One Brain's journey

A friend asked me recently why I was interested enough in neuroplasticity to undertake the creation and maintenance of a blog on the subject. I replied, and I had to think for a moment, that I found it exciting because it was a new frontier in medicine. The friend happens to be a physician and her response was a knowing smile and a nod. I have read that almost all of our knowledge in the field of neuroscience has been gained in the last ten years. But there is more to my interest than that. Neuroplasticity means hope, hope that things will change. I read a post on a site called MD Junction by a patient who is particularly depression prone.   She takes great comfort, not that new findings in neuroscience can treat her depression but that it can help reverse negative behaviors and habits.  Current thinking in the treatment of neurological disorders is that if you don’t have symptoms you don’t have the disorder.  For example, a firefighter might have been diagnosed with ADHD in high school but in his high stimulation job, he functions quite well–so no symptoms, no ADHD.  To me this means that the disorder gets separated from the person. Not long after my diagnosis, a friend said to me at a low point, “You are not an ADHD person–you are a person with ADHD.”  I still have symptoms, even on medication but I have never forgotten the hope inherent in my friend’s statement.  And he would know because he too has been diagnosed with ADHD.  Hope means many things but perhaps the most important is the idea of change.  St. Augustine said that hope has two lovely daughters: anger at the way things are and courage to see that they do not remain the way they are.

A comment made in a lecture a few years ago by Umesh Jain, who heads the ADHD clinic at Center For Addiction and Mental Health here in Toronto came back to haunt me over the last couple of days. He said that the major difference between treatment for Adults with ADHD and children is that with the adults you must first deal with the self esteem issues or you won’t get anywhere with treatment. With children, he went on to say, there usually aren’t any self esteem issue. There hasn’t been time. It is a different story with adults where has been failure after failure, defeat after defeat and years of not measuring up, all leading to self condemnation and despair. This is probably the reason that I have trouble controlling my anger when I encounter people who refuse to recognize that the disorder even exists. I hesitate to say that only a person who has been through the kind of failure that a lifetime with ADHD can breed can really understand that.  Someone who has been down that path can have a special empathy for another fellow traveler. Perhaps some of us have developed a mechanism that prevents us from feeling sorry for ourselves.  You could say this is a part of the resiliency that comes with making it into adulthood coping with a disorder that can be so debilitating.  This mechanism doesn’t prevent us from feeling sorry for another individual who is struggling, perhaps still undiagnosed.

I have been puzzled lately, by how quickly I can be moved to tears, not in public, but in the privacy of my own apartment.  Any suggestion on television or on the Internet that has to do with human suffering can trigger tears.  After the potential for embarrassment I do hold them back in public.  It doesn’t seem appropriate for a person with a second degree black belt in karate.  But I am still affected.

On the other hand there is an upside to being an adult who has ADHD.   Years  of failure and defeat but never giving up means you have to have developed resiliency.  It means you have staying power and you can survive.  If you are an adult who has just been diagnosed–this simple fact may offer hope, perhaps enough hope to help you raise your self esteem.

My father’s mother, my grandmother, developed dementia in her 80′s, I was about 14 at the time. It was not a pretty sight. She didn’t know me, she didn’t know my father and most of the time she didn’t know where she was. She was in a Salvation Army Home For The Aged and, I might add, well looked after. I also have a vivid memory of a neighbor trying to break down our front door, with her caregiver trying sesparately to prevent her, while I cowered just inside trying to remain invisible. She was calling out to be let in and I was trying to give the impression that no one was home. This time I was about 10. I know times have changed since those times and there is better care and better medication for what we used to call senility but better still would be not to have it at all. New studies in neuroplasticity indicate that it can be avoided and, if you do get it, you might be able to overcome at least some of the symptoms. This is reported in an earlier post in the blog referring to the Nuns’ Study. This study reported, amongst other things, that nuns who showed physical symptoms of Alzheimer’s Disease but no neurological symptoms had been active in teaching right up until they died. This would tend to indicate that keeping the brain active is good but engaging with other humans is even better. A post yesterday in the Huffington Post authored by Dr. Marie Pasinski, a neurologist at Massachusetts General Hospital suggest that activites present us with new ideas and challenges and require us to adapt in new and different ways are best to keep the brain healthy. She also emphasizes eating right, particularly foods rich in antioxidants such as Omega 3′s. She suggests seeking things that ignite passion which enhances our brains ability to learn and remember. “By enriching your mind each day with new experiences and information you are building up what is called ‘cognitive reserve’. It’s like putting money in the bank–the more information you have stored over time, the more resilient your brain will become.”

My earliest impressions of dementia are from a time when there was little that could be done about it.  Those impressions need to be brought forward and rexamined in light of what medicine can accomplish now.  But more importantly, there is much I can accomplish now and the time to start is today.  Apparently reading posts on blogs is good.  Writing them is even better.

Today I came across reference to a new therapy called the Dynamic Neural Retraining System (DNRS) that employs the principles of neuroplasticity to cure chemical sensitivities, Cronic Fatique Syndrome, Fibromialgia even Gulf War Syndrome. At first glance it looks a bit like snake oil but on closer examination it caught my interest.  The system was developed by Annie Hopper whose life was devastated by multiple chemical sensitivities that resulted eventually in the lose of her job, her family and even her home.  She began to educate herself in various approaches to treatment and in the process noticed that many of her symptoms were similar to those of persons suffering from Acquired Brain Injury (ABT).  ABT usually results from a blow to the head. She developed DNRS based on methods used to treat ABT and now conducts three-day workshops to provide participants with enough familiarity with the system to carry on treatment on their own. Her website has many testimonials attesting to its effectiveness.  At the time that her life was overwhelmed by these chemical sensitivities, Hopper had a therapy practice employing what is described in her bio as core belief counselling.  I experienced something known as Core Belief Reengineering (CBR) about 15 years ago with some success but nowhere in her bio does it say that the counselling Hopper did was based in CBR.  However, I did make this leap.  About 15 years ago many of my friends were going throiugh the process of CBR with the only practitioner in Eastern Canada. I became intrigued. At the time I was a sucker for anything except chemicals or pharmaceuticals to make me feel better. I had just exited a relationship that in many ways was the most normal I had ever experienced and I was about to turn 50. There were a number of other things going on but suffice it to say I was an anxious mess. I have had anxiety most of my adult life in addition to the other numerous mental health disorders I have made reference to in past posts but pn top of all that I began to experience symptoms of Obsessive Compulsive Disorder (OCD)–probably because of the high level of anxiety. OCD is a devastating disorder and I count myself fortunate that I only had symptoms for a short time.  When my friends doing CBR started to report life-changing results I decided to do it.  I was also intrigued by the term reengineering. I was working as a management consultant at the time and Business Process Reengineering (BPR) was all the rage in the business world with huge global corporations, such as Ford Motor Company, were being transformed by it.  The idea of applying similar principles in a therapeutic model was most intriguing..  Towards the end of my therapy sessions a number of things happened. A chronic pain in my left hip, the result of a shortened ilioibial band, disappeared. The OCD symptoms also went away and then miraculously my asthma seemed to be cured. Now I’m a skeptic and in spite of what I was experiencing, I was hard-pressed to ascribe  these changes to CBR. The disappearance of asthma symptoms I thought could also be due to a new mattress, new pillows and new bedding. I knew, at the time, that one of the main causes of asthma is dust mites and with a new bed I would have been dust mite free.  Having both allergies and ADHD I have seen many different kinds of alternative treatments and most of them leave me cold to the point where am long past any interest in exploring any of them that don’t seem to be backed by solid scientific research such as Cogmed Working Memory Training. Having said this there are few alternative therapies rooted in sound science available to address mental health issues that exploit neuroplaticity other than Cogmed. In fact, DNRS is one for the first I have come across. Taking this into account plus my own experience with CBR and my rather grudging acceptance that some really benficial changes did happen, if not as a result of CBR, at least simultaneous with doing the therapy, I am intrigued and will write further about this in future posts.

Once again a study, this time at Duke University in Durham, North Carolina, examined role of working memory, and some other cognitive functions, in the development of schizophrenia. This time they were studying the pattern of cognitive disorders schizophrenics exhibit as children long before they have symptoms of schizophrenia. Duke researchers drew on the results of a long-term study conducted in New Zealand with more than 1,000 participants and found a consistent pattern of developmental difficulties starting at age seven. Co-author of the study, Richard Keefe, director of Duke’s Schizophrenia Research Group said, “These kids are lagging behind to begin with and they continue to fall behind.”

There were two patterns emerging:

1. Children who later developed schizophrenia had early deficits in verbal and visual learning, reasoning and conceptualization and these remained as they grew older

2. They also developed more slowly than their peers in processing speed, attention, visual-spatial problem solving and working memory

How all this ends up as schizophrenia is still unknown but another co-author in the study, Avshalom Caspi, who is the Edward M. Arnett Professor of Psychiatry at Duke, speculates that a child who struggles to make sense of the world becomes more socially isolated or more delusional.

Keefe said that eventually he hoped that they might be able to intervene, perhaps with anti-psychotic medication, in childhood and head off the adult psychosis. The study suggests that adult psychosis doesn’t just emerge fully formed but has early roots in the developmental process.

I have thought for a long time that schizophrenia is one of the saddest disorders as it seems as if one’s mind turns against oneself but there is another disorder that it is even sadder where one’s mind does something quite similar. That disorder is Obsessive Compulsive Disorder (OCD). One of the required symptoms for a diagnosis of OCD is that the person must be conscious of their obsessive or compulsive behavior but be helpless to do anything about it. I know at least one person who has OCD and my heart goes out to her. Many times when she is exhibiting symptoms, she is in tears. I have, for a brief time in the past, had OCD symptoms and so have some understanding of how this plays out. In my case the behavior was checking and it was like I had forgotten whether I had locked a door again and again and again. I had, as a child, seen my father do this (so maybe it’s a family trait) and at the time a part of me marveled at the fact that I was repeating this simple action so many times. In my case it passed and has not returned. It happened at a time of great stress so I do have a worry that it could, at some point, return but the person that I was describing earlier has it most of the time and spends much of that time locked in her apartment because it is so painful for her to go outside. Her behavior is also checking but it involves looking at every scrap of paper she comes across to see if one of her friends or family has left her a personal message. A mutual friend who was trying to help her by walking with her one time asked her, “Do you really think that a friend would leave a note for you on the street in the gutter.” The friend with OCD just looked down and cried.

I am so glad that my own symptoms were so short lived but I also hope that this new study will lead to the possibility of earlier intervention and perhaps head of the disorder–at least for schizophrenia.