SilverJacket

Be All That You Can Be, And Then Some

 I first took Ritalin in first grade. I went off it soon after but tried it again in high school and have been reliant upon it and other psychoactive medications for the last 14 years--nearly half my life. Do i feel artificial? Do I feel like I'm cheating? Do I feel like I'm not being the real me? Those aren't even questions I ask myself anymore. After much experimentation with various molecules and dosages and life situations, I've made peace with my drug dependence, and now when pondering a prescription refill or an individual pill in my hand, instead of asking which me is the real me--chemically modified or au natural--I ask which me I prefer.

Despite the popularity of caffeine and alcohol, not everyone feels the same, and new research (that I covered in the August issue of Psychology Today) maps out our fears regarding artificial cognitive enhancement.

Continue reading this post at Brainstorm.

Kall and Response

Yesterday the New York Times science section asked, "What is vitamin K good for, and where can it be found?"

As if reading their minds, on the same day the Washington Post style section wrote, "Ketamine, sweet ketamine, answer to our glutamatergic dreams."

Let me elaborate. What is K good for?
A. Chillaxing / Seeing God (depending on dosage.)
B. Anesthetizing animals, children, and the elderly. (It's very safe because it doesn't depress respiration. It's not used more widely because of occasional side effects; see above.)
C. Here's the news: Treating depression.

A paper published in the August issue of Archives of General Psychiatry shows that administering sub-psychedelic amounts of ketamine can have antidepressant effects that begin within two hours and last two weeks. Wickid.

At first I didn't notice that paper when the August Archives came across my desk. Either because it was unremarkably titled "A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression" instead of "Injecting fucking special K makes you trip balls AND totally puts you on cloud nine." Or because we got Oprah Magazine that day. (My job requires that I cast a wide eye on news and trends. Have you seen Oprah's new hair? OMG.)

Once I read the study I spotted a mighty confusing line though: "Adverse effects [included]... perceptual disturbances... euphoria... and increased libido." Reminded me of that old Ali G segment where he asks a narcotics agent about hash:

Ali G: And what is its effects?
Guy: You can go paranoid, which means you think people or things are coming at you. It makes your heart race. Your blood pressure can go low, so you can feel a bit woozy sometimes. It’s got a lot of medical effects on the body.
Ali G: And is there any negative effects?

Bottom line: I'm not sure I'm getting my biweekly recommended dosage of vitamin K. I can't wait for the chewable Flinstoner version to come out.

Related: The side effects of vitamin R.

When Ledes Mislead

Good science writing for a popular audience needs to be (at least) two things: entertaining and informative. Starting your article with a catchy headline and a snappy opening is always good, as long as they're not misleading. Yesterday I encountered a prime example of snap over substance.

It's an article in Wired News about an emerging treatment for depression.

    The hed: "Shock Therapy, Version 2.0"

    The lede: "Shock treatment for depression is making a comeback, and it no longer resembles a scene from One Flew Over the Cuckoo's Nest."

Here's the thing: The article is NOT ABOUT SHOCK TREATMENT.

It's about repetitive transcranial magnetic stimulation, or rTMS. In rTMS, a device that causes a focused magnetic field is held against the head.

Shock treatment is electroconvulsive therapy, or ECT. In ECT, an electric current is briefly applied to the head to induce a seizure. (The therapeutic aspect actually results from the seizure, which lasts 30 seconds, not the jolt of current that triggers it, which lasts half a second. Originally, from 1933-1938, the seizures were induced by injecting chemicals.)

The article says rTMS and shock treatment are "based on the same therapeutic principle." But they are very different. rTMS: magnets. Shock treatment: seizures. rTMS is not the "comeback" of shock treatment. It is a replacement for shock treatment.

I might also note that shock treatment has already had a comeback--the comeback began in the 1970's, and ECT is still in wide use. To boot, it has not resembled the scene from One Flew Over the Cuckoo's Nest since the early 1950's. Patients are now given an IV carrying an anesthetic and a muscle relaxant, so they're not awake, and their bodies don't shake.

Now, why would rTMS replace ECT? Both are safe and effective. In the short term they're even better than Prozac. But ECT has this nasty side effect of memory loss and confusion.

My mom had several sessions of rTMS in 1999 (with Dr. Alvaro Pascual-Leone, the leading American researcher in the field), and I could sit in the room and talk with her during her appointments.  Shock treatment, on the other hand, fucks you up. Between 1997 and 1999 my mom had 28 ECT sessions. In 1997, she had six sessions after doing her Christmas shopping for the year. Christmas morning, we would open gifts from her and she would say, with genuine surprise, "What a great gift! Who gave you that?" We could only grin and say, "You did, Mom. Thanks."

Actually, it was quite funny.

A Tail of Two Sassies

All this talk of disturbed pets reminds me of my family's second dog, a spritely  English Setter puppy that I named Sassafras, or Sassy for short. Our first dog, an adorable black and white Cocker Spaniel named Katie lived until 15, but she faded slowly, so her death was somewhat of a relief, and I was ready to start fresh.

Sassy's name turned out to be quite fitting, as her spirited nature often got the best of her. She'd go from a lapwarmer to a blur, a circular torrent of energy, tearing around the coffee table unprovoked for minutes at a time. Her behavioral quirks just made me love her more, perhaps because I could relate <grin>. Sassy and I were quite a pair.

Don't bogart the happy pills, human!

Giving psychoactive meds to pets has become a pretty common practice, but I never considered whether zoo animals need them too. Apparently they do, as National Geographic documents. I only question one of Nat Geo's examples:

"Polar bears are notorious for pacing," explained zoo veterinarian Doug Whiteside. "They wander in the wild for long distances and probably have this internal drive to walk, and zoos can't provide them with the huge distance."

Whiteside said Misty significantly reduced her pacing when she was given the drug [Prozac] in 1995. She only had to stay on it for five months to cure the disorder. [emphasis mine]

The Man Who Takes the Science out of Scientology

For years I've had a recurring dream in which, outlandish as it sounds, Matt Lauer and Tom Cruise debate the finer points of neuropharmacology on national television. Crazy stuff, fodder for a Spielberg movie, I know. But today my odd dreams retroactively became premonitions.

Okay, there are a few differences. Replace "finer points" with "coarser points." Replace Cruise in a flight suit with Cruise in a creepy stupor, sporting bags under his eyes and a cult-addled stare. And replace Lauer dressed as a court jester with Lauer as my new Hero. [Also, remove the weird sex stuff.] There you have what transpired this morning on "Today."

Scientologists notoriously hate psychiatry. Lauer breaches the topic and eggs Cruise on, revealing Cruise to be pedantic, myopic, and apparently illiterate. I'm still not sure how a man who says "you have to evaluate and read the research papers on how they came up with these theories, Matt, okay?  That's what I've done" in the same conversation as "there is no such thing as a chemical imbalance" can figure out which tube is for food and which tube is for air.

Against Depression

In The New York Times Magazine on Sunday, Peter Kramer, author of Listening to Prozac, published an amazing essay called "There's Nothing Deep About Depression." He combats the myth that depression offers special powers of insight and creativity, a fantasy he traces back to the dawn of history. After a down period, melancholy surged in status during the Renaissance, and still rides the wave of Hamlet, a text that "cements our admiration for doubt, paralysis, and alienation."  According to Kramer, "the rumination of the depressive, however solipsistic, is deemed admirable. Repeatedly, melancholy returns to fashion."

Nine years ago, in 12th grade at Groton, I gave my Chapel Talk about depression. I decried what I called the glorification of suffering:

Cursed

A friend of mine just returned from Costa Rica, smuggling a 2000-year-old jade god figurine back with her. She didn't know it was illegal to remove the item from the country until after the purchase, when the the seller pointed out, "Oh, and if customs stops you, just tell them you brought it with you here." (Expect supernatural payback to ensue shortly.)

Supposedly the item has special powers. If you wear it over your solar plexus, it calms your emotions and heals you when you are sick. And for the ladies: "He also explained to me in very funny English without saying any gross words that if women have cramps, you put it in a glass of water for a while and then take it out and drink the glass of water and you'll feel better," she told me. Oh and mysteriously it "can't touch metal." The cost: a chunk of change, plus a chunk of soul.