Brain Anatomy, Development, and Plasticity

Lobotomy

The rise and decline of frontal lobotomies and their alternatives

Frontal lobotomy was seen as a breakthrough treatment for mental illness (especially for the serious ones such as schizophrenia and psychosis). Antonio Egas Moniz developed the procedure in 1936, known as leucotomy back then. It was developed when other interventions were also very popular such as insulin coma therapy (or insulin shock therapy) and electroshock therapy (or electroconvulsive therapy). Insulin coma therapy is exactly what it sounds like -- a coma induced by insulin. A high dosage of insulin is injected to the patient which causes a lapse into a hypoglycemic coma. Then, an injection of glucose essentially 'revived' the patient -- it was thought that the brief coma "short-circuited" the abnormal 'psychotic/schizophrenic' brain into a normal brain. A single patient could be induced into a countless number of comas as a form of treatment. Electroconvulsive therapy involved administration of either camphor or metrazol to induce a seizure. Later, electroshocks were used to induce seizures (hence the name electroshock therapy). A common side effect was memory loss, which was sometimes very severe (Well, yeah, the brain is fried with hundreds of volts of electricity -- of course it will affect memory).

Moniz won the Nobel Prize in Medicine in 1949 for his "breakthrough intervention", but Walter Freeman was the one who made it popular in the United States. To be specific, he developed a procedure called transorbital lobotomy, also known as ice pick lobotomy. It is called this because he used an ice pick, shoved it above the patient's eye in the eye socket to reach the brain, and wiggled the ice pick around with a hammer to sever the frontal lobes.
Here is a segment of a PBS documentary on Walter Freeman and his ice pick lobotomy. I warn that the video can be disturbing to some people -- indeed it can be gruesome:

Today, I'm not sure if actual "lobotomies" take place -- the last 'lobotomy' may have taken place in the 1980's, which isn't too long ago. If any modified form of lobotomy does take place, I'm sure (and hope) that the instances are extremely rare. Instead, there are alternative procedures, such as a bilateral cingulotomy which is defined online as "a surgical procedure which may be performed in cases of treatment-resistant mental illnesses." The target areas are the cingulate gyrus and the frontal lobe. The cingulate gyrus is targeted because it is thought to control emotions. The way it works is -- a gamma knife or an electrode is guided to the cingulate gyrus through stereotactic magnetic resonance imaging. A 1/2 inch lesion is made there. Basically, dime-sized lesions are burned/cooked in the cingulate gyrus or the frontal lobes of the brain in order to reduce the afflicted symptoms of serious 'mental illnesses' such as depression, bipolar disorder, generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). One side effect is seizures, but headaches, nausea, and vomiting are much more common.

NOTE: I have also included the full documentary on Walter Freeman below if anyone is interested in watching the whole thing. It's about an hour long:

Synapses, Drugs, and Addiction

Neurotransmitters and “Mental Disorders”

Mental disorders are typically seen as caused by an excess or deficit of certain neurotransmitters.

However, is this ever so popular 'chemical imbalance' theory thoroughly backed up by good science?

The DSM-III established psychiatry as a medical specialty, allowing psychiatrists to don the white coat and expand their prescribing powers. The introduction of Thorazine (chlorpromazine) in 1954 sparked up the psychopharmacological “revolution.” However, this drug was first introduced as a major tranquilizer (because it was used as an anesthetic for surgery – psychiatrists used the drug’s “side effects” to help sedate troublesome schizophrenic patients; they believed it produced a chemical lobotomy.) The term that we’re more familiar with – antipsychotic – was developed later as a marketing scheme to emphasize that it treats an underlying disease. Antipsychotics, antidepressants, anti-anxiety agents, are not scientific terms but marketing terms in order to describe what they are supposed to treat as what they’re supposed to do. Antidepressants were first called psychic energizers. Anti-anxiety agents were first called minor tranquilizers.

 

In the midst of discovering magic bullets for infectious diseases, like antibiotics to combat bacteria, psychiatry sought to catch up with medical profession to find their own “magic bullet”/miracle cure for mental illness. These miracle drugs only treat the patient for the short-term. Good long-term outcomes are rare – in fact, most medications actually worsen long-term outcomes. Now, I’m not saying these psychiatric medications should be abolished from society. They certainly have their place, but I believe they should be used in a more limited manner (for short-term outcomes) and psychosocial, alternative non-drug therapy, good diet, and exercise should be considered for the long-term. However, the most profitable treatment is one that you have to take every day for the rest your life. Pharmaceutical companies and psychiatry work together in such a way that the mentally ill essentially become a consumer 1^st and a patient 2^nd. I’m not saying that you shouldn’t care about money – but shouldn’t a helping profession (like medical doctors) be more concerned with helping people for the long-term? 

 

The most popular theory for the cause of depression is insufficient monoamines (serotonin and norepinephrine) in the brain. Similarly, schizophrenia is thought to be caused by an overabundance of dopamine. This biochemical imbalance as a cause for mental illness is usually described as being exactly like how people with diabetes need insulin treatment for life – people with mental disorders need medications for life. With the chemical imbalance theory, psychiatry has a biological disease of the brain in which they can treat with chronic medications to “correct” this imbalance. However, these “illnesses” aren’t caused by a chemical imbalance – they’re iatrogenic. The treatment for the disease creates the chemical imbalance, fueling dependence of the medication. When you take a mental patient off his daily dose of whatever the case – whether that’s an antipsychotic, antidepressant, benzodiazepine, stimulant, or a combination, etc. – that mental patient will experience withdrawal (to say the least), and these severe symptoms are claimed to be symptoms of the illness. Therefore, in psychiatry’s logic, you cannot take a mental patient off his medication because he will become ill (even if his illness clearly became worse after use of medication.) 850 adults and 250 children are becoming disabled by mental illness daily (Whitaker, 2010). Children as young as two-years of age are becoming diagnosed as “bipolar.” The number of disabled children by mental illness has rose thirty-five fold within the past twenty years, despite these “advances” in mental health.

 

If any of the following information stirs any interest for you, please check out Robert Whitaker’s book Anatomy of an Epidemic.

 

Whitaker, R. (2010). Anatomy of an epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America. NY: Crown Publishers.

 

 

 

DISCLAIMER: If you or anyone you know is taking a prescriptive psychiatric medication for stress, anxiety, depression, or any other reason deemed appropriate by the prescribing physician, alteration or discontinuation of the drug(s) is NOT recommended. Discontinuation or alteration of prescriptive medications can be life-threatening and can only be done under the authority and supervision of a licensed medical doctor!

Nerve Cells and Nerve Impulses

Multiple Sclerosis

Multiple Sclerosis, or MS, is a very serious autoimmune neurological disease in which the immune system attacks and damages the myelin sheath of axons, causing very poor nerve conduction. This disease can be chronic and very debilitating. The exact reason why the immune system attacks the myelin sheath is currently unknown. Multiple Sclerosis is complex and involves multiple levels of pathology -- involving the immune system and the nervous system. Because of MS, myelin sheaths in axons of neurons in the CNS (central nervous system; e.g., the brain and spinal cord) weaken, tear, or deteriorate -- this is called axonal demyelination. The damage within the central nervous system can also be caused by the inflammation and breach of the blood-brain barrier. Multiple sclerosis affects the white matter of the brain and spinal cord.

The exact cause and cure for multiple sclerosis is not currently known -- even though much the physiological mechanisms are known. The disorder was coined by Jean-Martin Charcot in 1868. He named the disorder 'multiple sclerosis' because of the lesions in white matter. There are theories concerning the genetics, environmental risks, and infections, but the most prominent modern theory is that MS is caused by immune system abnormality.

This short clip introduces the autoimmune theory:

Some devastating symptoms include:

• Loss of sensitivity
• Numbness or tingling
• Muscle weakness or spasms
• Poor motor coordination or balance (dizziness or vertigo)
• Difficulty swallowing or talking (slurred speech)
• Visual problems (loss of vision)
• Chronic pain or fatigue
  

Introduction to Physiological Psychology

Biological Psychology

The study of physiological, evolutionary, and developmental mechanisms of behavior and experience

 

However, it is much more than just a field of study. It is a point of view.

 

Currently, most philosophers and neuroscientists reject the idea that the mind exists independently of the brain. I respectfully disagree. I understand that this course is Physiological Psychology, and I am certainly not rejecting the field. Every field in psychology fascinates me, and I am eager to learn every side, every position, and every angle of psychology.

Biological psychologists believe that your brain physiology is you. However, this fundamental belief is one of the very reasons why our mental health system is so broken today. It's been broken for more than fifty years, ever since our mental health system has been based under a strictly medical model -- more specifically, a drug based treatment paradigm.

These "miracle" drugs are designed to treat an underlying "illness", an underlying disease, (now called a disorder) despite the fact that many, if not all, of these so-called treatments were created (but more like stumbled upon) before any of these "diseases" existed. This flawed model is based on the assumption that you are your brain. The brain is part of the body; therefore you are your body. These “diseases of the brain” are biological, therefore treatable with drugs. Psychiatrist Thomas Szasz in his article published in 1960 entitled "The Myth of Mental Illness" explains that mental illness is a double metaphor. A mental disorder is obviously not the same as a physiological illness.

The mind does not really exist. It is not your brain. It is not your body. It's not something you can see on an MRI scan. The mind is a concept, a metaphor actually. Complex human behavior should not be reduced to your brain. And the statement "You are your brain!" does just that.

More specifically, for example -- most people nowadays associate depression (and several other mental disorders) with a chemical imbalance within a neurotransmitter system. In more layman's terms, if your brain is “low” in serotonin, you are depressed. Because you are now clinically depressed, you will most likely receive chronic drug treatment (which is always more profitable for pharmaceutical companies.) Instead of a chemical imbalance, I'd lean more towards some experience, stress, or immediate environmental impact (social, cultural, financial, etc.) has caused this depression. These drugs can actually create a chemical imbalance, fueling dependence.

I could go on and on; however in conclusion, this failed medical model is much better than no model at all or attempting to start a new model from scratch. This model needs to be altered somehow.

You Are Mental Health Tomorrow, Join Us In Advancing The Paradigm Shift!

DISCLAIMER: If you or anyone you know is taking a prescriptive psychiatric medication for stress, anxiety, depression, or any other reason deemed appropriate by the prescribing physician, alteration or discontinuation of the drug(s) is NOT recommended. Discontinuation or alteration of prescriptive medications can be life-threatening and can only be done under the authority and supervision of a licensed medical doctor!