Anxiety is the bane of millions all over the globe. It isn’t a matter of weak countenance, poor ability to control yourself or the ineffectiveness of years of psychotherapy. In truth, anxiety may be a poorly understood variant of early brain damage or, perhaps more appropriately, problems in brain development in specific regions of the brain. In other words, poor pathways to mental health.
Only now, when President Obama has specified a reboot of this to be the Decade of the Brain, (originally in the 1990s) will there be more research, but what type of research is the seminal question all of us need to more fully investigate for ourselves and the researchers may not agree. Research is built on huge, multi-million-dollar grants that uncover treatments (again, read that profitable) for disease and kickstart careers.
You can appreciate the degree of competition by reading the website, Retractionwatch.com, where the questionable deeds are described and the researchers are called out for their devious tactics in their “research.” Recently, one researcher had just short of 20 scientific papers removed because of abuse, fraud and downright lying.
Anxiety, while it is a very serious, frequently debilitating condition, isn’t really seen as a “disease” but rather a disorder. No, it’s not hair-splitting because IMHO “disease” is caused by a pathogen, while “disorder” has some other nebulous basis for its existence. Until we find a pathogen, I’ll stick with disorder, but those who collect insurance payments will loudly disagree with me.
Pharmaceutical companies have only compounded the problem by creating yet more “diseases” in the quest for profits. The latest example, of course, has to do with female incontinence. It’s a billion-dollar business now. Is alcoholism truly a “disease” or is it a condition? I agree it requires treatment, but of what type?
Another part of the problem here and elsewhere is the lack of a common, clearly delineated nosology and scientists have been very demanding in exact communication, haven’t they? Yet, they pedal along using the same old watchwords and failing to see their own bias in it. In that they share a common frailty with computer programmers who believe their code is pristine and devoid of bias, yet it is riddle with it.
Once or twice, I had an opportunity to discuss anxiety and a medication meant to treat it with a pharmaceutical representative. He had a pedestrian knowledge of the biology of anxiety, by virtue of a one-week course at the company, but couldn’t really describe the mechanism of the neurotransmitter, GABA, or his company’s med regarding it and anxiety. All he knew was that it treated it, denied any addiction and was all for consumer-driven groups to support it. And support these groups the pharmaceutical company did by creating a national consumer organization. It is now seen as a leader in the field of anxiety research.
Researchers jockey for positions at these groups’ annual meetings where they present papers on their latest efforts, but are they truly representative of the whole field of anxiety research? Of course they’re not. Only now are we getting information on papers that don’t support specific medications or approaches to treatment. Look at the current battle between cognitive therapy and depression meds.
What of early brain development and its effects on portions of the brain devoted to anxiety promotion or reduction? We know that an almond-shaped structure, the amygdala, plays a highly important role in fear production and that it may be counterbalanced by signals from other brain structures.
Researchers are now looking at early childhood development as providing the neural network necessary for anxiety’s growth or inhibition. But, can we reverse this imprinted, biological learning by therapy or drugs or is it a lifelong challenge that must be managed in other ways? Too little is known about it. We’re discovering that exercise may play a role in alleviating some forms of anxiety and depression. Can it be that simple or are there areas to which we have been blind? Is the early patterning so solidified that we can’t change it or can we? Who will be the next voice crying out in this wilderness?
Brain research isn’t something anyone should consider as an area of study without serious consequences. Examples provided by attempts to treat serious mental disorders, such as schizophrenia, have provided dramatic visuals of how off-track these approaches may be. The treatments address the overt symptoms and not the underlying process. Perhaps that is the best we can do, but do we know that definitively?
Now we’re hearing that drug and alcohol abuse may provide the fertile ground in the brain for the development of schizophrenia and that is quite interesting. Anxiety plays a major role in schizophrenia (SZ) as does depression. But aren’t persons with incipient SZ seeking solace from their mental anguish and they seek relief with alcohol and drugs?
The basis for the development of SZ , or early brain development, has been laid on the doorsteps of stress, nutrition and the list goes on with each new advocate expounding on their thinking about it.
Currently, the brain remains the final frontier even as we plan trips to Mars and colonies on that fabled planet. Continuing to treat anxiety as we do are we helping, hindering or hurting persons who experience it as a roadblock to their living a happy and productive life?
Prevention to access to medications to provide relief appears to have griped the imagination of legislators who want stiff controls over it, but is that wise? How educated are our medical professionals in this area and has addiction taken over their ability to weigh the risks and benefits?
I recall speaking to a physician treating a terminal cancer patient who was in excruciating pain. The only treatment would have been a potent mixture containing morphine and his response was, “But she’ll get addicted!” No, she’ll die without pain, doc. He, to his patient’s misfortune, had once worked in an addictions clinic and couldn’t get past that experience now in the face of intractable pain.
Important questions need to be asked and answered. Where will the money lie? Perhaps that’s the question that will determine how we view anxiety relief for the coming decade.