Sunday, October 27, 2013

The Overrated and Understudied Brain

I bought a 2004 Toyota Prius this week. I call it “future car” because it starts not by turning a key, but pressing the “on” button. Despite being nearly 10 years old, this impressively engineered vehicle doubles the gas mileage of most other new cars. Looking at how it's designed, it's almost impossible not to be impressed at the sophistication – a testament to the complexity of the human brain.

But what does it say about us that the very same brain that we all admire for creating a car like the Prius is also responsible for the catastrophic problem of global warming to begin with? And why is it harder for us to praise the simplicity of an act like walking to work than it is to marvel at the invention of something that, despite improvements, still spits out greenhouse gases? 

Because, look, if some mysterious higher power were to evaluate the status of our planet and find the element most likely to cause its demise, the human brain would be at the very top of the list. In fact, it would probably be the only thing on the list. And after everything that I have gone through over the past two years and counting, I feel pretty secure in saying that our brains are both fantastically sophisticated and horribly designed to live the way we do.

Consider that for hundreds of thousands of years, humans lived and evolved in small social groups of hunter gatherers. Over this time, our brain's ability to recognize and respond emotionally to familiar faces became increasingly sophisticated and helped us forge the necessary bonds for survival. To protect us from outside threats, that same sophistication led to equally strong reactions to unfamiliar faces.

And while that was great for us in small tribal groups, it had some horrible consequences in the last few hundred years when our population and range expanded - slavery, war,  genocide...sports. In fact, I would argue the amygdala and its primal power within our reactive minds is now far more destructive than helpful.

That's not nearly the only flaw in the human brain either. A friend of mine on Facebook posted the youtube clip below that provides a biological explanation for the universal human trait of marriage.

So that's how we safeguard the brain while it matures - marriage? Not exactly a fool-proof device. Throw in an alcoholic parent, an impoverished couple, or a sexually abusive relationship and the same system required for healthy brain development turns the mind to a dangerous weapon of self-destruction and/or a threat to others. It can also lead to an unacceptable amount of suffering.

All of this and my current experience suffering from benzodiazepine withdrawal shapes one of my primary views of mental health – that our brains aren't as elegant as we think they are. It also makes me more convinced in the biological underpinnings of mental health problems and leads me to the opinion that our current mainstream approach to treating them is, so far, wholly inadequate and primitive.

It also puts me in a strange place in the current debate over psychiatric medication. My sympathies now strongly lean toward the anti-psych medication arm of the discussion but I'm perversely put off by that same crowd's insistence that mental health disorders are not problems of biology. I understand what drives their passion – mental health experts and pharmaceutical companies performed a heinous human crime insisting on a simplistic theory of chemical imbalance to justify the need for medications like SSRIs and benzodiazepines.

But as many researchers have pointed out, that shouldn't mean we throw the baby out with the bathwater. All human behavior is biology and all human behavioral problems are also biological. When I say “biological” I don't mean just our genetic makeup or anything that is a set-in-stone trait. Any true definition of the word encompasses the fact that genes can't be separated from their environment. Much of our DNA are just complicated instructions our body has for how to react to life's events. And how we react to life's events, as much as we insist differently, is not ever entirely within our control.

This belief comes from my own direct experience. The way I have felt and reacted to events put in front of me over the past 19 months is so far afield from how I wanted to react and how I knew I should feel that I either conclude that I'm suddenly astonishingly inept at basic human functioning or that changes in the biology of my brain was so much more profound than the 42 years of life coping skills I developed prior to getting off xanax. I'm just going to go with the latter on that.

We have simultaneously overrated and understudied this bloated pink contraption running the show.

So what I need from readers of this blog as I start writing about my thoughts on benzodiazepine withdrawal, the brain, and the horrific gap between knowledge of withdrawal and the depth of suffering it creates is to accept the view of the brain as a potential loaded weapon. The disruption that causes the weapon to do harm can just as easily be a traumatic life event as a pharmaceutical drug because both effect brain chemistry.

Accepting this premise shouldn't make us de-facto proponents or opponents of medication. Rather, it should light a fire under our respective asses to put far more resources into understanding brain function and environmental influences than in creating drugs to treat the maladies we so poorly understand.

Because I'm pretty sure that knowledge is going to result in a collective gasp of horror at how crude our current pharmacological approach has been.