The Center Cannot Hold

14 10 2014

Yes, it is not a new book but in case you have not read it yet I want to recommend the book: The Center Cannot Hold: My Journey Through Madness by Elyn R. Saks. Saks is an esteemed professor, lawyer, and psychiatrist and is the Orrin B. Evans Professor of Law, Psychology, Psychiatry and the Behavioral Sciences at the University of Southern California Law School, yet she has suffered from schizophrenia for most of her life, and still has ongoing major episodes of the illness. THE CENTER CANNOT HOLD is the eloquent, moving story of Elyn’s life, from the first time that she heard voices speaking to her as a young teenager, to attempted suicides in college, through learning to live on her own as an adult in an often terrifying world. Saks discusses frankly the paranoia, the inability to tell imaginary fears from real ones, the voices in her head telling her to kill herself (and to harm others); as well the incredibly difficult obstacles she overcame to become a highly respected professional. This beautifully written memoir is destined to become a classic in its genre.

In addition to this book you can find her lecture at TED: http://www.ted.com/talks/elyn_saks_seeing_mental_illness

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“a sane reaction to insane circumstances”

11 08 2013

To all appearances, Eleanor Longden was just like every other student, heading to college full of promise and without a care in the world. That was until the voices in her head started talking. Initially innocuous, these internal narrators became increasingly antagonistic and dictatorial, turning her life into a living nightmare. Diagnosed with schizophrenia, hospitalized, drugged, Longden was discarded by a system that didn’t know how to help her. Longden tells the moving tale of her years-long journey back to mental health, and makes the case that it was through learning to listen to her voices that she was able to survive.

Eleanor Longden overcame her diagnosis of schizophrenia to earn a master’s in psychology and demonstrate that the voices in her head were “a sane reaction to insane circumstances.

 

To see & hear her talk at TED click HERE

 

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Another Great Recovery Story from Schizophrenia

28 09 2012

This time I wish to present the story of Erin Hawkes, a Neuroscientist that copes with Schizophrenia. Recently Erin wrote a book about her recovery journey entitled “When Quietness Came: A Neuroscientist’s Personal Journey With Schizophrenia

 

Here is an article about her story that was published at CBC books (Canada).

 

Erin Hawkes started hearing voices and music when she was a small child, voices that eventually turned nasty and led to a suicide attempt, a bout of electro-shock therapy, eight different medications, and 12 hospitalizations. But Hawkes was also a straight A student who earned a master’s degree in neuroscience. She has written a memoir about her struggle with mental illness and schizophrenia, called When Quietness Came, and she discussed the book and her experiences in a recent interview on North by Northwest.

For Hawkes, the voices started when she was very young and they were never alarming in her childhood. Indeed, Hawkes describes them as her “little friends.” She also heard music. “I would hear it when we were in the car and it mostly sounded like it was coming out of the trunk,” she told host Sheryl MacKay. “I’d ask my mom to turn up the volume because I couldn’t hear it very well and she’d say, ‘Erin, the radio’s not on.'”

As a child, she took the audio hallucinations for granted. “I never thought it was anything different. I thought everyone had their own little voices. Everyone says, ‘The little voice in my head said this’ and I just assumed it was the same thing,” she explained. “But around adolescence they started to get more persistent and meaner, talking about me as if behind my back or telling me what to do, what not to do, what I shouldn’t have done, what I should do.”

When the voices started to get nasty, Hawkes tried to avoid them by studying really hard. “I excelled at school and put all my effort into it. I had a few good friends, so I was relatively normal,” she said. “I kept the voices to myself. I thought everyone had them and there was no point in discussing them.”

Hawkes earned a master’s degree in neuroscience and excelled in school, earning high averages and multiple scholarships — even while dealing with the inner turmoil of hearing voices that urged her to commit suicide. “I think the studying was a coping mechanism,” she said. “The harder I studied, the more I could ignore the voices.”

Studying was also a way to reassure herself that she was in control of her mental health. “I had heard about schizophrenia, and some part of me wondered if that was me. But I heard the stereotype of schizophrenia — uneducated and stuff like that — and I thought, ‘Well, if I maintain an A-plus average there’s no way I could have schizophrenia,” Hawkes said. “And a doctor once told me, which I don’t agree with, but he said, ‘You’re too smart to have schizophrenia.'”

Hawkes is schizophrenic, but it took a long time to receive an accurate diagnosis. First she was told she had depression, borderline personality disorder, and was even given electroshock therapy, which is not usually used on schizophrenics. She often felt misunderstood, and lost in the system.

“One of the reasons I wrote the book, and put on the cover ‘Erin Hawkes, MSC,’ is that I really wanted to reach professionals,” she said. She thinks that many psychiatric professionals have a lot of learn about the experiences of their patients, and she hopes her book is viewed as not “just” another memoir by a schizophrenic and that she’ll be taken seriously. “I think my credentials should make it more acceptable to a professional.”

Hawkes also wants to reassure others with mental illnesses similar to hers. “There’s always hope…When you’re in the middle of it, it seems like it’ll never be normal again,” she said. “And in some ways it will never be ‘normal’ but it is very livable.”





Schizophrenia and Glutamate

28 08 2012

When I was young and pretty, I had a chance to investigate the role of NMDA on negative symptoms of schizophrenia. The theoretical framework of this research was based on the  glutamate hypothesis of schizophrenia. In short, the idea of a glutamatergic abnormality in schizophrenia was first proposed by Kim and colleagues in 1980 based on their findings of low cerebrospinal fluid (CSF) glutamate levels in patients with schizophrenia.Furthermore, the fact that Phencyclidine (PCP) or ketamine (Glutamate antagonists) produces “schizophrenia-like” [negative and positive] symptoms (e.g., delusion and hallucination, avolition, apathy, and blunted affect, deficits in attention, memory, and abstract reasoning and disruptions in prepulse inhibition of startle)  in healthy individuals and profoundly exacerbates pre-existing symptoms in patients with schizophrenia strengthen the glutamate hypothesis.  Moreover, genetic studies suggest that the majority of the genes that have recently been associated with an increased risk for schizophrenia can influence function linked to glutamate receptors. Finally, postmortem receptors studies show changes in glutamate receptor binding, transcription, and subunit protein expression in the prefrontal cortex, thalamus, and hippocampus of subjects with schizophrenia.

I am writing this post in order to inform you about two interesting new papers about this issue. I wonder whether we will see a new line of medications based on this hypothesis.

Here are the papers and their abstracts:

Moghaddam, B, Krystal, J.H. (In press). Capturing the Angel in “Angel Dust”: Twenty Years of Translational Neuroscience Studies of nmda Receptor Antagonists in Animals and Humans. schizophrenia Bulletin

Here, we describe our collaborative efforts to use N-methyl-d-aspartate (NMDA) receptor antagonists as a translational tool to advance our understanding of the pathophysiology of schizophrenia and identify potential new targets for treatment of schizophrenia. We began these efforts in the late 1980s with a keen sense that, in both human and animal studies, we needed to move beyond the dopamine hypothesis of schizophrenia; if the dopamine hypothesis were correct, the existing dopamine antagonists should have cured the disease but they have not. We used NMDA receptor antagonists, not to produce schizophrenia, but as a tool to provide insights into effects of disturbances in glutamate synaptic function in schizophrenia. Our work has provided insights into potential mechanisms that may contribute to disrupted cortical function in schizophrenia and has helped identify potential treatment targets for the disorder. The translational nature of this study made the clinical testing of the first of these targets feasible. Advances in systems neuroscience approaches in animals and humans make new types of translational research possible; however, our concern is that the current obstacles facing translational research funding and academia-industry collaborations threaten the future progress in this field.

Egerton A, Stone JM. (2012).The glutamate hypothesis of schizophrenia: neuroimaging and drug development. Curr Pharm Biotechnol. 2012 Jun 1;13(8):1500-12.

Over the last 50 years, evidence for central involvement of glutamatergic neurotransmission in the pathophysiology of schizophrenia has accumulated. Recent advances in neuroimaging technology now allow several components of glutamatergic neurotransmission to be assessed in the living human brain. Positron emission tomography (PET) or single photon emission tomography (SPET) in combination with select radiotracers allows visualization of glutamatergic receptors in vivo, and magnetic resonance (MR) – based techniques allow mapping of the effects of glutamatergic agents on regional brain activation, and the measurement of regional glutamate concentrations. These imaging studies have provided evidence for regional glutamatergic abnormalities in psychosis, and are beginning to describe both the evolution of these abnormalities over the course of the illness and their response to therapeutic intervention. In parallel, advances in small animal imaging and the development of animal models have provided a platform to explore the neuropathological consequences of glutamatergic abnormality, and the potential antipsychotic efficacy of novel compounds. The molecular diversity of the glutamatergic system has driven the design of several compounds targeting aspects of glutamatergic transmission, and clinical trials have yielded encouraging results. Here, we review the contribution of imaging studies to date in understanding glutamatergic abnormalities in psychosis, and discuss the potential of new glutamatergic compounds for treatment of the disorder.

 





“Please hear this: There are not ‘schizophrenics’, there are people with schizophrenia.”

10 07 2012

Here is another fascinating story of a person with a health condition and disability. In this video by TED, Elyn Saks , a mental health law scholar and writer,  speaks for the rights of mentally ill people. In 2007, deep into her career, Saks dropped a bombshell–her autobiography, The Center Cannot Hold. In it, she reveals the depth of her own schizophrenia, now controlled by drugs and therapy. Clear-eyed and honest about her own condition, the book lent her new ammunition in the quest to protect the rights and dignity of the mentally ill. Thank you Namma for recommending this interesting lecture!

To watch and hear this lecture click HERE