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It was the most peaceful, joyous, incredible,
life changing experience I've ever had in my life. There were scary parts, foreboding
parts … I always knew there was beautiful and joy and peace on the other side of it.
It was freeing, it was really freeing. This is Alana. She’s describing what she
felt after she took a dose of this stuff — psilocybin. It’s a naturally occurring psychedelic compound,
the kind you find in magic mushrooms. But she wasn’t tripping in a dorm room or
at Woodstock — it actually wasn’t recreational at all.
If anything became unreal or I was feeling nervous or not in touch with reality, I would
squeeze his hand and he would squeeze mine back just to reassure me that I was okay and
everything was alright. It was part of a controlled medical test to
see if psychedelics could be useful in helping people quit cigarettes. Alana had been smoking
for 37 years before her session with psilocybin, and she hasn’t had a cigarette since. Research on psychedelics for medical use is
preliminary. Most studies suffer from really small sample sizes.
That’s partly because the
federal government lists LSD and psilocybin as Schedule 1 drugs. So researchers face extra
red tape, and funding is really hard to come by. Vox writer German Lopez reviewed dozens of
studies that have been done. He found that psychedelics show promise for treating addiction,
OCD, anxiety, and in some cases, depression. One small study of 15 smokers found that 80
percent were able to abstain from smoking for six months after a psilocybin treatment.
In a pilot study of 12 advanced cancer patients suffering from end-of-life anxiety, participants
who took psilocybin generally showed lower scores on a test of depression.
And smaller study suggested psilocybin treatment could also help people with alcohol dependence
cut back on their drinking days.
We don’t have all the answers as to what
exactly these treatments are doing in the brain. But they seem to work by providing
a meaningful, even mystical experience that leads to lasting changes in a patient's life. The issues that I talked about, or thought about, or went into during my experience were transformative in the sense that I got to look at them through a different lens. I know this sounds weird, I feel like I have more connections in my brain that I couldn't
access before That feeling that Alana is describing is actually
pretty spot-on. When you take LSD your brain looks something
like this. You can actually see a higher degree of connectivity
between various parts of the brain, it’s not limited to the visual cortex.
This communication inside the brain helps explain visual hallucinations — and the researchers argue that it could
also explain why psychedelics can help people overcome serious mental issues.
They wrote that you can think of psychiatric disorders as the brain being “entrenched
in pathology.” Harmful patterns become automated and hard to change, and that’s what can make
things like anxiety, addiction and depression very hard to treat. That’s Albert Garcia-Romeu, he’s a Johns Hopkins researcher who worked on studies of
of psilocybin and smoking addiction, like the one that Alana's involved with. He says that when participants take psychedelics, One of the big remaining questions here is
how long these benefits actually last after just the one-time treatment.
A review of research on LSD-assisted psychotherapy and alcoholism found no statistically significant
benefits after 12 months. And a recent study on psilocybin and depression
found that benefits significantly dropped off after three months. And of course are some big risks to using
psychedelic drugs. It’s hard to predict a patient’s reaction
and some might actually endanger themselves.
Those predisposed to psychotic conditions
are especially at risk for having a traumatic experience while on the drug.
It’s difficult to draw solid conclusions from the existing studies.
But there’s more than enough promise here to merit further research and further funding
for that research. As Matthew Johnson of Johns Hopkins said,
"These are among the most debilitating and costly disorders known to humankind.” For
some people, no existing treatments help. But psychedelics might. One thing you might still be wondering is why so much of this research is so new, when we've known when we've known about psychedelics for thousands of years. Well since these drugs are so old, they can't be patented, which means that pharmaceutical companies don't really have any incentive to fund any research into them.
So that really leaves it up to governments and private contributors to fund all these studies. And there actually was a lot of research done into these drugs in the 50s and 60s, but there was a big enough backlash to the abuse of psychedelics in that period, especially around events like Woodstock, that funding really dried up, and research stopped. And that's why it's only now that we see this research happening, with private, not government contributions..
What do Emma Stone, John Mayer and Amanda Seyfried all have in common? They've all publicly admitted to suffering from panic attacks. Those who've experienced one will tell you it can feel crippling, life threatening. But, it doesn't have to be. Psychiatrist, Dr. Dominick Sportelli joins us now via Skype to give us three tips to help calm a panic attack. So, Dom. Hey guys. Dr. Sportelli, I love that we're going over this because obviously, there are medications that people will take if they're having a panic attack, but these are non-medicinal ways that you can potentially break the spell if you will of a panic attack, so talk us through what people can do. Yeah, you got it so, listen guys, four million people suffer from panic attacks, and most people don't even report it.
So, that number's probably so much higher than that and guess what you can add one name to your list and that's me, I have suffered from panic attacks. They're horrifying, they're incredibly scary, and psychiatrists are not immune. I'm glad you admitted that doc, because sometimes those people who seem the most cool, calm, and collected and who are can still have panic attacks, and it's not anything to be ashamed of. At all. So I am glad that you're personally someone who knows how to treat it, but also have experienced it, can you do us a favor.
Can you, before you go into the three tips, can you talk about even in your own, personal experience, what happens when you're having a panic attack? It's a physiologic response, it's actually an evolutionary response to save our lives believe it or not. Here's the thing your body thinks that it's running from a Saber tooth tiger. So, your heart rate increases, you get short of breath, you start to sweat, your muscles tense up, blood goes to different places in your body so your G.I. system gets crampy and you get nauseous. So, the thing is that you're not running from a tiger you're probably just at a business meeting or you know on the stage of The Doctor's or on Skype right. So, here's the important thing, it's an over reaction to a perceived threat, people become afraid of being afraid, so if you understand what causes the panic attack and you understand how to deal with it, it's less scary so what we want to do is put the brakes on the sympathetic nervous system and activate what's called the vagus nerve.
And the vagus nerve is the parasympathetic nervous system. But its basically, slows down all of those symptoms. The racing heart, the shortness of breath, the nausea, the shaky, the sweaty feeling, and we have ways to activate that vagus nerve and calm your body down without medications. So, what's tip number one Dr. Sportelli? All right, this is literally, when I say literally ground yourself, I mean it. I mean take off your shoes, get comfortable, put your feet on the ground, make sure you're in a safe place if you're driving, pull over for example. But if you're in your house or in your office, take your shoes off, put your feet on the ground. Feel the ground, and at that point you're gonna take slow deep breathes. Taking slow deep breathes activates that vagus nerve, that we were talking about. So, you're gonna take a deep breath in for five seconds, you're gonna hold for two and you're gonna go out for five.
Just that act is gonna slow your heart rate down, and prevent that snowball that we're feeling. And I love your second tip, because this is something that we can use sometimes in the ER, something, sometimes we all do for fun after a hot run, but what is your tip number two? So tip number two, if you have the availability, guys fill up your sink with a really, really cold sink full of water, ice cold, as cold as you can make it. And dunk you head directly into the water. That will, or has been shown to slow your heart rate, down by up to 25%, and that can break a panic attack in and of itself. And talk to us about this last tip that involves, whether it be caressing or self massaging, what is that? Yeah, I love this one, so this one's great, and I rolled up my sleeves, for you guys.
So, this is called the wrist-forearm technique. And what you're gonna do, is again keep in mind grounding, feet on the floor, comfortable, the breathing techniques that we talked about, and at the same time, grab your elbows and drag your hands along your forearms, down to your wrists, and then just repeat. Do that again, it's just a little self massage, nice and easy, it's very, very soothing at the same time breathing, and before you know it you're gonna be super calm, super chill. Focus on that act, on that exercise, it does have a calming effect.
Yeah. Exactly, 'cause a part of it is just distracting your mind from thinking something horrible's gonna happen.
Translator: Abdul Ameti Reviewer: Helena Bedalli In the mid-90s CDC and Kaiser Permanente discovered an anomaly that dramatically increases risk for seven of the top 10 causes of death in the US. In large doses, it affects brain development, immune and hormonal system and also the way our DNA is read and transcribed. People who are affected by this anomaly in very large doses have three times the risk of death from heart disease, lung cancer, and a 20-year volatility of life expectancy. In addition, doctors are not trained for daily examination and healing. The anomaly I am talking about is not something chemical. It is the trauma of childhood. What trauma are we talking about? I’m not talking about failing the exam, or losing a basketball game.
I'm talking about such harsh and penetrating threats which in the first sense of the word convey to us and change our physiology things like: abuse, negligence or growing up with a parent suffering from a mental illness or drug-dependent. For a long time, I looked at these things the way I was trained to look: or as a social problem – referred to in social services or as a mental health problem – referred to medical services.
Then something happened that made me reconsider my whole approach. When I finished the internship, I wanted to go to a place where I felt needed a place where I could make a difference. And I went to work for the California Pacific Medical Center, one of the best private hospitals in Northern California, and together, we opened a clinic in Bayview-Hunters Point, one of the poorest and neglected neighborhoods in San Francisco. Before we talk about this, was just a pediatrician all over Bayview to serve more than 10,000 children, so we got down to business, and gave great quality of treatment regardless of financial capabilities. It was something so beautiful. We targeted typical health inequalities access to medication, vaccination rates, hospitalization rates for asthma, and broke all records. We felt very proud of ourselves. But then, I started noticing a worrying trend. Many children referred to me for “Concentration Disorders and Hyperactivity ”(ADHD) but in fact, when I did one deep historical and physical research what I found is that many of my patients I could not diagnose them with ADHD.
Many of the children I checked had experienced such severe trauma so much so that I felt something else was happening. Somehow, something important was escaping me. Before I started my internship, I completed my master's degree in public health and one of the things to teach in public health school is that, if you are a doctor and sees 100 children drinking from the same well and 98 have diarrhea you can start and write recipes dose-by-dose antibiotics or go to the place and say, "What the hell is going on in this well?" So I started reading everything that came my way about how exposure to disasters affects a child’s developing mind and body. And one day, my colleague came to my office and said: "Dr. Burke, have you seen that?" In his hand was a copy of a study called "Study of Childhood Disaster Experiences" That day changed my internship at the clinic, and finally my career. Study about childhood disaster experiences it is something that everyone should know. It was done by Dr.
Vince Felitti in Kaiser and Dr. Bob Anda on CDC, and together they interviewed 17,500 adults about their experiences about what they called "child misfortune" (ACE) These included physical, emotional or sexual abuse; physical or emotional neglect; parental mental illness, drug addiction, imprisonment; parental separation or divorce; or domestic violence. For each positive response, they received a point on the ACE score. What did they do then was the correlation of these ACE results against health consequences. What they found was surprising. Two things: Number one: ACEs are more common. 67 percent of the population had at least one ACE, and 12.6 percent, or 1 in 8 had four or more ACEs. The second thing they found was a "dose-response" relationship The higher the ACE score, the more severe the health consequences. For a man with an ACE score of four or more risk of chronic obstructive pulmonary disease was 2 and a half times larger than in a man with an ACE zero score.
For hepatitis, also 2 and a half times larger. For depression, 4 and a half times. For suicide, 12 times. A man with an ACE score of seven or more there was three times more risk to life from lung cancer. and 3 and a half times the risk of ischemic heart disease. the number one killer in the US. Of course that makes sense. Some people saw this data and said, “Look. If you had a difficult childhood, you are more likely to drink alcohol. and to smoke and do all those things that destroy health. This is not science.
It's just bad behavior. " This is exactly where science intervenes. Now we understand better than ever, how early disasters affect the development of the brain and body of children. Affects "nucleus accumbens" (from lat. Supported nucleus) the center of pleasures and rewards in the brain which is involved in drug addiction. It inhibits the parafrontal cortex which is necessary for the control of impulses and executive functions a critical space for learning. In MRI scanners we notice measurable differences in amygdala, fear response center. So there are obvious neurological reasons why people are exposed to large doses of adversity are more likely to exhibit high-risk behaviors, and this is important to know. But it turns out that although they do not exhibit high-risk behaviors, individuals are more likely to develop heart disease or cancer.
The reason has to do with the hypothalamic-pituitary-adrenal axis, which is the brain and body reaction system, who oversees the reaction called “fighting or running”. How does this work? So imagine you are walking in the woods and see a bear. Immediately your hypothalamus sends a signal to your pituitary gland which signals the adrenaline gland that says: "Release the stress hormones! Adrenaline! Cortisol!" And so your heart starts beating, Your eyelashes expand, the airways open, and you are ready to either fight him or run away from the bear. And that's great, if you are in the woods and there is a bear. (Laughter) But the problem is, what happens when the bear comes home every night, and this system is constantly activated and passes from being appropriated, or life-saving at detrimental health pressure.
Children are especially sensitive to repetitive stressful activity because their brain and body is developing. Large doses of disasters not only affect structure and function of the brain but adversely affect the development of the immune system, development of the hormonal system, even the way our DNA is read and transcribed. So for me this information threw out my old training window, because when we understand the mechanism of a disease, when we know not only which roads are interrupted, but like us as doctors, to use science for prevention and recovery.
This is what we do. So in San Francisco, we set up a Youth Welfare Center, for the prevention, examination and treatment of the impact of ACE and toxic stress. We just started with routine examination of each of our children, in their physical activities because I know that if my patient has 4 in the ACE result is 2 and a half times more likely to develop hepatitis or lung disease is 4 and a half times more likely to get depressed, and 12 times more attempted suicide, than my patient with zero ACE. I know this when he (the patient) is in my examination room. For patients with a positive test, we have a very disciplinary team working to reduce disaster doses and treats symptoms using the best ways to include home visits, coordination of care, mental health care, nutrition holistic interventions, and yes, we also give them medication if needed. But we also educate parents about the impact of ACE and toxic stress in the same way that it would take to cover electrical outlets or lead poisoning, and we expand the care of our asthmatics and diabetics in a way that justifies that you may need tougher treatment taking into account hormonal and immune changes.
So the other thing that happens when you understand this science, is desire to shout with fingers in ear because this is not just a child issue in Bayview. I immediately thought that anyone who would find out about this, we would have daily examinations, treatments with multidisciplinary teams and would be a competition for the most effective clinical protocols of healing. But no. This did not happen.
And it was a very good lesson for me. What I thought was just the best medical practice, i understand it to be a whole move. In the words of Dr. Robert Block, former President of the American Academy of Pediatrics, “Childhood Disasters are the only two most unaddressed threats to public health which our nation is facing today. " And for many people this is a terrible prospect. The extent and extent of this problem seems so extensive that it seems futile to think about how we could approach them. But for me, that's where the hope lies, because when we have the right system, when we are clear that this is a public health crisis, then we can start using the right tools to find solutions. From nicotine and lead poisoning to HIV / AIDS The U.S. actually has a strong past in addressing of public health problems, but to repeat these successes with ACE and toxic stress, we will need determination and commitment, and when I see what the reaction of our nation has been so far, I ask myself, "Why haven't we taken this more seriously?" You know, at first I thought we marginalized this issue because it doesn’t apply to us.
This is an issue for those children in those neighborhoods. Which is weird, because the data doesn't prove it. The original ACE study was performed on a population which was 70 percent white race, 70 percent, with high school. But then, the more I talked to people, I began to think that I might have understood it backwards. If I were to ask how many people in this room have grown up with a family member who has suffered from mental illness I bet some of you would raise your hands. And if I were to ask how many people have had one parent who probably drank too much, or who believed that he who loves you beats you I bet some more hands would be raised. Even in this room, this is an issue that affects many of us, and I am beginning to believe that we are marginalizing this issue precisely because it applies to us as well. Maybe it's better to look elsewhere because we don’t want to see it.
We would rather stay sick. Thankfully, scientific achievements, and, to be fair, economic reality makes this option less likely every day and more. The science is clear: Early disasters dramatically affect life expectancy. Today, we are beginning to understand how to stop the transition from early facts in premature death, and 30 years earlier, child with high ACE score, and whose behavioral symptoms are invisible whose asthma management is not related and continuing to develop high blood pressure, and early heart disease or cancer, will be just as abnormal as a 6-month HIV / AIDS mortality. People will look at this situation and say, "What the hell happened there?" This is curable.
That could be. The only thing that matters most is that we need it today the courage to look this problem in the eye and to say that this is true and is for all of us. I believe we are the movement. Thank you. (Applause) .
[♪ INTRO ] If you’ve ever experienced anxiety and depression
— in the clinical sense, I mean — you’ll know that they can feel really different. With anxiety, you’re all ramped up. And with depression, you’re very, very down. Yet they tend to go together. And a lot of medications, especially certain
types of antidepressants, can be used to treat both. We still don’t know a ton about how exactly
anxiety and depression work in the brain — or how antidepressants work to treat them. But over time, psychologists have come to
realize that the two types of conditions are surprisingly similar. They may feel very different in the moment. But they actually have a lot of symptoms in
common, and involve some very similar thought patterns. They might even have similar brain chemistries. So if you’re looking to understand a little
more about how anxiety and depression manifest themselves — whether for yourself or for
someone else in your life — those connections are a good place to start.
Depression and anxiety aren’t really specific
disorders — they’re generic terms for types of disorders. But the most common, and most closely linked,
are major depressive disorder, or MDD, and generalized anxiety disorder, or GAD. In any given year in the U.S., where it’s
easiest to find detailed statistics, about 7% of the population will have MDD, and about
3% will have GAD. Lots of those people have both: About 2/3
of people with major depression also have some kind of anxiety disorder, and about 2/3
of people with generalized anxiety disorder also have major depression. And whether you have one or the other or both,
the same medications are often at the top of the list to help treat it — usually antidepressants. Unsurprisingly, psychologists have noticed
these statistics. But for a long time, we’ve thought of generalized
anxiety and major depression as very different things, and understandably so. Probably the most noticeable symptom of anxiety
is arousal, which in psychology is a technical term rather than a specifically sexual thing. It basically just means being on high alert
— whether psychologically, with increased awareness, or physically, with things like
a racing heart and sweaty palms.
Arousal isn’t part of major depression,
though. And there’s a key symptom of MDD that doesn’t
usually show up in generalized anxiety: low positive affect, which is the technical term
for not getting much pleasure out of life and feeling lethargic and just kind of … blah. So there are important differences between
anxiety and depression, which is part of why they’re still considered separate classes
of disorders. But when you look at the other symptoms, you
start to realize that major depression and generalized anxiety have almost everything
else in common. There’s restlessness, fatigue, irritability,
problems with concentration, sleep disturbances … the list goes on.
And that’s just in the official diagnostic
criteria. So for decades, psychologists have been examining
the models they use to describe anxiety and depression in the brain to see if they point
to a similar source for both types of disorders. They’ve come up with lots of different ideas,
as researchers do, but the most common ones tend to center around the fight or flight
response to stress. Fight or flight kicks in when you’re confronted
with something your mind sees as a threat, and it automatically prepares you to either
fight or run away. And when you think about it, anxiety and depression
are just different types of flight. Psychologists often characterize anxiety as
a sense of helplessness, at its core, and depression as a sense of hopelessness. Anxiety might feel like you’re looking for
ways to fight back. But part of what makes it a disorder is that
it’s not a short-lived feeling that’s easily resolved once you have a plan.
Of course, as with all things mental health,
anxiety disorders can be deeply personal and won’t feel the same for everybody. But clinical anxiety does tend to be more
pervasive. The worry sticks around and starts to take
over your life because it doesn’t feel like something you can conquer. So anxiety and depression might just be slightly
different ways of expressing the same flight response: helplessness or hopelessness. And maybe that’s part of why they so often
go together. That connection also shows up on the biochemical
side of the stress response. There are a lot of hormones involved in this
response, and their effects interact in super complex ways that scientists still don’t
fully understand.
But both depressive and anxiety disorders
are closely associated with an oversensitive stress response system. Researchers think that’s one reason both
of these types of disorders are so much more common in people who’ve experienced major
stresses like trauma or childhood abuse. Those stressors could make their stress response
system more sensitive. The main hormones involved aren’t always
the same, but the changes can cause some of the same symptoms — problems with sleep,
for example. So anxiety and depression seem to be two sides
of a similar reaction to stress, in terms of both thought processes and hormones. Still, that doesn’t really explain why some
antidepressants can treat both anxiety and depression. Because those medications primarily affect
neurotransmitters, the molecules your brain cells use to send messages to each other. If you thought we had a lot left to learn
about how the stress response works, we know even less about what the brain chemistry of
anxiety and depression looks like, or how antidepressants help. But if the thought processes and physical
responses that go along with these disorders aren’t quite as different as they seem on
the surface, it makes sense that the brain chemistry would be similar, too.
And that’s exactly what scientists have
found. More specifically, lots of studies have pointed
to lower levels of the neurotransmitter known as serotonin as a major factor in both anxiety
and depression. Researchers have even identified some more
specific cellular receptors that seem to be involved in both. There’s also some evidence that the way
the brain handles another neurotransmitter, norepinephrine, can be similar in both anxiety
and depression. Since most antidepressants work by increasing
serotonin levels, and some of them also affect norepinephrine, that could explain why they’re
so helpful for both anxiety and depression. Although again, there’s a lot we don’t
know about their exact mechanisms. Ultimately, there’s no denying that in the
moment, anxiety and depression can seem like very different feelings. And if someone has both types of disorders
— well, it’s easy to see how that could feel overwhelming. Like, it’s hard enough treating generalized
anxiety or major depression on their own.
And it’s true that it is often harder to
treat these conditions when someone has both. But maybe not twice as hard. After all, anxiety and depressive disorders
have a lot in common, from their symptoms to the basic brain chemistry behind them to
some of the treatments that can help. The fact that they often go together can be
really tough. But understanding more about why that is has
also pointed us toward better treatments and more effective therapies, that really can
help. Thanks for watching this episode of SciShow
Psych. If you're looking for someone to talk to about
your mental health, we left a few resources in this video’s description. And if you'd like to learn more general info
about treatments, you can watch our episode on misconceptions about antidepressants. [♪ OUTRO ].
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