Mental Health

Contents: — Revised Feb2018
Human Nature
Limbic System
Anxiety/Panic
Depression
Boredom
Addiction
Sleep
Self-Harm
Therapy
Medications


HUMAN NATURE

How an individual deals with different situations, at any given juncture, depends on a complex of experience, temperament, ……. whatever.

The narrative of how this individual got to this juncture and got to their current personality will have depended on many situations and factors, but humans are aspiring and we also seek rewarding experiences — we take chances.

Our basic natures are the result of how humans evolved.

The Human Psyche is vulnerable. Often when things go wrong our Human Nature allows matters to get worse — This is a cost of mankind’s cravings for excitement and curiousity.

Evolution is enabled because we have a limited lifespan.


CCP116

The limited lifespan meant that a means of reproduction is essential.

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CP32

The human offspring, because of its complexity, is slow to develop to basic self-sufficiency.

Growing and maintaining mobility, etc, requires regular nutrients, and waste disposal.

Our environment, with its climates, flora and fauna, is a provider but also a source of hazards and threats (Illness, rapists, insecurity, boredom, etc).

In order to cope we humans have evolved our 21 basic Senses (ref 79), and a range of genetically programmed elementary Needs (ref 58)

Your particular package of Needs are a large part of personality – but your Needs change with time and your circumstances.

Our control systems are based on our Central Nervous System, our Autonomous Nervous System and our Endocrine (Hormonal) System

The Autonomous Nervous System detects, generally through one or more specific Senses, when there is a Need. If, for example, it was to deal with the need to eat, and we do so, then we become aware of pleasurable feelings — the “reward” system!. When the need fulfilled the “inhibiting” system takes over, and we should feel satisfied.

Another example — Alcohol intake raises the levels of a neurotransmitter (Norepinephrine) thus providing enjoyment, but also impulsivity — explaining why we lose our inhibitions whilst drinking. However another neurotransmitter system, GABA receptors become effective when alcohol concentrations reached 0.33 mL/L (The legal limit for driving is 0.08 mL/L), and these should warn against further drinking, as the feeling of enjoyment is removed. However, with many people this corrective process is ineffective, as discussed later.

Meeting the basic needs for sustenance, shelter, safety, has enabled the development of social groupings.

So, we survive and commune, but we also compete; and our brains have evolved for these purposes.

The Harvard Medical School descibes us as having “a dog brain with a human cortex stuck on top” {ref191) — and that “not a second goes by that our animal brain isn’t seeking to influence our options”.

For the implications in daily life (and on our psyches) consider the following commonplace narratives called “Just another day!” from Hardwiring Happiness — by Rick Hanson

The Green Responsive Mode

After waking up, you spend a few minutes in bed lightly thinking ahead about some of the people you will see and the things you will do.

You hit traffic on the way to work, but you don’t fight it; you just listen to the radio and don’t let the other drivers bother you.

You may not be excited about your job, but today you’re focusing on the sense of accomplishment you feel as you complete each task.

On the way home, your partner calls and asks you to stop at the shops – it’s not your favourite thing to do after work, but you remind yourself it’s just fifteen extra minutes.

In the evening, you look forward to a TV show and you enjoy watching it.

These Scenarios indicate that we can be dominated by the Sympathetic (dog brain) mode of our Autonomic nervous systems.

Now, let’s look at the same day, but imagine reacting to it in a different way.

The Red Reactive Mode

After waking up, you spend a few minutes in bed pessimistically anticipating the day ahead and thinking about how boring it will be.

Today, the traffic really gets under your skin, and when a car causes you to brake sharply, you get angry and honk your horn.

You’re still rankled by the incident when you arrive at work, and to make matters worse, you have an unbelievable number of tedious tasks to get through.

By the time you’re driving home, you feel drained and don’t want to do a single extra thing.

You remember that you have to stop at the shops. You feel put upon but don’t say anything.

Then you spend much of the evening quietly seething that you do all the work around the house. Your favourite show is on, but it’s hard to enjoy watching it, you feel so tired and irritated

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The Para-sympathetic system generally looks after our normal functions — blood pressure, digestion, etc. It does so without our awareness leaving the conscious mind fully available.

The Sympathetic (dog brain) deals with perceived threats to our well-being. In the above the threats were mis-interpreted, but they still caused upset, unhappiness and probably fatigue. Worst still the anxiety may have become habitual – a bad

The most effective psychotherapy, Cognitive Behaviour Therapy (CBT) — (ref 296) is based on the following cognitive model — “the way that individuals perceive a situation is more closely connected to their reaction than the situation itself”.

Evolution has provided us with the means by which a human grows, learns and develops.

The human child develops basic capabilities as outlined in CCP112a. Their amazing ability to learn during this time varies as in CCP6.

CCP112a


CCP6
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We continue to learn as we need additional learning/programming/practice to cope with demands and our aspirations. Our Apps cover a wide range of the good habits (skills, attitudes, and dealing with inherent needs) and many are employed to relieve us of having to think our way through routine daily activities.

To repeat again — our basic nature is the result of how humans evolved.

The School at Medicine at Mt Sinai explains that we have “reward pathways” — (ref 291).

The most important reward pathway in brain is a dopamine system.

Under normal conditions, the pathway controls an individual’s responses to natural rewards, such as food, sex, and social interactions, and is therefore an important determinant of motivation and incentive drive.

The reward system associated with the evolutionary need for reproduction is complex and has major roles in human societies.


CCP85 Corridors of Power

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MedicalNewsToday Website looks at “Habit & Addiction” (ref 204) as follows:

A habit may eventually develop into an addiction (A bad habit) — Many of us can use substances or become engaged in activities without any significant problems. Some people, however, may experience damaging psychological and/or physical effects when their habit becomes an addiction.

Chronic anxiety and severe depression also start as habits — evolutionary functions. Read more at:
 The purpose of anxiety — (ref 271);
 The evolution of Depression — ref 273, and
 From the Open Access Library (OALib)the Function of Boredom has provided (ref 277)

So anxiety, a basic alertness, can be triggered by lots of experiences and false perceptions, and if these cause chronic stress then anxiety can be our habitual response.


CCP46

See also The Emotional Brain — (ref 140)

Emotions as they are experienced can be broken into three categories:

  • primary emotions,
  • secondary emotions, and
  • background emotions.

Primary emotions are experienced as a byproduct of a stimulus-response chain of events — these emotional responses have, to some degree, been hardwired in our brains over the course of evolution. Fear, anger, disgust, sadness, and joy are the “chairs of the board” of primary emotions.

Secondary and background emotions are the product of an internal feedback loop.

While the emotions involved in primary emotional reactions can also play a part in secondary and even as background emotions, nonprimary emotions are more likely to be some dues-paying subsidiary of a primary emotion — For instance, fear as a secondary emotion might feel more like anxiety, stress, or shyness; secondary emotions related to joy might be experienced as ecstasy, pleasure, or amusement.

Depression can be caused by a thought pattern called rumination and it can result from focussed thought, In the depressed state these ruminations are compromised by wrong and negative interpretations. As no natural reward transpires then no relief seems attainable.

The above reference on “What is Depression”, notes the following, including the loneliness aspect — Many other symptoms of depression make sense in light of the idea that analysis must be uninterrupted.

The desire for social isolation, for instance, helps the depressed person avoid situations that would require thinking about other things.

Similarly, the inability to derive pleasure from sex or other activities prevents the depressed person from engaging in activities that could distract him or her from the problem. Even the loss of appetite often seen in depression could be viewed as promoting analysis because chewing and other oral activity interferes with the brain’s ability to process information.

Boredom is a signal that you need to try something different.


CCP94 — But also in a world with readily available fake rewards.

Addiction can start of as social anxiety.- relieved by drinking alcohol.

For what happens to your Brain through use of Alcohol — see (ref 112)

Alcohol, according to conventional wisdom, is a depressant. Yet, that doesn’t fully explain alcohol’s effects. People often drink to liven up a party, not mellow it out. A few drinks can spark energy, elation and excitement; it gives you a buzz.

Alcoholic have a Tolerance for alcohol — (ref 18)

As blood alcohol content (BAC) is increased, we get elation, excitement and extroversion, with simultaneous decreases in fatigue, restlessness, depression and tension – what a reward!.

Elevated levels of a neurotransmitter, Norepinephrine, increase impulsivity, which helps explain why we lose our inhibitions whilst drinking.

If drinking continues then a different neurotransmitter becomes active — by means of the GABA (delta) receptors (target cells in CCP160)…


CCP160

GABA activity kicks in when alcohol concentrations get to around 0.33 mL/L. – – The legal limit for driving is around 0.05 to 0.08 mL/L .

Concentrations over 0.3 ml/L can be enough to cause someone to vomit and/or pass out.

With rising BAC the cognitive functions are reduced and our “Dog Brain” has taken over.

It is still unclear what the delta receptor does, but because GABA is the primary inhibitory neuron in the brain, it can affect virtually every system — depression returns and it seems that the reward system can then encourage even more booze.

PET brain scans show that regions of the brain, responsible for decision making and rational thought, have decreased activity and this explains why alcohol causes us to act impulsively, and aggressively.

The reduced activity in other parts of the brain indicates why walking is erratic and why drinkers can “black out”.

When drinking is suspended a descending BAC corresponds to an increase in fatigue, confusion, and depression — the only relief/reward is to start drinking again.

The most important reward pathway in brain is the mesolimbic dopamine system — (ref 291)

This pathway (VTA) is a key detector of a rewarding stimulus. Under normal conditions, the circuit controls an individual’s responses to natural rewards, such as food, sex, and social interactions, and is therefore an important determinant of motivation and incentive drive.

In simplistic terms, activation of the pathway tells the individual to repeat what it just did to get that reward. It also tells the memory centers in the brain to pay particular attention to all features of that rewarding experience, so it can be repeated in the future.

The VTA-NAc pathway is part of a series of parallel, integrated circuits, which involve several other key brain regions.

The VTA is the site of dopaminergic neurons, which tell the organism whether an environmental stimulus (natural reward, drug of abuse, stress) is rewarding or aversive.

The NAc, also called ventral striatum, is a principle target of VTA dopamine neurons. This region mediates the rewarding effects of natural rewards and drugs of abuse.

The amygdala is particularly important for conditioned forms of learning. It helps an organism establish associations between environmental cues and whether or not that particular experience was rewarding or aversive, for example, remembering what accompanied finding food or fleeing a predator. It also interacts with the VTA-NAc pathway to determine the rewarding or aversive value of an environmental stimulus (natural reward, drug of abuse, stress).

As stated above, the MedicalNewsToday Website — (ref 204) declares: A habit may eventually develop into an addiction — Many of us can use substances or become engaged in activities without any significant problems. Some people, however, may experience damaging psychological and/or physical effects when their habit becomes an addiction.

With a habit you are in control of your choices, with an addiction you are not in control of your choices.
 Addiction – there is a psychological/physical component; the person is unable to control the aspects of the addiction without help because of the mental or physical conditions involved.
 Habit – it is done by choice. The person with the habit can choose to stop, and will subsequently stop successfully if they want to. The psychological/physical component is not an issue as it is with an addiction. A habit may eventually develop into an addiction.

Many of us can use substances or become engaged in activities without any significant problems. Some people, however, may experience damaging psychological and/or physical effects when their habit becomes an addiction.

Addiction to substances or activities can sometimes lead to serious problems at home, work, school and socially.

The Science behind “addiction and habit” is considered in (ref 267), as follows:

“By seeing habit as part of addiction, Jolie was able to work out a treatment plan with me that wasn’t too overwhelming, pathologizing, or frightening for her to commit to. As she recognized her difficulty in moderating her drinking behaviour, especially when under stress, Jolie agreed to accept AA as an addiction-recovery resource. She now understood that her drinking was encoded in her brain in a way that went beyond an ordinary habit pattern.

At this stage, neurobiology’s biggest contribution to addictions treatment isn’t so much a distinct clinical method, but a means of increasing motivation for change. By destigmatizing clients’ shame and self-blame, brain-based explanations get resistant clients to listen to treatment recommendations they might otherwise reject. For therapists, this leverage may be brain science’s most important contribution to our clinical toolbox.”

Anxiety also can be a bad habit, but alternative simple habits can defeat anxiety — see (ref 263).

The Director of the National Institute of Anxiety and Stress, a teacher and learning expert, and a former anxiety sufferer presents his remedies in (ref 264 — Five mental habits that steal years from your life

Published by the Journal of Clinical Endocrinology and Metabolism suggests that chronic stress increases your chance of death five-fold. Beyond that, stress tends to spoil life along the way. So, we all owe it to ourselves to get it under control.

Best Practices/Habits of Mind is from the DBQ Project that was founded in 2000 to support teachers and students in learning to read smart, think straight, and write more clearly — (ref 268)

Three steps to habit change is by James Clear who is an author, photographer, and weightlifter. He studies successful people across a wide range of disciplines — entrepreneurs, artists, athletes, and more — to uncover the habits and routines that make these people the best at what they do — (ref 215.

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The Limbic System

Your Neurotransmitter Levels and Emotional Health
Re-training the Limbic System

Emotion involves the entire nervous system — but there are two parts of the nervous system that are especially significant — The limbic system and the autonomic nervous system — see The Emotional Nervous System

The Limbic System comprises:
• Thalamus:– A “relay station” for sensory input – then being directed to other parts of the brain.
• Amygdala:– Governs things like fear, anxiety, anger, and violence; sometimes referred to as the aggression center.
• Hippocampus:– Helps create short-term memories and turn them into long-term memories.
• Hypothalamus:– Regulates the autonomic nervous system by releasing stress hormones like adrenaline — this is where the fight/flight response originates.

Trauma routes directly to the limbic system.

Mental healing is blocked if trauma is poorly processed.

Long-term emotional distress (and often physical pain) are triggered by the events of everyday life.

In addition, unresolved trauma often manifests in these disorders — Ref480 EMDR & Limbic System

The autonomic nervous system (ANS) is so important in regulation of a vast number of body processes that one could say “it’s relevant in almost every disease state”!

However, autonomic dysfunction plays a particularly prominent role in certain diseases, including Heart failure and Tetanus — ref527 Relevance of ANS, and ANS and Emotions

Emotional life is largely housed in the limbic system, and it has a great deal to do with the formation of memories.

This System is a complex animal with other roles to play, but you can probably see why people call it the emotional brain.

Your senses, behaviors, and hormones – all closely tied to emotion – are processed here.

• Post-traumatic stress disorder (both single-event and complex forms)
• Test/performance anxiety
• General anxiety/depression
• Panic attacks
• Addiction
• Eating disorders
• Chronic physical pain

The adult nervous system is not static, but instead can change, can be reshaped by experience.

It is apparent that stress can alter plasticity in the nervous system, particularly in the limbic system. The adverse effects of stress upon the nervous system—the capacity of stress to impair synaptic plasticity, to hasten the death of such neurons, and to impair Neuro-genesis have always been viewed as the dark side of plasticity.

Such plasticity has been demonstrated from the most reductive to the most integrated levels, and understanding the bases of this plasticity is a major challenge — Ref342 Plasticity &Stress in the Limbic System

Your thoughts cause a cascade of and can either hurt or help your limbic system — Ref325

This source provides an alternative list of damage to the Limbic system:–
• Changed, or inappropriate emotional responses.
• Change to drive and appetites such as not being able to control or monitor eating.
• Alteration and fluctuations in temperature control.
• Some memory functions are lost and difficulty learning can occur.
• Motivation may be impaired.

One important set of connections for people with chronic depression is the connection between the limbic system and the prefrontal cortex — It appears that depression is associated with significant alterations in functioning in both of these areas.

When not functioning properly due to injury or impairment, the limbic system becomes hyper-sensitive and begins to react to stimuli that it would usually disregard as not representing a danger to the body.

So, a number of factors can significantly impair Limbic System function such as Psychological and/or Emotional Trauma, see — 525 Dis-regulation of autonomic nervous system .

It is a common characteristic of a variety of psychiatric disorders, including depression, schizophrenia, and panic disorder.

We should recognize that addiction is one of the most powerful memories we can have.
These memories are embedded in the brain; we do not forget an addiction any more easily than we forget our first love.

People often receive drug treatment more than once, and still relapse. Relapses are unfortunately common in treating addiction, but the same thing happens in treating Cancer and we still keep trying for a cure.

We must take the same attitude toward addictive diseases and offer extensive as well as intensive treatment.

But, most of all, we must offer understanding, which comes from knowing that addiction lies at the very core of our brains — Ref403 How Addiction Hijacks Our Reward System

See also: DepressionAnxietyBoredomAddictionSelf harmTherapy TreatmentsAddiction Helper</a

And — How the Internet is making us stupid

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Your Neurotransmitter Levels and Emotional Health Ref472 Chemical imbalance in Health Problems

Your emotional health is a combination of attitudes, personality, support systems, and your brain’s neurotransmitter levels. Positive attitudes and a healthy personality help us through life’s difficulties and a good support system of family and friends is also valuable during times of trouble.

Despite having these resources, there are times when coping with our experiences and life events changes our neurotransmitter status. Like an overheated automobile, we begin to have difficulty operating properly.

A variety of conditions and circumstances encountered in life can produce changes in our brain chemistry. These changes can then create mental health problems. We have known for years that chemical and substances in the body can become unregulated as in high blood pressure, high cholesterol, low/high blood sugar, etc.

There is no stigma associated with using medications to return these body chemicals/substances back to their normal levels.

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Retraining the Limbic System

But there are means of Ref470 Re-training the Functions of the Limbic System

For example you can help depression by healing your limbic system — Ref 325

In his book ” Change Your Brain, Change Your Life ” — Ref471 — The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Lack of Focus, Anger, and Memory Problems”, by Dr. Daniel G. Amen explains it this way:

When the deep limbic system is overactive, it sets the mind’s filter on “negative.”

People who are depressed have one dispiriting thought after another. When they look at the past,they feel regret. When they look at the future, they feel anxiety and pessimism. In the present moment, they’re bound to find something unsatisfactory. The lens through which they see themselves, others, and the world has a dim grayness. They are suffering from automatic negative thoughts or ANTs.

See also how changing your thoughts changes your limbic system, in the book by Rick Hanson — Ref626 Neurology of Awakening workshop

Limbic System Retraining Conclusions — see Ref341 Limbic system retraining

Taking everything that I’ve presented on this page into account, I encourage you to embrace the new concepts of neural retraining, rewiring the brain, limbic system retraining or retraining the Amygdala and explore what benefits they may be able to bring to your health.

However, be aware that it should not be used in place of other health care approaches; it should be used in combination with all your other methods of healing, including eating a healthy diet and living green.

Research both the Dynamic Neural Retraining SystemTM and Gupta Amygdala RetrainingTM program and see which one resonates the most for you

Limbic system retraining can be beneficial for any condition associated with autonomic nervous system dysfunction, including, but necessarily limited to; multiple chemical sensitivities, fibromyalgia, chronic fatigue, electromagnetic hypersensitivity, adrenal fatigue, anxiety disorders, depression, high blood pressure, migraine headaches and insomnia.

There is a powerful way to re-program your brain that has been largely overlooked. A way to change your relationship with eating, sleep, sex and basic emotions like fear, love and aggression. While cognitive therapies can modify behavior, they are of questionable help in altering these basic drives — see Ref144 Limbic system repair

This article will explain how the Hypothalamus and Amygdala contribute to the regulation of basic drives like eating, sleeping and sexuality, and how the Amygdala can actually override the Hypothalamus by enhancing the reward value of foods and other stimuli. (As I will explain, however, my take on “food reward” is different from that of Stephan Guyenet and other advocates of the Food Reward Hypothesis). This dual-control model can help explain anomalies such as obesity, addiction, and disordered sleep.

Finally, I will provide suggestions on effective and natural ways to re-program the Hypothalamus and Amygdala and change your homeostatic set points, using the principle of Hormesis.

Hormesis is a biological process whereby a beneficial effect (improved health, stress tolerance, growth or longevity) results from exposure to judicious doses of an agent that is otherwise detrimental at higher doses.
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Ref480 EMDR & Limbic System

Now, the limbic system is a complex animal with other roles to play, but you can probably see why people call it the emotional brain. Your senses, behaviors, memories, and hormones – all closely tied to emotion – are processed here.

Trauma routes directly to the limbic system. Thus, mental healing is blocked if trauma is poorly processed. Furthermore, long-term emotional distress (and often physical pain) are triggered by the events of everyday life. In addition, unresolved trauma often manifests in these disorders:

• Post-traumatic stress disorder (both single-event and complex forms)
• Test/performance anxiety
• General anxiety/depression
• Panic attacks
• Addiction
• Eating disorders
• Chronic physical pain

On the outside, the EMDR therapist 1) guides the client through brief episodes of recalling distress, and 2) simultaneously introduces new sensory input in the form of bilateral stimulation. This input usually involves rhythmic eye movements (thus EMDR’s name), but it can also be tactile (tapping the hand) or auditory (making sounds).

So, what’s happening on the inside? The limbic system is gaining new sensory information and new associations that allow it to process and/or replace the trauma and undo the blockage. Moreover, you might call it a clever trick that takes advantage of how the emotional brain receives and handles data.

EMDR therapy operates both on the outside and on the inside.

On the outside, the EMDR therapist 1) guides the client through brief episodes of recalling distress, and 2) simultaneously introduces new sensory input in the form of bilateral stimulation. This input usually involves rhythmic eye movements (thus EMDR’s name), but it can also be tactile (tapping the hand) or auditory (making sounds).

So, what’s happening on the inside? The limbic system is gaining new sensory information and new associations that allow it to process and/or replace the trauma and undo the blockage. Moreover, you might call it a clever trick that takes advantage of how the emotional brain receives and handles data.

Whatever you call it, research shows EMDR to be highly effective and often really fast. Some single-event trauma victims find relief in as few as three 90-minute sessions.

Ready to get your life back?

If you think you might be suffering from unresolved trauma, you can get your life back, and I would like to help. Please contact me via voicemail or email so we can discuss how we might work together to achieve your therapeutic goals as quickly and effectively as possible

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Anxiety/Panic

The VeryWell Website explains the function of anxiety — ref 271), as follows:

Most people view anxiety and fear as very unpleasant emotions, especially people with an anxiety disorder such as post-traumatic stress disorder (PTSD). This is because anxiety and fear are often associated with uncomfortable bodily sensations, such as increased heart rate, muscle tension, sweating, racing thoughts, shortness of breath, and tunnel vision. In fact, anxiety and fear are often viewed as “negative emotions.”

However, even though anxiety and fear may feel unpleasant or uncomfortable, they are in no way negative. They actually serve a very important purpose, and it would be very hard to get by in life without these emotions”.

Coping With Anxiety and Fear

There are many skills that can make it easier to move forward in life despite anxiety and fear.

Diaphragmatic breathing and progressive muscle relaxation are two effective ways of coping with anxiety and fear.

Mindfulness may also help you take a step back from unpleasant thoughts and emotions, allowing you to better connect with your present moment experience.

The next time you experience anxiety or fear, take a look at it. Ask yourself if the anxiety is stemming from a real or imagined threat.

Also consider the practice of Mindfulness for Anxiety — (ref 272)

Mindfulness has been around for ages. However, mental health professionals are beginning to recognize that mindfulness can have many benefits for people suffering from difficulties such as anxiety and depression.

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DEPRESSION

Depression is one of the most common mental health problems in the UK — and it shares a complex, mutually reinforcing relationship with excessive alcohol consumption

There is a saying: “The journey of a thousand miles begins with a single step.” But many depressed people can’t get out of bed, much less take a thousand-mile journey. For many sufferers, medication is the first step.

There are those who scoff at the idea of medication as an answer. But for those in a major clinical depression, life is a dark place full of pain, hopelessness and insecurity.

Sometimes the blame can be placed on brain chemistry. Neurotransmitters don’t work right, and brain chemicals such as serotonin, norepinephrine, and dopamine — your feel-good chemicals — often don’t go where they’re supposed to go. Medications deal with chemical imbalances. Find the right one, and you may feel more like your old self again. Because you feel better, getting motivated becomes a little easier.

A good therapist goes hand in hand with medication. One without the other is kind of a half-solution. By talking to a trained professional, you’ll feel better because you’re talking to someone who knows how to listen.

There are several Types of depression — (ref 318), notably:
 Alcoholic — (ref 321)
 Major — (ref 322)
 Seasonal — (ref 322)

Depression may be caused or precipitated by the use or abuse of substances such as drugs, alcohol, medications, or exposure to toxins. A mental health professional or physician must determine whether the mood disorder occurs as a result of the substance or just happens to occur at the same time by coincidence. If it develops as a result of the use of or exposure to the substance then this diagnosis may be appropriate. To make a diagnosis of a substance-induced mood disorder, the disturbance can only occur while a person is intoxicated, going through withdrawal, or within four weeks of either.

The Scientific American addressed the problem — “What is Depression” (ref 273 – date 2000), and noted “Depressed people often think intensely about their problems. These thoughts are called ruminations; they are persistent and depressed people have difficulty thinking about anything else. Numerous studies have also shown that this thinking style is often highly analytical. They dwell on a complex problem, breaking it down into smaller components, which are considered one at a time”.

(Ruminations — (ref 350) Ruminations)

A major component of depression is rumination, which involves dwelling and brooding about themes like loss and failure that cause you to feel worse about yourself.

The Scientific American have found evidence that people who get more depressed while they are working on complex problems in an intelligence test tend to score higher on the test.

Analysis requires a lot of uninterrupted thought, and depression coordinates many changes in the body to help people analyze their problems without getting distracted.

In a region of the brain known as the ventrolateral prefrontal cortex (VLPFC), neurons must fire continuously for people to avoid being distracted. But this is very energetically demanding for VLPFC neurons, just as a car’s engine eats up fuel when going up a mountain road. Moreover, continuous firing can cause neurons to break down, just as the car’s engine is more likely to break down when stressed. Studies of depression in rats show that the 5HT1A receptor is involved in supplying neurons with the fuel they need to fire, as well as preventing them from breaking down. These important processes allow depressive rumination to continue uninterrupted with minimal neuronal damage, which may explain why the 5HT1A receptor is so evolutionarily important.

Many other symptoms of depression make sense in light of the idea that analysis must be uninterrupted.

The desire for social isolation, for instance, helps the depressed person avoid situations that would require thinking about other things.

Similarly, the inability to derive pleasure from sex or other activities prevents the depressed person from engaging in activities that could distract him or her from the problem. REJECTING THE REWARD FUNCTION

Even the loss of appetite often seen in depression could be viewed as promoting analysis because chewing and other oral activity interferes with the brain’s ability to process information.

But is there any evidence that depression is useful in analyzing complex problems? For one thing, if depressive rumination were harmful, as most clinicians and researchers assume, then bouts of depression should be slower to resolve when people are given interventions that encourage rumination, such as having them write about their strongest thoughts and feelings.

However, the opposite appears to be true. Several studies have found that expressive writing promotes quicker resolution of depression, and they suggest that this is because depressed people gain insight into their problems.

There is another suggestive line of evidence. Various studies have found that people in depressed mood states are better at solving social dilemmas. Yet these would seem to have been precisely the kind of problems difficult enough to require analysis and important enough to drive the evolution of such a costly emotion. Consider a woman with young children who discovers her husband is having an affair. Is the wife’s best strategy to ignore it, or force him to choose between her and the other woman, and risk abandonment? Laboratory experiments indicate that depressed people are better at solving social dilemmas by better analysis of the costs and benefits of the different options that they might take.

Sometimes people are reluctant to disclose the reason for their depression because it is embarrassing or sensitive, they find it painful, they believe they must soldier on and ignore them, or they have difficulty putting their complex internal struggles into words.

But depression is nature’s way of telling you that you’ve got complex social problems that the mind is intent on solving.

Therapies should try to encourage depressive rumination rather than try to stop it, and they should focus on trying to help people solve the problems that trigger their bouts of depression. (There are several effective therapies that focus on just this.) It is also essential, in instances where there is resistance to discussing ruminations, that the therapist try to identify and dismantle those barriers.

When one considers all the evidence, depression seems less like a disorder where the brain is operating in a haphazard way, or malfunctioning. Instead, depression seems more like the vertebrate eye—an intricate, highly organized piece of machinery that performs a specific function.

The Scientific American also established that there is a A function for Depression — (ref 273, and queried “So what could be so useful about depression?” — noting:

Depressed people often think intensely about their problems. These thoughts are called ruminations; they are persistent and depressed people have difficulty thinking about anything else. Numerous studies have also shown that this thinking style is often highly analytical. They dwell on a complex problem, breaking it down into smaller components, which are considered one at a time.

This analytical style of thought, of course, can be very productive. Each component is not as difficult, so the problem becomes more tractable. Indeed, when you are faced with a difficult problem, such as a math problem, feeling depressed is often a useful response that may help you analyze and solve it. For instance, in some of our research, we have found evidence that people who get more depressed while they are working on complex problems in an intelligence test tend to score higher on the test.
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The relationship between Brain Functions and Depression are considered in (ref 274).

A study for adolescent considered Rewards in depression — ref 287

The reason why the effects of neurotransmitters are not clear-cut has to do with the fact that antidepressant medications do not work in the same pattern for every individual. If there were a direct causal link between the level of a neurotransmitter in the brain and depression, then we would expect a much higher rate of success with medication. Further, although antidepressant medications can change the level of a neurotransmitter in the brain immediately, it normally takes a few weeks for a person with depression to feel better.

The apparent anomaly with regard to positive feelings and depression lead to a redefining of depression in — (ref 244):

While many people tend to characterize depression as simply an abundance of negative feelings, it is important to note that a lack of positivity is also an important characteristic.

In fact, it may be the most important!

Researchers now believe that this may be due to the fact that people who are prone to depression have an active habit of suppressing positive feelings that come up naturally throughout the day.

Common Belief About Depression That Was NOT Validated

In a surprising contrast, researchers found that a tendency to dwell on negative feelings did not contribute to the development of the depression.

In other words, suppressing positive feelings may be the critical, causal element. So, we could define depression (in part) as a lack of positivity, with dwelling on negativity as a merely more noticeable outcome.

If you suppress the positive, then you are left with the negative.

Baffled: Why Would Anyone Suppress Positive Emotions?

When happiness is unfamiliar to you, you don’t trust it. So, when you begin to feel positive emotions that might lead to greater happiness, you tend to dismiss them in favour of a more familiar (if negative) state.

Drinking profoundly alters mood, arousal, behaviour, and neuropsychological functioning — and it often becomes addictive — (ref 112)

Addiction is unquestionably destructive, yet it is also uncannily normal — an inevitable feature of the basic human design. That’s what makes it so difficult to grasp — socially, scientifically, and clinically — Ref2003 The Biology of Desire by Marc Lewis

The drinking experience can alleviate deep-seated anxieties they have about themselves and their lives. In other words, alcohol provides more than temporary camaraderie for such drinkers. It provides existential relief. And people find such crucial psychological benefits are hard to relinquish —
o (ref 181) — “Stages of Alcoholism”
o (ref 182) — “Why do-we get hangovers”
o why-alcoholics-drink (ref 183) — “why alcoholics drink”.
o (ref 184) — “alcohol use disorder”.
o (ref 185) — “Hangovers – by Mayo Clinic”.

Precautions:

The use of SSRIs to reduce dependency — If depressed you may not be able to cope with detoxifying — Book ” The Noonday Demon by Andrew Solomon– p220″.

Drug or alcohol use or abuse or withdrawal of them can cause or worsen anxiety.

Rewards in Depression< were reviewed the Nature publication and reported in (ref 287):

Altered brain function has been observed during the anticipation of reward and the receipt of reward, suggesting that adolescent depression involves changes in both the motivation to obtain reward and the enjoyment of rewards once obtained.

The Psychiatry Advisor-noted that Depressed Children show Blunted Response to Rewards in (ref 288)

The Science Daily in 2008 noted that there was a “Conflict of reward in depression” (ref 289):

“Findings are consistent with formulations that depression involves difficulties in the processing of positive information, and suggest more specifically that depressed people actually experience conflict when they are faced with the likelihood of receiving a reward.”

Dr. Krystal concludes that “One intriguing potential implication of this work is that some forms of depression may be experienced, not as the absence of pleasure, but as the ubiquitous presence of emotional pain, disappointment, or frustration.”

Dr. Knutson and his colleagues are currently examining whether this increased experience of conflict when anticipating reward hinders recovery from depression.

The Biological Psychiatry Journal in 2010, examined “Rewards and Depression from a Biological viewpoint” in (ref 290)

“Depression is a complex and heterogeneous disorder whose cause is poorly understood.

There is good evidence that depressed patients exhibit abnormal behavioral responses to rewards and punishments and that these tendencies correspond to aberrant function in frontostriatal systems modulated by the monoamine systems.

Furthermore, computational studies have generated testable predictions for how these neural signalling and neuro-chemical abnormalities might contribute to the symptoms of depression.

Combining these approaches—as well as molecular and behavioural work in animals provides great promise for furthering our understanding of this common and debilitating disease.”

Web References for Depression: 2, 18, 52, 112, 114, 115, 141-150. See Ref 114 and 152

Non-Web
Ref2001 — The Noonday Demon by Andrew SolomonRef2001 — p436 Loneliness
Ref2001 — p469 Insomnia
Ref2001 — p470 CBT for insomnia (not swelling – Gluten-free no evidence
Ref2001 — p471 new treatment
Ref2001 — p450 napping counter-productive

To Contents
BOREDOM

Psychology Today considered The Key Points Underlying Boredom

Open Access Library (OALib) states about “The Function of Boredom”:– We argue that boredom has important implications for human functioning, based on emotion theory and empirical evidence. Specifically, we argue that boredom motivates pursuit of new goals when the previous goal is no longer beneficial. Exploring alternate goals and experiences allows the attainment of goals that might be missed if people fail to reengage.

In “Boredom and substance abuse” we are urged to
“Live Your Life with Passion” — do some serious self-analysis and know what authentically makes your heart race — The number one key to success, excitement and feeling fulfilled is doing something you just love to do.

The British Psychological Society considers The Exciting Side of Boredom and moves onto Mindfulness in tackling boredom

To Contents
ADDICTION

The commercial organisation Choose Help has presented “Stages of Alcoholism The Progressive Nature of Alcoholism^, with the message “Alcoholism is progressive!” — (ref 266)

Psychology Today addresses “How Alcohol Affects You” — (ref 112):

Alcohol, according to conventional wisdom, is a depressant. Yet, that doesn’t fully explain alcohol’s effects. People often drink to liven up a party, not mellow it out. A few drinks can spark energy, elation and excitement; it gives you a buzz. Alcohol may be more than simply a depressant.

Classification of drugs can be explained by their chemical targets within the brain.
• Stimulants may influence dopamine or norepinephrine.
• Depressants target a chemical called GABA, the primary inhibitory Neurotransmitter and Receptors in the Brain

As alcohol is consumed, drinkers gain increases in elation, excitement and extroversion, with simultaneous decreases in fatigue, restlessness, depression and tension.

Conversely, following drinking there is a decrease in vigour and an increase in fatigue, relaxation, confusion, and depression.

Researchers found that drinking increases levels of Norepinephrine — the chemical target of many stimulants.

Alcohol is not simply a depressant. Elevated levels of Norepinephrine increase impulsivity, which helps explain why we lose our inhibitions whilst drinking. PET brain scans show that regions, responsible for decision making and rational thought, have decreased activity and this explains why alcohol causes us to act impulsively, and aggressively — and drink excessively. The reduced activity in parts of the brain indicates why walking is erratic and why drinkers can “black out”.

However, if alcohol is a depressant, it should facilitate GABA receptors. GABA receptors do not respond to alcohol until alcohol concentrations reached 0.33 mL/L (The legal limit for driving is 0.08 mL/L).

(BAC, for a given alcohol intake, depends on gender and weight — try BAC calculator. When drinking is stopped BAC reduces by 0.015/hr – to give the “morning after” dilemna)

The delta receptor, one of the less common types of GABA, is concentrated in the same brain regions which had lowered activity through drinking. It is still unclear what the delta receptor does, but because GABA is the primary inhibitory neuron in the brain, it can affect virtually every system. Alcohol is more than simply a depressant.

It seems that Alcoholism is Progressive — (ref 266)

The effects are related to Blood/Alcohol Content (BAC). For a given alcohol intake, depends on gender and weight — try BAC calculator.

When drinking is stopped BAC reduces by 0.015/hr – sometimes to give the “morning after” dilemna!

BAC (% by Volume) — Typical Behaviour — and possible Impairment
To 0.1———– Reduced inhibition ———— Reduced reasoning
0.1 – 0.2 ——- Boisterous/Angry————— Staggering
0.2 – 0.3 ——- Stupor—————————— Blackout
0.3 – 0.4 ——- Severe depression—————–Incontinence
> 0.4 ————Coma ———————————Risk of death, damage

So, a simple model explains what happens as we continue to drink. Though an alcoholic has a greater tolerance to alcohol.

• Alcohol first of all initiates pleasure by activating tan excitatory neurotransmitter, thus stimulating the body.,
• However, above a BAC of around 0.33 mL/L they activate an inhibitory neurotransmitter as the body decides that enough is enough – the depressive phase.
• However reduced inhibition and a much greater tolerance to alcohol cause the alcoholic to continue drinking – the inhibitory neuro-transmitter is ineffective

But There is evidence that alcoholics have less of a problem with hangovers — (ref 18)

Every Day Health asks “Why do we-get hangovers” in — ref 182

The Mayo Clinic also considers Hangovers in — ref 185

Psychology Today looks at “Why alcoholics drink”ref 183

Psychology Today also considers the Alcohol use disorder” in — ref 184

Referring again to “Redefining Depression” ref 244, we note:

Researchers now believe that this may be due to the fact that people who are prone to depression have an active habit of suppressing positive feelings that come up naturally throughout the day.

This implies that only powerful feelings, such as the craving for alcohol, will get a ready response from depressed alcoholics – thus reinforcing the addiction.

INSERT June 2018

Ref508 The Sinclair Method of Addiction Treatment

The Sinclair Method (TSM) uses the nervous system’s own mechanism, called “extinction”, for gradually removing the interest in alcohol and the behaviors involved in alcohol drinking. Therefore, the technical term for TSM is “pharmacological extinction.”

Re506 Naltrexone-for-alcoholism

The key scientific discovery underlying the treatment was that, contrary to earlier beliefs, detoxification and alcohol deprivation do not stop alcohol craving but in fact increase subsequent alcohol drinking[1],[2]. The old idea that alcoholism is caused by physiological dependence on alcohol, therefore, needed to be discarded, and a new understanding of alcoholism developed.

Subsequent research showed that alcohol drinking is a learned behavior[3]. Some individuals, partly for genetic reasons, get so much reinforcement each time they drink, and have so many opportunities to drink and get reinforcement, that the behavior becomes too strong. They cannot always control their drinking; they cannot “just say ‘no’.” And society calls them alcoholics — see — Ref507 Addiction treatment – “A personal journey”

See also What you want to know about Selincro

While a number of Selincro’s predecessors focused on alcohol abstinence, Selincro’s mission is to decrease the amount of alcohol someone drinks. For example, over a one-month period, Selincro can reduce the number of “heavy-drinking days” experienced, along with decreasing the total number of drinks consumed on those drinking days, according to new research.

Selincro doesn’t reach peak effectiveness in the brain for at least two months.

Selincro (and Naltrexone) work to block the endorphins released so that reward isn’t passed on to the drinker’s brain and over a period of time (generally 3 to 6 months) pharmacological extinction is reached – which means that the drinker’s brain is able to function as a “normal” drinker as in “no buzz = no reward”.

To Contents

SLEEP Disruption to — and Other Biological Rhythms — Source

Although alcohol has sedative effects that can promote sleep onset, the fatigue experienced during a hangover results from alcohol’s disruptive effects on sleep. Alcohol induced sleep may be of shorter duration and poorer quality because of rebound excitation
(see the section “Effects of Alcohol Withdrawal”) after BAC’s fall, leading to insomnia.

Furthermore, when drinking behaviour takes place in the evening or at night (as it often does), it can compete with sleep time, thereby reducing the length of time a person sleeps.

Alcohol also disrupts the normal sleep pattern, decreasing the time spent in the dreaming state (i.e., rapid eye movement[REM] sleep) and increasing the time spent in deep (i.e., slow-wave) sleep.

In addition, alcohol relaxes the throat muscles, resulting in increased snoring and, possibly, periodic cessation of breathing (i.e., sleep apnea).

Alcohol interferes with other biological rhythms as well, and these effects persist into the hangover period. For example, alcohol disrupts the normal 24-hour (i.e., circadian) rhythm in body temperature, inducing a body temperature that is abnormally low during intoxication and abnormally high during a hangover.

Alcohol intoxication also interferes with the circadian night-time secretion of growth hormone, which is important in bone growth and protein synthesis.

In contrast, alcohol induces the release of adrenocorticotropic hormone from the pituitary gland, which in turn stimulates the release of cortisol, a hormone that plays a role in carbohydrate metabolism and stress response; alcohol thereby disrupts the normal circadian rise and fall of cortisol levels.

Overall, alcohol’s disruption of circadian rhythms induces a “jet lag” that is hypothesized to account for some of the deleterious effects of a hangover

Note that research indicates:
 Your brain may flush out toxins during sleep — (ref 294)
 Sleep resets brain connections crucial for memory and learning — (ref 295)

See also
Ref2001 – The Noonday Demon by Andrew Solomon– p469 Insomnia
Ref2001 — p470 CBT for insomnia (not swelling – Gluten-free no evidence

To Contents
SELF HARM

There is a basic tendency to self-sabotage and negative psychological attachments. We can get attached to inner negativity in childhood because it is so common – and not only because many parents are bad parents. An example was the rejection of positive thoughts when depressed.

But the habit of self-sabotage can be unlearned in a relatively short period of time if you are open to its existence within you. To learn more about self-sabotage and negative psychological attachments (and how to overcome them)watch the enlightening free video at this site.

To Treat Compulsive Physical Self- Harm see — Ref 633

Ref 253 seems to have withdrawn

One of the most effective types of treatment for compulsive self-harm disorders is cognitive behavioural therapy. The goal of CBT is to help the individual identify unhealthy and irrational thought patterns, and “re-wire” their thinking. By doing so, they can learn to replace the self-harm behaviour with healthy ways to cope with anxiety, emotional pain, and other triggers. Researchers have found that CBT is far more effective than a medication-only approach.

In one study, CBT had a more dramatic impact on reducing the “Hair-pulling” disorder than antidepressants.

In severe cases, a therapist or psychiatrist may recommend medication in addition to therapy. The antidepressant Fluoxetine, for example, may reduce compulsive skin picking

However, because of the risk of serious side effects, antidepressants are often used only in severe cases in which the behaviour results in infection, ulceration, or disfigurement.

Since people who struggle with compulsive self-mutilation often suffer from other psychiatric disorders, such as PTSD or major depression, a successful treatment plan will also integrate therapies to address those conditions as well.

Self-help strategies are essential tools for managing and eliminating self-mutilating behaviours.
INTERPERSONAL THERAPY ( IPT) is a short-term, focused, treatment for depression
It was originally developed to treat depression in adults, it has been shown to be effective in treating adolescent depression and is commonly recommended as a treatment for depression in children These include:
• Managing stress.
• Expressing emotions.
• Keeping hands busy.

Self-mutilation behaviours, from nail biting to skin picking, are more than inconvenient habits. If your behaviour is causing embarrassment, shame, or physical problems, seek help.

A skilled mental health professional will be able to reverse these conditions.

To Contents
THERAPIES

Although the role of cognitive behaviour therapy (CBT) in severe depression has not been adequately studied, a trial of CBT may be considered in severely depressed patients whose symptoms respond poorly to an adequate antidepressant trial, who are intolerant of antidepressants, have contraindications to pharmacotherapy, and who refuse medication or other somatic therapy.

A combination of CBT and antidepressants may also be beneficial in some patients.

Electroconvulsive therapy (ECT) may be indicated in severe psychotic depression, severe melancholic depression, resistant depression, and in patients intolerant of antidepressant medications and those with medical illnesses which contraindicate the use of antidepressants (e.g. renal, cardiac or hepatic disease).

There are 3 main talking therapies — (ref 299):
• Cognitive Behaviour Therapy (CBT) that helps patients understand the thoughts and feelings that influence behaviours. CBT is commonly used to treat a wide range of disorders including phobias, addictions, depression, and anxiety. Cognitive behaviour therapy is generally short-term and focused on helping clients deal with a very specific problem.
• The longer-established Psychodynamic Therapy (PT), which is an alternative approach to CBT but is more holistic, i.e. looking at the whole person, and takes much longer
• Interpersonal Therapy ( IPT) is a short-term, focused, treatment for depression. It was originally developed to treat depression in adults, but it has been shown to be effective in treating adolescent depression and is commonly recommended as a treatment for depression in children

There are a number of specific types of therapeutic approaches that involve CBT that are regularly used by mental health professionals. These types include:
• Rational Emotive Behavior Therapy — (ref 300)
• Cognitive Therapy — (ref 301)
• Multimodal Therapy — (ref 302)
• Dialectical Behaviour Therapy — (ref 303)

What is learnt from therapy has to be adopted as life-tools and put into practice.

CBT is concerned with “wrong thinking” and a basic tenet is — “Just because you think it does not make it true”.

Having basic tools that you put selectively into practice at all times is useful. This is the basis of Mindfulness, which has come into wide use.

To Contents
MEDICATIONSxmeds

See how Psychologists Ask and Answer Questions — (ref 297)

Note there is a that only 15 percent of therapy success is related to the type of therapy you practice — these being the therapeutic alliance, environmental factors and even the placebo effect play a far greater role — (ref 333)

The Harvard Medical School considered the best approach to Severe depression — (ref 298)

They first defined Severe Depression, as follows:

A major depressive episode can be categorised as severe based on depressive symptoms, scores on depression rating scales, the need for hospitalisation, depressive subtypes, functional capacity, level of suicidality and the impact that the depression has on the patient.

Several biological, psychological and social factors, and the presence of comorbid psychiatric or medical illnesses, impact on depression severity. A number of factors are reported to influence outcome in severe depression, including duration of illness before treatment, severity of the index episode, treatment modality used, and dosage and duration of and compliance with treatment. Potential complications of untreated severe depression include suicide, self-mutilation and refusal to eat, and treatment resistance. Several antidepressants have been studied in the treatment of severe depression.

These include tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline (norepinephrine) reuptake inhibitors, noradrenergic and specific serotonergic antidepressants, serotonin 5-HT(2) receptor antagonists, monoamine oxidase inhibitors, and amfebutamone (bupropion).

More recently, atypical antipsychotics have shown some utility in the management of severe and resistant depression.

Data on the differential efficacy of TCAs versus SSRIs and the newer antidepressants in severe depression are mixed.

Some studies have reported that TCAs are more efficacious than SSRIs; however, more recent studies have shown that TCAs and SSRIs have equivalent efficacy.

There are reports that some of the newer antidepressants may be more effective than SSRIs in the treatment of severe depression, although the sample sizes in some of these studies were small.

Combination therapy has been reported to be effective. The use of an SSRI-TCA combination, while somewhat controversial, may rapidly reduce depressive symptoms in some patients with severe depression.

The combination of an antidepressant and an antipsychotic drug is promising and may be considered for severe depression with psychotic features.

Although the role of cognitive behaviour therapy (CBT) in severe depression has not been adequately studied, a trial of CBT may be considered in severely depressed patients whose symptoms respond poorly to an adequate antidepressant trial, who are intolerant of antidepressants, have contraindications to pharmacotherapy, and who refuse medication or other somatic therapy.

A combination of CBT and antidepressants may also be beneficial in some patients.

Electroconvulsive therapy (ECT) may be indicated in severe psychotic depression, severe melancholic depression, resistant depression, and in patients intolerant of antidepressant medications and those with medical illnesses which contraindicate the use of antidepressants (e.g. renal, cardiac or hepatic disease).

There are 3 main talking therapies — (ref 299):
• Cognitive Behaviour Therapy (CBT) that helps patients understand the thoughts and feelings that influence behaviours. CBT is commonly used to treat a wide range of disorders including phobias, addictions, depression, and anxiety. Cognitive behaviour therapy is generally short-term and focused on helping clients deal with a very specific problem.
• The longer-established Psychodynamic Therapy (PT), which is an alternative approach to CBT but is more holistic, i.e. looking at the whole person, and takes much longer
• Interpersonal Therapy ( IPT) is a short-term, focused, treatment for depression. It was originally developed to treat depression in adults, but it has been shown to be effective in treating adolescent depression and is commonly recommended as a treatment for depression in children

There are a number of specific types of therapeutic approaches that involve CBT that are regularly used by mental health professionals. These types include:
• Rational Emotive Behavior Therapy — (ref 300)
• Cognitive Therapy — (ref 301)
• Multimodal Therapy — (ref 302)
• Dialectical Behaviour Therapy — (ref 303)

What is learnt from therapy has to be adopted as life-tools and put into practice.

CBT is concerned with “wrong thinking” and a basic tenet is — “Just because you think it does not make it true”.

Having basic tools that you put selectively into practice at all times is useful. This is the basis of Mindfulness, which has come into wide use.

EMDR Therapy

EMDR
How does EMDR work

EMDR can be thought of as a physiologically based therapy that helps a person see disturbing material in a new and less distressing way.

what does emdr treat

What does EMDR treat

Treatment for trauma, anxiety, panic, disturbing memories, post traumatic stress and many other emotional problems.

To Contents
TREATMENTS

THERAPIES & MEDICATIONS

INSERT 524 Depression therapy — bright light

A recent treatment in the UK is exemplified by The Sinclair Method of Addiction Treatment

See Addiction treatment — “A personal journey”

The Sinclair Method (TSM) uses the nervous system’s own mechanism, called “extinction”, for gradually removing the interest in alcohol and the behaviors involved in alcohol drinking. Therefore, the technical term for TSM is “pharmacological extinction.”

The key scientific discovery underlying the treatment was that, contrary to earlier beliefs, detoxification and alcohol deprivation do not stop alcohol craving but in fact increase subsequent alcohol drinking[1],[2]. The old idea that alcoholism is caused by physiological dependence on alcohol, therefore, needed to be discarded, and a new understanding of alcoholism developed.

Subsequent research showed that alcohol drinking is a learned behavior[3]. Some individuals, partly for genetic reasons, get so much reinforcement each time they drink, and have so many opportunities to drink and get reinforcement, that the behavior becomes too strong. They cannot always control their drinking; they cannot “just say ‘no’.” And society calls them alcoholics.

A controversial method of dealing with various mental disorders is called neurotransmitter repletion — (ref 279) Neurotransmitter Repletion

The Harvard Medical School considered the best approach to Severe Depression — (ref 298) — A combination of CBT and antidepressants may also be beneficial in some patients. Electroconvulsive therapy (ECT) may be indicated in some cases.

Medications and talking therapies are often combined, with in severe cases a psychiatrist responsible for medications.

Antidepressant medications do not work in the same pattern for every individual. If there were a direct causal link between the level of a neurotransmitter in the brain and depression, then we would expect a much higher rate of success with medication — (ref 274)

Further, although antidepressant medications can change the level of a neurotransmitter in the brain immediately, it normally takes a few weeks for a person with depression to feel better — (ref 274)

Medications are the province of medical professionals, but nutrition is also important — (ref 279).

There are three aspects of the talking psychotherapy process: therapeutic engagement, dysfunctional patterns ( i.e. what’s wrong) and therapeutic change — — (ref 333)

This reference claims that only 15 percent of therapy success is related to the type of therapy you practice — and that the therapeutic alliance (The relationship you have with your therapist and the level of trust), environmental factors and even the placebo effect play a far greater role

The most effective psychotherapy, Cognitive Behaviour Therapy (CBT) — (ref 296) is based on the following cognitive model — “The way that individuals perceive a situation is more closely connected to their reaction than the situation itself”.

The use of an SSRI-TCA combination, while somewhat controversial, may rapidly reduce depressive symptoms in some patients with severe depression.

The combination of an antidepressant and an antipsychotic drug is promising and may be considered for severe depression with psychotic features.

Although the role of cognitive behaviour therapy (CBT) in severe depression has not been adequately studied, a trial of CBT may be considered in severely depressed patients whose symptoms respond poorly to an adequate antidepressant trial, who are intolerant of antidepressants, have contraindications to pharmacotherapy, and who refuse medication or other somatic therapy.

A combination of CBT and antidepressants may also be beneficial in some patients.

CBT is concerned with “wrong thinking” and a basic tenet is — “Just because you think it does not make it true”.

Electroconvulsive therapy (ECT) may be indicated in severe psychotic depression, severe melancholic depression, resistant depression, and in patients intolerant of antidepressant medications and those with medical illnesses which contraindicate the use of antidepressants (e.g. renal, cardiac or hepatic disease).

There are 3 main talking therapies — (ref 299):
• Cognitive Behaviour Therapy (CBT) that helps patients understand the thoughts and feelings that influence behaviours. Cognitive behaviour therapy is generally short-term and focused on helping clients deal with a very specific problem.
• Psychodynamic Therapy (PT), which is an alternative approach to CBT but is more holistic, i.e. looking at the whole person, and takes much longer
• Interpersonal Therapy ( IPT) is a short-term, focused, treatment for depression. It has been shown to be effective in treating adolescent depression and is commonly recommended as a treatment for depression in children

There are a number of specific types of therapeutic approaches that involve CBT that are regularly used by mental health professionals.

There are a number of specific types of therapeutic approaches that involve CBT that are regularly used by mental health professionals. These types include:
• Rational Emotive Behavior Therapy — <a href=”http://albertellis.org/rebt-cbt-therapy/” target=”_blank”>(ref 300)</a>
• Cognitive Therapy — <a href=”https://www.beckinstitute.org/get-informed/what-is-cognitive-therapy/” target=”_blank”>(ref 301)</a>
• Multimodal Therapy — <a href=”http://www.therapyhub.com/articles/informational/multimodal-therapy” target=”_blank”>(ref 302)</a>
• Dialectical Behaviour Therapy — <a href=”http://www.webmd.com/mental-health/dialectical-behavioral-therapy#1″ target=”_blank”>(ref 303)</a>

Alcohol-related neurologic disease — (ref 187)

How is alcohol-related neurologic disease treated?
Avoiding alcohol is the best way to avoid these conditions and relieve symptoms. The earlier you stop intake, the more likely you are to recover. You may need inpatient rehab, especially if you exhibit alcoholism or alcohol dependence. A good source of help is support from family and friends. Other support sources include:
• Local Alcoholics Anonymous (AA) support groups
• National agencies
• Helplines

Once you stop alcohol intake, a doctor can address your specific symptoms. Every person’s needs are different. Doctors tailor specific treatments and alcohol abstinence programs to the individual.

Treatment may include:
• Vitamins and supplements
• Physical therapy
• Prescription medication
• Painkillers

Intravenous thiamine may reverse the symptoms of WKS. But delirium tremens is a medical emergency and requires a hospital stay. You may need to be sedated for more than a week until the alcohol withdrawal symptoms go away. And a doctor may use brain-imaging techniques to monitor treatment over time.

How can alcohol-related neurologic disease be prevented?

Early intervention by doctors or family and friends can help you avoid alcohol-related neurologic disease.
Steps you can take for prevention include:
• educating yourself on how much alcohol is considered too much
• limiting your daily alcohol intake to one drink or less for women, and two drinks or less for men

Ultimately, the best way to prevent alcohol-related neurologic disease is to not drink any alcohol at all.

 

Ref155 new-brain-old-brain-mindfulness-compassion-
Ref272 Mindfulness for Anxiety
Ref276 Mindfulness in tackling boredom>
Ref292 (ref 292) mindful anxiety calming-rush-panic-body

To improve your Motivation — see (ref289)

Use positive thoughts about yourself to create new neural pathways. Over time, the old, bad, unused pathways wither, die and fall off, much like the branches on an old tree. With some determination to stay on the positive path, you create a new soundtrack, which is filled with hope, giving you more motivation to keep stepping forward.

The same premise applies to self-talk in the mirror. Whenever you see yourself in the mirror, say something positive about yourself. Some people carry flashcards to remind themselves of their good traits when they’re feeling particularly down. This is a behavioural psychology method to get you to replace bad thoughts with good ones. Before long you are reminded of all the wonderful things that you have to offer, and you are motivated enough to take another step in the healing process toward rejoining the world.

Socialization is important. Make a standing appointment to have a friend or family member pick you up to go out. This way you’re held accountable to someone else. If there are no friends or family members available, don’t use that as an excuse. Going to the bookstore and people-watching in the coffee-shop is preferable to sitting home alone. Who knows? You may make a new friend. That is certainly motivating.

Give yourself credit for progress made, even if it seems tiny. Set small goals.

To Contents

Alcohol Reward Cycle & Selincro

545 Alcohol Medication

ccc

CCP193

549 dopamine-norepinephrine

Dopamine is the precursor to norepinephrine
Dopamine plays a large role in the pleasure/reward pathway (addiction and thrills), alertness, concentration, focus, memory, motivation, motor control, generates energy for the metabolism, stimulates the heart, helps to regulate the flow of information throughout the brain.

Norepinephrine stimulates the heart, blood vessels, sweat glands, the large internal
organs,the adrenal medulla in the brain, alertness, arousal,f ightor flight,learning,long term — memory,sense of wellbeing, euphoric,

Low dopamine levels can cause depression, loss of motor control, loss of satisfaction, addictions, loss of pleasure, world looks colorless, unable to love, to feel attachment, cravings, compulsions, low sex drive, poor attention and focus, no remorse upon own actions, ahedonia, distractibility,
Low norepinephrine : lack of energy,lack of motivation, depression (first state)

High
When dopamine levels are elevated symptoms may manifest in the form of anxiety, paranoia, or hyperactivity.
Norepinephrine high levels : anxiety, fear

Optimum
feelings of pleasure,attachment/love,altruism,integration of thoughts and feelings,

Dopamine levels are depleted by stress, certain antidepressants, drug use, poor nutrition, and poor sleep. Alcohol, caffeine, and sugar all seem to decrease dopamine activity in the brain.

Dopamine is a neurotransmitter in your brain that, according to Medhelp, is associated with

feelings of bliss, pleasure and euphoria; it also stimulates proper motor movements, focus and

appetite control. In addition, Patrick Holford states in his book “New Optimum Nutrition for the

Mind,” that dopamine helps you to deal with stress, reduce fatigue and both motivates and

stimulates you. Finally, lowered dopamine levels have been associated with Parkinson’s

disease, and according to Brookhaven National Laboratory, both addicts and obese people

have fewer dopamine receptors than the general population.

ccc

Role of GABA in the brain
550 role-of-GABA-in-the-brain

GABA is an inhibitory neurotransmitter which means that when it reaches at the receptor site of a neuron, it reduces the activity level of that neuron and makes it less likely to fire it action potential.

GABA is a natural calming and anti-epileptic (epilepsy is a disorder of the brain and nervous system.

This condition causes the brain to send out abnormal electrical signals and these signals cause the body to have a seizure) agent.

It is vital for proper brain functioning. GABA also helps our bodies make endorphins. These are the chemicals that make us feel happy. GABA affects mood because it reduces high levels of the hormones adrenalin, noradrenalin and dopamine. It also affects the neurotransmitter serotonin.
High amount of GABA in brain is linked to being relaxed and happy. Less GABA is linked to the sleeping problem insomnia, and feeling anxious, stressed and depressed.

CCP194

See — Ref551 Dopamine and GABA (Addiction) Genetics

Glutamate and GABA (gamma-aminobutyric acid) are the brain’s most plentiful neurotransmitters. Over half of all brain synapses use glutamate, and 30-40% use GABA.
Since GABA is inhibitory and glutamate is excitatory, both neurotransmitters work together to control many processes, including the brain’s overall level of excitation. Many of the drugs of abuse change the balance of glutamate or GABA, exerting tranquilizing or stimulating effects on the brain. Drugs that increase GABA or decrease glutamate are depressants. Those that decrease GABA or increase glutamate are tranquilizers or stimulants.
• Alcohol decreases glutamate activity.
• PCP, or “angel dust,” increases glutamate activity.
• Caffeine increases glutamate activity and inhibits GABA release.
• Alcohol increases GABA activity.
• Tranquilizers increase GABA activity.
Dopamine is the neurotransmitter used by the reward pathway (also called the mesolimbic pathway, which is closely linked with the mesocortical pathway). But there are two other important pathways in the brain that use dopamine: the nigrostriatal pathway and the tuberoinfundibular pathway. Generally, drugs that affect dopamine levels affect all three of these pathways.
Mesolimbic and Mesocortical pathways: Ventral tegmental area to nucleus accumbens, amygdala, hippocampus, and prefrontal cortex — Memory, motivation, emotion, reward, desire, and addiction

Comment — Looking for changes to pathways in context of neuro-plasticity
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Object of Neural Plasticity
557 Object of Neural Plasticity

Systemic neuroplasticity is an inherent feature of the nervous system that enables the system to adapt to changing environmental conditions by affecting, in particular, the processes of learning and memory, as well as a self-repair capacity.

These characteristics apply to neurons at all levels of the nervous system, and various types of neuroplasticity are recognized as follows:
• Developmental plasticity, post-injury plasticity of a fully developed brain (compensatory plasticity),
• Neuroplasticity caused by repeated sensory (inputs) or motor (outputs) experiences,
• Plasticity associated with the processes of learning and memory,
• Plasticity formed during the development of addiction, and
• Pathological neuroplasticity induced by the development of epilepsy (epileptogenesis) or neuropathic pain.

The changes in the strength of interneuronal connections, with modifications in the strength (efficacy) and the number of synaptic connections (nerve synapses), comprise the underlying foundation of these neuroplastic changes

During the prenatal development of the nervous system, the quantity of developing neurons exceeds the number of neurons that survive. The neurons “compete” with each other for the chance to form synaptic connections with other neurons (synaptogenesis), and the neurons that do not produce these connections experience programmed (and controlled) cell death (apoptosis).

The key factor in the formation of synapses at both the cellular and molecular levels is long-term potentiation (LTP)

Object of Neural Plasticity Based on studies of the structure and function of the brain, dynamic modifications of this organ occur under the influence of different factors.

The plasticity of the brain is defined as nerve pathway reorganization in response to external stimuli, which is primarily expressed in the modulation of the density and quantity — B. F. Kania et al. 46 of neural pathways with changes in the mode of synaptic communication. Moreover, morphological changes occur in neurons. Plastic changes in the nervous system are a consequence of the natural development and life of an organism; however, paradoxically, these changes may also result from various types of damage and injury, repeated activity (experience) in response to environmental stimuli, learning and memory processes, or addiction.

The nervous system is particularly vulnerable to these factors during developmental stages; however, this capacity is preserved in the adult brain.

Stimuli that alter the neural structure include psychoactive drugs, diet, disease, stress, growth factors, anti-inflammatory agents, sex hormones, and organic brain damage.

Changes in behaviour are associated with changes in the organization and/or properties of the brain, primarily by the modification or creation of new elements, which may result in an anatomical imprint.

These changes are primarily present at the level of the synapse. The examination of these changes is difficult because the area of interest will always be too limited relative to the extremely substantial number of synapses, which for the human brain consists of 100 billion nerve cells that may each produce several thousands of synapses.

The simple, neuron staining technique of Golgi is used to estimate changes in the quantities of synapses that depend on changes in the dendritic length or dendritic spine density. Using this method, a significant difference is identified in the number of synapses in specific brain regions of pet animals placed in environments that are rich or poor in stimuli.

In the enriched environments, e.g., in which a stimulating element, such as a running wheel, is introduced, a two- to threefold increase occurs in the number of hippocampal neurons [19].

Various stimuli, such as different odors, affect not only the number but also the life span of neurons in the medulla oblongata.

Subsequent studies on animals at different stages of development have identified quantitative and qualitative differences in the organization of synapses in animals placed in identical environments that were rich in stimuli [20] [21]. In adults and older animals, the length of dendrites and the density of nerve synapses in the sensory and motor cortices increase in response to stimuli;

in contrast, in young animals, the dendrites grow in length, but the density of dendritic spines decreases. Therefore, the conclusion is that even mild stimulation, such as treatment with a small brush three times a day for 15 minutes at a young age, improves motor and cognitive functions in adult animals, which suggests that anatomical changes occur in the nervous system

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558 brain organisation — Plasticity and functional recovery in neurology

Conclusion Theories on brain function over the past three centuries have been based on two extreme views.

The first was the doctrine of modularity: the notion that different mental capacities, whether as mundane as motion perception or as complex as moral judgement, are mediated by relatively autonomous, highly specialised brain regions.

At the other end of the spectrum is the ‘holistic’ view championed by Karl Lashley and revived in recent years by neural network aficionados.

Work in the past decade argues against both extreme views, and instead suggests that specialised mechanisms do indeed exist but with a great deal of back and forth interaction between them; these interactions can be fruitfully exploited in neuro-rehabilitation.

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SELINCRO

The most recent addition is another opioid antagonist, nalmefene (Selincro; Lundbeck), which was approved in Europe in 2013, but is not yet approved in the United States for alcohol addiction. Unlike the others, it can be taken ‘as needed’ when the person feels the urge to drink. The drug was made available on the NHS in 2014 to help problem drinkers cut down their alcohol intake, but its use has been controversial.
Some studies have reported limited effectiveness and that it works no better than counselling. And some researchers have questioned the regulator’s decision to license the drug and suggested that company-sponsored trials were poorly designed[5],[6].
Anne Lingford-Hughes, deputy head of neuropsychopharmacology at Imperial College London and a consultant psychiatrist at Central North West London NHS Foundation Trust, says nalmefene has a place for people who are not highly dependent but are trying to reduce their drinking and who are also receiving counselling. But she adds: “It is a tricky drug to use because of the side-effect profile.”
547 could-nalmefene-cure-your-drink-problem
Professor Carole Longson, director of the Centre for Health Technology Evaluation at NICE, for instance, concludes that nalmefene “works well and is good value. It adds to our range of treatments. But it isn’t just a pill to take in order to carry on drinking.”

To Contents

Retraining the Limbic System

There are means of Re-training the Functions of the Limbic System — Ref470

For example you can help depression by healing your limbic system — Ref 235

In his book Change Your Brain, Change Your Life – The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Lack of Focus, Anger, and Memory Problems“, by Dr. Daniel G. Amen — “Ref 471 explains it this way:<

When the deep limbic system is overactive, it sets the mind’s filter on “negative.” People who are depressed have one dispiriting thought after another. When they look at the past,they feel regret. When they look at the future, they feel anxiety and pessimism. In the present moment, they’re bound to find some thing unsatisfactory. The lens through which they see themselves, others, and the world has a dim grayness. They are suffering from automatic negative thoughts or ANTs.

See also how changing your thoughts changes your limbic system, in the Neurology of Awakening workshop — Ref 626

Limbic System Retraining Conclusions — see — Ref341 Limbic system retraining

Taking everything that I’ve presented on this page into account, I encourage you to embrace the new concepts of neural retraining, rewiring the brain, limbic system retraining or retraining the amygdala and explore what benefits they may be able to bring to your health.

However, be aware that it should not be used in place of other health care approaches; it should be used in combination with all your other methods of healing, including eating a healthy diet and living green.

Research both the Dynamic Neural Retraining SystemTM and Gupta Amygdala RetrainingTM program and see which one resonates the most for you
Limbic system retraining can be beneficial for any condition associated with autonomic nervous system dysfunction, including, but necessarily limited to; multiple chemical sensitivities, fibromyalgia, chronic fatigue, electromagnetic hypersensitivity, adrenal fatigue, anxiety disorders, depression, high blood pressure, migraine headaches and insomnia.

There is a powerful way to re-program your brain that has been largely overlooked. A way to change your relationship with eating, sleep, sex and basic emotions like fear, love and aggression. While cognitive therapies can modify behavior, they are of questionable help in altering these basic drives — Ref 344

This article will explain how the hypothalamus and amygdala contribute to the regulation of basic drives like eating, sleeping and sexuality, and how the amygdala can actually override the hypothalamus by enhancing the reward value of foods and other stimuli. (As I will explain, however, my take on “food reward” is different from that of Stephan Guyenet and other advocates of the Food Reward Hypothesis). This dual-control model can help explain anomalies such as obesity, addiction, and disordered sleep.

Finally, I will provide suggestions on effective and natural ways to re-program the hypothalamus and amygdala and change your homeostatic set points, using the principle of hormesis.

Hormesis is a biological process whereby a beneficial effect (improved health, stress tolerance, growth or longevity) results from exposure to judicious doses of an agent that is otherwise detrimental at higher doses.

EMDR & the Limbic SystemRef 480

Now, the limbic system is a complex animal with other roles to play, but you can probably see why people call it the emotional brain. Your senses, behaviors, memories, and hormones – all closely tied to emotion – are processed here.

Trauma routes directly to the limbic system. Thus, mental healing is blocked if trauma is poorly processed. Furthermore, long-term emotional distress (and often physical pain) are triggered by the events of everyday life. In addition, unresolved trauma often manifests in these disorders:

• Post-traumatic stress disorder (both single-event and complex forms)
• Test/performance anxiety
• Ge3neral anxiety/depression
• Panic attacks
• Addiction
• Eating disorders
• Chronic physical pain

On the outside, the EMDR therapist 1) guides the client through brief episodes of recalling distress, and 2) simultaneously introduces new sensory input in the form of bilateral stimulation. This input usually involves rhythmic eye movements (thus EMDR’s name), but it can also be tactile (tapping the hand) or auditory (making sounds).

So, what’s happening on the inside? The limbic system is gaining new sensory information and new associations that allow it to process and/or replace the trauma and undo the blockage. Moreover, you might call it a clever trick that takes advantage of how the emotional brain receives and handles data.

To start