Archive for the 'Health' Category

The anti-guilt pill

For a while now I’ve heard of a particular drug that purports to dull the formation of painful memories. I’ve always been a little unclear on how it works but I believe it takes away the emotional sting of the memory while leaving the recollection of the events. Ideally it could aid people who have suffered horrible crimes or soldiers suffering from PSTD. I had not heard of a more controversial use: the pill as a way of ducking emotional damage caused by committing heinous acts, especially in war time. This article, from 2003, describes a scenario.

The artillery this soldier can unleash with a single command to his mobile computer will bring flames and screaming, deafening blasts and unforgettably acrid air. The ground around him will be littered with the broken bodies of women and children, and he’ll have to walk right through. Every value he learned as a boy tells him to back down, to return to base and find another way of routing the enemy. Or, he reasons, he could complete the task and rush back to start popping pills that can, over the course of two weeks, immunize him against a lifetime of crushing remorse. He draws one last clean breath and fires.

That sounds a little overdramatic but makes the point. The rest of the article is a very even handed look at the whole issue. Some might say we can never use the pill in this way as it will destroy our humanity. But the response is that, look, if a killer is wounded during his crime, he still gets medical treatment for his physical wounds. Why would we deny him treatment for his psychological wounds? And if the person is a soldier why should he be doomed to a lifetime of guilt why the politicians who put him in the position get off scot-free*? It’s quite an interesting ethical debate.

* Writing this sentence made me consider how the term “scot-free” came to be. You’d think it was based on some story about a guy named Scot, but not so. it’s derived from an old english term that means exempt from royal tax.

Timing your mental activity

A while back I was reading a book titled “The Circle of Consciousness.” One point it made, one that we’ve all heard before, is that different people are more alert and functional at different times of day. Some people are morning people, some are night owls, and some are, according to the book, a kind of hybrid person that comes alive after waking up, then burns out after a few hours but can then have a second wind around afternoon or evening. I suspect I fall into that category.

So why is this? I don’t really know though I suspect it has to do with the way your metabolism varies throughout the day. At certain points maybe energy can better get to your brain or something.

It seems our eating schedule affects this as well. I usually wake up and have a not-heavy breakfast (plus coffee!) I can then work on whatever for a good couple hours and get things done. Eventually the nagging of hunger gets to me and I’ll have a lunch. And almost always my brain then conks out a bit; I become more sluggish. This seems like the opposite of the way you’d think it would work—more food should give me more energy. But I find that slightly hungry morning period is my best period for mental activities. (I tend to write these erudite blog posts during that period.) To be slightly hungry actual makes my brain run better.

I could look up the whys of this but in a way it doesn’t matter. What I try to do is organize my day so that key mental activity takes place during that first hungry period (or perhaps later in the day at my second wind) and mundane, unintellectual stuff is after lunch.

Maybe the trick for optimum mental ability is the classic six light meals a day program that keeps your metabolism burning but never overwhelms you digestion.

Is your parasympathetic nervous system sympathetic enough? (Or is it merely nervous?)

I talk a lot about systems of the body around here, particularly as they relate to pain and anxiety. I’ve become particularly interested in the parasympathetic nervous system which is essentially the body’s tool for bringing about calm (as opposed to the sympathetic nervous system which is about getting excited, flight or fight, that sort of thing.)

I just stumbled across an interesting article on Dr. Andrew Weil’s new procedure for using breath to bring about sleep. The details are at the link and it sounds easy enough. One point from the article:

This extra oxygen can have a relaxing effect on the parasympathetic nervous system, which promotes a state of calmness.

During times of stress, the nervous system becomes over stimulated leading to an imbalance that can cause a lack of sleep.

As well as relaxing the parasympathetic nervous system, Dr Weil says 4-7-8 helps you feel connected to your body and distracts you from everyday thoughts that can disrupt sleep.

Morning moodiness

Years ago my Dad mentioned to me that he would often lie in bed in the morning worrying about largely inconsequential things. For example, when he was building a house in Montana he would worry about whether or not he had enough material for flooring or whatnot. This surprised me because he was generally the epitomy of cool, of a non-worrier.

The admission also struck me because I have had periods of similar morning anxiety. (Not lately though – I sleep like a baby these days.) Could we (my dad and I), I wondered, share some genetic trait for morning worrying?

Well, I don’t know and may never know. But today I was thinking about this and was reminded of a bit of knowledge I’d picked up at some point. You body tends to make hormones at night and then “use them up” during the day. So in the morning as you wake up, you have peak hormone levels. I also recalled that the hormone cortisol is associated with anxiety. Is cortisol one of these “morning buildup” hormones? A little research on cortisol confirmed that it is.

Blood levels of cortisol vary dramatically, but generally are high in the morning when we wake up, and then fall throughout the day.

That makes sense. Ever get the sense later in the day that you’re too tired to worry? Your cortisol levels have fallen.

So I was thinking about this fact that cortisol is associated with anxiety and moodiness. I considered that there’s a particular time of the month when women are especially moody. (A great Modern Family rerun I recently watched highlighted this.) Is cortisol to blame here?

Indeed.

After ovulation, the empty follicle that once contained the egg begins to secrete the hormone progesterone to thicken the lining of the uterus and prepare it for the possible implantation of an embryo. As progesterone levels rise, you may begin to feel moodier. This happens because progesterone helps the body make cortisol, a hormone that tends to be higher in people who are stressed. If cortisol levels are already elevated because of outside factors, like a busy workweek, the progesterone can cause an excess of cortisol in the body. “If I’m already doing something to give myself high cortisol levels, by the time I get to the second half of my cycle, I’m going to be irritable,” Schwarzbein says.

(I have to say, this article ends with what I consider troubling advice. “If you’re practicing good habits and still have period-related moodiness, contact your doctor, as you could have a hormone imbalance that needs correcting.” Doctors. There’s nothing nature can do that they aren’t eager to “fix.”)

Anyway, this all seems indicative of what I’ve suspected for some time, that we are puppets on a string dancing to the rhythms supplied by our hormone and neurotransmitter masters.

Morgellons disease

I’ve discussed in the past my interest in psychogenic diseases (though I tend to use the term “psychosomatic.”) What are they? Let’s ask wikipedia.

Psychogenic diseases are physical illnesses that stem from emotional or mental stresses.

I have, for example, talked about the girls of Le Roy who developed weird, twitching body tics though for which no cause could be discovered.

Now I stumble on a Vox article on Joni Mitchell’s bizarre illness called
Morgellons. It’s a disease that causes debillitating pain and the appearence of strange fibers in the skin and flesh. But…

For the past decade, researchers have searched for a biological cause or single underlying factor that might explain the suffering. But they have mostly concluded that Morgellons is “a psychosis or mass-shared delusion.”

In one of the most comprehensive studies to date, published in the journal PLOS, researchers from the CDC collected detailed epidemiological information, medical histories, and skin samples from 115 Morgellons sufferers in Northern California.

“No parasites or mycobacteria were detected,” they reported. The researchers also couldn’t find any environmental explanation for patients’ suffering.

The fiber-like strands on sufferers were mostly just cotton debris, probably lint from clothing. Their skin damage seemed to be caused by nothing more than sun exposure. While some patients had sores, these appeared to have arisen from chronic picking and scratching.

I, of course, am in no position to definitively say whether the disease is real or not. But if it is not, we are again forced to examine a disturbing conclusion, that the mind* alone is capable of inflicting serious distress on on the body. Bizarre.

*Of course, I don’t really believe in a “mind” (in the sense of some non-material soul or whatever); I use the term here to designate the variety of what we call mental processes that go on in the brain.

Cracked on health

You might recall Cracked magazine as a second rate competitor to Mad magazine back when the world had magazines. Cracked has since become a fairly entertaining web portal with articles that are informative and funny. I was pretty impressed with the medical information in this article.

7 Basic Things You Won’t Believe You’re All Doing Wrong

It tackled heady subjects, such as pooping, bathing, sitting and what not. I’ve already adjusted my pooping stance.

Damasio, Jaynes and Sarno

In past writings I’ve mentioned my excitement when I first read Antonio Damasio’s neuroscience tome “Decarte’s Error.” In that book Damasio laid out his observations that emotions are really physical sensations, particularly sensations of our internal body: guts, lungs, circulation etc. If you take away the physical sensation of an emotion you take away that emotion’s “sting.” (One way to mitigate a negative emotional state is, of course, through booze and drugs which bring about a pleasant body high. Not that I advocate such activities.)

I’ve also mentioned that I’ve recently been reading Julian Jaynes’ “The Origin of Consciousness.” In the chapter I just finished he examines the famous Greek stories The Iliad and The Odyssey. He argues that several of the Greek words frequently used in these stories have been mistranslated. Words such as thumos and phrenes have been translated to mean soul and heart (in the figurative sense) respectively but he argues they refer more correctly to particular sensation of the body, exactly the sort of sensations Damasio wrote about. (Jaynes believes thumos, for example, really refers to the sensations present in the activation of the body’s stress response: increased blood pressure, increased energy etc. Basically, being “amped up.”)

Essentially, Jaynes argues that in the Greek era people were much more conscious* of their body state. When modern people say, “I feel angry” they are only tangentially aware of their erratic heartbeat and hot face, whereas ancient people, Jaynes argues, were acutely aware of their physiological state. He also alleges that people didn’t always feel “ownership” of these emotional states, e.g. they were aware of the sensations but did not ascribe the sensations to a particular self (the way we do.) But that’s a more complex discussion.

* Well, this isn’t entirely true as Jaynes famously argues in the book that for some parts of history men weren’t conscious at all! I use the word “conscious” as a synonym for “aware” here.

I’ve also talked much in the past of Dr. John Sarno’s notion that much recurring pain, gastrointestinal issues and other maladies are actually caused by a distraught subconscious. Jaynes hints at the very same idea with no knowledge (to my knowledge) or Sarno’s work.

I think it is obvious to the medical reader that these matters we are discussing under the topic of the preconscious hypostases have a considerable bearing on any theory of psychosomatic disease. In the thumos, phrenes, kradie and etor we have covered the four major target systems, of such illnesses. And that they compose the very groundwork of consciousness, a primitive partial type on consciousizing, has important consequences in medical theory.

Resetting the pain threshold

I’ve long discussed the topic of physical pain on this blog and I’ve touted the idea that our sense of pain is not a simple measurement system by which X amount of damage to the body results in a corollary amount of pain. I suspect, mood, anxiety and other aspects of psychology change how much pain we feel. A depressing new article alleging that Americans are facing greater pain toward the end of their lives offers some food for thought.

Reports of patients experiencing pain near the end of life increased 11 percent between 1998 and 2010, according to a new study published in theAnnals of Internal Medicine. Reports of depression and periodic confusion also increased 26 percent over this time.

“There were certainly reasons to think that things were getting better,” said Joanne Lynn, the author of the report and a palliative care clinician. “We were using hospice so much more, there was more use of narcotics and so much more attention to symptoms, there was reason to think we were doing better.”

Lynn sees two major possible explanations for her conclusion. Patients and family members could be expecting more from the care provided and have “reset their thresholds” over the 12 years in this study. Another is that the number of treatments have increased, allowing patients to live longer with the diseases that ultimately kill them.

This resetting of thresholds ties directly into my thoughts on the psychological aspects of pain. Having said that, it seems likely the second reason is a factor as well.

A connection between stress and cancer?

If you know me, and I believe you do, you know I have an interest in mind/body medicine which argues that calming the mind can have beneficial effects on the body. There’s a lot of anecdotal evidence making this case but not a great understanding on how this process could work. This article from the Harvard Medical School notes the following.

A new study from investigators at the Benson-Henry Institute for Mind/Body Medicine at Massachusetts General Hospital and Beth Israel Deaconess Medical Center finds that eliciting the relaxation response—a physiologic state of deep rest induced by practices such as meditation, yoga, deep breathing and prayer—produces immediate changes in the expression of genes involved in immune function, energy metabolism and insulin secretion.

A systems biology analysis of known interactions among the proteins produced by the affected genes revealed that pathways involved with energy metabolism, particularly the function of mitochondria, were upregulated during the relaxation response. Pathways controlled by activation of a protein called NF-κB—known to have a prominent role in inflammation, stress, trauma and cancer—were suppressed after relaxation response elicitation. The expression of genes involved in insulin pathways was also significantly altered.

I read that and said, “Hold on! Cancer?” Many people have theorized about a connection between stress and cancer but until now I’ve never seen any real science to back this up. I’ll be interested to hear what more research brings.

Hooray for salt?

You may have heard the recent allegation that saturated fat, long thought to be evil, is actually fine. (This NY Times op-ed has details.) Along with red wine, coffee and chocolate, saturated fat seems to be another substance that the medical and diet industries got wrong for years.

When the revised opinion of saturated fats hit the news, I passed it on to several people in conversation. They would usually say something like, “Oh, so it’s ok for me to eat pepperoni pizza?” I would have to warn them, “That food is high in salt and salt is still bad.”

Except, maybe not. Peruse this NY Times editorial.

The current average sodium consumption in the United States is about 3,400 milligrams per day. This is mostly ingested in processed foods and is equivalent to the amount of sodium in about 1 1/2 teaspoons of salt. Dietary guidelines endorsed by the federal government and leading medical groups recommend reducing the average to 2,300 milligrams for the general population and 1,500 for groups deemed at greater risk, like adults older than 50, African-Americans, people with high blood pressure and diabetics, among others.

There is considerable evidence that lowering sodium can reduce blood pressure, but there is scant evidence that reducing blood pressure from levels that are not clearly high will necessarily reduce the risk of heart attacks, strokes and death.

Previous studies have found little evidence to support those low recommended sodium targets. Now a large study by researchers at McMaster University in Ontario, Canada, which tracked more than 100,000 people from 17 countries on five continents, has found that the safest levels of sodium consumption are between 3,000 and 6,000 milligrams.

My dad is on a 1500 milligram a day limit. Should I be worried that it’s too low? Maybe.

Other studies have found that very low levels of sodium can disrupt biochemical systems that are essential to human health or trigger hormones that raise cardiovascular risks.

To be fair, as the article states, the science is not settled here. But given that the track record of the health nannies is becoming more and more dubious I think an extra slice of pizza is justifiable.