Health

Which Comes First? Mental Illness or Addiction?

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We all recall the impossible question of “What comes first, the chicken or the egg?” This questions causes those to spiral in the possibility of both scenarios where the egg to needs to bring the chicken and the chicken needs to lay the egg. There is no cohesive answer.

Another form of this question currently is a major topic of interest in research. Does mental illness bring about addictive tendencies or vice versa, addictive tendencies bring about bouts of depression and anxiety?

One study found that roughly 37% of alcoholics and 53% of substance abusers have at least one mental illness diagnosis or meet the diagnostic criterion for a mental illness. Though seems like a straight shot answer, keep in mind that it was also found that 29% of those diagnosed with at least one mental illness also abused alcohol or other substances.  Even extending into adolescent study, 60% of individuals in a substance abuse rehabilitation facility either have a diagnosis or meet the diagnostic criterion for a mental illness.

The most common mental illnesses to be seem in a comorbid relationship with substance abuse are those that appear to have a dysregulation in dopamine signaling and/or excitatory and inhibitory neurotransmission, physiologically represented by depressive episodes. These mental illnesses include Bipolar Disorder, Depression, ADHD, and Schizophrenia. If any of the previously listed disorders significantly impact the quality of the life of the individual, they are more likely to fall into substance abuse to satisfy the lack of serotonin and get a sense of “euphoria.” 1 in 4 diagnosed with serious mental illness abuse some substance.

Figure 1: Rate of Dual Diagnosis between substance abuse and serious mental illness.

As you can see, this poses a major concern about going about treatment. If someone has a serious mental illness, psychiatrists may begin to lean to stronger medications, such as Xanax. However, unless it is openly addressed about addictive tendencies of the individual, they may accidentally begin a downward spiral of prescription medication addiction. Addictive tendencies can have a hereditary nature, so having open communication with patient and practitioner is vital to prevent a spiral into addiction when treating serious mental health disorders.

Vice versa, when treating addiction, you need to be sure that an open and trustworthy support system is available to prevent mental illness development in those in rehabilitation. Unless a support system is available, treatment seems to take progressively longer.

One question this poses, is “Does behavioral addictions, such as phone usage or exercise, exhibit the same level of risk toward mental health disorders?” Though behavioral addictions are not to the diagnostic criterion level of addiction, they still pose immense threat to the quality of life of those already experiencing maladaptive neurotransmission and improper neuroplasticity regarding memory and learning. Phone and social media addictions are more prevalent than ever and exposure to nicotine and other substances are at an all-time high. Behavioral addictions can have damaging effects to physical and mental health to the same degree as substance addictions. If we do not take behavioral addictions to the same extent as substance addiction, we are likely to see an increase in mental illness diagnosis as more and more children grow up in the age of social media.

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Addiction: Risk Factors for Relapse

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Relapse prevention skills are important for living a happy life in recovery. In order to learn these prevention skills, one must know what the risk factors for relapse are. Relapse can occur at any stage of the recovery process and is considered a normal part of the recovery process. It is believed that 40-60% of addicts relapse at least once during their recovery. In order to understand relapse risk factors, it is important to understand why people become addicted in the first place.

Why Do People Become Addicted to Drugs?

During drug use, the reward pathway (mesolimbic dopamine pathway) becomes impaired, especially within the ventral tegmental area (VTA) and the nucleus accumbens (NAc). This happens when there is prolonged drug exposure. In chronic drug use, repeated exposure activates CREB (cAMP response element-binding protein) which involves D1 and D2 spiny neurons within the NAc. ΔFosB is a protein in the CREB pathway that increases production in the NAc during chronic drug exposure. ΔFosB affects D1 spiny neurons, increasing the sensitivity to the drug, creating more rewards. It suppresses dynorphin (an opioid peptide) in CREB, allowing for more reward effects. ΔFosB also creates more reward effects by targeting the c-Fos protein and repressing it.

The consistent intake of drugs, and heightened reward effects, causes long-term depression of the NMDA receptors on the dendritic spines, ultimately changing them. This increases the presence of AMPA receptors and creates long-term potentiation. The change takes place at the postsynaptic site and adapts to the amount of drug use. This in turn reduces the sensitivity to a drug, so they can become more tolerant and dependent to the drug, and require a higher dosage for the reward. Tolerance creates a vicious cycle of relapsing and withdrawal. This means that chronic drug use starts out as positive reinforcement and then turns into negative reinforcement throughout prolonged exposure. To simplify, repeated drug use –> plasticity in the brain –> vulnerable brain –> compulsive drug seeking behaviors –> loss of control of drugs use.

Risk Factors for Relapse

There are two types of risk factors: external and internal. Both risk factors can create the urge to use drugs again. The top internal risk factor for relapse is stress. Other internal risk factors include, but are not limited to:

  • Mental illness
    • Mental illness can greatly increase the risk of relapse if left untreated. For example, people with bipolar disorder and schizophrenia are at a much greater risk of alcohol addiction relapse, compared to those who do not have a mental disorder. Also, up to 50% of people with bipolar disorder also have an alcohol or drug addiction.
  • Overconfidence
    • People who become overconfident in their ability to stay sober may put themselves at risk by decreasing recovery meeting attendance, exposing themselves to triggers or trying to recreationally use the drug instead of abstaining. Relapse is less likely if one attends rehab, dedicates themselves to a recovery plan and avoids becoming overconfident in their ability to prevent relapse.
  • Persistent negative mood
  • Powerful cravings
  • Depressed mood
  • Genetic predisposition to or family history of addiction
  • Depression
  • Sadness
  • Fatigue
  • Self-pity
  • Loneliness
  • Feeling rejected
  • Guilt
  • Fear of withdrawal symptoms or fear of life without the drug
  • Insomnia
  • Relapse justification
  • Loss of motivation
  • Decreased ability to feel pleasure
  • Physical pain

External psychological or social stressors can play a part in bringing on a relapse as well. These external risk factors tend to be very individualized. The leading external factor for relapse is returning to an environment associated with drug use. Such as, being at a place where people are using the drug, where they once used the drug, or around people they used with. This may trigger cravings and cause a relapse. Other external risk factors include, but are not limited to:

  • Losing a job
  • Problems in their personal life
  • Bad weather for a couple days
  • Health-related issues
  • Academic problems

Conclusion

During addiction the brain is physically changing. The physical changes can make it very hard to become and stay sober. People who are recovering from drug use are at the highest risk of relapse during the early recovery stages, when they return to an environment associated with drug use, in the immediate moments after a traumatic event or during times of transition in their life. If one relapses, know that it is normal. With further treatment and dedication, sobriety can be maintained. For more information on how to maintain sobriety go to: https://www.banyanpompano.com/2018/03/26/how-to-maintain-sobriety-after-treatment/.

Sources

https://www.drugrehab.com/addiction/alcohol/relapse/#:~:text=Relapse%20can%20occur%20at%20any%20stage%20of%20the,a%20traumatic%20event%20or%20during%20times%20of%20transition.

https://www.therecoveryvillage.com/alcohol-abuse/stages-of-drug-alcohol-relapse/

https://www.everydayhealth.com/addiction/understanding-addiction-relapse.aspx#:~:text=Internal%20risk%20factors%20include%20a%20persistently%20negative%20mood%2C,the%20risk%20of%20addiction%20relapse%20if%20left%20untreated.

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Wait… Do I have an Addiction?

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Are you an addict? I know, the term “addiction” is quickly associated with a sour taste in our mouths, but it is quite more diverse than with substances as many may have initially imagined. How many times do you check your phone per day? Ok, too many to keep track. How about per hour? Still too many? Ok what about every 10 minutes? Do you hear little voices in your head telling you just 5 more minutes on Instagram or how you just need another new pair of shoes or how you get so antsy about not having been to the gym yet today that your throat starts to tighten, sweat runs down your forehead and your mind seems unable to concentrate on anything until you’ve finished your daily workout? Addiction comes in many forms, and so I ask the question again, are you an addict?

Behavioral Addiction

Just like in substance addiction, behavioral addiction can be summed up by having or feeling any compulsive/repetitive involvement in an act that results in a rewarding experience. Interestingly, the individual will still seek this reward even if they are aware of the consequences to follow. Some examples of behavioral addiction include gambling, shopping, exercising, and pretty much anything technology-wise. With all of the spotlight on substance addiction, just how similar are behavioral addictions?

Similarities via Symptoms

Imagine this, someone is trying a drug for the first time and it makes them feel incredible, so they continue use in order to get that same pleasant feeling, until day after day, it starts to become less enjoyable and feeling more like a chore. This is the result of a shift in a positive reinforcement to a negative reinforcement, which can also be seen with a behavioral addiction, and can be explored more here. Have you ever downloaded a new app that was at first fun to play but then over time you found yourself only logging on to collect the “daily reward”, or how beginning your journey at the gym to relieve stress turned into going due to fear of returning to what you looked like from a time before. Just like substance addiction, behavioral addicts can suffer from

  • Strong sense of craving
  • Loss of control over their behavior
  • Tolerance build-up
  • Difficulty during withdrawal period and preventative relapse

Two similar forms of treatment for both cases of addiction include psychosocial and pharmacological, although since many behavioral addictions cannot be diagnosed the same as substance addictions are (except gambling), current issues include getting people properly diagnosed and treated.

Similarities via Neurochemistry

Would you believe me if I told you that your brain can change how it is “wired”? Well, it actually can, and this is referred to as neural plasticity. Individuals who are addicted have more than likely developed changes in their neural circuits that can give rise to new meanings and reward perceptions to drugs/shopping/technology/etc. Studies have actually shown that there is an increase in the dopamine “dump off” at the nucleus accumbens (NAc), which gives a more pleasurable feeling to the individual and is heavily involved in the reward system. These changes can alter the function and shape of neurons in the brain, which currently, seems like in an irreversible way.

Are you still there? How many times have you checked your phone since reading this blog? Ok, just checking…

An interesting study was performed with rats, where there were two groups. They were all provided with drugs in a cage and had the ability to self-administer them, except one group additionally had an exercise wheel they could run around in. What researchers noticed was that the rats who had used the wheel in their cage showed increased levels of dynorphin, delta FosB, and increased levels of dopamine at the NAc– all of which are seen in addiction! These rats also did not end up self-administering drugs after their run either. Is exercising a way to help with addiction? Did the wheel act as an environmental variable instead of an exercising factor? As you can see, there are still many questions left unanswered, but maybe researchers are on to something.

A Future Full of…

With the rise of technology, what is our world going to look like in 5,10, 20 years from now? What are we going to do to prevent this? Is anything actually needed to be prevented? It only seems like a matter of time before there are ways for diagnosing not only substance addictions but behavioral addictions too. Until then, we might just have to continue on with our days, checking our phones once they “ding” with a notification, briefly pausing, thinking, “Wait, do I have an addiction?”.

Disease/Health/Hot topics

Are Oreos More Addictive Than Cocaine? Unwrapping Food Addiction

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A recent study found that rats equally prefer Oreos and cocaine over control substances (rice cakes and saline). Not only that—the same brain regions are activated when both Oreos and cocaine are consumed, and are even more strongly activated by Oreos. Does this mean that Oreos are more addictive than cocaine? How does food addiction work on a neurochemical level? Why don’t we have “Oreo junkies” running around the streets? Read on as we “unwrap” food addiction.

Addiction On The Brain

First we need some background on what being addicted to a drug of abuse does to the brain. Drug addiction has several behavioral trademarks. People experiencing addiction tend to experience a loss of control regarding behavior and consumption of a drug, they become dependent on the drug, and they can easily relapse if they try to stop using the drug.

On the molecular level, being addicted to a drug causes physical changes in the brain. Long-term consumption of a drug resulting in addiction can even change the way that our genes are expressed, meaning the way proteins are made based off our DNA.

These changes involve reward and learning pathways of the brain. Drugs elicit a positive “reward” response because they make us feel good. The brain learns that consuming the drug = having good feelings, so we turn to the drug with increasing frequency to feel good. The brain even becomes tolerant to the drug as it learns to expect a dose, having a less intense reaction when the same amount is consumed. The number of receptors for certain neurotransmitters that make us feel good, like dopamine, increases as drug addiction sets in. The amount of dopamine that our brain naturally produces decreases, especially in a certain brain region known as the nucleus accumbens. This means the brain requires a dose of the drug just to reach its normal level of dopamine, and then requires larger and larger doses to chase the “high” or good feelings—and if we stop taking the drug entirely, our brain is so accustomed to it that we can experience dangerous symptoms of withdrawal.

Is Food Addiction a Thing?

Experts have debated whether or not “food addiction” is a valid form of addiction. One argument against this classification is that food can’t be considered a drug since it is necessary for human life. However, there is a compelling argument that food addiction is valid, which we will focus on here—and whether it fits the bill of an ‘addiction’ or not in the long run, it is certain that food addiction is detrimentally affecting the lives of thousands of people daily.

Symptoms of food addiction are similar to drug addiction: losing control of what, when, and how much food is consumed and becoming dependent on food when experiencing stress or negative emotions. For people who try to break out of food addiction through diets and even medical procedures, relapsing into disordered eating habits is very likely.

The neurochemical similarities of food addiction and drug addiction are striking. The same reward circuit is activated when high-calorie, high-sugar food is consumed as when a drug is consumed. In the nucleus accumbens, dopamine levels decrease over time so the brain becomes reliant on food consumption to stimulate good feelings, like in drug addiction.

Are Oreos Really More Addictive Than Cocaine?

After getting some neurochemical background, now we can look at the “Oreos and cocaine” study. The study found that rats show an equal preference for Oreos over rice cakes as they do cocaine over saline. The researchers looked at the nucleus accumbens (the brain’s reward center discussed earlier) and found that Oreos stimulated even more reward neurons than cocaine or morphine.

Now, does this mean that Oreos are more addictive than cocaine, or that they’re even addictive in the first place? Not necessarily. Our brains do show a strong positive “reward” impulse when consuming high-calorie, high-fat, and high-sugar foods like Oreos, but this doesn’t necessarily mean we are forming addictive habits. First, everyone living eats food, and very few people become addicted. Additionally, food addictions don’t appear to be food-specific; people who are addicted to food don’t necessarily having a craving that can only be sated with Oreos, any calorie-fat-sugar blast tends to do the trick.

Although the study’s findings have interesting implications in relating neurochemical effects of food addiction to effects of drug abuse, we don’t have to worry about becoming Oreo junkies just yet.

Disease/Health

Addiction: Why Not Just Stop?

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Are You Addicted?

Everyone, take a moment to pull out your cellphone, go into your settings, and look at your daily average screen time. I’ll give you a moment as you pass through the five stages of grief. You are probably currently trying to justify the absurd amount of time you spend on the device. Think back to when you’ve missed placed your phone and the slight sense of panic that followed as you desperately searched for your device. We keep the little device on us at all times and everywhere you go you can find someone looking at the mesmerizing screen. We can’t seem to separate ourselves from these pieces of technology, depending on them to store information and remind us about it later, show us the way when going anywhere, solving problems, and run calculations for us and entertaining us. How many of you look at your phone while using the restroom? That’s what I thought, you may be addicted to your phone. Addiction can present itself in numerous ways such as drug, sex, food, caffeine, and technology addiction along with many other forms.

What Is Addiction?

So, what is addiction anyway? Addiction is experiencing a strong sometimes irresistible repeating impulse to pursue some behavior that triggers the reward pathway within an individual and creates a need or dependency for that reward sensation through repetition of the behavior. Addiction can be associated with sensitization, compulsive behaviors, loss of control, dependency, withdrawal, tolerance, and even relapse. One of the most common and well-recognized forms of addiction is drug addiction. Drug addiction can be very destructive and is a serious condition that shouldn’t be taken lightly alongside the many other forms of addiction.

How Does It Happen

In the case of drug addiction, the addiction aspect arises from repeated use of the substance which generates a positive sensation. This repetition in use promotes physical changes to the individual’s brain making them more susceptible and more likely to continue seeking the substance. If this individual continues to use the substance, they may eventually lose control over the use of the drug creating a further perpetuating cycle of dependence. Because of the physical changes within the brain, addiction can be extremely difficult to overcome and can have serious long-lasting effects. As an individual uses a substance, they begin to alter the brain’s sensitization to the drug meaning the neurons change their shape and connectivity to either increase or decrease their engagement with the substance. The brain adapts by developing a tolerance to the drug which neutralizes its effects requiring the individual to continually consume larger and larger quantities of the substance to experience the same stimulation they had the first time they used it.

Once addicted the individual experiences a need and severe craving for the substance due to the physical changes within the brain. If the user attempts to stop using the drug they experience severe negative symptoms including withdrawal that make it incredibly difficult to stop using the substance.

Why Does It Happen?

In drug addiction, the drugs bind to specific receptors in the brain typically within the Ventral Tegmental Area (VTA), and stimulate neural cells that interact with the Nucleus Accumbens (NAc) which is a reward pathway within the brain. This activates a cascade of signaling within the neural cells which ultimately leads to the activation of important transcription factors abbreviated as CREB and delta-FosB, along with many others that regulate the transcription/production of genes within the cells. The neural cells function based on the genes that are transcribed and their quantities. These changes in gene transcription result in the cells changing shape and increasing or decreasing receptors on their membranes (makes it easier or harder for them to interact with the drug), which ultimately affects the desires and behaviors of the user.

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898681/

https://www.psychiatry.org/patients-families/addiction/what-is-addiction

https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction

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Addiction Awareness: Binging vs. Chronic Use

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Addiction is a term that almost everyone seems familiar with. People can be addicted to a variety of things, whether it be substance use like alcohol or pills, a food addiction like sugar, or a behavioral addiction like gambling. One of the most common forms of addiction seems to be alcoholism, affecting approximately 14.5 million Americans age 12 and up and over half of all Americans have family history of alcoholism. This form of addiction is incredibly prevalent in our society and doesn’t seem to be stopping anytime soon. Researchers have been looking into the action of binge drinking as it occurs within the younger generations, age 15-25, to see if it could possibly be a source of etiology for chronic alcoholism.

Chronic vs. Binging Alcoholism

Chronic alcoholism is defined as partaking in a long period of excessive alcohol intake in which a person develops a dependence for the substance, a high tolerance, and experiences severe withdrawal symptoms. In comparison, binge alcoholism is considered to be a drinking heavily in an episodic manner, but these drinkers do not have a dependence, tolerance, withdrawal, or increased preference for the substance after the drinking episodes. Binge drinking is incredibly common within high schoolers and college-aged students and is actually three to four more times common than chronic use; it also seems to add more risk to becoming a chronic user, with 15% of binge drinkers going on to become a chronic alcoholic. The biggest question is, why does binge drinking not have the same effects as chronic drinking? The answers lie within the neurochemical background of addiction.

What’s Going on in the Brain?

During addiction, the reward pathway (mesolimbic dopamine pathway) seems to be impaired, especially within the ventral tegmental area (VTA) and the nucleus accumbens (NAc). This happens due to excessive drug exposure. In chronic alcoholism, repeated drug use sensitizes the brain’s response to the drug, creating a vicious cycle of relapsing and withdrawal. When the drug is excessively being used, CREB (cAMP response element-binding protein) is released within the NAc, which promotes a rewarding behavior. The chronic drug use causes the brain’s receptors to change so they can become more tolerant to the drug and require a higher dosage for the same pleasure. The constant intake of drugs causes long-term depression of the NMDA receptors on the dendritic spines to change and increases the presence of AMPA receptors instead and creates long-term potentiation. This conformational change that takes place at the postsynaptic site adapts to the amount of drug use and allows tolerance and dependence to form. To read more about this you can read here: https://thebrain.mcgill.ca/flash/i/i_07/i_07_m/i_07_m_tra/i_07_m_tra.htmlContinue reading →

Community/Disease/Health

Addiction’s Conviction

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Addiction has ravaged the population for countless years. Currently, there are nearly 21 million Americans with at least one addiction, yet only 10% receive treatment. Along with that, drug overdoses have tripled since 1990. If those statistics on how it’s affecting individuals aren’t enough, addiction costs the US government more than $600 billion every year. It is obvious that something must be done—we need to “convict” addiction.

The “what”

To figuratively put addiction behind bars, we first need to understand what it is. In the most general terms, addiction is “a chronic dysfunction of the brain system that involves reward, motivation, and memory.” After repeated use/exposure, the body can begin to crave the addictive substance or behavior, eventually reaching the point where all self-control is gone. Addicted individuals often show a lack of concern over consequences, though those consequences may be quite harmful to their mind, body, and spirit.

Addiction is a chronic dysfunction of the brain system that involves reward, motivation, and memory.

Addiction typically manifests as a cycle where the addicted individuals proceed through various “stages” as they continue to abuse the substance or behavior to which they have become addicted. The cycle also helps explain why most people don’t have a few drinks at a social event and wake up the next day as an alcoholic—addiction is a long, strenuous process where several circumstances have to line up in order for that person to become addicted. The cycle can be extremely challenging to escape, which accounts for the disheartened attitude seen so often in addicts seeking treatment. While the cycle may be seen as unescapable, even the most severe cases of addiction are treatable. Getting professional help is the way out and the way to a higher quality of life unaffected by the addictive substance or behavior.

The “how”

Surely there must be some explanation as to why so many people battle with addiction. And that there is! As mentioned previously, one of the main reasons individuals become addicted is because of the reward associated with that substance or behavior. In the brain, dopamine is the main neurotransmitter associated with reward because it is connected to the reward centers of the brain involved in the mesolimbic pathway. The mesolimbic pathway (pink/red in the figure) is a dopaminergic pathway that connects the ventral tegmental area (VTA) of the midbrain to the ventral striatum of the basal ganglia, which contains areas like the nucleus accumbens that are important in the “how” of addiction.

In order to get the reward, it all starts in the VTA. The VTA is activated when performing a pleasurable action (gambling, for example). Activation causes VTA neurons to release dopamine to neurons found in the nucleus accumbens. Dopamine release will cause the pleasurable effect that can ultimately result in addiction. What’s interesting is that after repeated use, the brain can actually “learn” in response. This results in what’s called long-term potentiation, a persistent strengthening of synapses based on recent activity. In the case of addiction, the synapses that are being strengthened are those associated with the mesolimbic pathway. These synaptic changes can result in the vulnerability seen in addicts that creates the compulsive drug-seeking behavior and limits self-control. Ultimately, there are many neurochemical elements related to addiction that cause the cycle mentioned earlier. For more information, check out the article linked at this website.

The “why”

We’ve already seen two important facets defending addiction’s conviction: the “what” and the “how.” But why should you care? Addiction may be nearing your doorstep sooner than you think. Phone addiction has been shown to demonstrate important behavioral similarities to compulsive gambling, the only behavioral addiction recognized in the DSM and known to have extremely addictive properties. With 81% of Americans now owning smartphones, the possibility of the younger generation become cell-phone and internet addicts is continually rising. It is important to keep these notions in mind while also realizing that our phones do serve important purposes in our lives. Just don’t let it control you! You may end up being the next big supporter of the conviction of addiction.

Disease/Health

How Tracking Your Menstrual Cycle Can Help Combat Drug Addiction

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How is Drug Addiction Defined?

Drug addiction can be defined as the inability for an individual to control or regulate compulsive seeking out and use of drugs. Behavioral changes in response to habitual, long-term drug use, including dependence, withdrawal, and relapse, can largely be attributed to physiological implications of drug use. In the literature article, “Cellular basis of memory for addiction,” Dr. Eric J. Nestler explores alterations in cellular physiology within the brain in response to drug abuse. Alterations of various molecular aspects, such as transcription factors, epigenetic mechanisms, synaptic plasticity, and whole cell plasticity, all contribute to the intense cognitive and behavioral consequences of drug abuse. 

Sex Differences in Response to Drugs

There is an unexpected relationship between men and women in response to drugs use and addiction, as women are more likely to experience many of the behavioral responses to drugs at a quicker rate than men, consequently promoting increased likelihood of addiction to drugs of abuse. Research and experimentation using animal models have shown that female rodents are more likely than male rodents to:

  • increase administration of drugs of abuse more quickly (i.e. tolerance)
  • have greater motivation to consume the drugs of abuse in the first place, along with higher initial doses of the drugs
  • experience greater rewarding effects of drugs
  • experience more intense negative withdrawal symptoms
  • begin using drugs again after a period of abstinence (i.e. relapse)

Why is there a Difference Between Males and Females in the Response to Drugs and Addiction?

 There is a correlation between fluctuations of the ovarian hormones of estrogen and progesterone and the greater likelihood that women over men will become addicted to a drug, become addicted at a faster rate, and will be more prone to relapse. Research has shown that fluctuations of these two hormones throughout biological events including the menstrual cycle, menopause, and the postpartum period undoubtedly modulate the effects of drug abuse and addiction in those who menstruate.  

Estrogen and Drug Addiction

In animal studies, female rates consume higher doses of cocaine when estrogen levels are high and lower doses of cocaine when estrogen levels are low. Additionally, estrogen increases and reinforces both the rewarding properties of opioids and heroin. These characteristics can be explained through a signal transduction event in which estrogen leads to the phosphorylation and therefore activation of the protein CREB. CREB is a transcription factor that induces transcription of genes that reduce sensitivity to the rewarding effects of drugs of abuse (i.e. establishing tolerance) and perpetuate the negative withdrawal symptoms that accompany drug abuse, thereby promoting dependence on the drug. These effects of CREB also make the drug user more prone to relapse as a result of the greater rewarding effects of using the drug and the intense negative effects of withdrawal from the drug. 

Progesterone and Drug Addiction

Maintaining the opposite effect of estrogen, higher levels of progesterone actually have a protective effect in reducing the intensity of drug cravings and the probability of relapse. An example of how progesterone can reduce drug addiction behaviors can be clearly seen in nicotine addiction. Within nicotine addiction, the receptor that binds nicotine in the brain, called the nicotinic acetylcholine receptor (nAChR), plays a central role in producing the reinforcing effects of nicotine. Progesterone blocks these receptors, preventing these reinforcing effects to take place and perpetuate addiction. When evaluating the effects of progesterone, it is important to observe the luteal phase of the menstrual cycle that occurs after ovulation, in which the follicle that had once stored the egg develops into a structure called the corpus luteum that secretes progesterone. The end of this period of time poses a high risk for drug cravings, intense negative withdrawal symptoms, and relapse due to a sharp reduction of progesterone during this phase. As a result, exogenous progesterone can be utilized as a supplemental treatment that has been found to be successful in undermining many behavioral consequences to drug addiction.

Menstrual Cycle Tracking as a part of Treatment Strategies

As a result of these fluctuations in ovarian hormones throughout the course of the month and their respective contributions to drug addiction, it would likely be beneficial for those struggling with drug abuse to look into tracking their menstrual cycle as a component of therapy. When an individual approaches periods of time throughout menstruation, menopause, or pregnancy in which estrogen levels are high and/or progesterone levels are low, it is important that they have the knowledge that they will be at greater risk for drug cravings and relapse during those times. Consequently, those struggling with addiction may be more diligent and avoidant of drug-associated stimuli during these periods of ovarian hormone fluctuations. Further research regarding addiction and these hormones should ultimately be pursued in order to better aid those combating drug addiction.

Abstract/Featured Image created by S. Wiger

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Is Schizophrenia Heritable?

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Introduction

When I think of a hereditary gene, I often think of physical appearances such as eye and hair color. If both parents of a child have brown eyes and brown hair, then there is a particularly good chance that the child will follow suit. To my surprise, this same process is shown in the psychiatric disorder, schizophrenia. Schizophrenia is a disorder that Merriam-Webster describes as, “a mental illness that is characterized by disturbances in thought (such as delusions), perception (such as hallucinations), and behavior (such as disorganized speech or catatonic behavior), by a loss of emotional responsiveness and extreme apathy, and by noticeable deterioration in the level of functioning in everyday life.” Genetics play a crucial role in the development for Schizophrenia. If an individual has a sibling or parent with the disorder, their probability of being diagnosed with the disease rise from one to ten percent. With this knowledge it is evident that there is something going on within the genetic makeup.

 

What Are the Contributing Genes?

Schizophrenia has been under extensive research for a long period of time. Due to the complications that are involved with this disorder, researchers have and still are having a tough time to determine the site where gene mutations are taking place. Although the disease is severely complicated, advancements in technology have allowed for bits of new information. The breach of this new information started with a study that looked at the genetic makeup of 186 Irish pedigrees. These pedigrees all had one thing in common right off the bat and that was Schizophrenia. After scans, researchers had noticed a vulnerable location in which there was activity. This activity was occurring on chromosome 6p.

 

The findings that the early Irish studied provided opened for a more detailed and extensive research. Scientist who were curious about this disorder were given a target to concentrate on. Studies would continue to become more and more in hopes to gain more knowledge on this complex disease. Results started to support that chromosome 6p was in fact a location with a lot of gene activity for Schizophrenia. Researchers however have not been able to target which gene or genes are accounting for this genetic vulnerability to schizophrenia.

What’s Next?

Chromosome 6p has now been a “hot-spot” for schizophrenia research. Researchers are continuing to try and pinpoint certain genes, but progress is not coming as fast as they would like. The goal would be to eventually identify these genes which would allow for future treatments and the possible deletion of the disease. Although this would be ideal, the complexity of Schizophrenia will not be allowing for that to happen anytime soon.

 

Conclusion

As one can tell, schizophrenia is an overly complicated disease. This complication causes many unknowns with treatments and identifications for the disease. Studies can prove that there is a hereditary gene or genes associated with the disorder but pinpointing these genes has been impossible to date. One positive note that studies did show at least gives research an area to study and that is within the 6p chromosome. Continuing with this data it is in hopes that one day we will be able to unravel this mysterious disorder.

Disease/Health/Uncategorized

Unwrapping Schizophrenia: It’s More Than Hallucinations

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artstract created C. Eisenschenk

Have you ever met someone who has schizophrenia? Odds are, probably not, but if you were to ask someone what schizophrenia is, they generally would respond with, “Oh, that’s the one with hallucinations”. Schizophrenia is highly misunderstood and negatively portrayed in the media as a disorder in which people only have vivid hallucinations and commit violent acts. While this can be a symptom of schizophrenia, it doesn’t happen in every case, and there are a variety of other symptoms that are overlooked.

What is Schizophrenia?

Schizophrenia is a neurodevelopmental disorder that usually has an onset in early adulthood. It has a collection of positive and negative symptoms; these positive symptoms are what are highlighted in the media. Some of the positive symptoms include delusions, hallucinations, and disorganized thinking. The negative symptoms are often overshadowed and forgotten to the public but can be the most troubling for the patient and include apathy, a flat affect, and asociality. Due to the complexity of schizophrenia, the etiology and treatments are hot topics in research but still unknown. There have been movements in uncovering the genetics though, and researchers have begun to better understand what is going on neuroanatomically and neurochemically, perhaps weaving a pathway for better treatments.

Dissecting the Brain’s Anatomy

The brain of schizophrenia is rather unique. Brains are comprised of gray matter and white matter. White matter is composed of axons, which send nerve signals throughout the body so it can move, react to stimuli, and use its senses like sight or touch. Gray matter is mainly composed of neuronal cell bodies and synapses; this allows nerve signals to complete their signal so the body can complete an action. In schizophrenia though, both gray matter and white matter are impacted. This disrupts neural connectivity. The white matter is much weaker, meaning the signals being sent aren’t as strong, and the gray matter is substantially decreased in volume. A majority of the brain in schizophrenia is shrunken, especially within the prefrontal cortex and the temporal regions. These regions are involved in memory, decision-making, motor movement, and processing auditory and visual stimuli. All of these regions are heavily impaired in schizophrenia, resulting in the variety of symptoms patients endure. The low gray matter found within schizophrenia patients is partially hereditary and can also be the result of intrauterine risk exposure.

Neurochemical Aspects

While understanding the neuroanatomy helps researchers localize what specific regions to target in the brain, it’s important to understand what is happening neurochemically to aid these symptoms and create disruptions in the frontal and temporal regions of the brain. The Wnt pathway is highly dysregulated in schizophrenia due to the overactivation of dopamine, which is a neurotransmitter that helps regulate emotional and motor responses. Dopamine binds to an inhibitory receptor known as the D2 receptor and stimulates the enzyme glycogen synthase kinase 3 (GSK3) to destroy the protein beta-catenin. The Wnt pathway regulates beta-catenin in order to transcribe developmental genes in the brain, but in schizophrenia, this protein is destroyed by an excess of dopamine and GSK3, and the developmental functioning can no longer occur. This ultimately helps the symptoms to occur because the developmental pathway that transcribes cognitive functioning genes is no longer working correctly.

The Future of Schizophrenia

Most treatments that exist today for schizophrenia are antipsychotics, which work to inhibit dopamine and GSK3 to allow activation of the Wnt pathway and beta-catenin. Antipsychotics help control and reduce the symptoms of schizophrenia so the patient can live a more normal life and gain back independence. That said, these medications don’t cure psychosis and can have severe side effects. Gathering a better understanding of the etiology of schizophrenia will help provide better pharmacological treatments for patients and create more knowledge on the risks that increase ones’ vulnerability to the disorder (genetics and intrauterine environment). Hopefully, findings of the etiology surround schizophrenia will allude to a more positive view of the disorder and provide an improved treatment method to give control back to those suffering from schizophrenia.

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