March 25, 2010
The vagus nerve is a cranial nerve, a honking big nerve that runs from your skull, down your chest and into your abdomen. The punch-in-the-gut feeling of a jolt of adrenalin/the start of an anxiety attack is carried on the vagus nerve.
The usual paradigm for emotions is they start in the brain. Most of the body’s hormones have a dual purpose as a neurotransmitter. The vagus nerve helps coordinate the physical feeling with the emotional feeling – they are one and the same. The mind-body connection.
Most of the body’s serotonin is in the gut. A squirt of serotonin doesn’t just happen in the brain, it happens in the whole body. Ditto adrenaline. The vagus nerve conducts information in both directions. I don’t think it’s entirely accurate to blame anxiety on a brain malfunction.
An interesting treatment for anxiety is “Vagus Nerve Stimulation.” In VNS, a device is implanted that applies current to the vagus nerve is to overwhelm it. It’s kind of like a TENS unit for pain. VNS is a last resort for intractible anxiety.
One implication of this is that if you can control the physical aspects of anxiety – relax your muscles, slow down your breathing & heart rate – then the emotional component will follow. Once the emotions are managed you can work out whatever brought on the anxiety.
Candace Pert, Ph.D. discovered opium (endorphin) receptors in the brain. She wrote an enlightening book Molecules Of Emotion: The Science Behind Mind-Body Medicine.
Also check out Timothy Leary. One of his more interesting ideas is that we have receptor sites for chemicals that haven’t been invented yet. Alexander Shulgin was a chemist who formulated a lot of them, but I don’t recommend you try it. 🙂
September 28, 2008
PSYweb DSM-IV Diagnoses and Codes.
PSYweb has a list of the DSM-IV Diagnosis Codes. Notice that there are a lot of psychiatric diagnoses caused by psych meds. This makes it totally clear that your meds can make you sicker, a good argument for doing the minimum meds to make you functional vs. medicating yourself into oblivion.
The following are a few examples of iatrogenic (physician-caused) psychiatric disorders:
- Opioid-Induced Mood Disorder
Yes, pain meds can make you look like a bipolar.
- Neuroleptic-Induced Acute Akathisia
He’s agitated, let’s give him more neuroleptic. Neuroleptics are old-fashioned antipsychotics such as Haldol.
- Amphetamine-Induced Psychotic Disorder, With Hallucinations
Some of the ADHD meds they give to kids, including Ritalin and Adderall, are amphetamines. Can you imagine turning your kid into a Speed Freak?
- Sedative-, Hypnotic-, or Anxiolytic-Induced Anxiety Disorder
Anxiety from anti-anxiety pills? Some of the benzodiazepines can even induce hypomania, however there doesn’t seem to be a diagnosis code for it. Maybe in the DSM-V. Or maybe not. I hear it’s being written by Big Pharma.
Another cool thing on psyweb is a Mood Disorder Flow Chart that is able to distinguish bipolar disorder from the other mood disorders. A real kick in the head is the question “Symptoms Psychotic in nature, occur at times other then during Manic or Mixed Episodes?”
This seems to imply that bipolars don’t have psychotic depressions, but other mood disorders do. Note that the only the 296 numbers are mood disorders, and only a few of those are called bipolar disorder. Been there, done that, bought the t-shirt.
A couple of years ago I did a decision tree for the bipolar disorders based on the DSM-III. It’s a little different from the DSM-IV-based version.
Psyweb also has a decision tree for differential diagnosis, and that’s a better choice than the mood disorders tree, even for diagnosed bipolars. This tree helps you figure out whether you have another psych diagnosis masquerading as bipolar, something that a 15-minute psych eval will definately miss. That would be truly disastrous, being treated for life for bipolar instead of dealing with something less severe. Have fun!
I think I’m going to invent Seroquel jimmies for ice cream.