationship.

Cornell scientists compared data sets including demographics, climate, TV viewing. They linked more rainfall to increased television viewing, and:

Michael Waldman, a professor of economics at Cornell’s Johnson Graduate School of Management and a co-author of the research paper, said, “The analysis shows that early childhood television viewing could be an environmental trigger for the onset of autism and strongly points to the need for more research by experts in the field of autism.”

Thirty years ago, it was estimated that roughly one in 2,500 children had autism, while today some estimate that number to have increased more than tenfold, to as high as one in 166. At the same time, television viewing has increased dramatically due to easy access to cable and satellite television, more traditional broadcast offerings and the market penetration of VCRs and DVDs.

…current school-aged children who live in California, Oregon, and Washington counties that received large amounts of rain and snow when the children were young are more likely to be diagnosed with autism. Furthermore, children who grew up in California and Pennsylvania counties during the 1970s and 80s with high cable subscription rates were also more likely to be diagnosed with autism. These analyses control for differences between counties in income, population, and demographic mix - other factors that may influence the autism rate - and also examine changes in county autism rates over time as well as differences at a point in time.

“Our analysis is not definitive, but it certainly raises questions that seem to have gone unasked in autism research to date,” added Sean Nicholson, an associate professor of policy analysis and management in Cornell’s College of Human Ecology. “The medical community is increasingly convinced that something is happening in the environment that triggers an underlying biological or genetic predisposition toward autism, and these findings strongly support the need for taking a closer look at early childhood television viewing.”

They don’t, unfortunately, suggest how television would have this effect or analyze programming.

Read more
Full research report (pdf)
Via The Neurophilosopher.

This story from Reuters that covers new research on public perceptions of appropriate mental health treatment. Specifically, the focus of the article is on endorsement rates by the public for biological or nonbiological treatments for a variety of mental disorders. Beliefs about appropriateness of medication was very high for depression (75%) and schizophrenia (85%), and somewhat lower for substance-related disorders (44%). Overall, more people found it appropriate to seek a nonbiological intervention (talking to family, seeing a therapist, etc) than medication. Wouldn’t a more eye-grabbing headline have been “Study: Americans Favor Talking Over Medication for Mental Disorders”? Instead the tone is directed toward those percentages being troubling because the rates of biological treatment appropriateness weren’t higher.

“”The majority of the lay public does recognize the need to seek formal (particularly biologically focused) treatment for depression and schizophrenia,” the researchers write. “However, the public is far more reluctant to endorse biologically focused treatments for substance abuse.” Informing people about the biological roots of such problems may help broaden acceptance for this type of treatment, they conclude.”

It is interesting to me when bias shows up so obviously in these stories. The entire article could’ve been written from a perspective that talking with friends, attending psychotherapy, and having discussions with clergy are highly endorsed and effective methods of help-seeking and treatment for people struggling with psychological problems. Instead the focus is on why more people don’t think medication is appropriate. The overarching issue really is the belief that these disorders are caused 100% by biological factors, and that any environmental or psychological factors are unimportant, which to me is dismissing half of the equation.