Sleep

Insomnia

Types of Insomnia

It is recommended that you get 7-8 hours of sleep every night. However, some people can manage to function with less. I know of some people who can manage to function with as few as 4 hours of sleep every night (perhaps during the week, but the probably sleep more on the weekends). Some people just don't need to sleep as much as everyone else. These people are usually considered "evening people" or "owls", because they typically tend to stay up late at night.

Everyone occasionally has problems sleeping. Insomnia is when you have difficulty falling asleep or when you don't sleep as much as you want to. With that general definition, a majority of people should suffer from insomnia. However, insomnia is best determined by how you feel the following day. Some people just aren't "morning people" -- I know I'm definitely not a morning person -- but if you are tired and generally do not feel good throughout the day because you find that you cannot fall asleep fast enough or have trouble staying asleep then it is most likely due to insomnia.

There are several types of insomnia, excluding sleep problems and disorders resulting from drugs or substances (i.e. coffee, medication), a medical condition, and organic, non-organic, and environmental causes. One type of insomnia is called acute insomnia. This type of insomnia is usually caused by high amounts of stress, which is why it is also known as stress-related insomnia, short-term insomnia, or adjustment insomnia. This type of insomnia requires poor sleep for about a month to be diagnosed. This insomnia usually subsides when the stress has been eliminated or when you adapt to the stress. Some symptoms of this type of insomnia include the inability to achieve and maintain refreshing sleep.

Transient insomnia is usually a more minor form of insomnia. It typically lasts for about a week. It can be caused by changes in sleep environment, jet lag, or changing your sleep pattern.

Chronic insomnia, also known as long-term insomnia, must last longer than a month in order to be diagnosed. Chronic insomnia can cause hallucinations, double vision, muscular fatigue, mental fatigue, and impaired psychomotor performance, and all of these symptoms result from the severe sleep deprivation.

Below is a YouTube clip explaining how insomnia could possibly be combated by classical conditioning:

Sex

The tragic story of David Reimer

Gender Identity

 

Nature v. Nurture

In August 1965, Bruce and Brian were born. They were identical twins and were healthy. However, six months later they began having trouble urinating because they had a condition called phimosis. As a solution, both of the boys underwent circumcision a couple months later. Instead of performing the typical procedure with a surgical blade, they decided instead to use an unconventional cauterizing needle which proved to fail. This unconventional method of circumcision burned Bruce's penis and genitals. After the failed surgery on Bruce, his parents decided not to do the surgery on Brian, and his phimosis resolved itself without the use of circumcision surgery.

Months later David's parents saw Dr. John Money, a psychologist and sexologist specializing in sexual identity on a Canadian news program called This Hour Has Seven Days and decided to take him to see Dr. Money at John Hopkins Hospital in Baltimore. The doctor believed that repair/construction of the penis was impossible. Backed up by absolutely zero scientific evidence, Dr. Money concluded that nurture was superior to nature in determining gender identity and suggested to surgically construct a vagina instead and raise Bruce as a girl. His parents agreed to Dr. Money's proposal and decided that Bruce should undergo sex reassignment surgery. His testes were removed through a procedure called orchidectomy. However, they did not surgically construct a vagina. Bruce Reimer was raised as a girl for the first 14 years of his life, as a girl named Brenda.

As part of Dr. Money's experiment, Bruce's parents should never tell him that he is actually a boy. Bruce had some female characteristics, but was also still masculine and had many "tomboy" traits. In Dr. Money's experiment, Bruce served as the experimental arm while Brian served as the control arm. I'm not going to go into Dr. Money's methodology of his case with David Reimer in great detail because it is very graphic, heinous, and disgusting to say the least. I have included 2 YouTube clips at the bottom of this blog post. The first is a short two-minute clip and the second is an hour-long BBC documentary called "Dr. Money and The Boy With No Penis" -- and I'm warning that this documentary has some of the graphic details of Dr. Money's experiment.

When Bruce was a teenager, he was lonely, rebellious, and suicidal. Dr. Money's theory was wrong. His experiment had failed. Being an "expert" in sexology, maybe his research and career got in the way of making a rational and objective judgement on what to do. Maybe he saw David Reimer as a potential "case". This is another example of how money and power blinds. Even though David Reimer never identified as female, his "caring" doctor published numerous papers that the sex reassignment was a success. In an act of desperation, Bruce's parents decided to tell him that he was actually a boy. From then on Brenda became David and had reconstructive surgery.

In 2002, David's twin brother Brian died from an overdose of antidepressants to treat schizophrenia. I wonder what caused his schizophrenia...Was it a chemical imbalance in his brain due to an overabundance of dopamine? Or perhaps was it the emotional scarring due to the horrible experiences he had with Dr. Money and experiencing what the doctor had done to his twin brother and himself and his entire family? David began suffering from depression. His brother's suicide, his unemployment, his strained relationship with his parents, and his divorce from his wife was too much to bear. In May 2004, when he was 38 years old, Bruce Reimer committed suicide.

Pain, Olfaction, Pheromones, and Synesthesia

Placebos

The "Breaking Blind" Phenomenon 

A placebo is a drug that has no pharmacological effects. It is often referred to as a ‘sugar pill’. In clinical trials, there is an experimental arm and a placebo-controlled arm. The experimental arm (or experimental group) receives the active drug treatment while the placebo-controlled arm (or control group) receives the placebo. When you get better from the actual active chemical within the drug, this is called the therapeutic effect or pharmacological effect. When you get better just from that fact that you are taking a drug, this is called the placebo effect. Just by acknowledging that you are being “medically” treated with drugs that are commonly believed to help, could in fact improve your symptoms -- and this is how powerful the placebo effect can be. 

For example, years of data analysis has shown that the difference between the chemical effect and the placebo effect in depression is actually quite small.  People experience symptom improvement in depression from placebo almost as much as they do from antidepressants. This data analysis took all of the research into account -- research that has been published and unpublished (the research that the pharmaceutical companies didn’t want the public to see).  Antidepressants can be seen merely as active placebos -- that is, they have little therapeutic effect with powerful and very noticeable side effects. 

I honestly don't think we should be testing drugs against placebos because of how powerful and confounding the placebo effect really is. For example, a lot of groups in clinical trials taking the drug/placebo “break blind” -- meaning they figure out what they are taking. If you were told that you needed this medicine to get better, and you took the pill and experienced no side effects, then you would probably figure out that you took the placebo. This could actually make your symptoms get worse. Your mentality is that you need the active drug to get better, and because you didn't get it you will get worse, and so you probably will. The reverse has also proven to be true. If you take the pill, and then start to experience side effects, you'll probably figure out that you took the active drug and you may feel relieved that you received the active medication, that you will get better from this treatment, and so you probably will. The doctors can also break blind by seeing patients experience these side effects. 

  

If any of the following information stirs any interest for you, please check out Irving Kirsch’s book The Emperor's New Drugs.

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!

Learning, Memory, and Amnesia

Types of Amnesia

Memory lapses are common. We all have them from time to time; everyone forgets and sometimes it can be rather embarrassing. Most people don't have great memory. Unfortunately, some people have much more severe conditions in memory problems. These memory deficits can occur when people have brain injury, Alzheimer's disease, or stroke. In the classic amnesiac syndrome, there is a deficit in episodic memory, but long-term memory and cognition is unimpaired.

Anterograde amnesia is when people are no longer able to form new memories. It is a problem of encoding, storing, and retrieving future memories. Retrograde amnesia is when you can no longer access past memories. You have difficulty accessing events that happened in the past, typically before the disease or injury that caused the retrograde amnesia.

Post-traumatic amnesia (PTA) occurs after a severe concussive head injury and you have difficulty forming new memories. This condition typically improves over time. Traumatic brain injury (TBI) occurs when the head receives receives a sharp blow or jolt. This can occur from a fall, a car crash or collision, etc.When a post-traumatic amnesiac recovers consciousness from the injury, their attention and capacity for new learning can be grossly impaired or disturbed. Post-traumatic amnesiacs who suffered severe brain injury typically recovered personal knowledge first -- who they were, their identity. They then recovered place -- where they were. Finally, they recovered temporal orientation -- the time and date, when they were. The recovery is gradual and the recovery time varies. After recovery, retrograde amnesia can persist, but it can shrink with time and rehabilitation.

Transient global amnesia (TGA) occurs when someone suddenly develops severe difficulties in forming and retrieving new memories. This can happen to relatively normal individuals with no previous problems in memory. Fortunately, this condition tends to resolve on its own and can resolve rapidly as well. However, the specific cause for this condition is still unknown.

Suffering from amnesia is a frightening thought. I believe we take our memory for granted because some people aren't as lucky as us -- some people can't even remember what happened 30 seconds ago. Whenever I forget something or have a poor memory, I usually get mad at myself for forgetting but now I'm glad that I have the ability to forget some small, trivial things sometimes -- some people can forget who they are, where they are, and when they are.

Even though amnesiacs have problems with new episodic learning, they can learn through classical conditioning. They can also learn through priming and have relatively intact implicit and procedural learning. A famous case of amnesia is Clive Wearing who suffers from varying degrees of anterograde and retrograde amnesia, however he still has his implicit memory intact. Below is a brief YouTube clip of Clive Wearing displaying his amnesia, but at the beginning you can see him playing the piano which clearly shows intact implicit memory:

Brain Lateralization

Severe Epilepsy

Severing the Corpus Callosum

 

Epilepsy is a neurological disorder of the brain that causes chronic seizures and convulsions. It can be caused by genetic birth defects, stroke, brain injury, meningitis, or other infectious diseases. However, most of the time the cause of epilepsy is not known. The corpus callosum connects the two halves  -- the left and right hemispheres -- of the brain together. This is how information communicates and travels between hemispheres. Since this is the route through which information is shared, the seizures also travel from hemisphere to hemisphere. Medications and anticonvulsants are effective treatments, but if the epileptic seizures are so severe and so uncontrollable and debilitating that the patient cannot function, then severing the corpus callosum may be a viable option.

The medical operation of severing the corpus callosum is called a corpus callosotomy. In order to successfully sever the corpus callosum, the brain must be exposed through a procedure called a craniotomy. The entire operation takes about four hours. After a corpus callosotomy operation, the seizures are not cured, but manageable. Because the corpus callosum is severed, the seizure only affects one hemisphere, therefore only one side of the body as well. Since the seizure cannot cross to the other hemisphere, the seizures may be less frequent and less intense, but they're still there.

However, after a corpus callosotomy, you now have a split-brain -- there's a left half and a right half, but they're no longer connected. It's as if you now have two independent brains -- working independent from one another, no longer communicating, no longer in synchronization. That's a scary thought: having two brains -- two independent cerebral hemispheres, two competing minds. I can't even imagine how horrifying that must be, especially at first.

For elaboration, I posted a YouTube video below showing an epileptic patient who had his corpus callosum severed and it shows a few experiments involving competition and a lack of communication between cerebral hemispheres in a split-brain patient: