Scientists discover brain area which can be targeted for treatment in patients with schizophrenia who ‘hear voices’.

Science Daily, September 4th 2017: Scientists discover brain area which can be targeted for treatment in patients with Schizophrenia who ‘hear voices’.

“For the first time, scientists have precisely identified and targeted an area of the brain which is involved in “hearing voices,” experienced by many patients with schizophrenia. They have been able to show in a controlled trial that targeting this area with magnetic pulses can improve the condition in some patients.”

As a person who hears voices often (near constantly) despite medication intervention I’m always looking for new ways to cope with them (the voices). And although I don’t see myself receiving Transcranial Magnetic Stimulation (TMS) anytime soon, I think it’s important to keep up with new treatments as they become possible or available.

So what is TMS and how might it help people with Schizophrenia and Schizoaffective Disorder? In a TMS session, an electric coil is placed against the head and a painless magnetic pulse stimulates nerve cells in certain regions of your brain. Right now it’s been used primarily for Major Depression Disorder but with this early research, it appears that TMS could be used to target regions of the brain associated with hearing voices.

“The French research team worked with 26 patients who received active TMS treatment, and 33 as a control group, who received sham (placebo) treatment. The researchers interviewed the patients using a standard protocol — the Auditory Hallucinations Rating Scale — which revealed most of the characteristic features of the voices which they were hearing. The treated patients received a series of 20 Hz high-frequency magnetic pulses over 2 sessions a day for 2 days. Using magnetic resonance imaging (MRI), the pulses were targeted at a specific brain area in the temporal lobe, which is associated with language (the exact area is the crossing of the projection of the ascending branch of the left lateral sulcus and the left superior temporal sulcus).

After 2 weeks, the patients were re-evaluated. The researchers found that 34.6% of the patients being treated by TMS showed a significant response, whereas only 9.1% of patients in the sham group responded (‘significant response’ was defined as a more than 30% decrease in the Total Auditory Hallucinations Rating Scale score).”

This is also highly promising for those people with Schizophrenia and Schizoaffective Disorder who are nonresponsive or resistant to medication and other traditional treatments. But I think what is most important about this is the finding of the anatomical area of the brain associated with auditory verbal hallucinations in schizophrenia. And while these studies have a long way to go before TMS could/would be accepted as a conventional treatment for Schizophrenia/Schizoaffective the results of this study are certainly promising.

 

*I’m planning on doing a write up about new breakthroughs and scientific studies in the mental health/illness field once or twice a week*

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Fast and Without Too Much Sadness

   Red curtains move in the wind of an open window. Warm wind then, on warm sunlight, peers through. Long sunlight fingers push aside the air. Dust floats. My cats like to lay in this type of sun and I like to sit with them, letting my socks get warm and warm my feet. Outside there are bugs and branches and leaves turning red. The play-dough scent of apple branches being pruned from their trunks evaporates around me even as I write. The smell of hardwood. The smell of sweet apple flesh and hazelnut candles. Pine trees at the top of the yard are green and settle their stout bodies against the cooling topsoil. People lean on one another in the face of gathering winter. For now, it’s still autumn. For now, we still have to use all our apples up and fix the snowblower and stitch our jeans and prepare the house for colder weather.

   The days grow shorter and darker and before we know it snow will arrive and we will be buried up to our necks in it. The cats will stop shedding and pack on some winter weight.

   The weather allows for hot showers now and I take ones that border on the cusp of being too hot. When I shower I do it at night with the lights off. Letting the water rinse the coffee grinds and chewed nails and dried skin away.

   Odd to think that I still don’t know myself. After all this time alone we never became acquainted. I am an introvert afraid of other people. This includes me.

   When I look in the mirror I don’t see myself anymore. I see a self made new by flesh. By antipsychotics and antidepressants. By new scars and new wrinkles and new stretch marks. I see a new body and a new brain. But I don’t see myself.

   It’s hard, having been so many things. Flashes of an aging young adult who never got to know herself. I was a kid once. A kid who always kept my hair cut short. A kid who needed braces but never got them. Once upon a time, I was a tomboy. An arm wrestler in the fifth grade who could beat the boys. For a while, I was a confused preteen. Baggy pants and tight shirts. A teen who didn’t want to have sex. An anorexic. A kid who, while good reading books, was poor at reading people. I obsessed over spirituality and religion. Questioning everything to the point of insanity.  I was homeless. I was a runaway. I was unhealthy. Underweight. Sick. Bedridden. Paralyzed. Non-Epileptic (PNES). Dependant. A smoker, god forbid. Someone buying drugs in the back seat of a station wagon that wasn’t my own. Having sex without enjoyment. An all A’s student attempting suicide in the middle of the night. A self-harmer. A frequent flyer at the hospital. Psychotic. Manic. Depressive. Confused. Boney. Absent. Schizophrenic. Bipolar. Schizoaffective. Catatonic. A nighttime-midnight-in the dark-showerer. A nighttime-walker. Empty. Lost. Someone who wished they were dead but ended up happy to be alive (well most of the time.) A college dropout. I used to be someone who listened to the voices. Someone who followed the hallucinations.

   And then came the antipsychotics and all the things I’d ever been came fullstop. Now I’m soft and bitter and my brain is full of Seroquel soup. I’m caught between meds having saved my life and having destroyed it. Of course, I should say that Schizoaffective Disorder did the destroying. Sluggish waves with no force behind them turning my psychotic wheels. Caught between wanting recovery and wanting destruction. For being happy for new my health and being spiteful of it. Between being accepting of antipsychotics and believing the benefits to be disingenuous.

   Out of all the things I’ve ever been I’ve never known any of them for very long.

  I want to see that change but I can’t say I know for sure that they will. Of course, this year went by faster than apples are falling from their branches this autumn. If I close my eyes and hold my breath and take my meds perhaps another year will move on like this one did. Fast and without too much sadness.

 

   

 

Confessions of a Schizoaffective

I have all this bitterness inside of me. Something I don’t show many people. And I have this deep sadness, as deep as wells are deep, that I don’t tell people about. Because if my sadness made other’s sad what a horrible thing that would be. My sadness is my own. My suffering if my own. My hot shower illnesses, those are my own. At the beginning, oh where now did it begin because it seems I’ve been sick my whole life, it was easy and warm and didn’t show me it’s dark side until it already had me. That’s what I mean when I say it’s like a hot shower. It’s warm and disassociating. Easy to slip into, and impossible to get out of. Mental illness is procrastinating. You swore it was just a few hours extra sleep, just a minute longer in that overfilled bath tub (the water lapping your hips and back), just a second longer with your eyes closed after you dismiss the morning alarm. And then all of a sudden you aren’t what you promised your parents you’d be when you left home. Of course, you are your own person, shaped by years of decisions and indecisions.
“And indeed there will be time/For the yellow smoke that slides along the street,/Rubbing its back upon the window-panes;/There will be time, there will be time/To prepare a face to meet the faces that you meet;/There will be time to murder and create,/And time for all the works and days of hands/That lift and drop a question on your plate;/Time for you and time for me,/And time yet for a hundred indecisions,/And for a hundred visions and revisions,/Before the taking of a toast and tea.” -TS Eliot, The Lovesong of J Alfred Prufrock
How did I become this other thing I never planned on being? I look up at my chubby cat, purchased keen upon my window sill. The birds come again. Loud as ever, on the inside of my ears. Nobody else hears them. Only me. My cat, half awake, as cats always are, looks down at me. Eyes oval half closed. Only hearing the rain and the fish tank in the other room. I ground myself. I breathe. I inhale. I exhale. I ground myself. I can’t remember what it’s like to experience silence. But I know I miss it.

Skeleton Bones, Poorly Oiled

The only thing that wakes me is a cold wind intruding on the warm, late night air of my hospital room. The change in temperature is noticeable, like oil in water. A bright light from the hall. A nurse, curly haired and round, pokes her head in, makes a note on a clipboard, and then vanishes behind a closed door again.

Fifteen-minute wellness checks grow tedious.

I shut my eyes against the darkness and roll onto my other side. Windows look out onto a dusty parking lot. Empty of the many cars the daylight would bring. In the morning the hospital would be full of doctors and nurses. People would go and come. But I would remain for, at least, a week. That’s what my doctor had told me, at least a week.

Tomorrow would bring art therapy group and CBT. I’d meet with a doctor. Be given medications. And work with a caseworker about a discharge plan. When I’d be leaving, where I’d be going, what my new medication regime would look like.

I sighed opening and closing my eyes again. I didn’t want to stay for another week. The monotony of the place ironically maddening. I threw my arm over my eyes, the crook of my elbow settling across my forehead. I bit at my lips. And then, as I finally felt sleep close by, another column of light slunk into my room and the same nurse looked in.

“Please!” I groaned, “Leave me alone!”

“Just doing my job dear.”

Darkness again.

In the hall, I heard two nurses in an exchange. A midnight but ultimately momentary admittance would arrive. They were not to remove his restraints. I thought back to my own admittance. Cowering beneath a tan Egyptian cotton blanket. Arms restrained to the stretcher which I was brought in on. Legs left free and pulled inward.

I begged for sleep, the nurses chattering on outside my door. The Zolpidem which they had given me to help me sleep had since worn off.

“I guess this guy is gonna be committed, we just have to hold him for the night.”

With my eyes shut I wrinkled my brow. Committed…?

“He killed his parents,” and I felt my mouth run dry, “said something about them being the devil’s work.”

I rolled back over, away from the door.

“Found him covered in his parent’s blood.”

A third voice now, “All the people that come through here are fucking psychos. If you ask me they should all be committed.”

My pulse, already high, threatened to break my ribs. I felt a hot bed of tears beginning to form at the edge of my eyes. I wasn’t in the right place to hear any of this. I was the youngest crazy kid on the adult psychiatric ward. Confused, distraught, suicidal, irrational, and impulsive. I thought, in that moment, that maybe I was destined to become the guy who would murder my parents. Maybe some day I’d show up covered in the blood of someone I loved. Maybe it was only a matter of time before I went crazy enough. In a silent rage, I brought the pillow from above my head over my face and screamed into. Emptying my lungs and then my throat, leaving my respiratory tract scratched and raw. I couldn’t have known I had five more of these hospitalizations ahead of me. That I’d almost die. That I was Schizoaffective. I couldn’t have known all the sad music views I’d see from my hospital windows, all the sad music scenes I’d see, all the sad music medicine I’d take before I found the one that worked…

Just as I went in for a second scream there was a commotion in the hall. The sound of a stretcher, a sound I’d never forget, rattling down the hall. Its thin wheels sounded like skeleton bones, poorly oiled, on the clean hospital lelonium. Click, click, squeak.

My next fifteen-minute wellness check came just as the stretcher made it’s way past my door. And in the hall, I saw a man pass by. His hands, though tightly bound, were clean hands. Pale Maine hands.  His face empty, eyes empty. A lost look plastered to him like a missing person’s ad. And as the entire stretcher passed my door I didn’t see a single drop of blood.

 

My “Nameless” Illness

I remember autumn upon autumn upon autumn that consisted in a dread of winter. Knowing my illnesses got worse as the days became as dark as they were quiet. Snow falling softly and coating the state in knee-deep sugar snow. It was these months (November-May) that I was the sickest. In one winter, at the height of my most ill, I was hospitalized three separate times, for a few weeks at a go. So it was, for this reason, I spent autumn, despite it’s what should have been, distracting beauty, dreading winter. Then spring would come and everything would melt. Snow turning to water and water to mud. Then summer, hot hot hot. Three months long in Maine. I often spent it lying naked in the river, my back pressed up against the rock bed in shallow water. The coolness of fresh water moving all around me. With my ears below the surface of the water, the world would grow muffled, but I craved the cotton ball silence. It seemed that even my voices dissipated in the water. Perhaps they were afraid of it, as most villains are.

June, July, and August are momentary. But this year, I am in recovery. Though it seems wrong to me. When you get diagnosed with something as life changing as Schizoaffective Disorder, you don’t expect to get better. In fact, very often, you’re told that you won’t. As another autumn begins. Another year passes when the only psych hospitalizations I have had to endure are in my nightmares. The weather grows cool and scattered amber and orange leaves are seen among the green. The apples on our apple trees are red now and the days to the first frost grow near. It feels wrong someone, to not dread winter. To function now. Guilt and shame frequent bedfellows. Depression growing smaller and smaller. “I get it now, you were always seductive. I see now how you made me feel misunderstood. An invisible number. A tiger behind a wall of glass.  I have felt like this for too long. So now, when I am happy, I miss the amenity that depression brings. I miss the song, that sadness sings.”

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I often wonder if it were the voices the caused the seizures. Too much noise like so many sticky bumblebees on the inside of my head. The seizures a reaction to the overwhelming. Much related to catatonia. And the pain, which still stays even to this day, a hallmark of the constant stress I felt. A mark of trauma left like a brand from hot metal forced onto my skin.  And the paralysis? I still don’t understand it. I remember how it felt though, I’ll never forget. Waking up one morning to find my lower body weighed down by an invisible hand. My frame hot like boiling sap. It started with a cane and progressively I needed a wheelchair. My legs completely paralyzed, even part of my left hip no longer working. At my doctor’s visits, I’d have seizures, at school I had seizures, in the shower, with friends, by myself. And for half of that year, I dragged myself around (or had others do it). Rendered immobile by a sickness nobody understood. The hallucinations stayed too, just as they had for the two previous years. The delusions grew worse. The voices constant and aggravating.

I had an illness with no name. And to this nameless illness, I lost four good years of my life. Years I will never get back, lives I will never live, doors which, once open, were closed to me because of this.

And now, in recovery, I feel guilty to be getting better. I feel as if I don’t deserve to be happy and healthy. I feel lost of course. Confused. Distant. The pull of sickness like a dead weight in my gut. Voices, still within me, urging me back into their company. Reminding me that I am losing the sick part of myself which defined me for so so long.

I’m changing and it’s scary.

Writer’s Block

I can’t think of a more doggish feeling than needing to write but being unable to. Pacing, canine. Rabid. An unyielding reminder pounding at the back of my head: write, write, write. But no words present. Only a rushing of blood, muscles tensing and untensing, a too fast heartbeat. Only humanity forms at the tips of my fingers but not a single letter. Nothing to show for my sentience. The one thing I was born to do, is something beyond my control. Words coming and going as they please. Presenting themselves only when they feel it’s best. I don’t get to decide on those words. When they come they are almost always unexpected. At midnight, at work, in the shower covered water. Forming from brain fog into firmness. Always inconvenient. Always when no pen is near. Arriving in pieces which I am later able to stitch together.

The rest of the time I listen to the voices, making up stories and lies until they arrive at some truth.

This is my bane as a Schizophrenic writer. My essays born of illness, while important to me, are never my decision to write. Perhaps I am more a vessel than a captain. After all, Schizoaffective Disorder is like sailing your ship through the roughest waters, without ever knowing what the water really is.