Eternal Sunshine of The Spotless Mind
August 29, 2014 7:04 AM   Subscribe

Researchers at Harvard-affiliated McLean Hospital are reporting that xenon gas has the potential to become a treatment for post-traumatic stress disorder (PTSD) and other memory-related disorders.
posted by we are the music makers (52 comments total) 21 users marked this as a favorite
 
This is very interesting however I worry that they will pre-treat soldiers with xenon in order to enable them to be more fearless and/or ruthless prior to going into conflict. The objective should not be to make it easier to face trauma, but easier to recover from it.
posted by St. Peepsburg at 7:25 AM on August 29, 2014 [3 favorites]


This would only affect the emotional, not declarative, memory of the event, so not exactly Eternal Sunshine yet! Exciting development though.
posted by monocot at 7:27 AM on August 29, 2014 [1 favorite]


Not all PTSD is related to military service. Childhood trauma and abuse is actually probably even more common than combat related PTSD and is one of the keystone issues of abuse-related depression and mental health issues.

Unrelated, I wonder if there is any connection between how Xenon works and how nitrous oxide and other dissociatives like DXM and Ketamine work, because I've know way, way too many people with PTSD who have self-medicated with one or all three of those chemicals/drugs.

(Alcohol, cannabis and other polydrug use/abuse not withstanding, but those three dissociatves seem to have the most therapeutic yet lowest risk and abuse potential in my anecdotal experiences and observations.)
posted by loquacious at 7:33 AM on August 29, 2014 [3 favorites]


I worry that they will pre-treat soldiers with xenon in order to enable them to be more fearless and/or ruthless prior to going into conflict.

I don't think that it works that way.
posted by Halloween Jack at 7:33 AM on August 29, 2014 [3 favorites]


Xe inhibits glutamatergic N-methyl-D-aspartate (NMDA) receptors involved in learning and memory...

Interesting; glutamatergic receptors again. Is this connected in some way with the recently reported or alleged actions of Ketamine e.g. NIMH, BBC?
posted by Wordshore at 7:36 AM on August 29, 2014


>>I don't think that it works that way.

The investigators used an animal model of PTSD called fear conditioning to train rats to be afraid of environmental cues that were paired with brief foot shocks. Reactivating the fearful memory was done by exposing the rats to those same cues and measuring their freezing response as a readout of fear. “We found that a single exposure to the gas, which is known to block NMDA receptors involved in memory formation in the brain, dramatically and persistently reduced fear responses for up to two weeks. It was as though the animals no longer remembered to be afraid of those cues,” said Meloni.

It could be possible - we are naturally afraid of situations where our lives are at risk, and any cues of that risk like guns, shouting, heights, tension etc. If we huff some xenon prior to running into a battlefield, we might no longer be afraid of raining bullets or the sounds of battle or other fear-based triggers.
posted by St. Peepsburg at 7:37 AM on August 29, 2014 [4 favorites]


I don't think that it works that way.

It might work that way if a reducing the emotional impact of one action makes you feel more comfortable doing that a similar action in the future.
posted by mhoye at 7:39 AM on August 29, 2014


I'm still puzzled why an inert gas would be bioactive. This article on another effect at least brings up the question.
posted by George_Spiggott at 7:40 AM on August 29, 2014 [9 favorites]


For example, I'm going to go huff some xenon now so I don't feel bad about clicking post without previewing in the future.
posted by mhoye at 7:40 AM on August 29, 2014 [2 favorites]


I have done a good bit of reading on xenon as an anesthetic agent (see here and here for examples; may be behind paywalls for some of you). What they say in this article makes a lot of sense, and I note that they are using about 1/2 to 1/3 the concentration needed to fully anesthetise a person. Just as with xenon anesthesia the cost of the gas and lack of commercially available delivery systems are the main hurdles to using this in clinical practice. A few years ago in Europe xenon delivery systems for anesthesia were available but never adopted widely. So there is enough experience with xenon in humans (the first human experiments were done in 1951) to bring it to market relatively easily if the technical hurdles can be overcome and if the initial findings in this article are found to apply to humans.
posted by TedW at 7:41 AM on August 29, 2014 [7 favorites]


I'm still puzzled why an inert gas would be bioactive.

By virtue of its displacing other stuff.
posted by mhoye at 7:49 AM on August 29, 2014 [2 favorites]


Do you know or are you guessing? Because simply increasing the proportion of nitrogen would also displace other stuff so there's going to be more to it than that, like whether and how it's taken up in the lungs, how it interacts with cell walls, maybe forms a barrier to or fools some other metabolic process....
posted by George_Spiggott at 7:56 AM on August 29, 2014 [2 favorites]


What frustrates me about treatments like this is that as they develop if they "work" turning of fear responses to cues, the public hears this "cure" exists and it becomes yet another thing people coping with trauma are expected to provide to those around them, regardless of the side effects they may be taking onto themselves.

Because I believe that terrible environmental conditions are worth being terribly upset over, I would not want this done to me. I would care for my family member if they were hurt by their experiences rather than try to shame and pressure them into doing something like this for me.

It's not to say such types of treatments shouldn't be available for those that want them, I just think my ability to feel sorrow or horror on remembering some things, is not something I think my community should have the right to take from me. And all to often "mental health treatment" for trauma essentially is communities believing they have this kind of right to control the emotions of people in response to terrible traumas for which they deserve to have such emotions and be supported with fully in coping with.
posted by xarnop at 8:01 AM on August 29, 2014 [5 favorites]


(It was a silly question anyway -- to the extent of my limited understanding a lot of bioactivity has to do with the shapes of molecules rather than their chemistry and the subject is probably too complicated to dispose of in a forum like this.)
posted by George_Spiggott at 8:02 AM on August 29, 2014


I'm still puzzled why an inert gas would be bioactive.

By virtue of its displacing other stuff.


If it were that, helium (or neon or argon) would work just as well, wouldn't it?
posted by Etrigan at 8:05 AM on August 29, 2014


Xenon has a dufferent atomic size and mass to any other gas, and has completely different chemistry. You couldn't play soccer with a ping-pong ball.
posted by Devonian at 8:07 AM on August 29, 2014 [2 favorites]


You could if you used very small nets
posted by feckless fecal fear mongering at 8:11 AM on August 29, 2014 [9 favorites]


I mean that if it's just by means of displacing other stuff, wouldn't the effect be similar for other noble gases? You can't play soccer with a ping-pong ball, but if you're only using them for packing material (and the ping-pong balls are of a similar durability to the soccer balls), then wouldn't they work pretty much as well, if in different quantities?

I'm legitimately asking the question here, not trying to refute anyone.
posted by Etrigan at 8:11 AM on August 29, 2014


Yeah, I also wanna know why xenon in particular.
posted by aramaic at 8:17 AM on August 29, 2014


If it were that, helium (or neon or argon) would work just as well, wouldn't it?

Different sizes, different displacements, different effects.

It appears that xenon acts as a receptor antagonist, basically, it blocks a receptor from grabbing what it would normally grab, but has significantly less neurotoxicity than other NDMA receptor antagonists like N2O and ketamine.

Helium at high pressure has some anesthetic effects, and at higher pressures has anti-anethsetic effects, which is something that only comes up in humans when they're doing *very* deep diving with trimix or heliox. Argon appears to not have much effect on the human body, which isn't surprising given that that roughly 1% of our atmosphere is argon. It's been used in diving is Ar/O mixtures to try to flush out nitrogen and seems to work just like nitrogen in our bodies.

Krypton has a noted narcotic effect. Radon may have similar effects to Xenon, but because of the radioactivity it's not useful (hell, downright dangerous) as a breathing gas treatment. Radon has been used in pellets as a localized radiation source for cancer treatment.

So, my guess is simple. Xenon is just fitting into the NDMA receptor -- not really binding to it, just getting it the way. Krypton may also do so, this would explain the narcotic effects, but not as well as Xenon. Gases, by and large, diffuse into tissues quite well, so it's easy for it to get there and get in the way.

Argon, Neon, and Helium are too small, they just get shoved out the the way. Radon might have a similar effect, or might be too large and not block the receptor, but the radiation hazard makes this completely unsafe -- Radon is an alpha, beta and gamma emitter, and it would just be a very stupid idea to be breathing any significant concentration of it.
posted by eriko at 8:25 AM on August 29, 2014 [13 favorites]


You couldn't play soccer with a ping-pong ball.

Just ask Gloria Upson.
posted by George_Spiggott at 8:30 AM on August 29, 2014


This is very interesting however I worry that they will pre-treat soldiers with xenon in order to enable them to be more fearless and/or ruthless prior to going into conflict. The objective should not be to make it easier to face trauma, but easier to recover from it.

Let's assume for this that the xenon works in humans, and that there is a way to give a proper dosage in a portable device that is administered by a trained professional, and project a bit into the future.

Taking this to an extreme, creating fearless, berzerking soldiers would not last long, and would be a waste of the time and materiel needed to train those soldiers. In combat, so I have been told, fear is just as valuable to keeping you alive as your training, wits, and skills are. In some sort of lower dosage, perhaps there could be a benefit, but with all the complexities and variables, the impairment of something so essential to the basic decision making process, even at an unconscious level seems a very uncertain gamble. It would perhaps be far more useful after a battle for keeping a soldier effective after an extremely traumatic situation, but even then, how will it affect their abilities in the short and long term? It could be that this kind of treatment would only be wise to use in a PTSD situation with non-active troops in a very supervised manner.

If it could work in a pre-treatment manner, I could see possible beneficial applications for emergency personnel in a first responder to some sort of natural or man-made disaster situation, to address not only the feelings during the situation, but the psychological aftermath. However, in such situations, could the proper dosage be found that could reduce the fear but not to a degree where it impairs the person's judgement in regards to their own safety? Would such treatment become not only common as time goes on, but almost seen as required for some professions?
posted by chambers at 8:30 AM on August 29, 2014


People have been working with Xe for a while. Krypton, another noble gas, has also been studied as an anesthetic. Xenon has a wide variety of uses in the medical field. The mechanism is not clear, but the anesthetic is believed to work by competitively inhibiting NMDA receptors by binding to a glycine site on the NMDAR.

Published in Science in 1951: The anesthetic properties of xenon in animals and human beings, with additional observations on krypton.
posted by gemutlichkeit at 8:33 AM on August 29, 2014 [5 favorites]


Apart from radon - which, as eriko says, isn't something you want to huff - xenon is the biggest inert atom you can get. It won't react with anything in the body (it does have a chemistry, but elemental xenon will only react with fluorine, and then only with considerable encouragement), so it has to be something purely physical rather than chemical bonding, and that has to be connected with its size.

In general, "how does anaesthetic X work?" isn't a well-answered question, and it's closely related to the other badly understood area of "how does consciousness work?". What makes anaesthetics so intriguing, though, is that a number of them are drastically simple - yet have a profound and curiously specific action on a very complex system. Lots of research ongoing, so it's a very worthwhile area to follow even as a layman.
posted by Devonian at 8:43 AM on August 29, 2014 [3 favorites]


It's not to say such types of treatments shouldn't be available for those that want them, I just think my ability to feel sorrow or horror on remembering some things, is not something I think my community should have the right to take from me. And all to often "mental health treatment" for trauma essentially is communities believing they have this kind of right to control the emotions of people in response to terrible traumas for which they deserve to have such emotions and be supported with fully in coping with.

Let's set aside the problem that this report is entirely based on very rough animal models with a large stack of assumptions about what the animals are experiencing when they associate electric torture with additional stimuli, as well as whether this is an accurate model for human PTSD.

But there's a bit of a slippage in our language for mental illness when we equate massively dysfunctional delusional states of consciousness with entirely functional emotional ones. I'd say sorrow and horror compare to symptoms of mental illness in the same way that the giddy rush of listening to good music compares to being absolutely shitfaced on a combination of beer and pot. It's the difference between reading a story like "Tell Tale Heart" as an exercise in figurative language, vs. reading it as a list of sensations that, within those states of mind, have the same subjective reality as the wetness of water.

Sorrow and horror are reasonable reactions, ones that involve enough distance from the event to say, "that sucked." Gibbering in the corner because you've become "unstuck in time," and oh yes, getting the ants under your skin as a freebie, not so much. As Octavia Butler has a character say in Parable of the Sower, "Maybe this sharing thing is all in my head? Of course it is! and I can’t get it out. Believe me, I’d love to." Those subjective realities may be all in our heads, but we still need to deal with them.

The mistake that always gets made by someone in these discussions is confusing the performance anxiety which pushes us to rehearse a few more times with gibbering in the only safe corner, judicious caution with compulsive work hours driven by avoidance of crowded pedestrian hours, sorrow with crippling paralysis, horror at an event vs. living subjectively in the event at uncontrolled moment, understanding that things are bad vs. conviction that the only escape is suicide.

Treatment for mental illness isn't about banishing reasonable sorrow and horror, it's about muting, blunting, or coping with obsession, compulsion, and fixation. It's the obsession, compulsion, or fixation that needs to be cured, not the sorrow.
posted by CBrachyrhynchos at 8:49 AM on August 29, 2014 [13 favorites]


Wordshore: "Xe inhibits glutamatergic N-methyl-D-aspartate (NMDA) receptors involved in learning and memory...

Interesting; glutamatergic receptors again. Is this connected in some way with the recently reported or alleged actions of Ketamine e.g. NIMH, BBC?
"

I believe so, yes. NMDA is, IIRC, involved in many of the dissociatives effect (PCP, Ketamine, DXM). I wonder if Xenon affects NMDA receptors differently than these. Though it does say that Xenon is used in Anaesthesia, so it seems that whatever it is in certain anaesthetics that appear to work on NMDA (all of them?) they must have a side-effect of dealing with trauma/memories of depression/PTSD. I wasn't sure if N2O had the same mechanism, and wiki says it is a weak NMDA blocker.

I love how we find so many new things about the brain and chemical interactions and the systemic effects between everything.

It think what's interesting about Xenon is that it's a primary element, not a compound like all the previously mentioned entities. I'm not sure if this makes it an UR-NMDA antogonist, but it seems this might be an ideal compound to use to study the effects involved (Not that I oppose N20 or Ketamin *ahem*)
posted by symbioid at 8:53 AM on August 29, 2014


Sociological studies are showing more and more that individuals' exposure to trauma at a very young age leads to a number of unhealthy and maladaptive behaviors that while they help the individual survive the trauma, they do little to help the individual after the trauma has ceased.

To be able to provide children who have experienced major trauma with the ability develop new, healthy ways of dealing with the world when the trauma is removed would be amazing. Think of the foster and adopted children who would be able to find a more level emotional footing with their peers. It's not enough to find ways to make these folks safe again, but to be able to help them learn to believe they are safe, it would be invaluable.

Like it was said above, PSTD isn't just about soldiers and the long-term ramifications of trauma can be extremely devastating.

I just think my ability to feel sorrow or horror on remembering some things...
It wouldn't be about removing your ability to feel sorrow or horror, but instead it would be enabling you to reflect on those feelings without the debilitating effects of those emotions. Instead of pathologically hoarding food or pushing others away because you starved or where repeatedly harmed by a loved one, you could remember the past and still be able to function in the present.

It wouldn't take the scars away, but hopefully, it could allow the wounds to heal.
posted by teleri025 at 9:05 AM on August 29, 2014 [6 favorites]


we might no longer be afraid of raining bullets or the sounds of battle or other fear-based triggers.

That's unlikely to make someone a better soldier. If you were training suicide bombers, maybe, but "run fearlessly into a hail of bullets" is not exactly modern infantry doctrine. FWIW, at least in my experience, a lot more training time is expended keeping people from doing dumb stuff than trying to get them to do stuff they don't want to do. Being impulsive gets you hurt, even just in training.

If psychotropic drugs (aside from some stimulants, e.g. caffeine and amphetamines in some situations) conferred any sort of battlefield advantage, we'd be using them; they don't. Modern pharmacology has yet to come up with many substances that improve on being clear-headed when other people are trying to kill you.
posted by Kadin2048 at 9:09 AM on August 29, 2014


College biochem: Noble gasses generally don't form covalent or electrostatic bonds. But a fair bit of protein biochemistry involves weaker "key-lock" (van der Waals, dispersion force?) interactions dependent on the size and shape of the molecules in question. Xenon is "stickier" than other noble gasses, and possibly works as an analogue to non-polar organic groups of similar size.
posted by CBrachyrhynchos at 9:13 AM on August 29, 2014 [3 favorites]


Until 1962 nobody had ever bonded a xenon atom to anything. (Today I learned that Neil Bartlett died of a ruptured aortic aneurysm in 2008.)

I'm extremely skeptical this xenon gas does anything to the human chemical system.
posted by bukvich at 9:19 AM on August 29, 2014


As CBrachyrhynchos notes, not all (bio)chemical interactions are bonding. Bonding isn't binary anyway, it's better thought of as a range of interactions with a range of strengths, covering everything from the traditional VB covalent bond, through adduct formation, hydrogen bonding, dipole, induced-dipole and van der Waals attractions. Many important gross physical behaviours, friction, viscosity, surface tension, happen because of this wide range of possible transient "non-bonding" interactions.

Thus, it's entirely believable that xenon, a big atom,with a big, floppy electron system with lots of available orbital types, a very "soft" atom, might interact with a complex electronic environment like a receptor. That it happens to block the lock of this particular receptor is (likely) a bit of random chance, but a fortuitous one. But it's not impossible or inconceivable. It's entirely consistent with MO theory---we just need to understand the specifics.
posted by bonehead at 9:32 AM on August 29, 2014 [3 favorites]


(It was a silly question anyway)

Naw, George, it wasn't! We don't appear to know the answer to it yet, which makes it a very good question. This is still the top-cited article on "how" xenon produces anaesthesia, but here's something from 2010 that still suggests "the mechanism is unclear."

I'm extremely skeptical this xenon gas does anything to the human chemical system

But we know it does
posted by tapesonthefloor at 9:35 AM on August 29, 2014 [3 favorites]


-5.3 to -0.7 kcal/mol. (tapesonthefloor's first link)

That's an interesting number. It's weaker than an H-bond (~35 kcal/mol) but stronger than most vdW interactions.
posted by bonehead at 9:43 AM on August 29, 2014


I am thinking that what is neglected by both well-known arguments posed thus far—the argument (for psych drugs) that they could allow people to heal from trauma, and also the argument (against psych drugs) that they might enable the exploitation of soldiers—is the structural analysis of the consequence of this kind of medical technology.

Not sure if that makes any sense, but my feeling is that while the individual is important, it's also critical to be able to try and articulate/understand how these things can alter certain societal-level incentives. Will medications ultimately distract society from the social sources of mental health problems? Will these mental reset buttons cause governments to be more willing to wage their wars, because the cost of war will have changed somewhat? I think those are societally-relevant ways to state/frame the issues.
posted by polymodus at 10:01 AM on August 29, 2014 [2 favorites]


What does that energy refer to, bonehead? The full article is paywalled.

But don't all the 'non-bonding' chemical interactions rely on some degree of polarisation? Xenon is indeed a big fat atom with lots of full electron shells, but that doesn't make any of the outer shell available. Except, as noted, to fluorine under energetic conditions, where (as I understand it in fat, floppy non-scientific terms) the shielding effect of the lower shells does loosen the nucleus's grip somewhat. Once you have bonded Xe with fluorine, then other things can take over that bond - so you can have oxides formed - but you need to rip that baby apart first.

Are there conditions when the charge distribution in the outer Xe shell beomes polarised?

(and yes, I do have an unhealthy interest in noble gases. They have the best names, and glow the prettiest colours, and are a really fascinating edge case in atomic physics)
posted by Devonian at 10:01 AM on August 29, 2014 [1 favorite]


tapesonthefloor: "(It was a silly question anyway)

Naw, George, it wasn't! We don't appear to know the answer to it yet, which makes it a very good question. This is still the top-cited article on "how" xenon produces anaesthesia, but here's something from 2010 that still suggests "the mechanism is unclear."
"

I thought I've read (perhaps a link from the blue, even), that we really don't understand *how* anaesthesia works? I would imagine that this includes xenon as a noble gas as an added mystery beyond the general question of anaesthesia?
posted by symbioid at 10:17 AM on August 29, 2014


Will these mental reset buttons cause governments to be more willing to wage their wars, because the cost of war will have changed somewhat?

Depending on one's definition, humanity has had about 30 days without an active war somewhere in the world in all of recorded history. That's not consecutive, that's total. There is hardly any way that governments could get more willing to wage wars, and the prospect of PTSD isn't the thing that's stopping them.
posted by Etrigan at 10:17 AM on August 29, 2014 [1 favorite]


It's also my limited understanding that you don't want strong covalent or ionic bonds in signal/receptor systems because you want for the receptor system to be sensitive to changes in molarity. And if you hammer that signal molecule in (in the form of an bond), you'd need a claw (in the form of something else) to get it out again.

But don't all the 'non-bonding' chemical interactions rely on some degree of polarisation?

There's an attractive force between most non-polar molecules, which is why they can have a liquid or solid phase. You can increase that force by increasing surface area, which is (to my understanding) is how enzymes, receptors, and a great deal of protein folding works.
posted by CBrachyrhynchos at 10:29 AM on August 29, 2014


The effects here don't result from blocking fear responses. They result from the delinking of previously-learned associative fear responses. It's a kind of unlearning.

Pair a given stimulus (tone) with pain (shock) repeatedly and the rat learns to associate the two. Once this association has been made, one may elicit a fear response (freezing) simply by playing the tone, even when no shock occurs.

Evidence suggests that fear-related memories are, in a sense, relearned each time they are recalled. Thus, the theory goes, if you inhibit learning mechanisms in the brain while eliciting a fear response, the relearning will be unable to occur and the association between stimulus and pain will grow weaker. Thus, the rat will be less likely to show a fear response in the future after hearing the tone.

The experiment involves a very simple, specific association. I don't think the effect would generalize to broad contextual types of stimuli such as one might encounter in a war zone. Even assuming it did, there's nothing to stop a desensitized soldier from rapidly relearning fear responses once they've been deployed.

It's also my limited understanding that you don't want strong covalent or ionic bonds in signal/receptor systems

This is generally true. There are a handful of drugs that bind irreversibly to their target (aspirin being a common example), but these tend to be the exception. Binding covalently to an active site is something like throwing a wrench in the cellular machinery. Good for antibiotics and pesticides, not so good for human systems.
posted by dephlogisticated at 10:42 AM on August 29, 2014 [1 favorite]


Aha - thanks, CBrachyrhynchos. that last comment led me to London dispersal forces, about which I did not know and which certainly provide one possible interactive mechanism for xenon and A N Otherstuff. Although they are quite weird, and I'll need to think about them a bit, they do seem to be particularly plausible for big atoms.
posted by Devonian at 10:43 AM on August 29, 2014


Xenon is a very weak reducer (electron donor), so it needs a very electronegative partner to form a bond, like fluorine (or an adduct like gold). Xe can also form somewhat unusual multi-centre bonds, but that's not what is happening here.

What's described above is fully understable as a van der Waals interaction, which xenon does reasonably well. It can articipate in both dipole-induced dipole (Debye forces) and induced dipole/induced dipole (London forces) interactions. Both are likely important here.
posted by bonehead at 10:44 AM on August 29, 2014


Will medications ultimately distract society from the social sources of mental health problems? Will these mental reset buttons cause governments to be more willing to wage their wars, because the cost of war will have changed somewhat?

To me, that's rather like saying we shouldn't have anti-inflammatory drugs rather than change the nature of work. It's an interesting conversation to have (I just read an excerpt of Afterparty that goes there). But I'm reluctant to go caveman science fiction on a hypothesis that hasn't gone beyond animal models. Currently there's more hope for VR as a treatment method than xenon. But that's not a magic bullet either.

I have plenty of other reasons for being fundamentally opposed to military adventurism, abuse, and sexual violence. A cure for PTSD doesn't make them less wrong in my opinion.
posted by CBrachyrhynchos at 11:51 AM on August 29, 2014


How noble.
posted by sexyrobot at 1:09 PM on August 29, 2014


Although xenon is a noble element, having a complete outer shell of electrons, it is not completely inert. It forms a number of compounds, notably halides and oxides, such as xenon hexafluoride, xenon difluoride, and xenon trioxide among others. Its reactivity may in part explain its effects here.
posted by haiku warrior at 1:27 PM on August 29, 2014


"Treatment for mental illness isn't about banishing reasonable sorrow and horror." I have found that while this is the claim, my experience dealing with mental health professionals, their diagnostics, their lagnuage and teaching in classes, and what my friends and acquaintances have dealt with seeking mental health care is that this is really not as often true as we would like to think.

To me, being totally debilited after trauma strikes me as totally reasonable. It's that we don't want to feed, house, and care for those who are mourning and need extra care, that we seek solutions like erasing their fear memories or chemically restraining them so that they are easier to deal with.

It's interesting you speak about how our current mental health system is supposed to help foster youth and adoptees, who are frequently pummeled with meds they don't want to be on, and whose outcomes are not actually improved by this strategy.

It can in many ways interfere with the process of mourning real trauma and pain, and yeah rocking back and forth and moaning or wanting to rip your fucking hair out are totally normal responses to horrible abuse and trauma.

I'm not saying people who want something to ease the pain shouldn't have access to it, but frequently these kids don't even want to to be knocked out of their gourds with these meds. They deserve better than this and it's totally a failure on us to be wiling to provide the level of care their need to more extremely painful difficulties in a supportive environment without requiring their emotions be numbed for the convenience of people around them who don't want to see it.

We deserve to have our pain seen even if it's inconvenient. Being witnessed and supported is a meaningful part in healing and in growing as a person, processing what happened, what variables were involved in why it happened and growing new strengths to stop those things happening to others or ourselves in the future, or present.
posted by xarnop at 1:56 PM on August 29, 2014 [4 favorites]


xarnop: It's interested you speak about how our current mental health system is supposed to help foster youth and adoptees, who are frequently pummeled with meds they don't want to be on, and whose outcomes are not actually improved by this strategy.

I don't know why it would be interested in speech that I did not express. I don't know if it would even be capable of interest since you didn't say what it might be. Is it an animal, vegetable, or mineral?

Now if you are asking me for clarification rather than trying to dictate two sides of a debate and attributing one to me, I'd say that my "strategy" is to give the full range of treatment options, support, control, and choice to individuals that need them.

That includes the choice to define our suffering as something alien: "It's merciless. All it wants is to get you in a room alone and kill you." (Harvey Fierstein)

It can in many ways interfere with the process of mourning real trauma and pain, and yeah rocking back and forth and moaning or wanting to rip your fucking hair out are totally normal responses to horrible abuse and trauma.

I'd say from doing deep mourning (in response to the death of my grandparents) and experiencing full-on crazy (in response to a utility bill, I'm not remotely kidding) that the two are not comparable and really shouldn't be equated. And yes, I will agree that the terrain between the two has been aggressively smudged by marketing forces. It still doesn't put the honest and the delusional at the same end of the field.

Letting that crazy go untreated can be just as bad for dealing with grief as over-medication. Here's where I pull out the "woo." I can't do ancestor reverence while I'm compulsively grinding. The beast is a monomania that doesn't allow space for any other emotion. If anything, it makes me long for the days of spirit possession when it was recognized that some states of mind are disruptively alien. No, I don't want a kleenex and quality time alone to wallow in my own reek with the beast. I want a big newspaper and a choker collar on it. It's been 30 years and we're still working on housebreaking. It threatens to kill me on a regular basis, but I'm still working on it.

I'm not saying people who want something to ease the pain shouldn't have access to it,...

I'd say that a half-sentence of disclaimer doesn't mean much of anything compared to an entire post describing medical treatment as unnecessary, not authentically human, and ridiculously hyperbolic in effect. Not to mention making medical treatment the enemy of support systems.

I live in a culture that habitually abuses caffeine to facilitate work and alcohol to facilitate social interactions. A stigma against my use of milder psychotropics that blunt, but do not eliminate, irrational panic over ridiculously trivial problems strikes me as absurd.
posted by CBrachyrhynchos at 3:16 PM on August 29, 2014 [2 favorites]


If I was having those experiences under the influence of a recreational drug, (for example, delirium tremens), no doubt I'd have an intervention of people saying, "Hey CB. You have a drinking/drug problem. Let me help you dry out." And if I had those experiences while high, I'd agree with them.

But having those experiences while clean, well, there's a lot of work put into romanticizing them as something other than a problem.
posted by CBrachyrhynchos at 4:27 PM on August 29, 2014


Depending on one's definition, humanity has had about 30 days without an active war somewhere in the world in all of recorded history. That's not consecutive, that's total.

But structural analysis is more complex than this. "Number of global war-free days" is already fallacious logic, I think for obvious reasons if one carefully thinks about it.

There is hardly any way that governments could get more willing to wage wars, and the prospect of PTSD isn't the thing that's stopping them.

I can think of two different counterarguments to this line of thinking.
posted by polymodus at 5:10 PM on August 29, 2014


Make that three…
posted by polymodus at 5:16 PM on August 29, 2014


My interpretation of xarnop's argument (and I could be wrong) is that if these treatments are seen to work in whatever way for some people then there's an increased expectation that everybody with trauma a.) recieve these treatments and b.) "get over it." You know, whether or not that's what they want/need/are ready to do.

frequently these kids don't even want to to be knocked out of their gourds with these meds

requiring their emotions be numbed for the convenience of people around them who don't want to see it.

Now I have personal experience with NMDA antagonists and their effect on depression and anxiety if not PTSD - not in a "real" medical context but used with the intention to explore their therapeutic value - so I don't feel at all that this is what they do. But I don't know anyone who has taken antipsychotics or mood stabilizers who hasn't felt that way at some point so it's not that weird to be concerned.
posted by atoxyl at 10:11 PM on August 29, 2014


I think that's an awfully slippery slope for a paper that's apparently about mice, electrodes, and xenon. This is the kind of treatment that strikes me as like gene therapy: radically disruptive in theory, but always about a decade away in practice.

Every treatment on the table has been abused at some point in the last century. I don't think people should be coerced into any of them. Talk therapies have been almost as destructive as surgery. Telling people to rough it out with "it gets better" has its own risks.

But where this discussion goes all pear-shaped in my opinion is focusing on the trauma rather than the uncontrollable obsession, compulsion, and/or fixation which, in my experience, are what separate a disorder from grief, trauma, stress, horror, or anger. Maybe, just maybe, the beast is an opportunist that grows from whatever trauma or trigger it can sink its claws into. But I'm profoundly convinced that it is something different.
posted by CBrachyrhynchos at 1:28 AM on August 30, 2014 [1 favorite]


If this really ends up working, then that would be something.

Yet I am disturbed that part of the experiment was administering shocks to rats. That seems awful.
posted by kinetic at 8:19 AM on August 30, 2014 [1 favorite]


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