Monday, February 15, 2016

Ranting and Raving about Neurological Disorders

There is a program on TV this season called Limitless, whose premise is that a man can take a pill and unleash far greater intellectual knowledge than normally possible. His mind can function limitlessly. There are tremendous downsides to this treatment, though, and how to deal with them is a great story. http://www.cbs.com/shows/limitless/

Unfortunately, there is no “limitless” pill today, but as I look back on my family’s history of a number of neurological disorders, including depression, ADHD, ADD and Anxiety Disorders, I think how some of the treatments for these may seem like that “limitless pill.”

Today there are many medications that I think act somewhat like this miracle pill, and yet there is controversy over whether to take them or not. I’m referring to treatments for ADHD, ADD, Anxiety Attacks, and all the mental illnesses. The medications (magic pills) used don’t make a person smarter, but they correct neurological imbalances in the brain so the individuals can overcome the deficiencies that cause the problem.

Not only medications are used to treat these illnesses; there are also psychological treatments and other training that can try to help individuals overcome these neurological problems. How great it is that we live in a day when we can get help for neurological conditions that in the past were often ignored.

 
DEPRESSIVE DISORDERS
I have suffered with clinical depression for over almost 30 years.  The medication to control this doesn’t make me feel happy all the time, or not allow me to feel sadness—it just makes me normal--to feel normal emotions at normal times, without the chemical imbalance skewing the situation.

I recall the moment I realized just how bad my depression was; I was driving and stopped at a light and some young people laughing and talking walked by in front of me. I remember thinking that I couldn’t imagine laughing at anything—it was literally beyond my comprehension at that time. It was like a bell went off in my head and I realized that I wasn’t just discouraged—I was mentally ill, if I couldn’t imagine laughing. That was the point when I sought treatment for my ailment.

(In discussing the following disorders, I am taking their descriptions from the government’s National Institute for Mental Illness’ website to be as accurate as possible.)
  
Depressive Disorders: “Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.[1]” [In this article, I am discussing only Major Depression, and not the other disorders, including Persistent depressive disorder, Psychotic depression, Postpartum depression, Seasonal affective disorder (SAD) and Bipolar disorder because I haven’t had experience dealing with these.]

Depressive illnesses are disorders of the brain. Brain-imaging technologies, such as
magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred. They also cannot be used to diagnose depression.[2]

What are the signs and symptoms of depression? “People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.

“Signs and symptoms include:
·         Persistent sad, anxious, or "empty" feelings
·         Feelings of hopelessness or pessimism
·         Feelings of guilt, worthlessness, or helplessness
·         Irritability, restlessness
·         Loss of interest in activities or hobbies once pleasurable, including sex
·         Fatigue and decreased energy
·         Difficulty concentrating, remembering details, and making decisions
·         Insomnia, early-morning wakefulness, or excessive sleeping
·         Overeating, or appetite loss
·         Thoughts of suicide, suicide attempts
·         Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.[3]


My paternal grandmother had what I think today would be diagnosed as depression. However, not much was known enough about these disorders then, and for a number of years she was in bed. No one ever knew what was wrong with her—she was just too sick to function.
ADHD/ADD
When my child who suffers from ADD was born, I thought that if only I was a better parent, he would act like a normal child and not have any of the symptoms which I later learned were that of Attentive Disorder. Now that I have grandchildren with ADHD or ADD, I understand that my parenting style may not have been as important as I thought.

ADHD (or as these are often called, Inattentive disorder).Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity).

·         “Predominantly hyperactive-impulsive
o   Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
o   Fewer than six symptoms of inattention are present, although inattention may still be present to some degree
.
·         “Predominantly inattentive
o   The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.

o   Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.

·         “Combined hyperactive-impulsive and inattentive
o   Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
o   Most children have the combined type of ADHD.”[4] 

These may be actions we all have at times, but in the person with ADHD, these are constant problems.

One might have a little ADD, and never be diagnosed, or have a lot of ADD and not be able to adapt to school at all. But it all cases, something short-circuits the focus of the individual, so their mind cannot complete normal tasks in a normal way.
I have family members with ADD, and for some, the right medication can be like the drug in the TV series, Limitless. Their mind suddenly functions correctly. In others, cognitive training can help overcome this disability.

Dealing with family members with ADD is like an analogy someone once used for having a child with Down’s Syndrome; you think you are arriving in England, but instead you are in the Netherlands. Your life is just different than you expected—not worse, just different. 
As a mother of a child with ADD, a constant feeling was that of frustration—but it was like trying to expect a child to change the color of their eyes. They are who they are—many are more intelligent and more creative than others without the disorder, but they have handicaps they have to overcome to succeed.
Whenever I think about how hard it is for a person with ADD to think or work, I recall that whenever I have a migraine, I can’t think straight (or walk straight—I am very unbalanced). I can’t think of common words to explain things; it is like my mind is frozen. So although I don’t have ADD, I can empathize with those who can’t focus or think when their ADD is bad. I am sure it is similar to when I have a migraine and getting frustrated trying to think or do things, that only makes it worse.


ANXIETY DISORDER
I think my family taught us to worry ourselves sick about everything. If we were late coming home, my father was sure we had been in an accident. If I felt sick, he was sure I had a fatal illness. I always thought it was a trained behavior, but if it becomes bad enough, it can become Generalized Anxiety Disorder (GAD).

Anxiety disorder: “Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. Anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. These feelings can interfere with daily activities such as job performance, school work, and relationships.[5]
“While some symptoms, such as fear and worry, occur in all anxiety disorders, each disorder also has distinctive symptoms.
  •  Generalized Anxiety Disorder (GAD)
  •  Panic Disorder
  •  Social Anxiety Disorder (Social Phobia)[6]

NIMH, National Institute of Mental Health explains about each type of disorder:
Generalized Anxiety Disorder (GAD): “All of us worry about things like health, money, or family problems. But people with generalized anxiety disorder (GAD) are extremely worried about these and many other things, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks.[7]

“Panic Disorder:People with social phobia tend to:
·         Be very anxious about being with other people and have a hard time talking to them, even though they wish they could
·         Be very self-conscious in front of other people and feel embarrassed
·         Be very afraid that other people will judge them
·         Worry for days or weeks before an event where other people will be
·         Stay away from places where there are other people
·         Have a hard time making friends and keeping friends
·         Blush, sweat, or tremble around other people
·         Feel nauseous or sick to their stomach when with other people.[8]

Social Phobia (Social Anxiety Disorder): “People with social phobia tend to:

  • Be very anxious about being with other people and have a hard time talking to them, even though they wish they could
  •  Be very self-conscious in front of other people and feel embarrassed
  • Be very afraid that other people will judge them
  • Worry for days or weeks before an event where other people will be
  •  Stay away from places where there are other people
  • Have a hard time making friends and keeping friends
  • Blush, sweat, or tremble around other people
  • Feel nauseous or sick to their stomach when with other people.[9]

My maternal grandmother developed what we would call “Social Phobia,” as she grew older. She found it difficult to be in social situations, including church, which she normally loved to attend. My aunt explained that as much as Grandmother enjoyed going to church, she would become anxious, to the point of illness, when she attended.

“The study results also attach numbers to molecular evidence documenting the importance of heritability traceable to common genetic variation in causing these five major mental illnesses. Yet this still leaves much of the likely inherited genetic contribution to the disorders unexplained – not to mention non-inherited genetic factors. For example, common genetic variation accounted for 23 percent of schizophrenia, but evidence from twin and family studies estimate its total heritability at 81 percent. Similarly, the gaps are 25 percent vs. 75 percent for bipolar disorder, 28 percent vs. 75 percent for ADHD, 14 percent vs. 80 percent for autism, and 21 percent vs. 37 percent for depression.
“It is encouraging that the estimates of genetic contributions to mental disorders trace those from more traditional family and twin studies. The study points to a future of active gene discovery for mental disorders” said Thomas Lehner, Ph.D., chief of the NIMH Genomics Research Branch, which funds the project.[10]
But I am encouraged by the fact that we live in a day and age when these common disorders can be diagnosed and relief can often be achieved. Unlike my paternal grandmother with depression and my maternal grandmother with social phobia, today there is help—medication, therapy, psychological training that can help us deal with these problems and allow the individuals so afflicted to live more normally.
Unfortunately, there is no “Limitless” pill that can make our minds work at miracle speed today. But I look forward to the next life when our minds will function limitlessly and looking back on our temporal minds’ limits will make us laugh. Until then, I will rely on what help is available, and be grateful that we have it.


  




[1] http://www.nimh.nih.gov/health/ “Depression”
[2] Ibid. “Depression”
[3] Ibid., “Anxiety disorders”
[4] Ibid., “Attention-deficit-hyperactivity-disorder-adhd”
[6] Ibid: “Signs and Symptoms”
[7] Ibid. “Generalized Anxiety Disorder (GAD)”
[8] Ibid. “Panic Disorders”
[9] Ibid. “Social Phobia (Social Anxiety Disorder.”

[10] Ibid., New Data Reveal Extent of Genetic Overlap Between Major Mental Disorders

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