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Frontiers of schizophrenia: Fighting hallucinations with hallucinations

The Montreal Gazette writes about a new, fascinating technique for treating schizophrenic hallucinations — virtual reality.

Basically, a patient will tell a researcher what their hallucination looks and sounds like, and the researcher will create a virtual reality, avatar doppleganger.

So if a patient sees a horrifying image and hears scary words, the researcher will try to recreate that image and words.

Once the avatar is created, the patient — when not hallucinating — will learn how to talk back to the avatar and cultivate greater awareness of how the avatar is attacking him.

Initial results are encouraging for treatment-resistant schizophrenia, and the Canadian Institutes of Health Research is funding a six year study, comparing this particular method with CBT (a recent study, I should note, suggests CBT isn’t helpful for schizophrenia).

It’s important to note that medications are still more effective at treating hallucinations and voices, leading to complete remission in many cases. But some patients can’t tolerate the medicine.

The Gazette’s story is anchored by a compelling story from a patient who’s had to deal with it.

The Montreal Gazette:

They popped up out of nowhere, telling Richard Breton how he was nothing, nothing but a bad father, a nasty husband, and had no friends because he was disgusting.

For 30 years the debilitating voices and hallucinations came 15 times a day. His head reverberated with voices shouting the worst scenarios: “The car driving down the road is going to swerve on the sidewalk and smash into you. A bomb will explode, or someone armed with a gun is going to shoot everyone,” he recalled.

Breton, 53, said he’d have done anything to make the demon voices leave him alone. Anything, that is, except increase the anti-psychotic medication prescribed for schizophrenia because the side effects were insufferable. He couldn’t work. It robbed him of energy, motivation and libido. He could barely manage to eat and wash himself, and he trembled, spending the better part of each day in a zombie-like, drug-induced daze.

But today that period of Breton’s life is long over. Breton has returned to school and has been working for two years, and he’s remarried. Also, his doctors reduced the antipsychotic medication to a minimum. Breton says his turnaround is not due to any wonder drug but to a new treatment that fights hallucinations with hallucinations.”=

Me, here.

My heart, and the heart of every Christian, should go out to those afflicted by this disease.

There are still huge swaths of the church that would misinterpret these types of symptoms as “demonic” when, in reality, they can mostly be explained by auditory processing problems in the brain — basically, you are hearing your own voice when you hear “other voices” and the terrible things they’re telling you about yourself? That’s actually your own voice and negativity, but because of the auditory processing problems, you interpret them as someone else’s.

Here’s more on that:

Essentially, the brains of hallucinating patients acted as though they were experiencing a “real” auditory experience. Their brains were generating the “voices or sounds” and they were “hearing” the sounds at the same time! Somehow the patients never made the connection that they were hearing their own voice. The patients believed that the voices were coming from someone else.

…..The actual problem, for the psychology majors in the audience, which was discovered, was an anatomical error within the fiber bundle that connects speech-generating areas in the frontal lobe with auditory cortex in the temporoparietal lobe. Essentially, if you do not know with certainty that you are speaking then you will assume that the voices are talking TO you. Sadly, and sometimes tragically, due to the underlying paranoia that these patients also experience, the voices instruct the patients to do disagreeable tasks.

Imagine the heartbreak of Christians living with schizophrenia who are told that they must “rebuke the devil” to get rid of the voices, or counter this disease with Scripture, when in reality, medical treatment can bring these awful symptoms into remission.

August 8, 2018

The most stressed workers: Women who rely on tips for wages

written by Christian Heinze

A huge new study in the American Journal of Epidemiology finds that women in the service industry whose income is significantly affected by tips are more likely to suffer from poor mental health than workers in any other industry.

The WSJ highlights some of the reasons:

First, women in the service industry (e.g. waitresses) are at the whim of customers. They can never be sure whether the customer will like them and tip well. So it’s hard to relax and say, “Well, at least I’ll make X this week.” Uncertainty is a big risk factor for anxiety. One famous study showed that people would rather be electrically shocked now than wait for a possible shock later. Uncertainty is worse than a shock that might never come.

Second, shift life significantly raises the risk of depression and anxiety. Humans need routine, stability, and the ability to sleep at night (not the day), due to the circadian rhythm and how disruptions can wreak havoc on our mental health.

Third to get more tips, servers have to be constantly bubbly and happy. The dissonance of that is especially difficult if you’re not feeling particularly bubbly and happy. Thus, it’s more likely to exacerbate existing depression.

Fourth, women are much more likely to be sexually harassed than men, and particularly in these industries. Sexual harassment has been linked to increased depression and anxiety.

And fifth, customers have much higher expectations of female servers than male servers. A separate study showed customers demand more of female servers than male servers, and were consistently tipped less for the same perceived customer service.

So Christians, we should tip generously, regardless of the quality of service. In our American mindset, so many people say, “Well, I don’t want to reward bad service,” as if we have a moral duty for “just remuneration.”

Christians never have a moral duty for “just remuneration” because the whole basis of our salvation is Christ’s showing mercy on the really really really bad servers we are.

We’ll be judged by the same standard we judge others, and do we want Christ to treat us for our bad service to him the way we treat servers for bad service?

We have no idea how difficult it is for anyone in life, and if we can afford to tip generously, we should. It’s eternally more important to show Christ than to “show them” for waiting around for that glass of water we desperately need to have a good meal.

This is their life. Their well-being. For us, it’s just a meal. And an opportunity to be loving.

August 6, 2018

Do low levels of acetyl-L-carnitine explain your depression?

written by Christian Heinze

A remarkable new study suggests that individuals with severe, treatment-resistant depression have significantly reduced levels of the molecule, acetyl-L-carnitine.

Prompting the question — will raising those levels help? We don’t yet know whether it’s correlation or causation.

Animal studies have already shown the link.

For example, depressed rodents are much more likely to have low levels of acetyl-L-carnitine, and raising their levels via supplementation restored normal behavior in days.

How?

Animal studies by Carla Nasca, a postdoctoral scholar in McEwen’s lab, suggest that acetyl-L-carnitine, a crucial mediator of fat metabolism and energy production throughout the body, plays a special role in the brain, where it works at least in part by preventing the excessive firing of excitatory nerve cells in brain regions called the hippocampus and frontal cortex.

But what about humans?

Well, the new study looked at both moderate and severely depressed patients and found that their levels of acetyl-L-carnitine were substantially lower than the populace, at large.

And the more depressed the individual, the lower their level of acetyl-L-carnitine and the less likely antidepressants helped.

Acetyl-L-carnitine levels were especially low in patients whose depression began in childhood, or who had a history of child abuse, poverty, or neglect.

The next question is obvious — will raising acetyl-L-carnitine levels help treat depression?

Well, we know that it seems to in animal studies, but there are very few studies on humans. However, a 2014 study showed that, within the study population, acetyl-L-carnitine supplementation worked as well as some major antidepressants, with fewer side effects.

The implications are enormous. Imagine a simple supplement helping treat your depression vs. high-powered antidepressants.

You can already buy acetyl-L-carnitine supplements, and there’s evidence that they can be useful for a host of medical conditions, including peripheral neuropathy and, possibly, dementia. As with most supplements, the limited studies are incredibly encouraging, but finding funding is difficult.

And remember, please be careful when considering the supplements. They are not regulated by the FDA, you really have to do your homework on getting the right one, and you can never be exactly sure what’s in it.

Also, please consider this warning from WebMd for those with a history of seizures.

“An increase in the number or seriousness of seizures has been reported in people with a history of seizures who have used L-carnitine by mouth or by IV (intravenously). Since L-carnitine is related to acetyl-L-carnitine, there is a concern that this might also occur with acetyl-L-carnitine. If you have ever had a seizure, don’t take acetyl-L-carnitine.”

(Read WebMD on acetyl-L-carnitine for side effects, uses, doses etc).

Nevertheless, keep in mind that the potential side effects of antidepressants are also significant, and all evidence suggests acetyl-L-carnitine is much better tolerated, with fewer adverse events.

If you’re interested, talk to your doctor.

August 3, 2018

“Exceedingly precious”: How a shepherd sees his sheep

written by Christian Heinze

Phillip Keller, a former shepherd, writing in his book “A Shepherd Looks at Psalm 23.”

“I recall quite clearly how in my first venture with sheep, the question of paying a price of my ewes was so terribly important.

They belonged to me only by virute of the fact that I paid hard cash for them. It was money earned by the blood and sweat and tears drawn from my own body during the desperate grinding years of the Depression.

And when I bought that first small flock, I was buying them literally with my own body which had been laid down with this day in mind.

Because of this, I felt in a special way they were in very truth a part of me and I a part of them.

There was an intimate identity involved which, though not apparent on the surface to the casual observer, nonetheless made those thirty ewes exceedingly precious to me.

But the day I bought them I also realized that this was but the first stage in a long, lasting endeavor in which from then on, I would, as their owner, have to continually lay down my life for them if they were to flourish and prosper…. Christ chooses us, buys us, calls us by name, makes us his own, and delights in caring for us.

It is this last aspect which is really the third reason why we are under obligation to recognize his ownership of us. He literally lays himself out for us continually.”

July 31, 2018

Brian Dawkins: Christianity has helped me deal with depression

written by Christian Heinze

Brian Dawkins, one of the best safeties to ever play football, talks with NBC Sports Philadelphia about the depression that hit him when the birth of his son coincided with intense professional pressures.

After a horribly dark period, Dawkins got on meds, turned to Christianity, and got his life back — while still acknowledging “that feeling” never entirely goes away.

Dawkins, to NBC Sports Philadelphia:

“I went through a real dark, deep depression. Alcohol was a tremendous crutch. There were times I didn’t even want to be around my family, didn’t want to be around my son.

I just wanted to be in a dark room by myself with nobody. My room, I won’t say was a frequent occurrence, but it was something I would do. My faith back then wasn’t that strong, so I listened to the other voice in my head, and that’s where suicidal thoughts came in, and then actually planning out how I would go about it in such a way that Connie (his wife) and my son would get the money from my insurance policy.”

Thomas and his wife eventually aided Dawkins in getting help. Dawkins began to see a psychiatrist and also began taking medication for his depression. The meds helped calm him down, but he wasn’t himself.

“The pain I was feeling was tremendous,” Dawkins said. “But then, I found a way to control it. I rededicated my life. Being able to deal with that through my renewed faith. Going to more and more bible studies. Giving my life over to the Lord, completely helped me go on to become the athlete I became and the person I became.”

Dawkins is winning the biggest battle of his life against depression.

“That feeling is always there to this day,” Dawkins said. “It’s just waiting for you to feel so sorry for yourself that you can come back down and start having those same feelings again. My faith is strong enough now that I can tell that part of me to shut up and that’s now who I am.”

July 30, 2018

How basketball star Steven Adams fights loneliness

written by Christian Heinze

In his new book, My Life, My Fight, Oklahoma City Thunder center Steven Adams talks about spiraling into depression after his dad passed away.

“After my dad died, I didn’t have [the fight]….I knew I wanted to do something but I just didn’t know what that thing was. And if a purpose hadn’t come along soon, I would have started looking for something, anything, to feel a high.

“When I think back, I realise that I was actually very lonely and, if I’m honest, probably a little depressed. No one had told us how to cope with grief. We didn’t see a counsellor or go to any therapy sessions.”

So what did Adams do?

“For me, the trick to fighting thoughts of loneliness has always been to find a routine.”

Routines are hugely important in the fight against depression.

Among other things, it’s thought that routines build “familiarity and predictability” and focus that can keep your mind from wandering into the end of a French movie.

Photo: Keith Ellison.

July 30, 2018

STUDY: Pre-partum depression affects infants’ stress response

written by Christian Heinze

A new study shows just how important it is for depressed pregnant women to get help — both for themselves and their babies.

A few key findings:

a. Just six days after birth, newborns of depressed mothers showed worse neurobehavioral functioning.

b. At 1 years old, infants of depressed mothers had higher cortisol responses to stress.

Further, women with major depression had a shorter length of gestation.

“Our findings that compared with women without depression in pregnancy, women with depression in pregnancy have increased stress-related biology, newborns with less optimal neurobehavioral function, and infants with a greater biological response to stress, confirmed our hypotheses,” Osborne told MedPage Today. “Our hypotheses were based on bringing together evidence from a combination of previous, but perhaps less clinically relevant, research.”

But here’s some good news.

A new IV-infusion called Brexanolone is expected to hit the market in 2019, and trials showed a 70% remission rate for pregnant women with major depression.

Photo: Pexels

July 30, 2018

Mental Health Links

written by Christian Heinze

ANXIETY:

a. 19 Natural Remedies for Anxiety. Cool fact — it takes about 21 minutes of exercise to reduce anxiety.

b. What’s the difference between anxiety and worry?

c. Bustle Magazine: “9 signs your anxiety might be making you paranoid.”

d. How to calm an anxious stomach.

DEPRESSION:

a. Conference presentation: Midlife depression and apathy can put you on the path towards early dementia.

b. The FDA is fast-tracking a new generation of fast-acting antidepressants.

c. Early-rising women are less likely to develop depression.

PTSD:

a. Parents of premature babies need more resources for dealing with PTSD.

SCHIZOPHRENIA:

a. Study: Talk therapy might not help with schizophrenia.

CHRISTIAN:

a. Desiring God: “Trusting God in Your Darkest Nights.”

b. The Gospel Coalition: “Why I thank God for my painful mid-life crisis.”

One of my favorite songs:

July 28, 2018

Love (III): “So I did sit and eat”

written by Christian Heinze

One of the most beautiful poems about Christ’s love is Love (III) by George Herbert:

“Love bade me welcome. Yet my soul drew back

Guilty of dust and sin.

But quick-eyed Love, observing me grow slack

From my first entrance in,

Drew nearer to me, sweetly questioning,

If I lacked anything.

A guest, I answered, worthy to be here:

Love said, You shall be he.

I the unkind, ungrateful. Ah my dear,

I cannot look on thee.

Love took my hand, and smiling did reply,

Who made the eyes but I?

Truth, Lord, but I have marred them: let my shame

Go where it doth deserve.

And you know not, says Love, who bore the blame?

My dear, then I will serve.

You must sit down, says Love, and taste my meat:

So I did sit and eat.

Those last four lines. Wow.

The Poetry Foundation writes that Herbert was “a pivotal figure” in poetry and “arguably the most skillful and important British devotional lyricist of this or any other time.”

After serving in the Parliament of England, he became the rector of a small parish in Salisbury. He died at 39 years of age of TB, and was noted for “unfailing care for his parishioners.”

July 24, 2018

Want to help someone with OCD? Don’t tell them everything is fine

written by Christian Heinze

Kavin Senapathy has a particularly good read on one way of helping someone you love who has OCD — basically, don’t help.

At least not in the way you might think.

Basically, people with OCD crave reassurance (it’s often called “the doubter’s disease”), and they frequently turn to their closest family or friends for that reassurance.

“Do you think this cut looks infected?”

“No, it doesn’t.”

“Okay, great.”

On the surface, that seems to be helpful, but for someone with OCD, it just reinforces their addiction to reassurance.

Self.com:

Telling someone with OCD that they don’t have cancer or that the baby is fine “are lies,” Yip points out. “How could a spouse possibly know that their loved one doesn’t have cancer without medical training and CAT scans?” she says. In most cases, a response that “everything is fine” is an educated and highly likely assumption, but it never quite fulfills what someone with OCD is craving.

And responding to these sorts of compulsions in such a matter-of-fact way also reinforces them, in a way. It made me believe my questions were reasonable and valid, and made me constantly seek the temporary comfort that the reassurance provided.

It’s also only a band-aid, a temporary solution. “If you respond with certainty, for example, ‘No, you won’t die,’ the person with OCD will still always wonder and have the same question and continue to ask in a hundred different ways,” Yip explains. “The best way you can support your loved one is to help him or her tolerate uncertainty.”

So how do you help? The article recommends these responses to requests for reassurance.

“That sounds like a reassurance question. I can answer, but it may feed your OCD. What would you like for me to do?”
“What if you waited a while before I answer that, and if it still feels pressing for you to know, I’ll tell you later?”
“Is that you asking, or your OCD?”

Ugh.

As someone who’s struggled with OCD, I really hate this, but it’s true.

There’s nothing better than feeling relief from our obsessions. But the point is that relief is only temporary, and the relief reinforces the underlying disorder. You know, kind of like a drug addiction.

Now — back to this site’s mission.

As I’ve written before, it takes a holistic response to tackle any health problem, including brain disorders like OCD.

Scripture sometimes helps, sometimes it does nothing, but the fact of the matter is that science has proven the medical basis of OCD, and those who suffer from it, I believe, will never truly be “cured.”

As of yet, there isn’t a medicine or surgery that can correct neuroanatomical defects that are associated with it.

The OCD advocacy site, Beyond OCD, writes, “OCD is chronic. This means it is like having asthma or diabetes. You can get it under control and become recovered but, at the present time, there is no cure…. the current thinking is that it is probably genetic in origin, and not within our current reach to treat at that level.”

Now, just like asthma or diabetes, you can often find relief from symptoms, and that’s where things like medicine, talk therapy, and spirituality come into play.

But I’ve found it particularly dangerous to tell people with OCD to “just stop worrying.” In my case, for example, that prompts me to start obsessing about the “sin of worry,” and starts a whole new round of OCD (But that’s just what happens when the prefrontal cortex, basal ganglia, and thalamus aren’t getting the job done right).

The thing to tell people with OCD isn’t “stop worrying,” but instead, “Hey, go get some medical advice. Medicine and talk therapy seem to help a lot of people. Maybe they can help you too!”

For more information on the medical basis of these disorders, please pick up a copy of Dr. Matthew Stanford’s fantastic book Grace for the Afflicted, and read my interview with him here.

We can help loved ones with OCD by (counter-intuitively) not reassuring them, but we can hurt them terribly by judging them for what is a real, observable medical condition. It doesn’t just hurt “feelings,” more importantly, it sends them on a new downward spiral of obsession over their failings.

July 21, 2018

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