Biomarkers – ‘Precision Medicine’ for the Brain

From the time of the ancient Greeks, medical practitioners have searched for biomarkers for physical illnesses. Hippocrates tasted patients’ urine for sweetness (he is thought to have been the first to diagnose diabetes mellitus).  More recently, doctors relied on patients’ complaints about the severity of their chest pains in order to diagnose a heart attack. Today, they measure cardiac enzymes in the bloodstream.

Think of it this way: Cancer treatment doesn’t treat the symptoms of cancer.  You don’t want the swelling to go down or the pain to disappear; you want to get rid of the cancer.  But that’s the protocol clinicians and researchers have used for years – the cataloging of symptoms such as sadness, fatigue and loss of appetite, rather than looking for biological clues associated with the symptoms in a blood test, a brain image or a saliva sample. The focus was treating the symptoms of mental disorders, not the causes.

Neuroscience’s inroads have emboldened a small but growing number of clinicians and researchers to reject diagnostic protocols on which mental health practitioners have relied for years and instead focus on finding the biomarkers, the concrete measurements of mental illness.

There was a huge shift in the approach to diagnose and treat mental illnesses beginning in 2013, when the National Institute of Mental Health announced that the government, the largest funder of mental health research in the world, drastically shifted its priorities.  Research based solely on the Diagnostic and Statistical Manual of Mental Disorders, the chief tool of mental health professionals, would no longer be funded.  The reason was “its lack of validity.”   First published in 1952, the manual has changed over the years, but its categorization of mental illnesses was based nearly entirely on symptoms either reported by the patient or observed by the clinician.  New funding is based on the premise that mental disorders are biological disorders involving brain circuits. Research into diagnosis and treatments such as talk therapy became relegated to the bottom rung of the research ladder.

New psychiatric methods visualize the nervous system and its activities, monitoring the physiological dynamics of mental health.  Rather than targeting brain chemistry to reduce symptoms, researchers now want to focus on brain circuitry.  Their efforts have been bolstered by advances in technology and imaging that now allow scientists not only to see deeper into the brain, but also to study single brain cells to determine which circuits and neurons underlie specific mental and emotional states.

Because of this huge shift from ‘brain chemistry’ to ‘brain circuitry’ some traditional psychotherapists are evolving onto “neurotherapists,” someone who first tries to understand a patient’s brain circuitry, then combines that with both psychological and physiological information to create a treatment plan.

While traditional psychotherapists might begin sessions by asking patients about their thoughts, feelings and problems, new diagnostic protocols might have patients fill out a color-coded form that matches statements about their thoughts and feelings with the parts of the brain most likely involved. Then patients undergo a quantitative electroencephalograph, or qEEG.

The EEG is a map of the brain’s electrical activity and reflects a patient’s emotional and cognitive states. The qEEG compares that information, in real time, to a digital database of hundreds of EEGs of healthy subjects. A patient’s brain map will pulse with red or blue if it is either overactive or under-active, compared with the norm.

Patient treatment plans can include psychotherapy and medication as well as neurofeedback, a technique in which patients are trained to increase or decrease brain-wave activity in the parts of the brain related to their complaints. Another tool is transcranial magnetic stimulation, a noninvasive method of delivering pulses of energy to the head, which has been approved by the Food and Drug Administration for the treatment of depression.

A person’s mental makeup is a kind of hierarchy, with personality on top, which is created by brain states that arise from circuits firing in a certain pattern below. With psychotherapy, you tweak the brain from the top down, dealing first with a patient’s personality and temperament. But with neurofeedback, combined with qEEG, patients are tweaked his from the bottom up, identifying the brain areas involved and then retraining those circuits to fire differently, resulting in changed moods or mental outlooks.

It’s a more precise way to  and it sure beats trial and error.

Do you ever wonder where your mind went?

Have you ever pulled into the driveway and thought, “I’m home,” and then realized that you have no recollection of the drive? Or maybe it’s after you’ve hung up the phone after the conversation and thought, “what was it we agreed to?” This is how the distracted mind works, and we all have one from time to time.

As pointed out in the March/April Scientific American Mind article, “Being in the Now” by Amishi P. Jha, the opposite of a wandering mind is a mindful one. She goes on to explain how having a “focus in the present” can make us happier and healthier, and that being mindful improves our ability to pay attention and concentrate. While this sounds like an easy fix for everyone, there is far more too it.

Mindfulness is being engage in the here and now, without reacting to it or evaluating it. Just being. Jha reviews recent studies completed at the University of Pennsylvania, Harvard Medical School, and Carnegie Melon University that all demonstrate the broad application of mindfulness, and how your quality of life can be enhanced physiologically, emotionally and cognitively. Being able to direct and monitor attention can improve your performance in all aspects of your life.

The good news is, the path to becoming mindful is not as hard as you might thin. It all starts with your breath. Find a comfortable place to sit, close your eyes, and pay attention to your breathing. Follow the movement through your body. How do you breathe? Are you breathing short, choppy breaths with the air stopping in your chest? Do you feel the air push down into your abdomen and feel your stomach expand?

When you start to find your mind wandering off – and it will – come back to your breath. Focus on the breath coming in, pause, and the breath going out. Finding focus can be hard to do, but this is training you to become mindful.

An optimal breathing rate is between 4 to 7 breaths a minute. When we are talking with our family and friends, we are breathing 12 – 14 breaths a minute, as we have to, to fuel conversation. You’ve probably never thought about how you breathe. The physiological effects of an optimal breathing rate can have profound impacts on your health. Imagine a car never getting the correct mixture of gasoline and oxygen, always running at half of it;s capacity. But once the two are synched up into an optimal mixture, the car runs like it never has before. This is exactly like your body.

Becoming more mindful can enhance your life in many ways, and the first step is to master your breathing. Block out 10 minutes a day for the next two weeks for your “workout”. Feel your whole body move with your breathe, think about what is going on around you, what you hear and smell. Be receptive to all the sensations and breathe. You are on the path to becoming mindful, improving your brain and most importantly your life.

To read the full article on mindfulness, click here:

TEENS AND THE IMPORTANCE OF SLEEP

Does your teenager want to sleep all day and stay up late at night?

The first sign that your child is becoming a teenager is when they start sleeping in until 11. Most teenagers get an average of 7.5 hours of sleep per night, when to perform at an optimal level they really need 9.25 hours. This results in teenagers not filling up their “sleep tank”, affecting their moods, ability to think, perform, and react appropriately.

Teens are learning a tremendous amount of information on a daily basis. The same part of their brain that works when learning continues when teens are at sleep, repeating and rehearsing, the brain consolidates and improves on what they just learned. The lessons are effortless. What determines how well a person will perform is a good nights sleep. Having a good nights sleep is what you need to be on top of your game. Some schools have even changed to a later start time, and have noticed that students were more alert, on task, on time and attendance was up.

It is important to make sure your growing teen is getting enough sleep. Here are some easy tips to get your teen to sleep at night.

-Breathing exercises and meditation.

-Limit Caffeine intake.

-Don’t let your teen go to bed hungry.

-Include daily “Winding-down” time.

-Make the bedroom an inviting, relaxing environment.

-Maintain a regular wake up time.

For more info, on teens and sleep please watch the video below.

www.pbs.org/wgbh/pages/frontline/shows/teenbrain/view/

Bulldogs Don’t Bully

Bullying goes on everyday in all walks of life. There are different forms of bullying, be they physical, verbal, or sexual. However, all of them are demeaning and hurtful to the person on the receiving end. It occurs at school, in the work place, in the home, and even at church. It is everywhere, and the worst part is that bullying is a vicious cycle, where the victims often become bullies themselves.

Bullying can be deadly. Thirteen years ago, April 20, 1999, the tragic school shooting at Columbine High School showed us just how deadly it can be.  The death of 12 students and 1 teacher evoked a lot of debate around gun control laws, the role of violent video games, and school security.  However, it also began to shed light on bullying as a root cause of tragedies such as this one, forcing people to address the problem that the two students/gunmen responsible had been outcasts and bullied to a point of mental distress. Bullying generally can start at school.  While it is hard to imagine how one could hope to control such a widespread problem, schools are beginning to do just that. A colleague and I recently had the opportunity to tour Dallas Academy and see first hand how a school is combating bullying in the hallways and classrooms.

Leigh Richardson, Henri Braun and Dallas Academy Headmaster Jim Richardson discuss the school's bullying program.

Dallas Academy, who’s mascot is the bulldog, works with a unique group of students.  Their mission statement is to restore the promise of full academic enrichment to students with learning differences.  Learning differences often involve problems with reading and writing, and their curriculum involves two hours a day skill work on these problem subjects. And, the kids love it. We walked in and out of the classrooms as Headmaster Jim Richardson, asked the students if they were having fun, only to be answered by emphatic and sincere groupings of “yes” at every turn.  I kept waiting for that one “no” but it never came.  Jim has been there since 1983, and knows the school from the ground up. He has been involved in activity at every level. What he and his team have created there is pretty special.  As we toured the campus Henri, one of my colleagues noted how relaxed all of the students appeared.  The campus is very peaceful, with plenty of trees and natural light, and feels like a warm and nurturing place that fosters learning.

So, in this beautiful setting where everyone is having so much fun learning, why would Dallas Academy spend over a year training its teachers and administrators on an anti-bullying program?  It is an expensive and time consuming process. WHY?  It’s because those who work at the Dallas Academy appreciate the unique population of students that they have.  They understand the difficulties that these students have had in other environments, and want better for their kids.  It’s as simple as that.  They realize that even in an environment such as this, the potential for bullying still exists.  Despite all the successes and hard work, the faculty at Dallas Academy knows that the students are only human. With the help of their teachers and staff, these students who could have otherwise easily fallen into bullying have managed to rise above and make the Dallas Academy a haven and natural environment for learning and personal growth. The administrators walk their talk, and so do the students and their parents.

Please take the opportunity to learn more about their bullying program, and visit the campus on May 9th for a parent’s presentation on bullying.  For more information click here, http://www.dallas-academy.com/.

If you have a child with learning differences, or if you think that your child may be a victim of bullying, then take this opportunity to learn what you as a parent can do to help your child. You won’t be sorry if you go.  I was so inspired during my first vist, I can’t wait to go back.  The kind of example that the Dallas Academy is setting might even cause you to stop and examine your own daily practices, and ask yourself how you can better the environment in which you work and learn in.

This Guy Took Our Breath Away.

What can you do with a 49 cent jar of bubbles and a heart of gold?

Daniel Hamiel, implementing biofeedback techniques in schools all over Israel.
Touch 250,000 kids, teach them to breath properly and develop necessary coping skills to deal with everyday life situations and trauma.

Impossible?  Not at all.

I met Daniel Hamiel at a conference this year and heard his unbelievable story that was both touching, and inspiring. Daniel created a school resilience program in Israel where missile attacks, war, and natural disasters have become a fact of everyday life. This leaves children with anxiety, nightmares, fears, difficulties with school and sleeping, detachment, and social withdrawal.  With this level of trauma everywhere, how could you hope to create balance in a child’s life in that environment?

Think about all the simple things we do to create balance within our lives.  Taking time for yourself, exercising, eating right, balancing our work and family needs; as simple as it could be, it still doesn’t ensure that we do it, despite the fact that we know it works.

Not everybody in Israel has the opportunity to create this kind of balance due to the situation and environment in which they live. The country stays in a constant state of survival mode, where people are thankful for each breath they take. Breath is life.  On a brief aside, did you know that research shows a high correlation between high blood pressure and poor breathing?

Nothing is more basic than breathing. We have to do it, but we don’t understand the impact that breathing can have on our well being.  We don’t think about the physiological function that occurs, and the impact that breathing has on our heart beat.  Did you know if you slow your breathe down, you can change your heart rate?  If you change your heart rate you feel calmer.  Breath can be a powerful tool and an easy one to master.  Daniel Hamiel is teaching many people to breathe properly through a simple and readily available activity, blowing bubbles.

Bubbles, that is a flash back memory, two little boys running around blowing bubbles, fun times. We all have fond memories of blowing bubbles with our children, they cost next to nothing, and you can do it anywhere, anytime.  But I never thought about using bubbles to teach people how to breathe. Think about what happens when you slowly exhale into a ring doused with soapy solution, a big beautiful bubble emerges. You are controlling your exhalation, probably to a count of six, and you are breathing at an optimal rate.

Daniel, along with a staff of three, has been to going into the school systems and teaching these proper breathing techniques to the counselors. In turn, the counselors teach the teachers, and of course, the teachers teach the children.  The children teach the parents and their siblings.  How simple can that be?  Simple enough to work anywhere, anytime. Daniel is helping little by little to enact change and bring a small sliver of calm into a very turbulent part of the world.

We encourage you to learn more about your breathing patterns, visit www.drweil.com.  Or, place your hand on your abdomen and count as you inhale and as you exhale.  Try to get to a count of 6 to begin with, if you are full of air before you get to 6, then pause and exhale.  Aim for 6 seconds of breath in, and 6 seconds out, resulting in 5 total breaths a minute. This is the optimal amount of breath for relaxation.

Get a feel for how you breathe, and try to bring some calmness into your crazy day.

Why Can’t I Get Motivated?

I can’t tell you how many times I have been asked the question, “What part of the brain can we tap into for more motivation? Is there a spot that we can focus on?”

That is a hard question to answer, because motivation comes from within; within the mind, body, and spirit. Research shows that both motivation and attention are controlled by the prefrontal cortex, which can be thought of as the “executive center” of the brain.

The prefrontal cortex, which continues to mature into early adulthood, controls functions such as planning, decision making and the ability to delay gratification.

There is a whole chapter on ‘Attention and Motivation’ in The Dana Guide to Brain Health, a great resource for anyone looking for more information, that explains the prefrontal lobe are its role in formulating complex goals and intentions. The authors note that “this means that the human brain is capable of creating models of the world not only as it is, but as we want it to be. The human brain is able to create models of the future. This is called intentionality. But merely creating a model of the future is not enough. We must have the ability to strive to change the world as it is into the world we want it to become. This ability is called motivation. Without motivation, no life challenge of any degree of complexity can successfully be met.”

We use the frontal lobes to set our short and long term goals, as well as to prioritize and keep our attention from being distracted from our goals. There is more to motivation that just setting a goal, as everyone is not goal oriented. Different people get motivated in different ways. For some people, motivation must come through positive reinforcement, such as:

  • Killing them with kindness; showering them with support. A positive brain approach.
  • Treating them with trust and respect.
  • Creating challenges.  Getting them excited!
  • Incentives and rewards.
  • Inspiring them – make them believe in themselves.

Inspiration – stimulating our mind and emotions to a high level of feeling and activity. Many of us can be inspired by the words of great leaders. One that rings especially true for me comes from Gandhi, who said “You must be the change you wish to see in the world.” We may get inspiration from a speech we hear, a story we read, or a simple act of kindness that we see during our daily lives. Poetry moves us in different ways. Music is a powerful vehicle for motivation; just ask anyone who feels the beat of their favorite song fueling them to run that extra lap, or work just a little bit harder the next time they exercise.

For me, motivation occurs on all levels, cognitively, emotionally and spiritually. I want to share this video with you that provided the inspiration for this blog. Just watch it. Texas County Reporter: Blind Quilter It will touch you in a way you didn’t expect.

Go explore your local library, the internet, or even ask your friends and family for sources of inspiration. Find something that rings true for you personally, and use that as your own personal call to arms, as your mantra to spur you forward towards healthy behaviors. However, if you still find yourself saying “none of that works for me, no matter how hard I try” and you feel out of control, you should stop blaming yourself and start wondering. Ask yourself, could there be a medical reason? Is your brain out of balance and not working the way it needs to? Are you depressed?  These are questions that require investigation. If you think you were born that way and can’t change it, you are wrong. You can. Seek the help of a neurologist or neuropsychologist who can provide you with the tools and treatment to help you heal yourself.

You can create positive change in your life!

Cognitive Behavior Disorders Center spreads awareness to both professional athletes and everyday people on the role biofeedback and neurofeedback can play in their lives.

We were proud to participate in the 2012 Ticketstock show this past weekend.  It was great fun hanging out with all the professional athletes, getting pictures taken with old and new stars, and getting the chance to meet some genuinely interesting people from all walks of life.  The best part is that these folks aren’t looking for the magic pill, or a silver bullet to improve their performance in life. In short, they’re our kind of people.

Ticketstock 2012

Our goal in attending the show was to create awareness of biofeedback and neurofeedback, and the far-reaching impacts they can have on your life.  You may be asking what a star athlete and child have in common. Neurofeedback and biofeedback give them the tools and ability to improve their mental and physical performance.  Research shows a high level of Biofeedback’s clinical efficacy for all kinds of neurological problems that range from ADHD, anxiety, to adult headaches, chronic pain, and addiction.

At the 2010 Vancouver Olympics, it was shown how biofeedback and neurofeedback can improve the management of the body’s stress response. Various athletes were trained to self regulate their physiological states by slowing their breath and synchronizing their heart rate, putting the body in a state of recovery.  They were trained to take their brain from a calm state to a focused state, and vice versa.  These are tools that can be used in the highest levels of competition, or in everyday life.

In many ways, everyday life can be a state of competition for many of us.  We can’t seem to get our “busy brain” to calm down when we need it to.  Or, we can’t seem to come out of the fog that surrounds us every day, which stops us from doing what we need and want to do, whether it be with our families, school, or on the job.  If your brain is over activated, under activated, or both, it is neurologically imbalanced.  To put it simply, the brain can’t do its job.

“Why me?”, you might ask yourself, laying awake at night. “Why do I have to work 3 times harder than my friends, but I still can’t seem to get ahead”? Sound familiar? If you had a head injury you may have changed the wiring in the brain.  If you have a family history of the problems you are experiencing, it could be genetics.  Your brain waves can be as much a result of genetics as your height or hair color.

The good news is that you can change your psychophysiological state of being.  You can teach both the brain and autonomic nervous system (lungs and heart) to self regulate.  You can create your own balanced state.  Even better, it can happen over a few months of hard work.  We encourage each patient to do some inward reflection.  Pay attention to your breath, and rank your anxiety on a piece of paper on a scale of one to ten.  Then slow it down to 4 – 7 breathes a minute, concentrating on your breath. Then rank your anxiety level, and see how much calmer you feel.  This is just a quick example of the powerful tie between mind and body, between psychological and physiological states.  Try to find a few minutes each day to get the brain in a relaxed alert state using this exercise.  If you would like to take a step further, try www.lumosity.com for a week (for free!), and see what you can do to improve your focus or your memory.  Begin to take some simple states to improve your performance in your everyday life!

Visit our website www.cognitivebehaviordisorderscenter.com and learn more about what you can do to take control of your life, hone your mind and body, and be the best you can be.

That is our wish for all of you.

In the words of St. Augustine, “The mind commands the body and it obeys. The mind orders itself and meets resistance.”