Hallucinogens, starvation, and magnets: A new cure for depression?

What do hallucinogens, starvation and magnets all have in common? No, they’re not the key ingredients for a wild and crazy weekend; they are all potential alternative treatments for depression that are being explored by researchers and clinicians alike.

Scientists have long known that the serotonin theory of depression is imperfect, yet few treatment options are available beyond the standard course of cognitive-behavioral therapy and selective serotonin reuptake inhibitors (SSRIs). In my new piece for Pacific Standard, I explore recent research that has emerged looking at some potential alternatives for depression that are rather… unconventional.

This includes giving people psilocybin, the active ingredient in so-called “magic” mushrooms, which also boosts serotonin levels and crucially taps into the amygdala, the brain’s major emotional center. Another possible avenue involves boosting ghrelin levels in the brain, a hunger hormone that may also play a role in protecting neurons from the destructive effects of stress, particularly in the hippocampus. Alternatively, using high-powered magnets, researchers and clinicians are able to activate certain key parts of the brain that can potentially lead to a suppression of other over-active emotional regions, turning down our feelings of anxiety or depression.

While none of these options is perfect, they do provide an encouraging new perspective, thinking outside the box to treat this condition that will afflict at least one in ten of us at some point in our lives.

You can check out the full story in Pacific Standard here.

Instant gratification as a way out of addiction?

Impulsivity is often seen as a hallmark of addiction — acting without thinking about the consequences of your actions and valuing the immediate reward of a drug-induced high over the future long-term payout of a healthy lifestyle. This type of delay discounting has been linked to a greater risk for drug addiction, but new research suggests that this type of “myopia for the future” may also improve someone’s chances of staying sober when they’re trying to get clean.

My latest piece for The Fix investigates the research behind this paradox, which suggests that those who are the most impulsive have the most to gain from effective treatment, cognitive training successfully improving their self-control. But is this effect a result of the treatment program itself or just a regression to the mean? Check out the article here to find out.

Can synesthesia in autism lead to savantism?

I’ve got a new piece out on the Scientific American MIND blog network today on the fascinating link that’s been discovered between synesthesia – a “crossing of the senses” where one perceptual experience is tied to another, like experiencing sound and color together – and autism spectrum disorder.

Individuals with autism have significantly higher rates of synesthesia than the rest of the population, and the two are potentially linked by a unique way in which the brain is wired. White matter tracts that traverse our brains, connecting one area to another, are thought to be increased in both conditions. This results in an abnormal wiring of the brain that may lead in more close-range connections, but fewer long-distance ones. And it’s possible that these extra connections may also contribute to some of the extraordinary cognitive abilities seen in some autistic individuals with savant syndrome.

For more on the story, check out the full piece on here.

Drug use, decision-making and the blunders of Rob Ford

I’ve got a new piece in The Guardian today on the unfolding debacle that is Toronto Mayor Rob Ford.

His consistent pattern of bad decision-making – including death threats, drunken driving and public boasts about his sex life – have all the signs of problem drug and alcohol use. Substance-dependent individuals frequently show impairments in decision-making abilities, with difficulties in impulse control and executive function, as well as corresponding abnormalities in relevant brain regions.

However, as Mayor Ford has vehemently denied any accusations of addiction, it could just be incompetence.

Check out the full piece here.

Is this a new tool to diagnose ADHD, or is it just another neuro-scam?

When I was in elementary school, there were two kids in my class who always got “special medicine” at lunchtime. I didn’t understand this at the time, as they never looked sick to me, so I couldn’t comprehend why they would need to take a pill. One day I got up the courage (as only an impertinent seven year-old can) to ask my friend why she needed to take medicine every day, but her answer just confused me even more. She said that without the pill she would get too energetic and be unable to concentrate in class. But this didn’t make sense, as I knew that I often got quite excited and would sometimes talk out of turn, but I certainly didn’t need to take any medicine for this!

Flash forward twelve years, and in college nearly all of my friends were regularly taking Adderall to help them study for exams, whether they were prescribed it or not.

Diagnoses of ADHD have skyrocketed over the last decade, rising 66% in the U.S. since 2000. As with the majority of psychiatric disorders, a diagnosis cannot be determined by a physical exam or empirical test, but is instead made using subjective self-reports provided by the parents, teachers and child himself. The doctor or psychiatrist then matches these descriptions to the clinical symptoms listed in the DSM – the Diagnostic and Statistical Manual of Mental Disorders – comparing them to her own observations and makes a decision accordingly. This means that diagnoses of ADHD can be highly subjective and, unfortunately, potentially easy to fake.

However, a new development is attempting to change this by using a physical test to look for signs of ADHD in an individual’s brain patterns.

The Food and Drug Administration recently approved a device that uses electroencephalogram, or EEG, to help diagnose ADHD. EEG measures electrical activity in the brain from the firing of neuronal cells. Different voltages, or different magnitudes of this signal, designate different types of brain waves, which can provide insight into the brain’s current activity. Researchers believe that the ratio between two types of these signals – beta and theta waves – may help better predict the presence of ADHD when combined with standard subjective assessments.

Both of these rhythms are involved in arousal, but in different capacities. Theta waves are most commonly seen during voluntary movements and are associated with an active readiness state. In fact, some studies have shown the presence of theta waves before a movement has even begun, suggesting that they play a role in initiating action. Conversely, beta waves are more associated with alertness and concentration, as well as with the inhibition of movements. They are the most common type of electrical signal present while we are awake.

Children with ADHD have been shown to have a higher ratio of theta-to-beta waves, potentially implicated in their hyper-active and hypo-attentive state. By measuring the ratio of theta and beta rhythms, researchers hope to provide a more empirical test of abnormal brain function in children suspected to have ADHD. Sensitivity using this tool – the percentage of children who are diagnosed with ADHD and show these abnormal brain patterns – has been estimated at 95%, while specificity – the percentage of children without ADHD who don’t shows these patterns – is around 90%.

However, others have refuted this claim, saying that EEGs provide no better assessment of ADHD than the current subjective symptom reports already used. Instead, they argue, selling high-tech machines to measure brain waves is just an easy way to make money off of concerned clinicians and parents, but without providing any more valuable information.

Additionally, as is always the case in psychiatry, there are some children with a subtype of ADHD who markedly differ from the expected patterns. Some show increased beta waves, while others have increased alpha waves or some different ratio of these three rhythms.

However, just because this method isn’t perfect doesn’t necessarily mean we should disregard the data supporting the use of EEG for ADHD and reject this option just yet. EEG may be a useful tool to assist in diagnosing, granted that it’s used in combination with the other currently standard methods, which it must be acknowledged are far from perfect themselves. Instead, a combination of these two imperfect methods may help bring us a little bit closer to a more perfect option.

(Originally posted on Mind Read)

Beating the odds of addiction

An article I wrote for The Psychologist magazine based on my thesis research investigating risk and protective factors in drug dependence was published online this week.

This work all stems from a question I (and countless others in the field) have of why some people are able to use illicit drugs without becoming dependent, while others seem to quickly succumb to addiction.

While we’re still far from answering this question definitively, my lab at Cambridge, headed by Dr. Karen Ersche, has some theories on why this might be the case.

For example, it appears that there are underlying traits, like impulsivity, compulsivity and sensation-seeking, that can put someone at a greater risk for developing drug dependence. Some of these traits also correspond to differences in brain structure and function, such as smaller frontal cortex volume potentially making it harder for people to stop or inhibit a behavior.

If you’re interested in reading more, a full link to the article is here (the magazine kindly made it available open access). So please check it out, and as always I welcome any questions or feedback!

An unconventional treatment for depression: Sleep deprivation

I watched a good ‘psychological thriller’ the other night – Side Effects by Steven Soderbergh – that centers on a woman’s debilitating depression and critiques the pharmaceutical industry’s untoward influence over clinicians (it turns into a plot-twisty crime thriller, but that’s beside the point). The film got me thinking about our reliance on psychotropic medications to treat psychological distress, and how helpless we are when these pills don’t work.

I’ve written before on the over-medicalization of psychiatric disorders and the pharmaceutical industry’s role in this controversy, but this time the topic got me thinking about possible alternative treatments for depression, other than cognitive-behavioral therapy or mood-altering medications.

One innovative method for treating depression that has received attention is sleep deprivation. Acute sleep deprivation has been touted as having a 60% success rate in immediate relief from depression; however, this effect is temporary, only lasting until you finally do nod off.

At first this might seem surprising, after all, think about how cranky and irritable you feel after a poor night of sleep. But complete deprivation (i.e. missing an entire night’s sleep, or more than 12 hours) can actually have the opposite effect. Remember that loopy, giggly, hysterical feeling you used to get staying up all night at a sleepover, or at 5am in the library while studying for exams? It is believed that this phenomenon is at least partially caused by an alteration in activation and connectivity in our frontal cortex, potentially offsetting the harmful effects chronic depression can have on this area.

It is still relatively unknown how or why exactly this works though. A recent study from Tuft’s University attempted to answer this question by testing sleep deprivation and its efficacy as an anti-depressant in depressed mice. First, researchers confirmed that depressed animals who were sleep-deprived for 12 hours displayed significantly less depressive symptoms than control depressed mice. Then, for the first time, they were able to link this effect to the activation of a certain type of brain cell, astrocytes, that release a particular protein, adenosine.

Adenosine is important in sleep regulation, and its absence has also been implicated in a greater risk for depression. Adenosine release is increased the longer you’re awake (to a point), making you feel less aroused and more tired, and acting as part of your normal sleep-wake cycle. A beneficial side effect of its release now also appears to be an alleviation of depressive symptoms. However, after 72 hours of sleep deprivation there was no change in adenosine levels, as the astrocyte cells had largely shut down by this point. Thus, there was no effect of more extreme sleep deprivation on feelings of depression. Also, as soon as you do catch up on some zzz’s your adenosine levels return to normal and the anti-depressant effects disappear.

Adenosine’s effect on depression potentially works by altering the electrical signals in your brain, causing an immediate change in mood and behavior. Other fast-acting, unconventional treatments for depression, like deep brain stimulation and electro-shock therapy, are thought to work in a similar manner, impacting the brain’s electrical currents. These treatments also last much longer, suggesting that there may be a way to channel adenosine’s electrical effect into a longer-term solution.

I should be clear that I am in no way against using psychotropic medication to treat psychiatric disorders; in fact, in many instances these pills are absolutely essential. But in cases where these medications don’t work, or where their Side Effects are too severe (seriously, go see the movie!), it is important to have well-researched alternatives to the standard course of treatment. Also, it’s always nice to know how to get a good natural high every now and then, if you can stay up that long.

(Originally posted on Mind Read)