Biology 202 Neurobiology and Behavior Spring 2003

On action potentials ... and mental "illness".

The nervous system "signals" by way of action potentials, which in turn reflect ionic movements, ionic gradients, and membrane proteins which establish and vary the permeability of the membrane to particular ions. Does this make it easier or harder to accept the idea that brain=behavior? In what ways does it help to better understand behavior? What new questions does it raise?

Another aspect of mental illness that seems interesting to me is that there has been much said about overcoming illness with good thoughts. People have claimed that the brain or at least thinking positively has helped people cure disease or made them feel better. It is a wonder then that mental illnesses may be the most complicated and misunderstood illnesses, because the very thing that can help you overcome disease is sick.

If the mind supervenes on the physical nervous system, then the fact that signals can start within the nervous system must have strong implications, although what those implications are, I haven't figured out yet.

Does this prove the existence of "a priori" (prior to experience) faculties of the mind, like Kant theorized? Does it help with an argument for free will, since it allows for a sort of self-stimulation? (no giggles, please) Or is it merely a complication of the issue with no real answers for the fundamental philosophical problems of neurobiology? I'm not ready to make any claims yet about the answers to these questions, but I am sure the stimuli which start "within the box" need to be included as a focus of the mind-body debate.

To support this theory I look to the ideas of Descartes. He purported that there is a medium, or veil, between mental and physical perceptions. For example, your senses process data that your mind then applies inferred fact to. Through this process you perceive the physical world. This is not to say that the mind and body are not closely intertwined. With that said, what affects the body effects the mind. Therefore, chemical changes do influence us both mentally and physically, because they control our physical bodies. Can the reverse be true—does our mind influence our body? Can the brain control physical processes? One answer to this can be seen in the effects of placebo on medical patients. In a most cases placebos work just as well as actual medications. This can have interesting consequences in the field of mental illness. Is it really mental?!

I personally am not someone who has never been too fond of taking medicine. I feel like the act itself is a sign of weakness in our minds, and that the only thing it can due is make us build a resistance, both physically and psychologically to the drug – that if we took one pill for this injury, I must need two or three pills for another injury.

Many times, including yesterday, when I play basketball, I get "injured". But what exactly does that mean is a very interesting question since I typically forget about the pain during the game because my adrenaline is pumping since the bigger priority to me at the time is win the ballgame. In a way, its saying that mentally, if I'm distracted or if I "just don't care as much", I won't feel any pain. I think that similarly, someone with a neurobiological disorder CAN alter their behavior according to the situation. I don't mean to offend anyone by making such a bold statement since there is no evidence of this, but I honestly believe that someone who can typically not perform normal functions due to psychological problems, can in fact overcome their disability under the right set of circumstances. For example, if they saw someone they were very close to, in danger, then I feel a lot of them would react to it in a way that they normally "couldn't". Now its very possible that the response won't be the same as what other people would have, but that's because the illness has built such a strong level of resistance over time that the particular individual may have actually forgotten how to control their behavior.

What I think I'm trying to say is that we have seen a dramatic increase in neurobiological illnesses (i.e. autism) over the past few years and that the issue needs to be approached not in terms of "finding a medical cure", but instead a change in society and how we live our lives. Times have changed as everything in life seems so fast paced that people can easily feel lost and alone. If we could provide people with outlets (sports, music, etc.) and constant support for one another, no one would feel those impulses in their brains that eventually can develop a neurobiological illness.

Amidst all my rambling, I hope people realize that I remain quite skeptical on whether the property of the brain equals a property of the mind. Scientists and pharmacologist develop and sell us these drugs/vaccinations that are suppose to balance our internal chemistry but its just too hard to believe that there is such a simple solution to any illness or injury, especially one involving brain and behavior.

as we are now breaking down the functional properties of the brain, it makes sense to me why i am so afraid of giving any credit to my possible deficiencies there. if i know that 99 percent of my actions come from within, then that is all i am working with and that does not leave alot of room for blame elsewhere. if i find that some of that 99 percent is not functioning properly, then i am already not working with a full set (now that i know we use more than 10%), and there is nothing to fall back on. if the "normal" person i measure myself against is working with a full set, that makes me less of something. less able? less in control? less human? i can give support to someone else and say that they are not less of anything, but the one thing i am the most scared of is becoming them.

the way i deal with this fear is by piling so many things on my plate all the time that i can't possibly do them all. when something goes wrong, i always have a quick scapegoat. i think its funny that however dynamic and confident i claim to be, the one part of me i have never examined or questioned, and the part that makes up 99 percent of who "i" am, is the most important. but as long as i see that "normal" person out there walking around, i will avoid asking the question, so that i may also continue to be normal. but, if i don't ask that question, what am i setting myself up for?

While it is partially romantic to think about societies that are less developed as ours, as happier, there may be a grain of truth to this thought. For example, schizophrenics, while they have or had difficulty fitting into our society, may have been able to have been shamans or medicine men. Thus, they would be able to play a functional and very important role in certain societies.

While I do NOT want to underplay the harshness and reality of mental illness (bipolar disorder seems to be a favorite among my family and friends) I think that we expect that we should be happy all the time. Possibly because of this it seems that a huge amount of people are on medication for depression or consider themselves depressed in the U.S. Since I have only lived here and not other countries for extended periods of time, it would be interesting to know more about how mental illness is treated elsewhere.

I do think it is interesting that mental illness is socially constructed and that different cultures have different views on what is categorized as mental illness. I think that as we try to define ourselves we categorize something (a behavior or person) as different or abnormal and quickly attach a stigma to it.

I want to respond to Arun's comments about overcoming an injury through "willpower". I think the analogy to basketball is an interesting one, but it leaves a lot out of the equation. That adrenaline that runs though your veins is what allows you to finish the game. It dulls the pain (I don't know the exact mechanism, but it has to do with neurotransmitters). So, although we may think of it as the desire to finish the game, its actually through a change in brain chemistry that allows us to continue to function. The difference with the physical injury is that the adrenaline ALLOWS you to ignore your pain. Sure, it is partially a response to your desire to win the game that makes you keep playing. But its also made possible because of a change in your brain chemistry. So its really all about brain chemistry. Brain does equal behavior.

I absolutely reject the idea that people with mental illnesses can change their behavior (in respect to their illness). I'm not saying that a person's perspective on the situation won't change things, but that alone is not enough.

These ion channels may be at the baseline of an extremely intricate and complicated system, thus, a mistake somewhere in the system or a defect in a structure that maintain and operate that system may be account for the behavior produce. This analogy seems tto be saying that the brain is the control center of a complex machine, in which the brain is ultimately itself a complicated machine. I do apologize for using this anology because I fervently believe that theres more to the brain but it will ease the discussion that we've been exploring so far.

Getting back to the anology of the brain as a machine, a defect in the system no matter what it is and where it is gives rise the behavior and abormally...to the mental illness. So getting back to the accountability of people whose actions they can not control because of some abnormality in their brain, I believe that they are indeed not accountable for their actions. Just like a machine, when the brain malfunctions because of some mistakes or defects it should be treated or fixed as so. I can understand someone who thinks that an intoxicated person should be held accountable for their actions because they choose to drink and be potentially intoxicated. The important implication in this example is that they get to choose an action that give rise to whatever consequences they gotten themselves into; however, with mental illness, how can you choose to be born with a mental illness that give rise to consequences that you are unable controlled? Your brain send signals that maintain and regulate every muscle in your body. However, if you are born with structures that somehow do not maintain and regulate these signals normally then is it valid to say that you are held accountable for hitting someone who was in your way?

Furthermore I would like to stress the tremendous influence our society have on our behavior, possibly as much as the brain. It seems to me, in one of our earlier discussions about similarities and differences between the different brains and different behavior, the brain and behavior have an influence on one another. So if society is shaping the way we behave and act day to day, especially in a time when the media is more powerful than ever, the chemical properties and maybe physical properties of our brain are affected as a result. Thus, society could be a cause of the growing trend of mental illness that are described today.

I find it particularly interesting that the brain, in its complexities,has somehow evolved and acquired the ability, ever since the beginning of its existence of life on earth, to learn and to adapt, and to be able to change its chemical and molecular basis to accomdate its external environment. So in a way the brain feeds on what we see, hear, and feel. And, like food, what it takes in may have an effect on its composition. I can understand that the chemical property of the brain is influenced by behavior and vice versa; however, I'm still unsure whether the physical properties (such as size and shape) of the brain is also affected by behavior and vice versa.

But in our society I feel we are so quick to look for an easy solution without looking at the real causes. We just want to say, "there is no reason, it's just physical, pop a pill, it will go away." But that reminds me of so many distopian novels full of overmedicated, numb people. I am definitely not saying that people classified with mental illnesses are weak and inhuman. I think the concept of mental "illness" has so MUCH to do with society.

In America I feel like we share this ideal and dream that everyone should be happy almost all of the time. We watch Friends or Will and Grace and think thats how life should actually be. Why is it so shameful that you don't feel able to attain this goal? Life is a struggle, for everyone. And struggles teach so much and are so enriching in inspiring actual thought and growth.

I am not saying that society completely creates differences that are often very genetic. But the pity and the stigma that is attached to mentally unique people is destructive and exacerbates what we see as their problems. There is nothing wrong with being different. We should appreciate unique people for the perspectives they bring to the human experience. This reminds me of a quote from a movie (called Molly) about a girl with autism I put in my paper:

"In your world, almost everything is controlled....I think that is what I find most strange about this world, that nobody ever says how they feel. They hurt, but they don't cry out. They're happy, but they don't dance or jump around. And they're angry, but they hardly ever scream because they'd feel ashamed and nothing is worse than that. So we all walk around with our heads looking down, but never look up and see how beautiful the sky is."

There is so much repression associated with mental illness. People who are classified with it feel the need to hide, and we need them to hide their differences in order for us to feel normal. If we all didn't have an idea of what normal was, we wouldn't feel such a need to gear our society towards one type of (bland) personality and to label so many people as pitifully incapable. They may not be capable in the ways that we are, but are our ways the "right" ways? Why do we have to fix them?

If we accept the concept of brain=behavior,as well as the idea that we can create our behavior to a large degree(which I think most of us are far from abandoning), then we have to accept that we can change our brains, and that means our brain chemistry. Genetic predisposition to traits is real, but it works hand in hand with environmental factors.....which are often the results of personal, group, or societal actions. There is no such thing as "just physical," because the brain and the soul are intertwined.

In terms of Kant (as mentioned earlier), it is an interesting idea that the ability for signals to start from ?within the box? could help to justify his idea of ?a priori? subjectivity. It doesn?t seem to work completely, however, because it is still unclear to me where the possibility for ?choice? exists and does not exist, and how this relates to prior experience. It seems that, although a signal from ?inside the box? is independent of external experience, it could still be linked to a certain INTERNAL experience, related to the I-function, which would necessarily differ for each person and would thus not be ?universal? as Kant intended.

And, to be honest, I am still very worried about free will? does this mean that am I stubbornly trying to grasp the mirage of ?decisions? and ?choice? and ?free thought? while my brain chemicals merely watch and laugh, tricking me into a false sense of control?

I realize that things do not work that way anymore, especially in this country. A parent cannot threaten his/her children in order to make them pay attention in school. However, I do not think that drugs are the best or only answer. E. Fulchiero said that "there can be no end to the benefits reaped from a society in which science can provide remedy for the failings of nature." This reminds me of the society created by Aldous Huxley in "Brave New World" where there are no real experiences anymore. Instead, life is a drug-altered stupor that seems pointless to someone who was not raised in that society. It seems to me that our society is headed in that direction. "You've got a problem? We've got a drug that can take care of it." Drugs may be the answer to some of life's problems, but it is not the answer to all of life's problms.

Here's the link: http://news.bbc.co.uk/2/hi/health/2621705.stm

Since Viagra has been so successful in sales, drug companies are looking to recreate that kind of market among women. However, it is entirely possible that this "sexual dysfunction" in women is due to natural changes in their sexual feelings which may happen after childbirth or being with the same partner for many years. There is probably also just a disinterest among many women, not necessarily indicating that there is something medically wrong with them. By producing a drug to "solve" this problem, it creates a mentality among women that says "Hey look..there's a drug out there that is geared to help you with this, you should take it if you have these 'symptoms'..." However, instead it might be better to look into other factors in the everyday life of these women to get a complete overview of what might be really wrong.

This is not to say that I do not believe that medication does help with chemical imbalances and in general some disorders/illnesses. However, I think that this article may shed light to the idea that some disorders can be cured without pharmaceutical medication by looking elsewhere. So while I do believe in the power of the drug, I sometimes feel that they become so commercialized and relied upon that it becomes more of an issue of sales than concern of the human body's condition.

In some aspects, i feel like people turn to medications (especially for some of the mental illnesses aforementioned) more because they want to give the control over to the hands of someone or something else (ie. doctor, medicine) instead of taking the responsibility upon oneself to want to overcome this obstacle oneself. Sure, we can say that some people are just not capable of taking this initiative and what not, but I think that's just all an excuse. Working in an elderly nursing home for over 4 years, I've seen people who basically turn to medication more because they have given up trying than because they seriously want to help themselves. Medication helps... and yes, there are just amazing benefits that we have and will reap from the medicinal technology. However, the problems arise when people turn to their doctors and ask for prescriptions merely because they just can't bring themselves to the point where they themselves want to make that difference.

I know someone mentioned obesity, and i agree that some people are predisposed to obesity. However, too often you see these college students, who are obviously not taking care of their body (ie. exercising and eating healthy) and then complaining that they have a weight problem... going on pills to lose weight. When I see that, I want to just shake them and say "Just exercise and quit eating three apple pies every meal!" I know a HANDFUL of friends who always try these diet pills thinking it'll help them control their appetite and what not... but sometimes, you really need to just take control yourself. I know the class hasn't fully decided yet whether we have control or not... but til we do, I am still prone to say that we do have some control over our lives and that free will does exist. And we ARE able to make choices for ourselves without the alterations from pills in our heads...

By the way, this class is getting pretty interesting... and I'm glad that people are being so honest with their opinions!!

The federal appeals court in St. Louis ruled yesterday that officials in
Arkansas can force a prisoner on death row to take antipsychotic medication
to make him sane enough to execute. Without the drugs, the prisoner, Charles
Laverne Singleton, could not be put to death under a United States Supreme
Court decision that prohibits the execution of the insane.

Yesterday's 6-to-5 decision is the first by a federal appeals court to allow
such an execution.

"Singleton presents the court with a choice between involuntary medication
followed by an execution and no medication followed by psychosis and
imprisonment," Judge Roger L. Wollman wrote for the majority in ruling by
the United States Court of Appeals for the Eighth Circuit.

Judge Wollman said the first choice was the better one, at least when the
drugs were generally beneficial to the prisoner. He said courts did not need
to consider the ultimate result of medicating the prisoner.

"Eligibility for execution is the only unwanted consequence of the
medication," he wrote.

Judge Gerald W. Heaney, in dissent, said there was a third choice. He would
have allowed Mr. Singleton to be medicated without fear of execution.

"I believe," he wrote, "that to execute a man who is severely deranged
without treatment, and arguably incompetent when treated, is the pinnacle of
what Justice Marshall called `the barbarity of exacting mindless vengeance.'
" Judge Heaney added that the majority's holding presented doctors with an
impossible ethical choice.

Mr. Singleton killed a grocery store clerk in Arkansas in 1979 and was
sentenced to death that year. His conviction was affirmed in 1981 by the
Arkansas Supreme Court.

In 1986, the United States Supreme Court held in an opinion by Justice
Thurgood Marshall, that the execution of the insane was barred by the Eighth
Amendment, which prohibits cruel and unusual punishment.

Mr. Singleton's mental health began to deteriorate in 1987. He said he
believed his prison cell was possessed by demons and that a prison doctor
had implanted a device in his ear.

In December 2001, he wrote to the appeals court to inform it that he did not
believe his victim was dead and that she was "somewhere on earth waiting for
me - her groom."

Based on extensive medical evaluations describing Mr. Singleton as
psychotic, his lawyers have argued that he is mentally incompetent and thus
cannot be executed. Drugs alleviate his symptoms, however, and Judges
Wollman and Heaney differed yesterday on whether they rendered Mr. Singleton
sane or merely masked his psychosis.

The Supreme Court has held that prisoners may be forced to take
antipsychotic medications in some situations. Prisoners who are forced to
take medications to ensure that they are competent to stand trial are
entitled to a hearing to consider the medical appropriateness of the
treatment, the risk the defendant poses to himself and others, and the
drug's effect on the defendant's appearance, testimony and communications
with his lawyer.

The Supreme Court has not ruled on whether prisoners may be medicated in
order to make them competent to be executed.

Over the years, Mr. Singleton has sometimes taken antipsychotic medication
voluntarily and has sometimes been forced to take it. Arkansas officials
argued that Mr. Singleton must be medicated because he posed a danger to
himself and to others.

Mr. Singleton's lawyers responded by saying, in Judge Wollman's
characterization, that forcible medication "becomes illegal once an
execution date is set because it is no longer in his best medical
interests."

The majority decision yesterday said Mr. Singleton's interest in being free
of unwanted medication must be balanced against society's interest in
punishing criminal offenders. It overturned a ruling by a three-judge panel
of the court, which had commuted Mr. Singleton's death sentence because he
could not understand his punishment without being medicated.

Judge Heaney, in dissent, noted that the majority's decision gave doctors
hard choices.

"Needless to say," he wrote of the majority's holding, "this leaves those
doctors who are treating psychotic, condemned prisoners in an untenable
position: treating the prisoner may provide short-term relief but ultimately
result in his execution, whereas leaving him untreated will condemn him to a
world such as Singleton's, filled with disturbing delusions and
hallucinations."

Judge Heaney's opinion was joined by three other judges. Judge Diana Murphy
dissented on a different ground. She said the record was not clear on
whether Singleton was psychotic and that it was premature to take up the
case.

The American Medical Association's ethical guidelines prohibit giving
medical treatment that would make people competent to be executed, said Dr.
Howard Zonana, who teaches psychiatry and law at Yale.

"You can't treat someone for the purpose of executing them," he said.

Jeffrey Marx Rosenzweig, Mr. Singleton's lawyer, said that he was
considering asking the United States Supreme Court to hear the case, which
he said presented an important question of constitutional law.

"To what extent," he asked, "can a government take invasive, involuntary
action using medical personnel who are sworn to heal, save and treat when
the result of their medical application and experience is not healing,
treating and saving but instead has the result of causing execution?"

Kelly Kristine Hill of the Arkansas attorney general's office, who
represented the state, said the court's ruling was limited and correct.

"The ethical decisions involving doctors are difficult ones," she
acknowledged, "but they are not ones for the courts."

Oddly enough both arguments can find sufficient evidence in today's scientific findings. People who are given placebos do get better, and it is entirely because they fool themselves into it. No chemical balance was restored. However, just as many times those who have been mentally ill for several years are miraculously cured by the latest wonder drug. What then is the correct way to treat the mentally ill? Many doctors today blend a regimen of pharmaceutical and psychological therapy to help their patients achieve balance in their lives. This begs the question, what defines balance? The greatest creators of our history can all be classified as mentally ill. What Einstein's, and Mozart's have been turned into this societies definition of balances individuals? The definition changes daily.

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