Archives for December 2019

PTSD: The Reality of Post-Disaster Trauma

Dec 31, 2019 by United Brain Association Leave a Comment

Natural disasters such as hurricanes and earthquakes are not only capable of causing death, destruction, and catastrophe, but they also have the power to cause Post Traumatic Stress Disorder (PTSD), an emotional and psychological reaction to trauma.

Experts say that the devastating effects from natural disasters can linger long after the relief and rebuilding efforts take shape, as research has shown that as many as 25% of people directly or indirectly affected by high-impact disasters could be diagnosed with the symptoms of PTSD.

According to The Atlantic, following Hurricane Katrina, “Depression, anxiety, addiction and, for those who experienced life-and-death scenarios, post-traumatic stress disorder were common. In fact, one study found that rates of mental illness in New Orleans doubled after the storm. A 2012 Princeton study of low-income mothers in the New Orleans area found that even after four years, about 33 percent of its participants had Katrina-related PTSD, and 30 percent reported psychological distress.”

“Natural disasters can cause losses of homes, neighborhoods, belongings and even the death of family and friends. When exposed to life-threatening situations or those which encompass significant loss or grief, PTSD can disrupt the lives of sufferers for years until they recognize the symptoms and seek help,” says Anna Harwood, a clinical psychologist.

The video below highlights the mental health crisis in Puerto Rico that resulted following Hurricane Maria, one of the worst natural disasters in recent history.

The Effects of PTSD

According to Dr. Susanne Babbel MFT, PhD, Somatic Psychology, “These types of experiences are particularly insidious because they tend to traumatize large populations of people at once, and can result in epidemics of Survivor Guilt and other PTSD symptoms.”

The American Psychiatric Association says that PTSD sufferers have recurring intense, disturbing thoughts and feelings connected to the experience that lingers after the traumatic disaster has ended. PTSD may manifest through flashbacks or nightmares and those that suffer may feel a range of emotions such as sadness, fear, anger, detachment or isolation. Those with PTSD may avoid certain situations or get triggered by things such as noises that remind them of the event.

The American Psychological Association also cited these other common symptoms of PTSD:

Unpredictable mood swings, with periods of anxiety and depression
Confusion or difficulty making decisions
Sleep or eating issues
Fear that the emotional event will be repeated
A change in interpersonal relationships skills, such as an increase in conflict or a more withdrawn and avoidant personality
Physical symptoms such as headaches, nausea, and chest pain
Repeated and intrusive memories of the event, causing physical stress reactions (e.g., sweating, rapid heartbeat, breathing difficulties, etc.
Difficulty concentrating

Dr. Babel says, “Additionally, victims do not need to have experienced the disaster firsthand in order to be psychologically affected. For example, someone living in San Francisco with relatives in Haiti at the time of the recent earthquake could have been subjected to countless hours of television coverage, coupled with an inability to get information about their own family. This type of situation can take an emotional impact on someone even from afar.”

It’s important to note that PTSD following a natural disaster will set in at different times with each individual. Some survivors may appear perfectly fine right after, only to be plagued with symptoms months after.

How to Cope with PTSD Following a Natural Disaster

Once the disaster relief subsides, mental health clean up must begin. While it is common to feel a level of anxiety following the event, know that within a few months most are able to resume functioning as they did prior to the disaster. Those that cannot are likely suffering from PTSD, and it’s important to seek support.

If you think you or a loved one might be suffering from PTSD following a natural disaster, rest assured that there is hope. Here are a few things you can do to build emotional well-being and gain a sense of control:

Be patient with yourself: Allow yourself to mourn, get emotional, and feel whatever comes your way, knowing that this will be a difficult time in your life. Give yourself time to heal and adjust.

Seek support: Social support from family and friends will be a key part of your disaster recovery. Getting through your symptoms of PTSD won’t happen in isolation, so it’s crucial that you open up and lean on your trusted network for emotional support.

Communicate about your experience. Express your feelings in whatever ways that feel comfortable for you. Whether it’s talking privately with a close family member or expressing yourself creatively, go with it and be open.

Find local support groups. Seeking a support group in your area led by appropriately trained and experienced professionals are often available for survivors. You may find it extremely helpful and comforting to engage in group discussions with people who have experienced something similar.

Cope with excessive stress through positive & healthy behaviors. When you’re in a period of emotional fragility, it’s important to pay attention to your health and well-being. From eating well-balanced meals and getting enough sleep to exercising, be mindful of self-care. It’s equally important to avoid or limit numbing mechanisms such as alcohol or drugs, which may delay or detract from the healing and coping process.

Be mindful of establishing routines. In a time of uncertainty or distress, having positive routines will give you something to look forward to. Whether it’s pursuing a new hobby or taking a daily walk, these regular practices will keep you engaged.

Avoid making major life decisions. Now is not the time to make a big change in your life such as moving or changing jobs, which tend to be highly stressful enough on their own.

If you notice persistent feelings of distress, hopelessness and are barely able to function through your daily responsibilities and normal activities, we encourage you to seek and consult a licensed mental health professional such as a psychologist or therapist. Working with an experienced professional may provide you the support, guidance, and strategies needed to face and manage the mental anguish you’re feeling.

To find a psychologist in your area, visit APA’s Psychologist Locator.

Be Prepared

While we may not have the power to stop the forces of Mother Nature, one thing you can do beforehand is to arm yourself and those you love with information about the emotional toll that may result following a natural disaster. To provide yourself a level of comfort, be aware of potential PTSD symptoms, as well as how to cope and seek treatment if necessary.

Check out https://www.ready.gov/ to learn more about being emotionally and physically prepared both before and after a natural disaster.

SOURCES
Psychiatric Times
Psychology Today
Sunrise House
Scientific American
APA
Psychiatry.org
The Atlantic

FDA Approves a New Non-Medication Treatment for ADHD

Dec 24, 2019 by United Brain Association Leave a Comment

Attention Deficit Hyper Disorder (ADHD) is one of the most commonly diagnosed neurological conditions in school-age children, affecting over six million children in the United States. Symptoms of ADHD include inattention, hyperactivity, and impulsivity. ADHD typically begins in childhood and can persist into adulthood, and may contribute to low self-esteem, depression, delinquent behaviors, and difficulty at school or work.

According to the Centers for Disease Control and Prevention (CDC), about three out of four children receive treatment for ADHD, be it medication, behavior treatment or a combination of the two. Deciding on a treatment plan for ADHD can be a difficult decision for parents, however, parents now have another option, as the FDA recently approved the first-ever non-stimulant medication as an effective alternative.

The Monarch eTNS (external Trigeminal Nerve Stimulation) is created by NeuroSigma, a California-based life sciences company that focuses on manufacturing TNS devices for neurological disorders. This system provides a safe, noninvasive new treatment option for ADHD – one that would avoid medication.

Monarch eTNS treats the symptoms of ADHD by sending gentle electrical pulses to the trigeminal nerve, which activates the neural pathway to other parts of the brain thought to be involved in ADHD. Neuroimaging studies have shown that eTNS increases activity in brain regions that are known to be important in regulating attention, emotion, and behavior.

Sandra Loo, co-principal investigator of the study and professor-in-residence of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA and a member of the Jane and Terry Semel Institute for Neuroscience and Human Behavior, says, “A head-to-head study has not been done, so we can only compare how effective the treatments were in their own clinical trials. Trigeminal nerve stimulation performed better than other non-drug treatments, like behavior therapy, and is roughly equivalent to nonstimulant medications used to treat ADHD, such as guanfacine and atomoxetine.”

How Monarch ETNS Works

The Monarch eTNS System is meant to be used at home under the supervision of a parent or caregiver while the child is sleeping. The cell phone-sized device is loosely attached to the child’s pajamas and contains two wires that connect to an adhesive patch that is worn on the forehead, just above the eyebrow. These wires send low-level electrical pulses, described by patients as a tingling sensation, through a wire to the small patch affixed to the patient’s forehead. The therapeutic pulses stimulate the branches of the trigeminal nerve believed to be involved in ADHD. According to Dr. Loo, “The direction we give parents is to turn it up until the child feels it, and then turn it down one step. It’s noninvasive and is nothing like electroconvulsive therapy. The device indirectly stimulates the brain through the cranial nerves, which then send signals to various areas in the brain that we think may be involved in ADHD.”

Parents are advised to have their child receive mild stimulation for eight hours nightly. Clinical trials suggest that a response to this form of treatment may take up to four weeks to become evident.

Who Would Benefit?

The FDA’s approval of Monarch eTNS is a breakthrough for many parents with children suffering from ADHD and would be highly desirable for parents seeking to avoid pharmacological treatment, especially following a new diagnosis. The device is also a safe alternative for children who did not respond positively to stimulants or experienced unwanted side effects from ADHD medication.

Available by prescription-only, The Monarch eTNS device is indicated for the treatment of pediatric ADHD as a monotherapy in patients ages 7 through 12 years old who are not currently taking prescription ADHD medications.

Because there is currently no empirical way to predict if a child will respond to this treatment as opposed to another, the decision to use this form of treatment is based on the clinical expertise of the treating professional, along with the wishes of the parent.

Dr. Loo states, “Hopefully, future research will help us identify individual characteristics that predict which treatment will likely work for that person.”

Side Effects of the Monarch ETNS

No serious adverse events have been associated with using The Monarch eTNS, and the most common side effects observed include:

Drowsiness
Increase in appetite
Trouble sleeping
Teeth clenching
Headache and fatigue.

During Dr. Loo and team’s first study of the device, parents reported significant improvements in their children’s sleep, however in the second clinical trial, they did not see any improvement or worsening of sleep in participants. That said, no one stopped treatment because of difficulty sleeping. Further analyses are being done to better understand the effect of TNS treatment on sleep.

Learn More About the Monarch ETNS

New products approved for the treatment of ADHD are not immediately reimbursed by patients’ insurance, however, the company is working diligently with insurance companies to try and obtain coverage for the system by as many plans as possible. The price for the Monarch eTNS System starter kit is $980, which includes everything needed to begin therapy including the controller unit and a 4-week supply of electric patches. Refill electric patches are sold in packages of 7, which cost $70.

Contact your child’s doctor or click here to see if the Monarch eTNS System might be appropriate for your child.

SOURCES

https://newyork.cbslocal.com/2019/04/23/adhd-treatment-electrical-shocks/
https://www.monarch-etns.com/
https://www.cdc.gov/ncbddd/adhd/data.html
http://newsroom.ucla.edu/stories/drug-free-treatment-adhd-children

Grieving The Loss Of A Person Still Living

Dec 19, 2019 by United Brain Association Leave a Comment

Grief…

It’s painful, complicated, overwhelming and handled so differently by each individual. When we lose someone or something, the process for coping and healing can be all-consuming. While we typically equate grief with funerals or sympathy cards, it is also possible to mourn the loss of someone very much alive.

Whether it’s your mother battling dementia, a close friend suffering dramatic effects from a brain injury, or your child fighting addiction, there is an emotional process behind the feelings of loss for the person you know and love, and the person they have become, because of their disease or disorder. Though they may be present physically, their diagnosis may have caused changes to the person they once were and the dynamics of your relationship with him/her. As a result, it is both the person living with the condition AND those around them that can feel strong feelings of grief and loss.

“Witnessing dementia in a parent is one of the hardest things we face as adults. We see our former caretakers become dependent and disabled, often over a long period of time. Even in the early stages of the disease, we confront the vulnerability of someone who at one time we viewed as strong and powerful. The emotional consequences for adult children can seem endless and overwhelming,” says Tamara McClintock Greenberg, Psy.D., M.S., associate clinical professor of psychiatry at the University of California, San Francisco.

What is Ambiguous Loss?

Coined and pioneered by Dr. Pauline Boss, a thought leader in the interdisciplinary study of family stress, there is a term for this type of grief – ambiguous loss – and it happens as a result of seeing the person we once held dear become someone else.

Unlike anticipatory grief, which is the normal mourning that happens when a patient and his/her family is expecting death, an ambiguous loss means that our loved one is physically here, but because of reasons such as addiction, dementia, traumatic brain injuries or mental illness, is psychologically gone.

“Ambiguous loss makes us feel incompetent. It erodes our sense of mastery and destroys our belief in the world as a fair, orderly, and manageable place,” says Dr. Boss.

This video gives a personal insight into ambiguous loss:

Tips for Managing Your Grief

Author, Vicki Harrison said, “Grief is like the ocean; it comes on waves ebbing and flowing. Sometimes the water is calm, and sometimes it is overwhelming. All we can do is learn to swim.”

Like grieving someone who has passed away, grieving one still physically present manifests itself differently for everyone.

According to Dr. Boss, “If we learn to cope with uncertainty, we must realize that there are differing views of the world, even when that world is less challenged by ambiguity . . . If we are to turn the corner and cope with uncertain losses, we must first temper our hunger for mastery. This is the paradox.”

Here are a few tips to help ease the effects of ambiguous loss as it pertains to your loved one battling a brain disease or disorder.

1. Feel your grief.

Grief is a roller coaster of emotions, so be gentle with yourself as you ride the ups and downs. The healing process will never take shape if you don’t face and feel whatever comes your way.

Glenn Brynes, Ph.D. says, “When someone we love is gone from our lives, it is as if a piece of us has been torn away. The loss rends the fabric of our lives and the wound must be repaired. Grief is the process by which our minds heal this hurt.”

2. Hold your memories close.

While living in the past won’t change the current situation, cherished memories do make the past ever-present. It’s ok to remember the person he or she once was as a way to help you see beyond the person they have become. It will reinforce the idea that your loved one is still the same person, but suffering from something beyond their control.

3. Accept the new normal.

In holding onto memories, as time presses forward, you will eventually have to accept the changes that have occurred in your loved one and your relationship. While it may take time to reach the point of acceptance, you will find that it’s a crucial part of the process and learning to cope with how life and your loved one have changed.

A part of this acceptance may also mean focusing on gratitude, staying present and not thinking too far ahead into the future

4. Practice self-care.

Grief can be all-consuming. Whether it’s exercising, having a massage, or indulging in a special meal, make yourself a priority! Being conscious of your emotional and physical state will sustain you throughout the process and give you the strength to forge on and face your grief.

5. Seek support.

Kristi Hugstad, author, speaker, certified Grief Recovery Specialist, and host of “The Grief Girl” show says, “Grieving the living can be a lonely, isolating process because often, the support system you receive when a loved one dies isn’t there; people don’t understand or relate to your loss the way they would if a funeral was involved.”

While some may not be able to understand your grief, the process of healing will never occur without open and honest communication. Sharing your feelings with your trusted inner circle or even a professional will help suppress that pain involved with this type of loss.

While the grief you might feel for someone still alive can be painful and isolating, remember that this is a process that will take time and patience. Some days may be harder than others. We encourage you to give yourself time and space to feel whatever emotions come your way. and know that what you’re feeling is normal.

Visit The American Counseling Association for grief and loss resources.

Sources:
https://whatsyourgrief.com/ambiguous-grief-grieving-someone-who-is-still-alive/
https://www.ambiguousloss.com/
https://www.huffpost.com/entry/grieving-the-living-when-your-lost-loved-on-is-still_b_5a206399e4b05072e8b56722

How Parkinson’s Disease Can Dramatically Affect Both Movement And Memory

Dec 17, 2019 by United Brain Association Leave a Comment

Parkinson’s disease (PD) affects about 1% of the population over the age of 60 and 5% of those age 85 and up. Up to a million Americans suffer from this disorder, which unfortunately worsens over time.

While many think of Parkinson’s disease as a debilitating movement disorder affecting motor skills, muscle coordination, and balance, did you know that it can result in several non-movement symptoms such as thinking and memory problems, ranging from mild to severe?

Caused by the loss of dopamine-producing neurons in the brain, cognitive difficulties and dementia affect approximately 40% of people with Parkinson’s.

Disease and Movement Disorders, Department of Neurological Sciences at Rush University Medical Center, Chicago, IL says, “It is now recognized that Parkinson’s disease (PD) is much more than a motor disorder. Tremor, slowness, stiffness, and walking trouble are only part of the picture. Non-motor symptoms in Parkinson’s disease are common and affect cognition, behavior, sleep, autonomic function, and sensory function. Studies of Parkinson’s disease patients followed over many years reveal that non-motor symptoms become even more important as Parkinson’s disease advances. Increased recognition and improved treatments for these non-motor symptoms are greatly needed.”Jennifer G. Goldman, MD, MS, Assistant Professor, Section of Parkinson’s

How Memory Can Be Affected By Parkinson’s Disease

Cognition is a general term that refers to the mental abilities that we use to process information and apply knowledge. These processes allow us to perform daily functions such as paying attention and problem- solving. Memory is typically considered a large focal point in the study of cognition, as it controls so much of our life and basic activities.

Memory can be classified into different processes and types, and include:

Immediate: Seconds-minutes
Short-term: Minutes-days
Long-term: Days-years
Declarative: Facts, concepts, or events
Procedural: How to do certain tasks like tie our shoes or brush our teeth
Working: Process of temporarily storing information in one’s mind and manipulating it over a short period (i.e. mental arithmetic)

Dr. Goldman says that Parkinson’s sufferers may have difficulty recalling information. She says, “With PD, people frequently recall information more readily when given cues or choices. This helps the person to retrieve information from the brain’s memory storage. Long-term memory function typically remains intact in PD.”

According to Johns Hopkins Universit School of Medicine, experts don’t have a definitive understanding of how or why dementia or memory impairment may result from Parkinson’s Disease, however, it’s apparent that problems with cognitive function are linked to changes in the brain that cause problems with movement.

It’s important to note that not all Parkinson’s Disease sufferers experience memory impairment, but mobility issues coupled with a higher risk of cognitive decline have the power to dramatically impact the daily functioning of Parkinson’s patients.

“We now recognize that mild cognitive changes may be present at the time of Parkinson’s disease diagnosis or even early in the course of PD. They may or may not be noticeable to the person. They may or may not affect work or activities, depending on the demands of specific tasks and work situations,” states Dr. Goldman.

Seeking Treatment For Memory Impairment In PD Patients

Managing cognitive impairment as a result of PD will vary depending on the timing and degree of cognitive dysfunction. Physicians will assess each situation and treatment will differ should memory issues develop abruptly or over time.

Here are a few common ways memory is impaired as a result of Parkinson’s disease is managed:

Despite being different diseases, medications used to treat dementia in PD have been based on FDA-approved treatments for Alzheimer’s disease. The medications work on the cholinergic system in the brain (a neurochemical involved in attention and memory)
Non-medication strategies can help patients with cognitive tasks, communication, and daily activities with the goal of improving the quality of life and addressing safety concerns. Routines, alarms, checklists, and daily planners can help manage executive functions and day-to-day activities
Mental “exercise” is important for cognition in PD and can include partaking in brain-enhancing activities such as puzzles, playing cards or other games, reading a book, going to lectures or concerts, or learning a new activity/hobby
High-intensity physical movement and exercise delays the progression of Parkinson’s and can sometimes prevent falls and improve balance

ABS Supports Parkinson’s Research Project

In an effort to learn more about the memory impairment aspect of Parkinson’s, the American Brain Society is proud to announce our support Dr. Gregory Pontone’s research project being conducted at Johns Hopkins University School of Medicine.

Our participation in this project showcases our steadfast commitment and support for the scientific research community who are working tirelessly toward finding treatments and cures for this brain disorder and many others.
J. A. Boulton, Founder

Research Project:
MEMORY IMPAIRMENT IN PARKINSON’S DISEASE

**Lead Scientist: Gregory Pontone, MD, MHS**

SCIENTIFIC GOALS & DESCRIPTION:
The goal of Dr. Pontone’s research is to gain a deeper understanding of how Parkinson’s disease injures a vital part of the brain called the hippocampus, which raises the risk for memory impairment.

His team believes that returning the hippocampus to a normal level of activation will restore memory with the potential of slowing or preventing the progression to dementia.

If successful, this would be the first treatment for mild cognitive impairment in Parkinson’s disease and could lead to new treatments for neuropsychiatric disorders.

SCIENTIFIC PROCESS:
Dr. Pontone and his research team will study adults age 65 or older with advanced techniques in functional magnetic imaging (fMRI), focusing on the non-motor aspects of Parkinson’s disease and related disorders.

PROJECT EXTENSION:
The research team will seek further funding to continue the project, which will enable them to enroll additional participants in their study, conduct further testing on the effects of hippocampal hyperactivity and perform a pilot trial of an experimental treatment.

ABOUT LEAD SCIENTIST, GREGORY PONTONE, MD, MHS:
Gregory Pontone, M.D., M.H.S. is an Associate Professor in the Departments of Psychiatry and Neurology at Johns Hopkins University School of Medicine in Baltimore, Maryland.

Dr. Pontone has extensive experience in geriatric psychiatry and movement disorders focusing on Parkinson’s disease. He is an Attending Psychiatrist in the Geriatric and Neuropsychiatry division where he treats patients with neurodegenerative disorders (including Parkinson’s disease and related disorders, Alzheimer’s dementia), and behavioral disturbances resulting from these diseases.

Make a Donation, Make a Difference

It is through research projects like that of Dr. Pontone that we seek to gain a deeper understanding of this debilitating disorder and how it affects so many aspects of the body AND mind.

Learn more about this breakthrough Parkinson’s Disease research project and how you can support the work being done to bring us closer to a cure.

Links

American Brain Society
Johns Hopkins Medicine
American Parkinson Disease Association

How Researchers Are Reading the Minds & Brain Activity In Patients with Autism

Dec 11, 2019 by United Brain Association Leave a Comment

Researchers at Carnegie Mellon University have been able to use imaging technology to get a peek inside the minds of test subjects. While not exactly mind-reading in the science-fiction sense, their techniques offer an unprecedented look at the way our brains construct our thoughts.

Looking for Patterns

The Carnegie Mellon team is using functional magnetic resonance imaging (fMRI) to look for patterns in subjects’ brain activity. The fMRI technology allows scientists to see the brain’s electrical activity in real-time, as the subject is asked to think about different things.

Using fMRI in conjunction with mental exercises, the team was able to identify distinct patterns of brain activity when the subjects were asked to think of broad concepts such as “disgust” or “spirituality.” The researchers found that not only did the subjects’ brain activity remain consistent individually, but it was also consistent from subject to subject. One person’s thoughts of disgust looked very much like any other person’s.

With a library of patterns identified, the researchers were able to look at fMRI images and tell when subjects were thinking of particular concepts.

“Now, obviously, people think very different thoughts,” says Marcel Just, PhD, the study’s lead investigator. “But, you know, people choose to do different things with their bodies. But they all walk putting one foot in front of the other. Nobody walks sideways. Nobody walks backward systematically. There’s something about the biological apparatus that makes you act in a certain way with your body. And I don’t think we realize the degree to which the biological apparatus that we have in our skulls governs, shapes the way we think.”

Watch full video

Patterns of Difference

The team’s techniques don’t allow them to read subjects’ specific, detailed thoughts–at least not yet–but the study does suggest the potential to better understand important differences in individuals’ thought processes. When Just’s team looked at brain activity in subjects with autism, for example, they found significant, unusual patterns.

When autistic subjects were asked to think of emotional words such as “hug,” the parts of their brains associated with thoughts of self were much less active than they would be in people without autism. This suggests that the autistic subject might be thinking of the definition of the word “hug,” rather than of a hug as an emotional activity in which he or she might participate. It’s a fascinating insight into the way autistic thought processes diverge from those of typical subjects.

Just and the University of Pittsburgh’s David A. Brent, MD, plans to build on their discoveries with a new study that will look for distinctive brain activity patterns in subjects experiencing suicidal thoughts. The prospect that his fundamental research could save lives is appealing to Just.

“It’s a lot of fun, if you’re a basic scientist, to discover how things work,” he says. “But there’s an extra level of gratification when you learn that it’s possibly helpful and useful.”

Sources

60 Minutes, Scientists Are Using MRI Scans to Reveal the Physical Makeup of Our Thoughts and Feelings

Carnegie Mellon University, Carnegie Mellon, Pitt Receive $3.8M NIMH Grant To Diagnose Suicidal Thinking Using Brain Imaging