There, but for the grace of God, go I

They’re dying. 

They have a disease that’s killing them – and wants him on his own, drinking. 

Drinking himself to death. 

It’s a terrible disease he has. 

And the irony of it is that it’s a disease that tells him that he hasn’t a disease. 

His body is telling him he’s dying – telling the world that he’s dying, and his brain is telling him to keep on drinking. 

And they don’t understand – sure what do they know!? 

It’s mad. It’s baffling. And cunning. 

But there’s hope.

- Glassland (2014)

A Death of One Thousand Subtractions

Alzheimer's is the cleverest thief, because she not only steals from you, but she steals the very thing you need to remember what's been stolen - Jarod Kintz, This Book Has No Title.

It'll become an epidemic once the baby boomer generation starts getting over 65 years of age. It's the revenge of longevity. 65 to 70% of Dementia is Alzheimer's. It always begins in the hippocampus, thus the loss of short term memory at the beginning of the illness. Short term memory (STM) just gets worse and worse at first, followed by the person's analytical abilities. Frustration can lead to aggression and even violent outbursts, muscle and movement loss progressively follow and the inability to swallow, then you're more or less looking at it really beginning to kill the person.

You can't converse with Alzheimer's sufferers in the way you do with others; the dialogue tends to go round in circles - Kevin Whately.
 

The care givers are also the heroes in this disease, along with the scientists. A death of 1000 subtractions, bit by bit, day by day, week by week, month by month, year by year. A slow death sentence. However, not everyone who lives to an old age gets Alzheimer's. No one is immune to the disease. Yes there is a genetic component, but inheritance is only about 5%, so you're far more likely to be in the 95th percentile.

People think it's just forgetting your keys. Or the words for things. But there are the personality changes. The mood swings. The hostility and even violence. Even from the gentlest person in the world. You lose the person you love. And you are left with the shell... And you are expected to go on loving them even when they are no longer there. You are supposed to be loyal. It's not that other people expect it. It's that you expect it of yourself. And you long for it to be over soon - Alice LaPlante, Turn of Mind.

Alzheimer's Disease Drug Risk

A popular sedative has recently been linked with an increased risk of developing Alzheimer's disease. Benzodiazepines, which are used to treat anxiety and insomnia, are associated with a heightened risk of developing the condition, a new study claims. Published on the British Medical Journal  (bmj.com) , it examined data from a health insurance database in Quebec.

 

French and Canadian researchers identified 1,700 elderly people with Alzheimer's disease and more than 7,000 healthy people for comparison. The use of benzodiazepines was associated with an increased risk of actually developing the disease. The risk was greatest among those who used the long-acting version of the medication.

_____________________________________________________________________________________________________________________

Cocaine cues and dopamine

In 2006 at the Brookhaven National Laboratory, New York, a set of experiments was conducted to discover the true nature of cocaine addiction. Mexican born scientist, Prof Nora Volkow, is one of America's leading specialists on drug addiction. She's on a personal mission to understand the cause of addiction, driven by memories of her alcoholic uncle. ''He was rejected by the system...not even being accepted from the perspective of him having a medical disease''.

 

Prof. Nora Volkow

What fascinates Prof Volkow is the nature of cocaine addiction. As late as the 1980's, many scientists and politicians believed cocaine was non-addictive, and she wants to prove them wrong.

 

She took fMRI images of people under the influence of cocaine to try and identify areas of the brain, and the proteins in the brain that get disrupted by use of drugs in people that lose control of their drug intake at the expense of everything else in their life.

 

 

Her images showed that cocaine changes the brains structure. ''Repeated exposure produces changes in the way that the brain gets connected, and functions that result in pathological behaviour'', and this is why she argues in favour of it being regarded as a disease.

 

Trying to understand the nature of this disease, Prof Volkow scanned hundreds of users and ex-users. While scanning the brains of ex-users she noticed an irregularity. When subjects were discussing cocaine their dopamine levels rose. She argues that you could make a case that people become addicted to the lifestyle of cocaine use. Their brains have started to respond to the lifestyle, that is; the environment, their friends, and their situations. Her team later conducted experiments to test the theory.

 

Subjects were placed in an fMRI scanner and shown images of people preparing and snorting lines of cocaine. Viewing the images resulted in a significant increase of dopamine levels in the brains of the subjects who were current users.

 

The neurological effect of cocaine

''When we exposed them with stimulants that have been linked with drugs, what we observe is a significant increase in dopamine signalling in those areas of the brain that drive the motivation of drug behaviour''.

 

Prof Volkow's research showed that cocaine is so addictive that simply showing images of its use is enough to increase a subjects dopamine levels and lead them into a relapse.

 

Law enforcement treats cocaine users as criminals rather than people suffering from a disease. Over the past ten years, the government in the U.S. has repeatedly slashed funding for drug rehabilitation programmes and increased funding for prisons. The result: a million Americans are imprisoned on drug related charges, costing the American taxpayer 12.5 billion dollars per year.

 

Prof Volkow believes that the government's approach of criminalising and imprisoning drug use without proper treatment is misguided and statistics support her claims. Cocaine users are likely to relapse after leaving prison and end up re-incarcerated with 40% of cocaine users and 77% of crack convicts being re-offenders.
_____________________________________________________________________________________________________________________

Volkow, N.D., Wang, G.J., Telang, F., Fowler, J.S., Logan, J., Childress, A.R., Jayne, M., Ma, Y., Wong, C.J. (2006). Cocaine cues and dopamine in dorsal striatum: mechanism of craving in cocaine addiction. Journal of Neuroscience 14; 26 (24): 6583-8

Stigma - A major barrier to Suicide Prevention

According to the WHO and the latest Burden of Disease Estimation, suicide is a major public health problem in high income countries and is an emerging problem in low and middle income countries. Suicide is one of the leading causes of death in the world, especially among young people.

Nearly one million people worldwide die by suicide each year. This corresponds to one death by suicide every 40 seconds. The number of lives lost each year through suicide exceeds the number of deaths due to homicide and war combined. These staggering figures do not include nonfatal suicide attempts which occur much more frequently than deaths by suicide.

                                                                                                                Suicides in Republic of Ireland from 2001-2013

2001 - 519
2002 - 478
2003 - 497
2004 - 493
2005 - 481
2006 - 460
2007 - 458
2008 - 506
2009 - 552
2010 - 490
2011 - 525
2012 - 507

*2013 - 475 (6% drop, with males accounting for over 83% of all suicide deaths last year.)

A large proportion of people who die by suicide suffer mental illness. Recent estimates suggest that the disease burden caused by mental illnesses will amount for 25% of the total disease burden in the world in the next two decades, making it the most important category of ill-health (more important than cancer or heart diseases.)

A significant number of those with mental illnesses who die by suicide do not contact health or social services near the time of their death. In many instances, there are insufficient services available to assist those in need at times of crisis. Lack of access to appropriate care is one of the many factors that magnify the stigma associated with mental illness and with suicidal ideation and behaviour. This type of stigma, which is deeply rooted in most societies, can arise for different reasons.

For some people, the term 'suicide' alone evokes panic and one of the causes of stigma is a simple lack of knowledge - that is, ignorance. This type of stigma can be directly addressed by providing a range of community-based educational programs that are targeted to specific subgroups within the society (that is, by age, educational level, religious affiliation, and so forth). Negative attitudes about individuals with mental illnesses and/or suicidal ideation or impulses (prejudice) is common in many communities. These negative attitudes often do not change with education about mental illnesses and suicidal behaviour.

Many health professionals who feel uncomfortable dealing with persons struggling with mental illnesses or suicidal ideation often hold negative, prejudicial attitudes towards such patients. This can result in a failure to provide optimal care and support for persons in crisis.

Stigma is also the underlying motive for discrimination - inappropriate or unlawful restrictions of the freedom of individuals with mental illnesses or suicidal behaviour. Such restrictions can occur at a personal, community or institutional level. One extreme example is the criminalization of suicidal behaviour, which still occurs in many countries. Discrimination can prevent or discourage people affected by mental illness and/or suicidal ideation or behaviour from seeking professional help, or from returning to their normal social roles, after receiving treatment for an episode of illness or crisis.

In both high-income and low and middle-income countries stigmatized conditions such as mental illnesses and suicidal behaviour receive a much smaller proportion of health and welfare budgets than is appropriate, given their huge impact on the overall health of the community.

Unless the stigma is confronted and challenged, it will continue to be a major barrier to the treatment of mental illnesses and to the prevention of suicide. Events like World Mental Health Day (October 10th) and World Suicide Prevention Day (September 10th) are ideal times to highlight and inspire people to work towards the goal of developing creative new methods for eradicating stigma and helping to save lives.
_____________________________________________________________________________
Each morning when you open your eyes, say to yourself:  “I, not external people or events, have the power to make me happy or unhappy today.  It’s up to me.  Yesterday is gone and tomorrow hasn’t come yet.  I only have today and I’m going to be happy in it.”