View Full Version : It's neurological.


Amtram
01-02-13, 09:04 PM
Interesting post (http://neuroskeptic.blogspot.co.uk/2012/12/when-mental-illness-isnt.html) from Neuroskeptic about how we're discovering physical origins of conditions in the brain - how just because we haven't found the physical cause of something doesn't mean there isn't a physical cause.

mildadhd
01-02-13, 09:34 PM
Interesting post (http://neuroskeptic.blogspot.co.uk/2012/12/when-mental-illness-isnt.html) from Neuroskeptic about how we're discovering physical origins of conditions in the brain - how just because we haven't found the physical cause of something doesn't mean there isn't a physical cause.


What doesn't have a physical part of the cause?

biopsychosocial

Candlewax
01-03-13, 08:28 AM
just because we haven't found it yet doesn't mean it doesn't exist... uhh, ok? it's true... but what's your point?

Drewbacca
01-03-13, 09:57 AM
just because we haven't found it yet doesn't mean it doesn't exist... uhh, ok? it's true... but what's your point?

I believe that the point is that research is beginning to find the underlying bio-mechanical mechanisms responsible for disorders and conditions that were previously thought to be psychosomatic.

Although, I suppose that it does have a certain "well, duh" quality to it... it's important to acknowledge that such research is occurring!

Amtram
01-03-13, 11:10 AM
I put this up mainly because it's a recurring theme among people who deny the existence of ADHD and other various mental disorders and diseases. Since there's no test that shows it's there, like a swab for strep or an x-ray for a broken bone, then clearly, it's imaginary. It's sort of like saying cancer didn't exist in ancient cultures, or there was no such thing as diabetes before glucose testing.

Eventually, the root causes will be teased out, but it's a long process of experimentation and research. I mean, wouldn't it be nice if we somehow had contrast dyes that had affinity for specific synapses, and we get an injection, go into a machine, and voila! We know whether it's a serotonin problem or a dopamine problem or whatever, because there are the test results! We don't have anything like that, but that doesn't mean that all the research that indicates those things are an issue is completely invalid.

Dizfriz
01-03-13, 01:23 PM
I suspect that most mental disorders will eventually be better described by biomedical causes. It is a long way off though but a lot of progress is being made.

It was a very good article. To me, the main point was that although it looked like Bipolar, it was able to be correctly identified and treated as biomedical and not too many years ago this would be impossible. As neuroscience develops you will see more and more of this. Just look at some of the gene deletion issues causing ADHD symptoms. This has be recently identified and now finding an effective treatment is possible.


As an aside, there was a very good response by Bernard Carroll.

Fair use does not allow me to post the entire response but this is the last paragraph

We often hear people assert that psychiatric diseases are fictive because no diagnostic tests exist for them. That position has always seemed illogical to me. The existence of disease is not predicated on having a laboratory test for it. The laboratory test is developed in response to the fact of disease. To another subject:

just because we haven't found it yet doesn't mean it doesn't exist... uhh, ok? it's true... but what's your point? That is not what she said.

What she said was just because we haven't found the physical cause of something doesn't mean there isn't a physical cause. To me that is a totally different context and has important meaning. There is a huge amount of research going on trying to find biomedical causes to disorders. The general consensus is that it is very probable that many if not most of the mental disorders will have some sort of possibly treatable biomedical basis and that is the aim of research, to discover these. The working assumption is that there is a biomedical cause and our job is to find it.

This is the hope of the future in treating mental disorders. Again we are a long way off but progress is being made and makes me very optimistic. We will get there.

Dizfriz

Dizfriz
01-03-13, 01:33 PM
I just looked more at the neuroskeptic site Amtram and at a first glance it seems to be well worth looking at. His description is A neuroscientist takes a skeptical look at his own field, and beyond. I just looked at the first article and it was Finally, Hard Evidence Against The "Autism Epidemic"?

I plan to go back and reading some of the articles as soon as I can. I am not recommending it until I have read more but it does look interesting.

The home site is http://neuroskeptic.blogspot.co.uk/

Dizfriz

Amtram
01-03-13, 01:55 PM
Yes, it's a very good blog, and the blog author is the very first person ever to get a research paper published in a major journal under his pseudonym. That's apropos of nothing, but an interesting tidbit. Sometimes he's a little more skeptical than I'd like, but he's always got some good neuroscience information.

mildadhd
01-03-13, 03:51 PM
While scientific humility is welcome,

a cause-and-effect model of disease is itself a source of misperception.

It cannot portray the ways that health is transmuted into illness or how illness may be turned toward health.

Sufi tradition tells the famous story of the twelfth-century fool and sage,

the mullah Nasruddin,

on his hands and knees searching under a street light.

"What are you looking for?"

his neighbours ask.

"My key,"

he replies.

The neighbours all join in the search,

carefully and systematically perusing every inch of ground in the vicinity of the lamp.

No one finds the key.

"Wait, Nasruddin,"

someone finally says,

"just where did you lose the key?"

"In my house"

"Then why are you looking out here?"

"Because, of course, I can see better here, under the light"

It may be easier (and financially more rewarding) to research isolated causes such as microbes and genes,

but as long as we ignore a broader perspective,

diseases will always be of unknown etiology.

A search outside where the light shines will not yield us the key to health;

we have to look inside,

where it is dark and murky.


-Gabor Mate M.D., WHEN THE BODY SAYS NO, (Chapter) The Power of Negative Thinking P,242

mildadhd
01-03-13, 04:24 PM
No disease has a single cause.

Even where significant risks can be identified-

-such as biological heredity in some autoimmune diseases or smoking in lung cancer-

-these vulnerabilities do not exist in isolation.

Personality also does not by itself cause disease:

one does not get cancer simply from repressing anger or ALS just from being to nice.

A systems model recognizes that many processes and factors work together in the formation of disease or in the creation of health.

We have demonstrated in this book a biopsychosocial model of medicine.

According to the biopsychosocial view,

individual biology reflects the history of a human organism in lifelong interaction with an environment,

a perpetual interchange of energy in which psychological and social factors are as vital as physical ones.

As Dr.Gelmon suggests,

healing is a phenomenon of finding balance and harmony.


We cannot remind ourselves too often that the word healing derives from an ancient origin,

meaning "whole"-

-hence our equation of wholesome and healthy.

To heal is to become whole.

But how can we be more whole than we already are?

Or how is it that we could ever be less than whole?


That which is complete may become deficient in two possible ways:

something could be subtracted from it,

or its internal harmony could be so perturbed that the parts that worked together no longer do so.

As we have seen,

stress is a disturbance of the body's internal balance in response to perceived threat,

including the threat of some essential need being denied.

Physical hunger may be one such deprivation,

but in our society the threat is most often psychic,

such as the withdrawal of emotional nourishment or the disruption of psychological harmony.



-Gabor Mate M.D., WHEN THE BODY SAYS NO, (Chapter) The Power of Negative Thinking P,243

Amtram
01-03-13, 04:49 PM
Well, if you have one person actively doing neurobiological research and getting published in important medical journals and one who isn't, only one of them will be able to root out the medical causes. Sort of like you can get good advice about cardiac health from a trainer at the gym and from a cardiologist - but only the cardiologist is going to be able to detect what's going on inside your heart.

mildadhd
01-03-13, 05:24 PM
I don't know exactly what you mean?

I hope the Cardiologist will recommend exercise,

healthy diet....etc,

and consider any abnormal stress that may be occurring in the patients life?

I think a connection between heart disease and stress is common knowledge?

mildadhd
01-03-13, 05:44 PM
I don't know of (or support) any denial of the impairments associated with ADHD?

Dr.Mate suffers from ADHD.

My point is that there is more than one part,

that causes the impairments associated with ADHD.

Amtram
01-03-13, 06:30 PM
The point is that this thread is about physiological bases for disorders, not psychological ones.

mildadhd
01-03-13, 07:07 PM
The point is that this thread is about physiological bases for disorders, not psychological ones.

My point is that physiological bases include psychological ones.

NEUROENDOCRINE AXIS MEDIATES BRAIN CONTROL OVER SOME ENDOCRINES AND THEIR HORMONES.

Complex neurohormonal regulation involves anterior pituitary and hypothalamus-

The interactions between the brain and the endocrine system are mediated by complex neurohormonal regulation.

The pituitary is attached to the hypothalamus,

a part of the brain involved in regulating visceral,

emotional,

and sexual functions.

A special portal vascular system connects the hypothalamus to the anterior pituitary.

Blood flowing through this portal system delivers the hormonal secretion from the nerve endings of certain hypothalamic neurosecretory cells directly to the anterior pituitary cells.

These hypothalamic hormones regulate the release of anterior pituitary hormones.




Such a neural mechanism superimposes control of the brain over the pituitary and its target glands and mediates the effects of moods,

emotions,

stress,

rhythmical neural activity (e.g.,diurnal rhythms),

and the environment (e.g., light, sound, temperature, and odors)

on the endocrine system and hormones.

Hormones of the target glands and the pituitary hormones act through long and short feedback loops to exert negative and positive feedback effects on the hypothalamic neurosecretory cells,

modifying their secretion of neurohormones.

Hypothalamic neurons,

like the pituitary cells,

contain receptors that can detect blood hormone levels.


The Physiology Coloring Book, Kapit/Macey Meisami: P115.

mildadhd
01-03-13, 07:19 PM
Neuroendocrine control is also exerted via the posterior pituitary,

autonomic nerves,

& adrenal medulla-

The nervous system and brain can control hormonal secretion via the posterior pituitary as well.

The hypothalamus controls plasma water content,

milk flow,

and parturition by releasing its hormones directly into the blood at the site of the posterior pituitary.

The hypothalamus also exerts rapid and direct effects on the secretion of several endocrine glands by modifying the activity of the sympathetic and parasympathetic nerves,

which innervate these glands.

A special case is the adrenal medulla,

whose secretion of catecholamines is regulated by the sympathetic nervous system.




The Physiology Coloring Book, Kapit/Macey Meisami: P115.

APSJ
01-03-13, 08:48 PM
I put this up mainly because it's a recurring theme among people who deny the existence of ADHD and other various mental disorders and diseases. Since there's no test that shows it's there, like a swab for strep or an x-ray for a broken bone, then clearly, it's imaginary. It's sort of like saying cancer didn't exist in ancient cultures, or there was no such thing as diabetes before glucose testing.

Eventually, the root causes will be teased out, but it's a long process of experimentation and research. I mean, wouldn't it be nice if we somehow had contrast dyes that had affinity for specific synapses, and we get an injection, go into a machine, and voila! We know whether it's a serotonin problem or a dopamine problem or whatever, because there are the test results! We don't have anything like that, but that doesn't mean that all the research that indicates those things are an issue is completely invalid.

This is a recurring theme, and the post provides an interesting perspective on it. The author in a sense emphasizes the distinction by noting how the patient in the example highlights the potential for people with physical illnesses to be diagnosed with 'mental' illnesses because we lack the knowledge or technology to diagnose the physical causes. (though, ultimately, the distinction highlighted is in my view between issues with more and less subtle neurological causes.)

However, I think the example also exposes the irrationality of dismissing or minimizing 'mental' illnesses. After all, if a 'legitimate' physically caused condition can be virtually indistinguishable from a mental disorder, with largely identical symptoms, what rationale can there be for treating one as more deserving of sympathy than the other? The cause may dictate treatment, but not generally legitimacy or consideration. If someone's sneezing and blowing their nose all the time, sympathy isn't conditioned on a positive test for allergies of viruses.

Amtram
01-03-13, 08:58 PM
I think you need to look at the article. It's about how biomechanical causes are becoming testable, which will improve specificity of diagnoses because it's an improvement over diagnoses based on expressed symptoms.

The opening of the article:

There's a theory that 'psychiatric diseases' like depression and schizophrenia aren't diseases because they're not diagnosed on the basis of any kind of biological abnormality, but purely on symptoms - unlike 'real' diseases like cancer and AIDS.

Now, in my view there's quite a bit of truth in that - but there's also a serious flaw in the argument. Sometimes, disorders diagnosed on the basis of psychiatric symptoms do turn out to have had a clear biological cause. So the original diagnosis of a psychiatric disease was correct: there was indeed a disease.

This is happening more and more often now because of biomedical advances.

We don't need more psychological information for diagnosis as much as we need accurate biological information for diagnosis. Psychological information is helpful to a certain extent, but nothing surpasses a testing method that targets the actual, unique individual and either pinpoints causation, or effectively rules out irrelevant conditions.

The article points out that a test for NMDA antibodies allowed a patient to be treated with drugs that were effective for his condition, rather than with medications that had not produced results, or medications he might have been prescribed if he had been evaluated based on presentation of symptoms.

This is about knowing more than just general information about how certain chemical or electric processes operate in clinical or laboratory settings. It's about knowing how to actually test a condition that might be labeled psychiatric or psychological in a quantifiable manner, not only to verify its authenticity as a condition, but also to determine the most effective treatment without months of trial and error.

Amtram
01-03-13, 09:07 PM
APSJ, there certainly is more than a grain of truth in what you're saying. However, I'm somewhat inclined to turn it around a bit, too - if we have tests that can confirm or rule out a biological mechanism, we can also avoid prescribing ineffective or unneeded medications for people whose problems don't have biological causes.

The reason that this is of concern to me is also noted in the article - the administration of medications that not only don't help, but also can cause additional problems. Anyone who's ever taken an SSRI, or different SSRIs, knows that it takes a long time for them to reach full effect, and a long time for them to leave your system. They change the neurotransmitter balances in your brain, and sometimes residual changes can be long-lasting. Giving a patient the wrong medication can have broad consequences; giving medication to a patient who doesn't need it can do the same.

Mental illnesses are already stigmatized. Biological legitimacy will do little to stigmatize them even more, but will definitely reduce the stigma of those that become testable.

mildadhd
01-03-13, 11:12 PM
I have seen a CatDog/DogCat Avatar,

here at ADDF.

And I wondered?


When the Dogcat,

is chasing the Catdog,

would the Catdog need to run backwards?

or

When the Catdog,

was chasing the Dogcat,

Would the Dogcat need to run backwards?







I think the answer to the cause is found in both (or more).

So I partly agree with you.


.