Take a minute

“I’m not taking those anymore.”

“Which ones?”

“The big ones there, for night time.”

“Why don’t you want to take them?”

“I don’t even know what they’re for.”

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Medicine is complicated. Twenty three years of schooling later, and I still find myself stumped with some of the patients I encounter in various medical disciplines.

Imagine how the patients feel.

One thing I’ve come to appreciate in my time as a physician, is how much we can take our knowledge for granted. Things that seem so obvious to me, like why do I get heart burn when I lay down, often mistify the patient, by no fault of their own, but simply by virtue of the fact that medical science isn’t part of traditional education.

Doctors forget this. Myself included. Which brings me to today.

I met a gentleman today with a number of chronic illnesses. As these things go, a number of illnesses means a number of medications. It can often be overwhelming to the doctor, let alone the patients. It can be difficult for patients to keep track of why certain medications were started, and how long they should be continued. Let alone what each individual pill looks like.

Don’t worry. As a physician my job is to help you keep track of these things, and to make sure you’re taking what you should, whent you should.

But that doesn’t mean leaving you in the dark.

“I had something stuck in my stomach,” the gentleman from the clinic said. “I was in the hospital for a few weeks… They cut me open, did something.” Tears began to fall and I moved closer. “I used to be so healthy, so active. Now, I can barely move. I’m terrified every night when I go to bed. ‘Will this be my last? I hope I go in my sleep… At least it’s painless.'”

He was terrified.

As you’ve heard me preach time and time again, knowledge is empowering. The opposite is also true. Ignorance is paralyzing.

This gentleman had no idea what had happened to him. They cut him open and entered his body and he was in the dark. Traumatizing? You tell me. Sure, many physicians had reminded him time and time again what had happened, but this information isn’t always easy to retain. To him, he felt abandoned. He had quit his medication, not only because he felt like he was taking pills blindly, but also as a form of protest. This man, who put his lives in our hands and felt so disempowered, had one last way to assert his control. By refusing.

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“I can understand. That sounds absolutely terrifying. Of course you’re anxious. I want to help you through this. I am going to help you.”

I sat with the patient for a while and discussed with him his illnesses, and his medications. He was beaming by the end.

And maybe the same thing will happen tomorrow. He might forget. And that’s ok. It’s not his responsibility to understand the medicine perfectly, I did eight years of medical education to achieve that. And trust me, I’m still working. What’s important, is that we as physicians remember the value of taking a minute to check in and make sure our patients feel educated, and included.

Dr. Travis Barron is a resident physician in Toronto, Canada.

Blogging for mental health

Of all of the human accomplishments through the ages, none capture the beauty of our soul to the same degree as art. Art is an activity unique to humans, and is perhaps the most significant way we differ from our animal relatives. Art transcends the individual, the collective, time, and space. Art in many ways is eternal. The impact of one person’s art, if forever forgotten in it’s truest form, is reproduced again and again through the impressions of those that first drank it in.

Which brings me to the topic of today’s blog post – blogging for mental health.

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I started this blog just over three weeks ago, on what would become the tail end of my time in the Department of Psychiatry. During the spring months, I held many conflicted feelings on the field. I was not happy professionally and yet mental health remained, and remains, something very important to me. My self reflection led to a conclusion – that I needed an outlet. So I started the blog.

And it’s helped. I went into medicine for a reason, to be a support for those in need. I hope I’ve lent myself to you. But I cannot understate the support you’ve given me by helping my spirit be at peace!

I’m not alone in this. The catharsis of art is undeniable and the positive impacts of art on our mental health have been documented for decades. Our human languages are beautiful, and often fail to describe the emotions many of us are feeling. Art provides a medium for expression, unquestionable expression, because you know at the end of the day that you’ve done this for you.

On a clinical level, I often recommend art to patients when they are suffering. And even when they are not. I’m often met with a comments like, “I don’t know how to paint,” to which I usually respond, “neither do I!” Art can be as simple as rearranging your bookshelf. Taking in a movie. Or writing a blog.

Dr. Travis Barron is a resident physician in Toronto, Canada.

How being in crowds (may have) caused psychosis

It’s Canada Day, and boy are you hungry. You have a hankering for sticky meats and while the drool begins to pool in your mouth, you remember. The Mandarin Chinese Buffet is having a free Canada Day buffet!

You hop on the subway and go to your nearest Mandarin. When you arrive at your stop, you wonder, “what’s that noise?” You exit the station and then it hits you. The noise was the massive crowd of hundreds of people who had the exact same idea as you. Just a few hours earlier.

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For me, those crowds were outside of my home, and man what a spectacle. Hundreds – maybe a thousand? – of people lined up to stuff their faces. This crowd is one thing at ten in the morning after a nice breakfast. It’s an entirely different beast at two in the afternoon with a rumbling stomach. Tensions start to build (indicated by the police presence that has slowly built up over time), and it’s easy to imagine how something could go wrong.

But it doesn’t. Against what seems tremendous odds, these events, as most do, go by without a major hitch or injury.  It leads one to wonder, what exactly allows us to do accomplish this as humans?

If you’ve grown up in a rural community like myself, you’re probably familiar with ant hills. If, like me, you essentially lived in a forest, there might be a few different ant hills around. Inevitably, as kids do, you take an ant from two different colonies and leave them together.

Spoiler: they fight to the death.

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This obviously doesn’t happen with humans. In fact, you can take two humans who couldn’t be from more different walks of life, and often times, a relationship will form. Why have we evolved this way? Well, it helps us! Humans are social animals at their very core, and our human society is the only society (think meercats, honey bees, other social animals), that have built a civilization. Civilization has allowed us as a species to thrive and master the planet like none before us. What does it take to build a civilization?

Trust, for one. Humans have needed to evolve trust of one another so that we can take full advantage of the world’s resources. We need to trust that by doing our jobs (which often times have absolutely nothing to do with the basic necessities of life), we get paid, and we need to trust that by getting paid, we are able to buy food and resources to sustain ourselves. It would be difficult to wake up every morning and be an insurance broker if that didn’t translate into food, shelter, and security for your family.

Trust, however, can only go so far. There are inevitably people among us who would violate that trust, and who would harm us, were our defenses so low. This problem has been increasingly important as humans live in denser and denser cities. It has required us to develop suspicion, to complement our trust of each other. In big cities, a mild level of paranoia keeps us safe. It makes us lock our doors at night, avoid the dark alley, and be aware of people acting strangely or dangerously around us. To simplify things, you could say all of us have inherited a little suspicion from our parents.

Sometimes, people can inherit too much suspicion. We may call this paranoia, or psychosis. This might make you believe people want to harm you, or that you are being monitored. You might begin to take meaning from completely innocuous things, due to hyperviligance. Think of psychosis as our natural suspicion in overdrive, suspicious traits that have become too concentrated. This perhaps lends to the fact that living in an urban environment significantly increases your risk of developing psychosis.

This theory is one of many behind the question, why does psychosis exist? We may never know for sure. What I do know, is that the human mind is fascinating, and we can often under appreciate the profound significance behind something as apparently simple as being in a crowd.

Like more on psychosis? Try this out!

Dr. Travis Barron is a resident physician in Toronto, Canada.

Mental illness exists for a reason (part 4)

Thanks for reading and keeping up with this series – Mental illness exists for a reason! In part 1, part 2, and part 3, we discussed the evidence for genetic control of behaviour in primates, and found that variability within a species’ genome allows that species to be adaptable. Humans are an example of a species with a variation in genes within  their genome, allowing us to become one of the most successful species on the planet! We discussed that because of this variability, some of us succeed in cities, rural areas, at high elevations, or thrive working underground. It also means that not all of us will succeed – at least in every environment.

So how do we guide treatment and recovery, with this understanding of mental illness?

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When I was in grade school, as there tends to be, there was always the one problem child. Teachers would scorn this child, parents would be caught whispering about the kid in hushed after-dinner conversations as they dispersed the latest rumors coming from the school. This child had bad grades, would act out in class, and was the regular example of how not to act when your parents warned you about the repercussions not studying. “Do you want to end up like Johnny? No future?!” You could say that in the eyes of the masses, this child was struggling.

Johnny felt he was struggling too. He didn’t seem to jive with the classroom environment. He had a lot of pent-up energy he felt he had nothing to do with. He intended well, but ultimately was ambivalent regarding his grades. ‘What will I ever need that for, anyway?”

I eventually moved on from grade school, and high school, and university, and medical school. Years later, on a short trip home to Newfoundland, I saw Johnny in the supermarket, He was with his beautiful family, and had three kids. We got to talking and it turned out he entered trade school after high school, was at work a few years later, and now actually owned a home. The thing that stuck out the most was he was glowing. Absolutely glowing., I couldn’t help but feel, this guys got it all figured out.

But Johnny was struggling. So what happened?

Not everybody will thrive everywhere. I could think of lots of examples from my office, but I thought that this example was more down to earth and a great example of how things are not always as they seem.

Johnny was never meant to sit in a classroom, and was intended to use his hands. When given the wide open expanse of a work day and a welders hat, he found his niche, and owned it. The reality is, the filtration system this is our school system didn’t work for him, and he struggled.

The conclusion? Sometimes, a change in environment is the most important intervention when you are struggling with a mental illness. If you live away from your family and friends, and are struggling, my pill will have limited benefit. Until jobs can stop requiring people to work 50, 60 hours a week for next-to=nothing, people will suffer.

Editor’s note: As if it wasn’t complicated enough, I’ll add an asterisk! Often times, when you are in the throes of a mental illness, your judgement can be distorted. In general, I recommend people do not make life-altering decisions while severely unwell. A discussion with your doctor on how to best approach this scenario is my recommendation.

Not all mental illness is a result of person-environment incompatibility. There are true, organic mental illnesses out there. Often times, a combination of medication, therapy, and life changes, is required.

I would like to credit Dr. Albert Wong at the Centre for Addiction and Mental Health for inspiring most of the content of parts 1-3 of this blog series.

Dr. Travis Barron is a resident physician in Toronto, Canada.

Can you develop ADHD?

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Andrew was always a high achiever. He got straight A’s in high school, was valedictorian, and assistant captain of the basketball team. Andrew would often spend long evenings on the weekdays and even some of the weekends studying. His parents reassured him he was developing good habits.

When Andrew was 17, he graduated high school, and started university. As in high school, he spent much of his time studying. He put considerable effort into his academics. Unfortunately, a few weeks into his first semester, Andrew forgets to hand in a major project. A few weeks later, he doesn’t do well on a test. Andrew begins to panic and decides to see his doctor.

“Doc, there’s something happening to me.”

“What makes you say that, Andrew?”

“I think my brain is… failing or something. I’m struggling so much at university and I never had any trouble in high school at all…”

Attention-deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects attention. You can read more about ADHD here. What does neurodevelopmental disorder mean? In general, this term refers to any problem which may arise during brain development. While brain development occurs to some extent throughout our lives, the major development of the brain happens while we are still a fetus! This means that our understanding of ADHD is that it develops before we are born, as a result of numerous genetic, environmental, intrauterine factors.

Andrew might have ADHD. So how does that make sense, given what we know about ADHD? If ADHD exists from birth (probably), how is he only having problems now?

What Andrew is describing may be what is known as adult ADHD. What is adult ADHD? Well, it’s the same as ADHD! And it’s also present from birth. The only difference between adult ADHD and ADHD is that adult ADHD has been, until adulthood, undiagnosed, for a variety of factors.

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ADHD screening is usually initiated by primary grade school teachers. Sometimes I meet kids from lower serviced neighbourhoods and poorer schools that simply were not given the opportunity to be screened as a child. I meet kids who were recommended to be screened as a child by their teachers, who have parents which declined the screen for any number of reasons, including not believing in ADHD and religion. I often meet women (and some men) who have gone undiagnosed, despite having struggles with academics when they were younger, because they have the “less obvious” inattentive subtype (previously known as ADD). Other times, I meet children who have been able to compensate for their natural attention abilities in their brain, for example by excessive studying (4+ hours a day in some cases) and who have flown under the radar. These kids often run into problems as they move through the academic system and the demands of the program exceeds their ability to compensate.

Andrew is an example of one of these children. He was likely able to compensate for a naturally lower attention span/hyperactivity in high school, and these coping strategies were likely overwhelmed when moving to post-secondary. Features of ADHD in adults can include mood swings, impulsive anger, losing keys, forgetting appointments, trouble holding down a relationship, and trouble holding down a job. Fortunately for Andrew, medications for ADHD are 85% effective, among the most of any drug! Ever.

So did Andrew develop ADHD? No. ADHD is a neurodevelopmental disorder, and is (in all likelihood) present since birth.

Editor’s note: There are however other illnesses which can affect attention which can develop later in life. Depression and anxiety, for example. One thing that is not ADHD, which I often see college age kids asking about, is marijuana. Marijuana interferes profoundly with attention is my most likely suspect when a marijuana user presents with new symptoms of inattention.

Dr. Travis Barron is a resident physician in Toronto, Canada.

The small things

“Thirty five!”

My heart begins to pound. Could it be? That’s three out of six numbers so far, I had never done this well.

“Seventeen!”

I’m out of the seat. I grasp the lottery ticket in my right hand tightly and stare at the TV. Images of yachts, parties, European vacations flash before me. The woman on the TV bends over and pulls the last number from the bin.

“Eleven!”

I’m screaming. Everyone’s screaming. We’re hugging, jumping crying in joy, when –

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BEEEEEEEEEEEEEEEEEEEEEEEEP

BEEEEEEEEEEEEEEEEEEEEEEEEP

BEEEEEEEEEEEEEEEEEEEEEEEEP

I role over as I bring myself from a foggy haze back to the planet Earth. I look to my side, expecting to see the brightness of the TV and the infinitely smiling lottery woman. Instead I’m met with a dark bedroom and the slightest hint of sunlight beginning to break through the bedroom window.

It was all a dream.

For a moment, I’m sad. I mourn my yacht. I mourn the Greek islands. I prepare to mourn for my would-have-been pet Tiger, when the hope begins to trickle into my mind.

It’s Saturday.

Oh, Saturday. The king of days, the glory of glory. We meet again. What have you brought me today? Is it a hike? An interesting play? The sweet nectar of shameless hedonism and laziness so that I may bathe myself in relaxation? Perhaps.

But first, there’s coffee.

Ah, coffee. I smell the sweet fumes, the pungency of the beans as they’re cracked over blade. I’m intoxicated with the idea. I climb out of bed and realize my mouth is watering. I sneak by my loved one and enter the kitchen, the regular opening scene to my Saturday-plays.

I grind the beans, turn on the machine, and wait patiently through the glug-glug. Soon, it’s ready. I sit on the step and drink from my chalice. I find myself wondering just how much of my blood is this very drink. For those moments, the world is still. As long as there’s blackness that sits in my cup, time is frozen, and it remains in good form until I take the final sip.

I find myself mourning the lottery once more. I look to my cup and smile to myself. What I really appreciate, are the small things.

Dr. Travis Barron is a resident physician in Toronto, Canada.

Mental illness exists for a reason (part 3)

In part 1 of Mental illness exists for a reason, we discussed the evidence behind genetic control of temperament in two different primate species, Chimpanzees and Bonobos.

In part 2, we discussed how having a variation of behaviours within a species makes that species adaptable to a broad range of environments. Voles were a great case study on how polymorphic genes lead to a variety of behaviours within a species, allowing voles to thrive in a wide range of habitats on the planet.

In part 3, we will be discussing the role of the gene we have been examining, vasopressin 1a receptor, in human behaviour, and extrapolating from that why mental illness may exist.

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Humans are not voles. Before we get started, I want to reiterate that there are thousands of genes which interact to have an effect on human behaviour. No one gene is responsible for the beauty that is the human mind. When we examine human behaviours in studies, like the one I will be discussing today, we are observing trends in behaviour, and not absolute rules. Remember, personality is thought to be at most 50% genetic, and each one of those thousand genes are in direct interaction with each other, and our ever changing environment, at any given moment, to produce the “climate” of traits that becomes our personality.

So what’s the deal with vasopressin 1a receptor? What is it anyway?

In the human body, brain function is dependent on something called neurotransmission. In a nut shell, neurotransmission is when two different nerve cells, called neurons, communicate with each other. Neurons are constantly communicating with each other at any given time to produce consciousness, vision, hearing, touch, and just about any neurological function you can imagine.

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Credit: Nature

How does neurotransmission occur? Through chemicals called neurotransmitters. In a neuron “discussion,” the first neuron sends a neurotransmitter to the second neuron. There is a receptor on the second/receiving neuron that picks up the message. Vasopressin 1a is this kind of receptor. Depending on the shape or form of the receptor, different things will happen to the second/receiving neuron. This is how variation in the receptor produces variation in effects!

Why is this important? Vasopressin 1a receptor has been implicated in pair bonding behaviours, across a wide range of species, including humans, chimpanzees, bonobos, and voles. Consistently, a “longer” form of the gene has been associated with increased pair bonding and less aggressive behaviours. Think the lazy, horny Bonobo and the monogamous Prarie Vole’s. And some humans.

A group at John Hopkins set out in the mid-2000’s to investigate the role of vasopressin 1a receptor in humans. You can read their study here. To summarize, the group found that a number of variations of the vasopressin 1a receptor exist in humans. That makes this a polymorpic gene. As expected, certain forms of the gene correlated with certain behaviours in humans. Longer forms of the gene were associated with increased pair bonding, as determined by a questionnaire. Amazingly, not only did carriers of the longer gene tend to report happier marriages, their partners did as well. Carriers of the shorter gene were unhappier in their marriages on average and were considerably more likely to have had a threatened divorce within the last year.

So why can’t we all be married, well fed, and happy?

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Like the Prarie Vole, humans live in a wide variety of environments. This is different than Chimpanzee’s and Bonobo’s, who are really good at living in the kinds of places they live, but not great at living elsewhere. Humans live in mountains, on swamps, the plains, the coasts. There’s hardly a terrestrial environment on this planet that we haven’t conquered. The point? Humans have had to be extremely adaptable to achieve this level of success across the wide range of environments we inhabit. This doesn’t only apply to geography. The massive differences between an urban metropolis and a rural village cannot be understated. The variation in cultures across the West and East is difficult to appreciate. These differences in the societies in which we lives requires a broad range of behaviours to be within our species to succeed.  We need people who thrive in a big city, among thousands of their peers, in cramped, noisy, stimulating environments. Without them, the economic engines of our nations would collapse. We need people that can’t stand the city, who need wide, open expanses, and tranquility to survive. Without them we wouldn’t be able to feed the masses. The point is that variation in our personalities allows some of us to succeed, and to excel, so that society and the species may go on.

But that doesn’t mean we are all meant to succeed. Or rather, that we are all meant to succeed in every environment.

Variation means exactly that – variety. For every person that thrives in a city there’s another who suffers. Sometimes, there is a fundamental mismatch between our personality, and our environment. Try as you may, a monogamous Vole ain’t gonna do well at a polygamous Vole frat party. A Bonobo chimp would be dead meat caught in a Chimpanzee civil war.

These mismatches occur in humans as well; sometimes, we may call that mismatch, a mental illness.

Join me in part 4 for a discussion of how we can use our understanding of why mental illnesses may exist to help guide treatment and recovery!

Editor’s note: I do not want to diminish the role of, “nurture,” in the nature vs nurture argument. By no means in personality 100% genetic (most studies show it’s around 50%)! This blog simply looks at the genetic side of things.

I would like to credit Dr. Albert Wong at the Centre for Addiction and Mental Health for inspiring most of the content of this blog post.

Dr. Travis Barron is a resident physician in Toronto, Canada.

Three weeks in!

Hello internet! Travis here, on day nineteen of the blog! Blogging is something new to me, so thanks for bearing with me as we go through growing pains together. I now know what a widget is!

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Why did I start blogging? Well, I find education empowering. As different as every single patient who takes a step into my office is, it amazes me how many similarities there are between their questions and misconceptions on the field of mental health. Hopefully by sharing my understanding, I can help someone out there find some clarity.

To that effect, do any of you have a topic you’re wondering about? Have any questions? Send them my way and I’ll do my best to answer them next week!

Stay tuned for Mental illness exists for a reason (part 3) this weekend! You can read part 1 here and part 2 here!

T

Chest pain is in your head

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It’s a beautiful winter’s day in suburban Ontario and you’re shoveling snow. It’s the first snowfall of the year so you don’t absolutely hate the task at hand. Yet. You stop to breath in the beauti—-

BLAARRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR.

The snow plow is on you in seconds and quickly packs your hard-shoveled driveway back in. As you swear to yourself, you continue to shovel.

Suddenly, there’s chest pain. Your vision goes black in the corners and you grab for something. You stabilize yourself on the side of your home and take deep, laboured breaths. You manage to pull your cell phone from your pocket, and dial 911.

“Hello you’ve reached 911 what’s your emergency?”

“I think I’m having a heart attack.”

***

“I don’t get what you’re saying.”

“Let me start from the beginning. Everything checked out fine with your heart. Your rhythm is normal and there are no signs of a heart attack. I think the most likely explanation is a panic attack.”

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“So you’re saying it’s in my head? That’s ridiculous. How could you possibly know it’s not a heart attack?”

“Besides the fact that your blood tests and EKG were normal, sir, you are 28. You have no previous cardiac history, you don’t smoke, and your family history is insignificant. Taking all of this together, there is no likelihood that this is a heart attack.”

“So I’m going crazy?”

“I didn’t say that…”

Panic attacks are real, intense manifestations of anxiety. Features of panic attacks include chest pain, shortness of breath, tunnel vision, dizziness, sweating, anxiety, and a fear you are dying, just to name a few. Best of all, panic attacks can have a clear trigger (snakes, for example!), or culminate out of apparent nothingness. Panic attacks can be unpredictable and debilitating, and are definitely uncomfortable. To put the icing on the cake, panic attacks can often present like a heart attack. Your fear of dying just got a lot better, didn’t it?

One of the most common consultations I have seen in my office are individuals who have presented to hospital numerous times with non-cardiac chest pain. The consulting physicians are usually suspicious of panic attacks. These consultations often unfold in a similar fashion – the discussion around the patients understanding of what’s going on, a discussion of their mental health and personal lives, and inevitably, feedback.

To all of my doctor friends out there in the internet, here’s what not to say when you suspect someone is experiencing panic attacks:

“It’s all in your head.”

Medicine and psychiatry are a lot of things, the least of which is not, being a source of reassurance. By dismissing an individual’s symptoms as “in their head,” you have immediately invalidated that person and there’s little chance they will listen to anything else you have to say.

But panic attacks are in your head, and so is the chest pain. But this is also the case with true cardiac chest pain. What am I saying? Everything, including true heart attacks, are to some extent, in your head!

What the hell am I talking about?

In your body, there are a specialized type of nerve cell called neurons. Neurons are like wires that connect different parts of the body and allow parts of the body to communicate with each other. There are neurons that go from your brain to your muscles, for example, which send messages on how to move. There are neurons that go from our skin to out brain which tell our brain what we are feeling.

This is equally true in heart attacks.

When you are having a heart attack, blood is suddenly cut off from a part of the heart and damages the heart muscle. This causes chest pain. The neuron that goes from your heart to your brain sends a message to your brain that you are having chest pain. This is how you become aware of it. As is appropriate when you’re having a heart attack and experiencing chest pain, you then begin to feel anxious. This anxiety protects us and drives us to call an ambulance and seek help.

So what’s going on in a panic attack?

pahaIf you recall, neurons are like wires. Like wires, messages can pass down nerve bundles in both directions. Messages can be sent from the heart to the brain (as in a heart attack), or from the brain to the heart. In panic attacks, our brain “hijacks” our natural nerve circuitry and sends the message in the opposite direction (brain to heart). This causes the cycle (chest pain -> brain aware -> anxiety) to reverse (anxiety -> brain aware -> chest pain)!

The take home message? The chest pain in panic attacks is as real as the chest pain in a heart attack. The difference is that the pain in each scenario is driven by a different cause (heart damage vs anxiety).

Why do I find this is important to understand? In my experience, when people seek help for panic attacks, often times a patient and physician can get too caught up on whether the chest pain is “really” happening. It definitely is. But to understand and accept that your chest pain is real and is highly unlikely to be caused by heart damage, for all of the reasons listed in the opening dialogue of this post, is empowering and indespensible.

Editor’s note: This article is not a substitute for medical consultation! If you think you are having a heart attack, particularly if you carry risks factors, you should seek medical attention.

Dr. Travis Barron is a resident physician in Toronto, Canada.

Mental illness exists for a reason (part 2)

In part 1 we discussed the differences in behaviour between Bonobo chimp’s and their closest relatives, the Chimpanzee. Bonobo’s and Chimpanzee’s each have distinct temperaments between their two species and minimal variation in the these temperaments within their own species. What does this mean? Most Chimpanzee’s are territorial, aggressive, and violent, and most Bonobo’s are chill, horny, and non-violent.

And now, to the promised star of part 2, the Vole.

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Voles are a group of small rodents that reside in North America. Unlike the Chimpanzee and Bonobo, Vole’s occupy an extremely wide variety of habitats. If you recall, Bonobo’s live in one small part of Africa, in a very specific habitat, while Chimpanzee’s have a large range of similar habitats (to their own, not Bonobo’s) all across Africa. You can find Vole’s in prairies, meadows, mountains, and your basement. So what is it that make voles extremely adaptable?

Behaviour, for one.Voles, unlike Chimpanzee’s and Bonobo’s, have a wide variety of behaviours within their species. Some voles are monogamous, and some are not. Some are territorial, and some are not. By having a wide range of available behaviours within their population, the Vole species always ensures that there’s somebody (somevole?) around who are able to handle the demands of the environment. Prairie Vole’s, for example, are monogamous, while Meadow Vole’s are not. Maybe this means that a gentle, monogamous Vole may not survive in the meadow, but it ensures, on a population level, the survival of the species across a wide range of environments.

What’s responsible for the variations in behaviour seen across the Vole’s? If you recall, in part 1 we discussed the role of a gene, vasopression 1a receptor, in the different behaviours observed in Chimpanzee’s and Bonobo’s. Well, as it turns out, the vasopression 1a receptor gene is also responsible for the different behaviours among the Vole’s.

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Credit: Science Magazine

As you can read in this study, genetic testing has shown a variety of vasopression 1a receptor mutations within the Vole genome. We would call this a polymorphic gene, meaning that many different forms of the gene exist within the same species. Humans have polymorphic genes for hair, eye, and skin colour, for example. Monogamous Vole’s appear to have a higher density of vasopressin 1a receptor and, similar to Bonobo’s, a “longer” version of the gene.

The take away? It’s not that vasopressin 1a receptor is the God-gene controlling our every instinct. The reality is there are thousands of genes that play a role in behaviour, and each one is more nuanced than the next. This should however stand as an example of how variation of a gene within the same species produces a variety of behaviours!

In part 3, we examine the role of vasopressin 1a receptor in human behaviour in an effort to extrapolate why mental illness exists!

Editor’s note: I do not want to diminish the role of, “nurture,” in the nature vs nurture argument. By no means in personality 100% genetic (most studies show it’s around 50%)! This blog simply looks at the genetic side of things.

I would like to credit Dr. Albert Wong at the Centre for Addiction and Mental Health for inspiring most of the content of this blog post.

Dr. Travis Barron is a resident physician in Toronto, Canada.