#IStandWithAhmed

Cool clock, Ahmed. Want to bring it to the White House? We should inspire more kids like you to like science. It’s what makes America great.

Looks like the paranoid, xenophobic actions of a Texas school may just have made Ahmed Mohamed’s life. Funny, that was the name of my uncle, a word and numbers savant! I’ve talked about him in my blog posts. But now it’s time to talk about Ahmed, the 9th grader who brought a clock he had made to school, and got arrested because a teacher called the police, claiming it was a bomb. Well he was released, and no charges are to be filed, however the police do, now, have his fingerprints. The police chief said that “… there was no support for the perception that Ahmed meant to create alarm”. Maybe the “alarm” he did create with his clock was to wake up America, to wake up from discrimination, xenophobia, and fear.

However, ironically enough, this incident has opened doors for Ahmed that before were not open. For example, the door of the White House! President Obama has invited him to the White House, MIT is preparing to invite him for a visit. Mark Zuckerberg has invited him for a tour of Facebook, and Jaime Casap of Google has issued an invitation. Well I like this kind of irony, I hope this bright 9th grader will leave the arrest behind and now embrace all these amazing opportunities that are being offered to him. I hope one of these opportunities makes his like!

So I went to the dentist today, and they gave me WHAT? Epinephrine!?

articaine

Yes, so I went to the dentist today to get a regular cleaning. First time in Louisville. Yes, I know, I’ve been ignoring my dental health since we moved here… so anyway, I thought it’s time to remedy that. This was the first time I’d been to this dentist. Some chiding for not having gone to the dentist in a while,  x-rays, a regular cleaning, and I’d be on my way, or so I thought. On the first visit, they just took x-rays and sent me home. On the second visit, they said they were only going to clean the teeth on my right side. They said they were going to give me an anesthetic, so the deep cleaning they were going to give me wouldn’t hurt. Ok. First they swabbed some anesthetic on my gums. Then they injected some short acting anesthetic, sticking me SIX times. Then they injected long acting anesthetic, sticking me another SIX times, this was to avoid pain??? After the long acting injections, my heart started to race like I’d run a 20 second mile! I told them I was having an adverse reaction as my heart was racing and I was feeling very jittery, deep breath. They very calmly informed me that that was the epinephrine in the long acting anesthetic to constrict the blood vessels so the anesthetic wouldn’t diffuse away. Epinephrine!!!!!???? They very calmly told me, that what I was experiencing was the fight or flight response in response to said epinephrine! Deep breaths, deep breaths. I said “You gave me what? Epinephrine? Do you know I have bipolar d/o, and the last time I was given epinephrine (in the form of Wellbutryn,) I has MASSIVE panic attacks!?!” I had written down in my history forms that I had bipolar disorder. They obviously didn’t read those. Giving someone with bipolar disorder epinephrine… really? This is a neurotransmitter, as such, it has effects on the brain, and the effect it has on my brain is a very undesirable one, namely severe panic attacks! They said “Oh well, it is a minuscule dose.” Well their minuscule dose had my heart racing and anxiety coursing through my brain and body. Luckily, oh so luckily, I didn’t have a full on panic attack, just anxiety, jitteriness, shaking muscles, and a deep desire to flee from there. I sat through the cleaning of the teeth on my right side, shaking and jittery. The left side is to be cleaned on October 8th. I’m canceling that appointment and finding myself a dentist who doesn’t even know what epinephrine is!

For cleaning my teeth, to avoid pain, they gave me topical anesthetic, short acting (six needle sticks) and long acting (six needle sticks) anesthetic and THREE appointments! Are they freaking out of their minds? Who does that? I’ve been having my teeth cleaned forever, and never have I been subjected to this, what do I call it but, craziness! I am still sitting here, shaking and jittery, and this is after almost 12 hours!

For god’s sake, how do you know what you are going to be subjected to? I thought I was going for a routine cleaning and then this… if he had told me he was going to give me epinephrine, I would immediately have disabused him of that notion. Before leaving, I did tell him that I had filled out forms in which I has written down that I had bipolar d/o. And that to give someone with bipolar d/o epinephrine is never a good idea, except maybe if they are going into anaphylactic shock, then it is a matter of life and death. I told him that the brains of people who have bipolar d/o are very sensitive and cannot be subjected to neurotransmitters, it can have catastrophic consequences, like the onset of mania. Now I am sitting here, checking every few minutes on myself, to make sure I have not been thrown into a manic phase. I don’t think so, but my heart rate is still up and my muscles are still shaky. Hopefully, I’ve dodged a bullet, a bullet that came out of a dentist’s syringe. And hopefully, now they will read history forms and inform people of what they are injecting into them before they actually inject it. Of course, I will keep monitoring myself, unbelievable as it sounds, for signs that a manic phase is on its way. I feel like an innocent bystander, who has just been run over by an 18 wheeler. Just need to calm down. Deep breaths. And plan my day tomorrow, some concrete, calming things and get some sleep. And never go anywhere near this dentist’s office again.

And to all of my blog mates, please be careful, we people with sensitive biochemistries have to be very careful who gives us what where.

Just a note: Epinephrine is a neurotransmitter and has effects on the brain and also on the body, such as making our hearts race when the fight or flight response is elicited. The reason it is called epinephrine is this: EPI means on top of, NEPHRINE refers to the kidney. It is made by the adrenal glands that sit on top of the kidney, therefore EPI-NEPHRINE. It is also called Adrenalin, because it is made by the adrenal glands. So epinephrine and adrenalin are the exact same thing. Another related molecule is norepinephrine, which is also called noradrenalin. Just FYI 🙂

Increased Seroquel dose, yes, under my doctor’s supervision. 

Increased my dose of Seroquel from 50 mg to a 100 mg. Emotionally, feel better already. The pain is almost gone. My heart doesn’t ache so much.  Physically, feel dizzy and tired. Mentally, feel about as sharp as a lump of dough. But the physical and mental issues will resolve in a few days and hopefully the emotional symptoms will stay away and I can be at peace in my own skin. I won’t be crying and heart broken over every thing that reminds me of my son or every thought I have about him. That’s what happens when you feel bad, thoughts attach to the bad feelings and then it’s a downward spiral if you don’t stop it with medication. If I’m not already feeling bad, mood wise, I can control my thoughts. But when my mood plunges, it takes me along for a nightmarish and painful ride into hell. That’s when Zoloft used to help. Now it’s Seroquel. And in a few days, I hope, I will be as right as rain, the distilled water kind, not the acid variety. Here’s to another day in our lives. May we get what we want and want what we get and live happily ever after. Well, who knows, somewhere, someone must be living a fairytale life!

Story Corp

Just found out about this thing called Story Corp. Such a great idea. We can all do this for our blogs as well, interview people, relatives, friends, and post the interviews on our blogs.  

https://storycorps.me
HOW IT WORKSChoose someone to interview.
 Pick great questions. Find a quiet place to record. Listen closely.

 When you’re finished, share your interview with the world.

 Help create an archive of the wisdom of humanity.

  

Not feeling the best

but trying to do things to make myself feel better. The old familiar sadness, is there a reason?  The tears, is it the season? The hollow, emptiness. The negative thoughts, the heaviness, yes this is what I was afraid of now that I can’t take antidepressants. Now what do I do? Let’s see what my psychiatrist pulls out of his hat now. Contacted him, haven’t heard back. Don’t like to feel bad, I have people to see, places to go and cooking to do. Haha. The sunglasses are not just to look cool, they stop you from crying from the shallot vapors. Crying, been doing much too much of that already. Wish I could wave a magic wand and make illness disappear. Sorry, I know this post is totally uninspired. Promise I’ll write a better one soon.   

  

Today is World Suicide Prevention Day

http://www.addiction.com/expert-blogs/suicide-prevention-is-everyones-business/

Suicide Prevention Is Everyone’s Business

Suicide Prevention Is Everyone’s Business

World Suicide Prevention Day (WSPD) is today, September 10. The theme for 2015 is “Preventing Suicide: Reaching Out and Saving Lives.” WSPD is an initiative of the International Association for Suicide Prevention and the World Health Organization and has taken place since 2003. In honor of the event, you can join WSPD on Facebook and light a candle near a window at 8 PM tonight. September 7 to 13 is also National Suicide Prevention Week in the U.S.

As someone with bipolar disorder, I have contemplated suicide at several points in my life. I’ve also experienced the loss of a friend to suicide, and I’m a mental health professional — so it’s easy to see why I have a significant interest in suicide prevention. However, the National Strategy for Suicide Prevention’s latest report concludes that “suicide prevention is everyone’s business.” Suicide impacts us all, directly or indirectly, and we all can play a role in its prevention.

In about 90% of cases, suicide is related to a mental disorder, most commonly major depression or another mood disorder, a substance use disorder, schizophrenia or a personality disorder—though in many cases the issue was not diagnosed or treated. Because mental disorders are treatable, suicide is largely preventable. However, there are a number of barriers to prevention that need to be overcome:

  • Underdiagnosis of mental disorders
  • Lack of access to or lack of insurance coverage for treatment
  • Lack of awareness in the general public regarding the signs of mental illness and the warning signs of suicide
  • Stigma, prejudice and discrimination regarding mental disorders; a taboo around talking about suicide
  • Inadequate training for health care professionals, including mental health professionals, in suicide assessment

While there are complex, systemic problems that need to be addressed, each of us has at least some power to prevent suicide. Below are 10 groups that play a key role in suicide prevention, and what each can do:

1. Everyone

Suicide impacts everyone. It’s the 10th-leading cause of death in the United States. The economic cost of suicide in the U.S. is estimated to be more than $44 billion annually, mainly due to lost wages and productivity. For every reported suicide, an estimated 12 people either attempt suicide or engage in some type of self-harm. Non-fatal injuries due to attempted suicide or self-harm cost an estimated $6.3 billion annually in medical care, lost wages and productivity.

What everyone can do:

  • Learn the signs of mental illness. Visit the Campaign to Change Direction and learn the five signs that someone might need help.
  • Learn the warning signs of suicide. Visit the American Association of Suicidology and learn the “IS PATH WARM?”
  • Educate yourself about suicide. Visit the American Foundation for Suicide Prevention for answers to frequently-asked questions.
  • Change your attitude. If you believe suicide is a sign of weakness or selfishness, recognize that people with mental illness who attempt suicide are incapable of seeing other options, incapable of making rational decisions or are acting out of impulse; weakness and selfishness don’t enter the equation.
  • Change your language. Learn and use non-stigmatizing terms regarding suicide. Most important, use “died by suicide” instead of “committed suicide,” and “attempted suicide” instead of “unsuccessful suicide.”
  • Answer phones at a local crisis center or become a suicide prevention advocate.
  • Choose a non-profit related to suicide prevention or a local mental health program.
  • Get involved in mental health treatment reform. The Treatment Advocacy Center, a national nonprofit organization, hassuggestions for advocating to remove barriers to treatment.

2. Those diagnosed with a mental disorder

Again, 90% of people who die by suicide have a mental disorder (this is determined by “psychological autopsy,” which includes reviewing records and interviewing people who knew the decedent). As someone with a mental disorder, I’ve come to understand that we have to be proactive about our own suicide prevention — and that we have a lot of power to help prevent it in others.

What you can do if you are diagnosed with a mental disorder:

3. Those who think they might have a mental disorder

Mental disorders are very common. In 2013, an estimated 18.5% of U.S. adults had some type of mental illness in the past year. Overall, only about half of those affected by mental illness receive treatment.

What you can do if you think you might have a mental disorder:

4. Family members or loved ones of someone who may be at risk for suicide

About one-third of people who die by suicide do not communicate their intent to anyone. However, most exhibit warning signs. People close to those with mental illness can play a powerful role by being on the lookout for warning signs and helping their loved one find treatment.

What you can do if you are a family member or loved one of somebody who may be at risk for suicide:

  • Call the National Suicide Prevention Lifeline for advice and resources in your area.
  • Be familiar with the warning signs of suicide. Get a free wallet card from SAMHSA.
  • Find a support group or education program for family through organizations such as your local chapter of the National Alliance on Mental Illness.
  • Talk openly with your loved one about suicide. You’re not going to plant an idea in their head that wasn’t already there.
  • Offer hope (“Things will get better”), but avoid platitudes (“Suicide is a permanent solution to a temporary problem”).

5. Those affected by the suicide of another person (also called a “survivor” or “one bereaved by suicide”)

The loss of someone to suicide is said to leave a “special scar.” People who have lost a loved one to suicide are more likely to die by suicide themselves. Many people bereaved by suicide feel alone and have trouble getting support. People can be significantly affected even if they weren’t close to the decedent.

What you can do if you are affected by the suicide of another person:

6. Those who know someone affected by the suicide of another person

If you know someone bereaved by suicide, it can be difficult to know what to do or say. Survivors are at risk for suicide, and they are at even greater risk if they are socially isolated.

What you can do if you know someone affected by the suicide of another person:

  • Offer your sympathy, condolences and support.
  • Don’t avoid the topic of suicide.
  • Be on the lookout for signs of mental disorders and warning signs of suicide.
  • Suggest the possibility of seeking counseling or joining a support group.
  • Take care of yourself so you can be there for the bereaved person.

7. Primary care physicians (PCPs)

Primary care physicians play an important role in screening for suicide risk. At any given time, 2% to 4% of patients visiting their PCP are having thoughts of suicide. Over 75% of those who die by suicide have seen a PCP in the year before their death; but only about 30% have received mental health services. Studies have shown that educating doctors in assessing and treating depression leads to reductions in suicide.

What you can do if you are a PCP:

8. Mental health professionals

Many mental health professionals haven’t received adequate training in suicide prevention. According to a 2013 study, only about 50% of psychologists, 25% of social workers, and 6% of counselors have training in suicide risk assessment.

What you can do if you are a mental health professional:

  • Get training in suicide risk assessment and renew your knowledge regularly.
  • Get a free Suicide Assessment Pocket Card for clinicians, available from SAMHSA.
  • Find trainings, webinars and other resources through the Suicide Prevention Resource Center.
  • Consult with colleagues as needed.
  • Communicate hope to clients and their families, and let them know that recovery is possible.

9. Employers and managers

Because mental disorders are so common, it’s highly likely that some of your employees have one — and it’s also likely that some aren’t getting treatment.

What you can do if you are an employer or manager:

  • Include mental health benefits in employee health plans and encourage people to use them when needed.
  • Promote the mental health of employees through organizational changes and wellness programs.
  • Check out the resources at Working Minds on suicide prevention in the workplace.
  • Arrange for the National Alliance on Mental Illness to do an “In Our Own Voice” presentation for your organization to increase employees’ understanding of mental illness.

10. Journalists, bloggers and others who report and write about suicide

Journalists play an important role in the public’s perception of suicide. By reporting news stories about suicides properly, they can help prevent the documented phenomenon of “suicide contagion” or “copycat suicides”. Suicide contagion is more likely when media sources describe the suicide method, sensationalize the story using dramatic or graphic content or give the story extensive and repeated coverage.

What you can do if you are a journalist, blogger or otherwise write or report on suicide:

If we all do our part to reach out and save lives on World Suicide Prevention Day and beyond, we can get people at risk the help they need, reduce suicides and alleviate a lot of pain and suffering.

Fibroblast growth factor 9 is a novel modulator of negative affect (depression)

This study used rats and postmortem human hippocampal tissue to show that there are two proteins in inverse relationships to each other that are involved in major depressive disorder (MDD). They are both fibroblast growth factors (FGF) specifically FGF2 and FGF9. FGF2 is decreased (http://www.ncbi.nlm.nih.gov/pubmed/25079902) in postmortem tissue of depressed individuals and FGF9 in increased. Also in rats, the same thing is seen. In rats if FGF9 levels are increased experimentally, they start showing symptoms of depression, and localized blockade of FGF9 reduces depression and anxiety symptoms. Also, “chronic social defeat stress” (an animal model recapitulating some aspects of MDD) in rats increases FGF9 levels.

What are FGF2 and 9? They are growth factors, produced by the cells of the body and the brain. They are involved in the proliferation and differentiation of somatic cells and neurons. They are important and key factors in the growth, differentiation and development of the brain. (The regulation of FGFs expression as well as of their receptors during development presumably plays a critical role in cell-cell signaling among neurons, astrocytes and microglia in the immature human brain: http://www.med.unibs.it/~airc/pdf/fgf%20human%20brain.pdf)

Important in the growth and development and differentiation of the brain, changed in depression, changed when depression is induced, and in normal controls, levels are different than in people with MDD. All good reasons to think of them as good targets for treatment and as markers for MDD.

Original Article: http://www.pnas.org/content/early/2015/09/02/1510456112

Fibroblast growth factor 9 is a novel modulator of negative affect

Molecular mechanisms mediating negative emotion and contributing to major depression remain elusive: here, we present evidence implicating fibroblast growth factor 9 (FGF9) as a key mediator. We use whole-transcriptome studies of postmortem human tissue to demonstrate that FGF9 is elevated in depression. Reverse translation animal studies demonstrate that both endogenous and exogenous FGF9 promotes anxiety- and depression-like behavior. Conversely, localized blockade of endogenous FGF9 expression decreases anxiety behavior. To our knowledge, this paper is the first description of hippocampal FGF9 function and the first evidence implicating FGF9 in negative affect. Thus, FGF9 represents a novel target for treating affective disorders. Moreover, our findings suggest that FGF2 and FGF9 work in functional opposition; we hypothesize that the balance between FGF factors may prove critical for optimal regulation of mood.

Abstract

Both gene expression profiling in postmortem human brain and studies using animal models have implicated the fibroblast growth factor (FGF) family in affect regulation and suggest a potential role in the pathophysiology of major depressive disorder (MDD). FGF2, the most widely characterized family member, is down-regulated in the depressed brain and plays a protective role in rodent models of affective disorders. By contrast, using three microarray analyses followed by quantitative RT-PCR confirmation, we show that FGF9 expression is up-regulated in the hippocampus of individuals with MDD, and that FGF9 expression is inversely related to the expression of FGF2. Because little is known about FGF9’s function in emotion regulation, we used animal models to shed light on its potential role in affective function. We found that chronic social defeat stress, an animal model recapitulating some aspects of MDD, leads to a significant increase in hippocampal FGF9 expression, paralleling the elevations seen in postmortem human brain tissue. Chronic intracerebroventricular administration of FGF9 increased both anxiety- and depression-like behaviors. In contrast, knocking down FGF9 expression in the dentate gyrus of the hippocampus using a lentiviral vector produced a decrease in FGF9 expression and ameliorated anxiety-like behavior. Collectively, these results suggest that high levels of hippocampal FGF9 play an important role in the development or expression of mood and anxiety disorders. We propose that the relative levels of FGF9 in relation to other members of the FGF family may prove key to understanding vulnerability or resilience in affective disorders.

Electrocortical therapy for motion sickness

IMG_7770

This would be wonderful for me, as I get motion sickness at the drop of a hat. Our friends have a lake house, with a pier that goes on to a floating platform, as soon as I step off the grounded pier, onto the floating part, I start feeling nauseous! I’m fine in the water, but floating piers, boats, and don’t even talk to me about roller coasters, just writing the word is making me feel light headed and nauseous… So this transcranial direct current stimulation application to suppress the vestibular system, which alleviates motion sickness, may well be a godsend to the likes of us. That just means a mild electrical shock will desensitize your balance system, which will then not interpret motion signals to cause motion sickness! This is much better than taking, for example, Dramamine, which knocks me out totally, so I don’t know if my motion sickness is really gone, or I just don’t feel it because I am,  ummm… unconscious! Sign me up please! And now I have to stop writing about this so my head can stop swimming! Seriously, someone make the room stop spinning!

http://www.neurology.org/content/early/2015/09/04/WNL.0000000000001989

Given a sufficiently provocative stimulus, almost everyone can be made motion sick, with approximately one-third experiencing significant symptoms on long bus trips, on ships, or in light aircraft.1–4 Current countermeasures are either behavioral or pharmacologic. Behavioral measures include habituation/desensitization treatment protocols5 as well as positioning the head in alignment with the direction of the gravito-inertial force and maintaining a stable horizontal reference frame.5 Pharmacologic measures include antimuscarinics, H1 antihistamines, and sympathomimetics, which all detrimentally impact upon cognitive function, rendering them inappropriate for occupational use.5 All current therapies are only partially effective. Since a functioning vestibular system is critical to the development of motion sickness,1 we proposed that suppressing vestibular activity could increase tolerance to nauseogenic motion stimuli. We previously showed that application of transcranial direct current stimulation (tDCS), specifically unipolar cathodal stimulation over the left parietal cortex, results in suppression of the vestibular system.6 Herein, we assessed whether such suppression of vestibular activity using tDCS in normal controls may alleviate motion sickness.

I do feel slightly over medicated, under stimulated…

IMG_8103

Sort of blah, sort of bored. Is this what normal feels like?

On loads of lithium, well actually on 900 mg one day and 600 mg the next day, so not loads, perhaps a bit of a hyperbole, yes, every now and then. Helps keep boredom at bay…

Wanted to go out dancing, but no one would go with me… There’s a band every Sunday, at a park a stone’s throw away from my house, people dance. I can hear the music playing, my feet eager and impatient to dance, but no partner… well if this is the worst problem I have then I can complain of nothing at all.

Nothing dramatic, sort of addicted to drama I think, are all people with mood disorders addicted to drama? Must have ups and downs or the steady, non fluctuating rhythm of life seems to get boring and then a boredom anxiety sets in, haha, damned if you do, damned if you don’t. Well, the dancing would have helped, I’m sure, moving my feet makes me happy, hence Zumba, hence dancing for 4 hours at weddings.

Very hot outside, have a bad case of allergies, the gym is closed today. So I’m going to exercise at home, inside, away from the ragweed allergens swirling outside.

Don’t have much to say, feel dull and bored. Time to reduce the lithium? At my own risk, but I do feel slightly over medicated, under stimulated… Time to call the doctor, oh never mind, I have an appointment with him soon.

Perhaps a cup of coffee!