Psychiatric Brain Disorders

For some time, I've been curious about the brain abnormalities - why they appear and what they result into. I came across this book called The Disordered Mind which I think is a good intro to this pretty heavy subject. It made me really want to go deeper into each disorder, but I'm gonna start with some general notes.

The Basics of Brain Function

I think it’s fascinating how our emotions and behaviors controlled by our brain. Pretty much everything is. Are we really just our brains? Because it seems that both consciousness and the sense of self reside inside our brain, and if there’s any changes to the brain’s function and structure, which basically leads to a mental condition, we’re not quite ourselves anymore, are we?

Anyways, there are 4 main brain regions to be aware of:

• Amygdala - our emotional command center that helps us process and respond to emotions.
• Prefrontal Cortex - responsible for making us think things through, thus preventing us from acting impulsively.
• Hypothalamus - regulate’s our physical response to emotional stressors, such as heart rate, sleep cycles, or blood pressure.
• Hippocampus - responsible for storing memories, our ability to learn and spatial navigation.

Our brain regions are able to communicate between each other with the help of neurotransmitters that travel though neural pathways - the networks of neurons. Neurotransmitters are chemicals that transmit signals across synapses, and are involved in regulating various brain functions. Synapses are the gaps between the neurons.

Here are some examples of neurotransmitters:

• Dopamine - dopamine is associated with the reward system and mood regulation. It affects our motivation to do something, chase things. That’s why we become addicted to what gives us the dopamine effect. Dopamine also helps control our movement, that’s why its lack is associated with Parkinson’s disease.
• Serotonin - serotonin, known as the happy hormone, is also involved in mood regulation - it helps keep anxiety and depression in check. Besides that, it controls our appetite and sexual function.
• Noradrenaline - noradrenaline is responsible for our stress response, attention, and alertness. It helps us with decision making, especially during a fear producing or stressful situation.
• GAMA (Gamma-Aminobutyric Acid) - GABA helps us calm and relax. It controls our level of excitement and lowers anxiety.
• Glutamate - glutamate helps transmit electrical signals between the neurons, helping us with our long term potential for memory and learning.
• Endorphins - endorphins contribute to the feeling of happiness and well-being, they are our body’s natural painkillers.
• Oxytocin - oxytocin, known as the love hormone, is involved in social bonding, reproduction, and emotional connection. It’s released during physical contact or childbirth, for example.

How Do Psychiatric Disorders Arise?

Psychiatric disorders are basically mental conditions associated with changes in the brain's function and structure. They're often a result of imbalances in these neurotransmitters inside the synapses (the connections between neurons) of the brain, and how these imbalances affect the neural pathways to different brain regions. To a certain extent, they're also genetic, or hereditary, and influenced by our environment.

Depression

I think, a lot of people, myself included, don’t take mental disorders seriously. Not on purpose of course, but due to lack of education on this subject. We often think of a person experiencing depression as weak, lazy, or lacking will-power to put themselves together. Get up and get over it, we say. But depression actually changes the structure of the brain. Amygdala, for example, becomes enlarged, which might explain why everything feels hopeless and overwhelming. Hippocampus loses its synapses, which in term affects memory.

The more prolonged and severe is depression the more the hippocampus region suffers. In part, this happens because depression depletes serotonin from the synapses. That’s why they’ve developed SSRIs to help repair the synapses and boost serotonin. However it takes ± 2 weeks to start working, so during that time there’s increased risk of suicide. To reduce that risk, some patients are prescribed small doses of ketamine, which acts as a rapid short-lived antidepressant.

Schizophrenia

Schizophrenia is, no doubt, devastating and horrible, but somehow also really fascinating in terms of the brain function. I mean, how is our brain able to enter the state of hallucinations? Generate what’s not real and make it appear part of the physical world, creating a gap between sense and perception?

What’s also interesting is schizophrenia doesn’t show up until adolescence or early adulthood, when life’s stresses become more intense. Schizophrenia has been linked to the excessive amounts of dopamine which are being released as a response to stress.

I watched a couple of videos on Youtube about the auditory hallucinations simulations. They are basically non-sensical, self-critical voices telling you how much you suck, and how everyone out there knows it and is conspiring against you, how the world is one big threat where you can’t feel safe. To say that it’s horrifying is an understatement. Some people experience it on a day to day basis in different severity, others have it provoked by the moments of stress - this is called psychosis. Imagine a constant voice in your head, sometimes more than one. What would you want to do? Probably, shout “shut up!”. Only the voices wouldn’t stop though. This is literal hell. And that is, besides auditory, there’s also visual and even tactile delusions.

Bipolar Disorder

Bipolar disorder shares some features with schizophrenia, including the possibility of psychosis during severe episodes. Though, it’s mainly characterized by the switch between manic (high energy, impulsive) and depressive (low energy, hopeless) episodes. Between these episodes, there can be periods of stable mood. Bipolar disorder affects the brain's reward and emotion systems, but typically results in less cognitive decline compared to schizophrenia.

Autism

Although, perhaps not exactly psychiatric, autism is also a very complex, and interesting from this standpoint, brain disorder. People with autism process social cues differently, particularly in how they interpret human emotions or facial expressions. For example, neurotypical people make eye contact to predict behaviors, or understand intentions - it’s an essential tool for communication - people with autism though, tend to not look in the eyes and instead focus on the mouth area, making it hard to read people’s faces.

As another example, seeing someone waving their hand at them might not automatically register as a socially meaningful greeting gesture, that is because in people with autism there’s a discrepancy between gaze and intention. Some research says that lack of oxytocin is responsible for having difficulty in interpreting emotions or showing empathy.

TBC

I think, social support and acceptance is what people with mental conditions need more than anything, but instead they are often misunderstood and shamed. So, I wonder if, for example, immersive AR/VR technologies could be useful in helping us walk in the shoes of people who experience various mental disorders and feel what they feel. This could help eliminate prejudicial opinions that the general population might have due to lack of educational resources or exposure to this subject.