Recovery Michigan

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Since the 1970s, hundreds of studies have suggested that each hemisphere of the brain is home to a specific type of emotion. Emotions linked to approaching and engaging with the world – like happiness, pride and anger – lives in the left side of the brain, while emotions associated with avoidance – like disgust and fear – are housed in the right.

But those studies were done almost exclusively on right-handed people. That simple fact has given us a skewed understanding of how emotion works in the brain, according to Daniel Casasanto, associate professor of human development and psychology at Cornell University.

According to the new theory, called the “sword and shield hypothesis,” the way we perform actions with our hands determines how emotions are organized in our brains. Sword fighters of old would wield their swords in their dominant hand to attack the enemy — an approach action — and raise their shields with their non-dominant hand to fend off attack — an avoidance action. Consistent with these action habits, results show that approach emotions depend on the hemisphere of the brain that controls the dominant “sword” hand, and avoidance emotions on the hemisphere that controls the non-dominant “shield” hand.

The work has implications for a current treatment for recalcitrant anxiety and depression called neural therapy. Similar to the technique used in the study and approved by the Food and Drug Administration, it involves a mild electrical stimulation or a magnetic stimulation to the left side of the brain, to encourage approach-related emotions.

I became an early riser over the time I made my major recovery from depression. Doubt it is cause and effect. But resetting your sleep cycle is an important part of managing depression...

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"Our results show a modest link between chronotype and depression risk," notes lead study author Céline Vetter. "This," she adds, "could be related to the overlap in genetic pathways associated with chronotype and mood."

This is the biggest and most thorough study into the link between mood disorders and chronotype conducted to date. The team's findings are reported in the Journal of Psychiatric Research.

Vetter and team allowed for the impact of environmental factors, such as exposure to light and work schedule, on a person's sleep-wake cycle. Other risk factors for depression — including weight, level of physical activity, existing chronic diseases, and sleep duration — were also accounted for.

First, the researchers' analysis revealed that late sleepers/late risers are more likely to live on their own and less likely to be married, as well as more likely to have a smoking habit and to report irregular sleep patterns.

Then, even after accounting for possible modifying factors, the team saw that "early birds" had a 12–27 percent lower risk of depression than "intermediate type" participants.

Also, "night owls" had a 6 percent higher risk of developing this mood disorder than "intermediate types," though it should be noted that this risk increase is so mild it cannot be considered statistically significant.

According to Vetter, "This tells us that there might be an effect of chronotype on depression risk that is not driven by environmental and lifestyle factors."

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Never in my long years of alcoholic drinking, not even after this terrible incident in which I could easily have cost someone else their life, did I ever consider that I was an alcoholic. This is in large part because the diagnosis — self, social, or professional — focuses on alcohol rather than actual symptoms. This would be like diagnosing diabetes by determining how many doughnuts you ate today. Stupid, right? But it’s exactly why there are countless untreated, suffering alcoholics and addicts, and why those afflicted by the disease try for years to convince themselves and their family and friends they don’t have it. After my accident I didn’t think alcohol was my problem, but my choices, and it wasn’t until seven years later that I walked into my first A.A. meeting, surprised to learn that alcohol is not actually what defines an alcoholic. 

I had even taken those online tests to determine if I was one. Though I cheated a little, it was easy to tell myself that I wasn’t really one because none of the standards were objective, nor helpful, and each suggestion or question originated from some violation of social standards rather than tangible symptoms. Because all the questions were about alcohol, they were not about the symptoms of alcoholism. A person can get totally blackout drunk on a weeknight and still not be an alcoholic, where another person (such as a friend of mine who died at the age of thirty-four) can be an alcoholic drinking just one or two beers every day, never getting wasted or driving while intoxicated.

If you believe or suspect you are an alcoholic, do not worry, getting sober was far easier than anything I ever did while drinking, and I didn’t have to give up a single thing of value to get it. One of the biggest hesitations for many people in getting sober is the fear that we will no longer be a part of life to the degree we think we are with a cocktail in hand, but I have had more fun and satisfaction without alcohol than I ever did with it. Even better, I am now able to avoid people who don’t have my best interests in mind, and am freed of the emotional chains associated with the disease that made life so perplexing and frustrating. It’s important to know that if you are an alcoholic or addict, that treatment centers are often presented as professional or expert in diagnosing and treating these conditions, but there is no regulatory agency for recovery centers and they are often owned and operated only by other addicts, and many centers are predatory at worst or misguided at best, and centers are more often used by alcoholics and addicts as a refuge from their disease which usually leads to relapse once rejoining society. My personal recommendations for therapy and description and treatment of the disease is outlined in my book or in my article, The Cure for Alcoholism and Addiction.

5 SIGNS YOU’RE ALCOHOLIC (OR AN ADDICT)

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Chronic social isolation has debilitating effects on mental health in mammals–for example, it is often associated with depression and post-traumatic stress disorder in humans. Now, a team of Caltech researchers has discovered that social isolation causes the build-up of a particular chemical in the brain, and that blocking this chemical eliminates the negative effects of isolation. The work has potential applications for treating mental health disorders in humans.

The work, led by postdoctoral scholar Moriel Zelikowsky, was done in the laboratory of David J. Anderson, Seymour Benzer Professor of Biology, Tianqiao and Chrissy Chen Leadership Chair, Howard Hughes Medical Institute Investigator, and director of the Tianqiao and Chrissy Chen Institute for Neuroscience. A paper describing the research appears in the May 17 issue of the journal Cell.

Confirming and extending previous observations, the researchers showed that prolonged social isolation leads to a broad array of behavioral changes in mice. These include increased aggressiveness towards unfamiliar mice, persistent fear, and hypersensitivity to threatening stimuli. For example, when encountering a threatening stimulus, mice that have been socially isolated remain frozen in place long after the threat has passed, whereas normal mice stop freezing soon after the threat is removed. These effects are seen when mice are subjected to two weeks of social isolation, but not to short-term social isolation–24 hours–suggesting that the observed changes in aggression and fear responses require chronic isolation.

“Humans have an analogous Tac2 signaling system, implying possible clinical translations of this work,” says Zelikowsky. “When looking at the treatment of mental health disorders, we traditionally focus on targeting broad neurotransmitter systems like serotonin and dopamine that circulate widely throughout the brain. Manipulating these systems broadly can lead to unwanted side effects. So, being able to precisely and locally modify a neuropeptide like Tac2 is a promising approach to mental health treatments.”

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Deep-seated fears, like the memory of a death or war-time trauma, can be crippling. They’re also notoriously hard to study and treat, says neuroscientist Ossama Khalaf, Ph.D. But finally, we’re making progress. In a Science paper published Thursday, Khalaf and his team show new evidence suggesting fearful memories that dwell deep in the brain’s neural circuitry don’t have to be a burden forever. It’s possible, the paper suggests, that they can be rewired.

The paper is rooted in the science of engrams — the idea that memories leave a physical trace in the brain. In this case, Khalaf, a researcher at École Polytechnique Fédérale de Lausanne, and his team traced deep-seated memories of fear of fear of fear of fear in rats back to the activity of specific neurons. They found that the way those neurons fire — and thus the fearful memory they encode — can be reprogrammed.

“In our study, we are providing the first experimental evidence that fear memory attenuation is mediated by the re-engagement of the original fear rewriting it towards safety,” Khalaf tells Inverse via email.

First, Khalaf and his team wanted to know what types of neurons fire when a deep-seated trauma — maybe a memory of a near-death experience — is remembered. They did this by traumatizing rats by repeatedly putting them in a box where they received mild electric shocks to their feet. Unsurprisingly, the rats eventually learned to fear the box — the experimental equivalent to a human having a deep-seated fear memory. Looking at the rat brains showed that these fears were associated with a specific pattern of neuron firing.

Then, they tried to rewrite those memories.

I personally had particular trouble with neurontin when I took it for shingles pain....

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More than a third of American adults use medications that list depression as a risk, and a quarter use drugs that increase the risk of suicide.

The recent suicides of celebrities Anthony Bourdain and Kate Spade have prompted many of us to look more closely at what may drive people to depression or to end their own lives.

One risk factor has gotten little attention in this discussion: the medications people take.

More than a third of American adults are using medications that have the potential to increase their risk of depression, a study published this week in JAMA finds, and nearly a quarter use medications that have suicidal symptoms as side effects.

The 203 drugs the researchers identified aren’t obscure; they include some of the most commonly prescribed medications around — like birth control, beta blockers for high blood pressure, and proton pump inhibitors for acid reflux. (You can see the full list at the end of this article.)

Strikingly, the researchers from the University of Illinois and Columbia University discovered, people using these drugs had an elevated risk of depression compared to the general population. And the more medications with depression as a side effect people took, the more their risk of the disease increased.

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Stewart is 49 years old. He has long silver hair and an eighth-grade education. For the past four years, he has taken large amounts of prescription opioids, ever since a surgery to replace his left hip, ruined by decades of trucking, left him with nerve damage. In the time since, his life buckled. First he lost his job. Then his house, forcing a move across the state to this trailer park. Then began a monthly drive of 367 miles, back to his old pain clinic, for an opioid prescription that no doctor nearby would write.

“It’s 10 after,” reminded Tyra Mauch, his partner of 27 years, watching him limp over to her.

“Got to go,” he said, nodding.

He hugged her for a long moment, outside the bathroom with the missing door, head full of anxiety. He knew what awaited him on the other side of the drive. Another impossibly difficult conversation with his provider, who, scared by the rising number of opioid prescribers facing criminal prosecution, would soon close the pain clinic. Another cut in his dosage in preparation for that day. More thoughts of the Glock.

The story of prescription opioids in America today is not only one of addiction, overdoses and the crimes they have wrought, but also the story of pain patients like Kenyon Stewart and their increasingly desperate struggles to secure the medication. After decades of explosive growth, the annual volume of prescription opioids shrank 29 percent between 2011 and 2017, even as the number of overdose deaths has climbed ever higher, according to the IQVIA Institute for Human Data Science, which collects data for federal agencies. The drop in prescriptions has been greater still for patients receiving high doses, most of whom have chronic pain.

The correction has been so rapid, and so excruciating for some patients, that a growing number of doctors, health experts and patient advocates are expressing alarm that the race to end one crisis may be inadvertently creating another.

“I am seeing many people who are being harmed by these sometimes draconian actions amid this headstrong rush into finding a simple solution to this incredibly complicated problem,” said Sean Mackey, the chief of Stanford University’s Division of Pain Medicine. “I do worry about the unintended consequences.”

Chronic pain patients, such as Stewart, are driving extraordinary distances to find or continue seeing doctors. They are flying across the country to fill prescriptions. Some have turned to unregulated alternatives such as kratom, which the Drug Enforcement Administration warns could cause dependence and psychotic symptoms. And yet others are threatening suicide on social media, and have even followed through, as doctors taper pain medication in a massive undertaking that Stefan Kertesz, a professor at the University of Alabama at Birmingham who studies addiction and opioids, described as “having no precedent in the history of medicine.”

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Solving homelessness doesn't just mean finding someone a physical home. A program in New Haven, Connecticut, focuses on helping people see themselves as members of their communities—as citizens.

Twenty years ago, Jim lived under a highway bridge in New Haven, Connecticut. He was in his 50s and had once been in the Army.

After an honorable discharge, he bounced from one job to another, drank too much, became estranged from his family, and finally ended up homeless. A New Haven mental health outreach team found him one morning sleeping under the bridge. His neon yellow sneakers stuck out from underneath his blankets.

The team tried for months to get Jim to accept psychiatric services. Finally, one day, he relented. The outreach workers quickly helped him get disability benefits, connected him to a psychiatrist and got him a decent apartment.

But two weeks later, safe in the apartment, Jim said he wanted to go live under the bridge again. He was more comfortable there, where he knew people and felt like he belonged, he said. In his apartment he was cut off from everything.

As researchers in mental health and criminal justice at Wesleyan and Yale universities, we have been studying homeless populations in New Haven for the past 20 years. In that moment, when Jim said he wanted to leave what we considered the safety of an apartment, the outreach team, which co-author Michael Rowe ran, realized that, while we were capable of physically ending a person’s homelessness, assisting that person in finding a true home was a more complicated challenge.

Helping the most marginalized people in society feel comfortable in a new and alien environment, where they were isolated from their peers, required a different approach that went beyond finding them a place to live.

The people we worked with needed to see themselves—and be seen as—full members of their neighborhoods and communities. They needed, in other words, to be citizens.

http://bit.ly/2HI9ycU

'Enhanced funding' available for treating neonatal abstinence, tracking prescriptions.

New guidance on Medicaid-funded tools for treating opioid use disorders and preventing abuse in the first place was announced Monday by the Centers for Medicare and Medicaid Services.

In materials aimed at state Medicaid directors, CMS's Timothy Hill, acting director of the Center for Medicaid and CHIP Services, outlined the program's support for treatments related to neonatal abstinence syndrome or NAS (including treatment for infants' opioid-using parents) and for technologies related to opioid prescription monitoring and telemedicine.

In a press release, CMS noted that 80% of all NAS treatment nationally is funded by Medicaid.

Not only is the infants' treatment covered, Hill noted, but "states may also seek to cover initial or ongoing SUD [substance use disorder] treatment services for Medicaid-eligible mothers and/or fathers concurrently with NAS treatment services directed at the infant."

Treating the parents maximizes the likelihood of successful infant treatment, he said.

"Through discussions with states, we have recognized their growing challenge in providing treatment services to the expanding number of infants with NAS," Hill said. "We have also recognized that states may not be fully aware of available options under Medicaid that can play a critical role in the care of these infants, as well as the limitations on Medicaid coverage."

In the second initiative, CMS highlighted "enhanced funding" available to states through Medicaid in developing "innovative substance abuse treatment" in areas with shortages of treatment providers -- including "virtual treatment centers" and "remote counseling" provided via telemedicine.

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“Opioid crisis” has become a catchphrase in the United States. The word crisis points to the panic that authorities in government and law enforcement feel about the situation — panic that seems to be spurring a fevered response to the issue.

A recent New York Times investigation looked at the fervor that has seized prosecutors around the country attempting to do their part to address the problem — by bringing homicide charges against the friends, family, and fellow users of people who die by overdose.

“I look at it in a real micro way,” Pete Orput, the chief prosecutor in Washington County outside Minneapolis, told the reporter, Rosa Goldensohn. “You owe me for that dead kid.”

Goldensohn wrote:

As overdose deaths mount, prosecutors are increasingly treating them as homicide scenes and looking to hold someone criminally accountable. Using laws devised to go after drug dealers, they are charging friends, partners and siblings. The accused include young people who shared drugs at a party and a son who gave his mother heroin after her pain medication had been cut off. Many are fellow users, themselves struggling with addiction.

Goldensohn (who goes by Rosie) spent nearly a year exploring this issue, in several states around the country. Longreads spoke to her and her editor, Shaila Dewan, about the investigation and how it came together.