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Nervousness, excitement, insomnia, flushed face, psychomotor agitation, rambling flow of thoughts and speech...with all of these symptoms you would think you were looking at the definition for a disorder according to the DSM.  As a matter of fact you are...these are symptoms for the psychological disorder of Caffeine Intoxication. Caffeine intoxication sounds like a made up disorder but it is very real and does appear in the DSM. Surprisingly enough, Daniel Nobel is being evaluation to see if that is what caused him to hospitalize two University of Washington students last Monday when he hit them with his car that morning. Can it really be that something as simple as caffeine is altering our behavior so much that it is considered a psychiatric disorder that can alter how we operate a vehicle just as alcohol can? According to researchers this is exactly what happened to Nobel when he was charged with vehicular assault and a hit and run on the by the University of Washington's Police. Blood tests are not back from the lab yet but from my understanding of the article alcohol consumption was rule out therefore there is some underlying cause as to why Noble was acting in such disarray that morning. Investigators and researchers predicted that Noble consumed approximately 2g of caffeine which is 10 times the amount an average person consumes a day (200mg). Normally people develop a tolerance to this drug and do not see such drastic results; however, there are clinics and treatment centers designed to get people "clean" from the addiction of caffeine.  After reading this article I became very interesting is this concept. Never have I heard that someone was driving recklessly due to caffeine overdoes. I am currently in a course at UNI called Drugs and Individual Behavior. In this class when we talked about stimulants we discussed caffeine and the effects is has on our body and in turn on our behavior. This article makes me think...if I was evaluated this case would I deem that Caffeine intoxication was a severe enough diagnosis that I would accept this for the reason for this ridiculous behavior that place two people in the hospital? For some reason (even after learning about how caffeine is a drug and can alter how the brain functions) I can not seem to link it in the same category as anxiety disorder, schizophrenia, and diseases such as alcoholism.

 

 

 

http://abcnews.go.com/Health/MindMoodNews/man-caffeinated-psychosis-defense-hit-run/story?id=9306666

Earlier in the semester we talked about the brain and how certain hormones influence or are activated due to emotions. Neurotransmitters such as dopamine, serotonin, norepinephrine, and endorphins are just a few that have been shown to influence mood and emotion. What we did not go in detail about was the parts of the brain that make contribute to moods, emotions, and behaviors. I found an article that discuss' this very topic.
Arousal is a process that involves cortical, behavioral, and autonomic mechanisms (Reeve, 2009, p. 374) This article talks about the cortical (activity of the brain) part of being aroused and the emotional reactions that can evolve from being aroused. Reeve (2009) lists four principles to explain arousal's contribution to motivation. There are two that relate to the study explained below:
1) A person's arousal level is mostly a function of how stimulating the environment is.
2) People engage in behavior to increase or decrease their level of arousal.
A new study was done to test if the lateral prefrontal cortex (LPFC) was a region of the brain that could help people control emotional reactions such as negative moods, rumination (not being able to get something off your mind), and substance abuse. After having several people in stable, healthy relationships journal daily and have brain scans done while viewing positive, negative, and neutral facial expressions of their partner, it was found that LPFC activity did predict how one would react to an interpersonal conflict. When there was a day of no interpersonal conflict, the LPFC activity was not related to the next day's mood or behavior. On the contrast, when there was a day when interpersonal conflict did occur LPFC did predict mood and behavior the next day. Low levels of LPFC activity was related for high levels of negative moods, rumination, and substance abuse.
This study is helpful when talking about coping with stress. To avoid bad coping strategies like over-eating or substance abuse, people can become aware and learn to introduce positive strategies such as counting to 10. If you are a person who has low LPFC function, it is possible you may become more susceptible to such behaviors.
Link:
http://news.oneindia.in/2010/03/03/howto-control-emotional-outbursts-in-front-of-yourpartner.html

I found an article that discusses how many universities have taken up new policies with regard to informing parents about their children's underage drinking.  They stated that most colleges will alert parents for major problems, such as being hospitalized or taken to the police station, however they do not involve parents for minor transgressions such as being caught with alcohol in their dorm.  Some schools have decided to inform parents of every alcohol or drug related issue that involves underage students.  Their reasoning behind this is that alcohol abuse on campuses has become a major issue and they feel that parental intervention could be one way to prevent it.  Many students simply do not agree with this policy.  

Here is an article from the Associated Press about a journal article to be published this April. The subject is how boredom affects our health. Researchers have found that people are more likely to participate in unhealthy behaviors when bored, especially if the boredom is chronic. These behaviors will then lead to other health complications and an earlier death. So, basically it's alright to be bored occasionally but if it's all the time...Get out of the funk and find something that engages your brain.

February 10, 2010 (LONDON) -- Can you really be bored to death?

In a commentary to be published in the International Journal of Epidemiology in April, experts say there's a possibility that the more bored you are, the more likely you are to die early.

Annie Britton and Martin Shipley of University College London caution that boredom alone isn't likely to kill you -- but it could be a symptom of other risky behavior like drinking, smoking, taking drugs or having a psychological problem.

The researchers analyzed questionnaires completed between 1985 and 1988 by more than 7,500 London civil servants ages 35 to 55. The civil servants were asked if they had felt bored at work during the previous month.

Britton and Shipley then tracked down how many of the participants had died by April 2009. Those who reported they had been very bored were two and a half times more likely to die of a heart problem than those who hadn't reported being bored.

But when the authors made a statistical adjustment for other potential risk factors, like physical activity levels and employment grade, the effect was reduced.

Other experts said while the research was preliminary, the link between boredom and increased heart problems was possible -- if not direct.

"Someone who is bored may not be motivated to eat well, exercise, and have a heart-healthy lifestyle. That may make them more likely to have a cardiovascular event," said Dr. Christopher Cannon, an associate professor of medicine at Harvard University and spokesman for the American College of Cardiology.

He also said if people's boredom was ultimately linked to depression, it wouldn't be surprising if they were more susceptible to heart attacks; depression has long been recognized as a risk factor for heart disease. Cannon also said it was possible that when people are bored, dangerous hormones are released in the body that stress the heart.

Britton and Shipley said boredom was probably not in itself that deadly. "The state of boredom is almost certainly a proxy for other risk factors," they wrote. "It is likely that those who were bored were also in poor health."

Others said boredom was potentially as dangerous as stress.

"Boredom is not innocuous," said Sandi Mann, a senior lecturer in occupational psychology at the University of Central Lancashire who studies boredom.

She said boredom is linked to anger suppression, which can raise blood pressure and suppress the body's natural immunity. "People who are bored also tend to eat and drink more, and they're probably not eating carrots and celery sticks," she said.

Still, Mann said it was only people who were chronically bored who should be worried.

"Everybody is bored from time to time," she said.

Since my December 18th knee surgery, I have been on numerous pain killers to manage the pain and discomfort while recovering. Many of them making me nauseous to the point of vomiting or extremely lethargic. I have switched prescriptions several time.
About two weeks ago, I slipped on the ice here on the UNI campus and went from being weeks ahead of my physical therapy schedule with little to no pain, to a swollen, painful, non-weight bearing knee joint with very little ROM (range of motion). I scheduled an appointment with my surgeon right away and he took an X-ray and an MRI. The MRI came back normal but the X-ray showed that a small bone fragment that had been inside the knee joint all along had been forced out laterally (to the outside of the knee joint) by the pressure of the fall. The pain was constant and severe even with the influence of the current narcotics I was taking, so I was prescribed a pain killer patch that would distribute a regulated amount of pain medicine for 3 days at a time, and then a new patch is applied.
This pain patch is typically prescribed to cancer patients and is highly addictive after lengthy periods of use. Because of my common reaction of getting sick off the pain pills, I started taking an anti-nausea pill again, which is on a 6 hour regiment. I was also recommended to take 800 mg of ibuprofen every 8 hours to reduce swelling, and of course, I went back to my original 3 day a week schedule of physical therapy after being reduced to 2 days a week for good progress.
So far, this blog is sounding more like a sob story on my part so I'll get to the point. On Tuesday of this week, when it was time to switch patches, I did not apply a new one to see if the pain is now tolerable without the relief of pain killers. I was also beginning to notice a change in my breathing patterns after a new patch had been on for the first 3 to 6 hours. Since the patch was regulating the medicine into my body in portions throughout the 72 hours, the medicine remained in my system even after the patch was removed. I began feeling abnormally tired beginning Wednesday morning and although I was still taking the anti-nausea pill every 6 hours, I had no appetite and was beginning to feel sick to my stomach by Wednesday afternoon. My knee pain is noticeable but relatively tolerable. But today, Thursday, I feel 10 times worse than the previous days. I feel like I've been hit by a truck, chicken noodle soup, saltine crackers and water have been the ONLY items on the menu for me & I'm beyond tired of them, it's the only thing my stomach can tolerate. Not to mention, my knee is killing me.
It's possible that during the time that I relied on that patch to take physiological care of my knee pain, I developed a dependence and my brain became content letting the medication do its job. Now that the medication patch is no longer administering the medication, my body is struggling to find a resolution to the withdrawal of the pain meds, and I am paying the price.
We talked about this briefly in class, in regards to many psychological medications to treat depression and other conditions. As if the last 2 months haven't been bad enough, this experience may be worse than the initial post-op recovery.  

I found this very interesting interview/transcript from Dr. Drew, who most of us are familiar with. In the transcript, people ask Dr. Drew various questions about all kinds of addictions. Dr. Drew makes a very clear statement about addictions in the beginning stating that the term "addiction" is used very inaccurately. Dr. Drew defines an addiction as "a specific biological disorder of the reward systems of the brain that permanently alters the survival system and thus the motivational priorities." Basically, addictions are based predisposed by our genes. If someone does not have a certain "addiction gene" they cannot possess an addiction. He mentions that people are often seen as having an addiction, when they simply have bad habits, or a dependency. I previously saw "addictions" as something that one partakes in regularly. We obviously overuse the word "addiction" in everyday language which leads to misconceptions. The article is sort of long, but it covers all addictions from online gambling, sex addictions, and of course drugs and alcohol. Does this article change your view towards addiction? Or was your perception of addiction similar to this? What did you find interesting in the interview?
http://www.medicinenet.com/script/main/art.asp?articlekey=54633

Alcohol, the cause of and solution to all of life's problems.  Difficulty walking, blurred vision, slurred speech, slowed reaction times and an impaired memory.  Sounds like an awesome weekend, but some people (like doctors) call these "damaging effects on the brain."  Fun haters.  This article talks about the effects that alcohol has on the brain.  For some, like binge drinking college students, alcohol can cause addiction.  But I'm guessing no one in our class has a drinking problem.  We drink, we get drunk, not a problem.  Anyway the article not only talks about effects on the brain it also talks about....oh yeah, blackouts.  I forgot what I was gonna write right there.  It throws out some comparisons between the effects that alcohol has on men vs. women.  Overall, not a bad read.

 

The question is how many of you think about the effects of alcohol on your brain when you're in the championship game of a beer pong tournament?  I'm guessing not too many.  But, how many of you think about the effects of alcohol on your brain when you wake up in your closet naked? 

 

http://pubs.niaaa.nih.gov/publications/aa63/aa63.htm

http://www.drugabuse.gov/ResearchReports/MDMA/default.html

This is a great resource to find information about many drugs from effects on the brain to addiction treatment.

For those of you that don't know MDMA, ecstasy or 3,4-Methylendioxymethamphetamine is a DEA schedule 1 substance.  Schedule 1 means drugs under this category have no medical use and a high potential for abuse. It is classified as a psychoactive amphetamine, meaning it has both psychedelic and stimulant like effects. Known for its relationship with Intimacy, it also diminishes feelings of anxiety, fear, depression and emotions run wild. The positive effects include mental stimulation, emotional warmth, empathy towards others, and a general sense of wellbeing.

 Before being made a schedule 1 controlled substance, ecstasy was actually used in psychotherapy, couples therapy and to treat anxiety disorders as well as clinical depression. Though there were no formal, documented clinical trials or FDA approval.  Therapists called it "penicillin for the soul" saying it allowed the user to communicate insight about their problems.  Though DEA still deemed it schedule 1 eventually, in late 2000 FDA actually approved MDMA for 2 sessions of psychotherapy for those experiencing PTSD.  Ecstasy was actually criminalized in all members of the United Nations in a UN agreement; this is for manufacture, sale or production of the drug. There are limited exceptions for scientific/medical research.

MDMA first broke out in the club scene, mostly at long extended dance parties called raves. It was mostly used by adolescents and young adults, but this typical profile has been changing. There is now widespread use outside of the club scene. Recent research has also shown the drug is moving from predominately white users to minority users. It also appears to be a rising trend in the "urban gay male" scene. This is a rising concern because of the existing high level of sexual activity in gay males; it causes an increase in high risk behavior that may lead to many sexually transmitted diseases. The first question is why? Perhaps they seem to frequent urban dance clubs in higher numbers. Also, why the movement away from white adolescents and young adults?

Ecstasy has incredible effects on the brain with just one or two tablets. Though its mechanism of activity is not fully understood in its simplest sense it alters the activity of dopamine, serotonin and norepinephrine by increasing their production. Though the process involving serotonin is more complicated due to the fact that it is not only a combination serotonin reuptake inhibitor, but also a serotonin-releasing agent, in addition to the other two transmitters it makes MDMA a neorepinephrine-dopamine reuptake inhibitor and a serotonin-norepinephrine-dopamine releasing agent. Confused yet?  

More specifically the effects of the drug cause all the previously mentioned positive effects of the drug. The excess release of the serotonin causes the brain to become depleted of this key transmitter. This is the largest contributor to the "hangover" effects that users can experience for several days after taking the drug. More research is needed, but it appears that this serotonin damage in humans can cause  long term effects such as confusion, depression, and significantly impact the memory and attention process.

So even with more research needed, the fact people still choose to do these drugs is very interesting to me. Some are ignorant, but others completely willing to take the risk despite their knowledge of the effects. The drug also can be addictive, the body can develop tolerance, and the brain changes to compensate for the difference in chemical production. Are people attracted to the emotional state they reach after doing the drug, or is it simply a chemical dependency?