OXYTOCIN
The Biology Behind the Milk of Human Kindness By NATALIE ANGIER
As the festival of mandatory gratitude looms into view, allow me to offer a few suggestions on what, exactly, you should be thankful for.
Be thankful that, on at least one occasion, your mother did not fend off your father with a pair of nunchucks, but instead allowed enough contact to facilitate your happy conception. Be thankful that when you go to buy a pale, poultrylike entity, the grocery clerk will accept your credit card in good faith and even return it with a heroic garble of your last name. Be grateful for the empathetic employee working the United Airlines ticket counter the day after Thanksgiving, who understands why you must leave town today, this very minute, lest someone pull out the family nunchucks.
Above all, be thankful for your brain’s supply of oxytocin, the small, celebrated peptide hormone that, by the looks of it, helps lubricate our every prosocial exchange, the thousands of acts of kindness, kind-of kindness and not-as-nakedly-venal-as-I-could-have-been kindness that make human society possible. Scientists have long known that the hormone plays essential physiological roles during birth and lactation, and animal studies have shown that oxytocin can influence behavior too, prompting voles to cuddle up with their mates, for example, or to clean and comfort their pups. Now a raft of new research in humans suggests that oxytocin underlies the twin emotional pillars of civilized life, our capacity to feel empathy and trust.
Reporting this month in The Proceedings of the National Academy of Sciences, researchers found that genetic differences in people’s responsiveness to the effects of oxytocin were linked to their ability to read faces, infer the emotions of others, feel distress at others’ hardship and even to identify with characters in a novel or “Doonesbury.” “I came into this research as a big skeptic,” said Sarina M. Rodrigues of Oregon State University, an author of the new report, “but the results had me floored.”
Oxytocin may also be a capitalist tool. In a series of papers that appeared in Nature, Neuron and elsewhere, Ernst Fehr, director of the Institute for Empirical Research in Economics at the University of Zurich, and his colleagues showed that the hormone had a remarkable effect on the willingness of people to trust strangers with their money. In the Nature study, 58 healthy male students were given a single nasal squirt of either oxytocin or a placebo solution and, 50 minutes later, were instructed to start playing rounds of the Trust Game with each other, using monetary units they could either invest or withhold.
The researchers found that the oxytocin-enhanced subjects were significantly more likely than the placebo players to trust their financial partners: whereas 45 percent of the oxytocin group agreed to invest the maximum amount of money possible, just 21 percent of the control group proved so amenable. Moreover, the researchers showed that the oxytocin boost didn’t simply make subjects more willing to take risks and throw their money around. When participants knew they were playing against a computer rather than a human being, there was no difference in investment strategy between the groups. Trust, it seems, is a strictly wetware affair.
Yet the hormone doesn’t turn you into a sucker. In the Nov. 1 issue of Biological Psychiatry, Simone Shamay-Tsoory of the University of Haifa and her colleagues reported that when participants in a game of chance were pitted against a player they considered arrogant, a nasal spritz of oxytocin augmented their feelings both of envy whenever the haughty one won and of schadenfreudian gloating when their opponent lost.
As a rule, though, oxytocin is a joiner not a splitter. Analogues of the molecule are found in fish, perhaps to help facilitate the delicate business of fertilization, by inhibiting a fish’s natural tendency to flee from other fish. The more elaborate grew the social demands, the more roles oxytocin assumed, reaching its apotheosis in mammals. If you’re going to give birth to a litter of needy young, why not let the same signal that helped push those mewlers into the world give you tips on their care and feeding? And if you’re a human, bent on turning everything into an extended family affair, here is oxytocin again to cheerlead and teleprompt. C. Sue Carter of the University of Illinois at Chicago, a pioneer in the study of oxytocin, suspects that the association between the hormone and childbirth long kept scientists from taking it seriously. “But now that it’s been brought into the world of economics and finance,” Dr. Carter said, “suddenly it’s very hot.”
Oxytocin acts as a hormone, traveling through the bloodstream to affect organs far from its origin in the brain, and as a kind of neurotransmitter, allowing brain cells to communicate. Unlike most neurotransmitters, oxytocin seems to deliver its signal through just one receptor, one protein designed to recognize its shape and shudder accordingly when clasped; dopamine and serotonin, by contrast, each have five or more receptors assigned to their care. Yet the precise contours of oxytocin’s hardworking receptor differ among individuals, to apparently noticeable effect.
In their new study, Dr. Rodrigues and Laura R. Saslow and Dacher Keltner of the University of California, Berkeley, looked at how two variants in the genetic code for the receptor might influence a person’s capacity for empathy, as measured by a standard empathy questionnaire (“I really get involved with the feelings of the characters in a novel”) and a behavioral task called “Reading the Mind in the Eyes.” In it, participants looked at 36 black-and-white photographs of people’s eyes and were asked to choose the word that best described each subject’s mood. Uneasy, defiant, contemplative, playful? In a related measure of oxytocin’s presumed calming effects, subjects were also tested for how strongly they reacted to the stress of hearing a series of loud noises.
In their sample of 192 male and female college students, the researchers found that those carrying the so-called A version of the oxytocin receptor, which previous reports had associated with autism and poor parenting skills, scored significantly lower on the eye-reading task and higher on the stress-prone test than did subjects with the G variant of the receptor.
“We’re all different, and that’s a good thing,” Dr. Rodrigues said. “If everyone were gooey and lovey-dovey, it would be an obnoxious world.” As she drolly admitted, she herself is Type A.
Psychiatry Today-Sad to Say
“Psychiatrists make diagnoses today the same way they did in 1840 when Abraham Lincoln was depressed, through talking to patients and looking for symptom clusters. Psychiatrists are the only medical specialists that never look at the organ they treat. Isn’t that a scam…to make diagnoses of brain dysfunction without ever looking at the brain?
No question we have a long way to go and a lot more research to do, but to continue as most psychiatrists currently practice is not only backwards it is downright hurtful to people.
Dr. Rubin’s assessment of my work misses the mark completely. I am not interested in what your brain looks like as part of a group of depressed patients. I am looking at what your own brain specifically looks like. I am looking at an N of 1, your brain. Illnesses like depression will never have a singular finding on scans because they are not a singular disease. There are many different types that need an individual approach, that is where scans help…what does your brain look like, so that I can target treatment specifically to your brain.
Thomas Insel, Director of the National Institutes for Mental Health said in 2005 at the American Psychiatric Association that “Brain imaging in clinical practice is the next major advance in psychiatry…Trial and error diagnosis will move to an era where we understand the underlying biology of mental disorders….We are going to have to use neuroimaging to begin to identify the systems pathology that is distributed in each of these disorders and think of imaging as a biomarker for mental illnesses…The DSM-IV has 100%reliability and 0% validity. We need to develop biomarkers, including brain imaging, to develop the validity of these disorders….We need to develop treatments that go after the core pathology, understood by imaging…The end game is to get to an era of individualized care.”
Dr. Insel believed in 2005 that brain imaging in clinical practice would be a reality in 5 years. I think that brain imaging in clinical practice is long overdue. You can try to kill yourself in virtually every major city in the world, and no one will look at your brain!…”
I couldn’t have said it better myself, and this is just my normal arrogance not my bipolar grandiosity. I appreciate every bit of symptom relief I am afforded however I really don’t want a guessed at diagnosis with a dire prognosis. I want to know exactly what is wrong with my brain and be able to employ the available tools to make the corrections that will allow me to have a life I cherish, one to put the HAPPY and THANKFUL in HAPPY THANKSGIVING!
Help …. How it Works
1: Psychopharmacol Bull. 2009;42(3):57-90. Links
A systematic review of augmentation strategies for patients with major depressive disorder.
Center for Health Economics and Science Policy, United BioSource Corporation, Bethesda, MD.
“Major depressive disorder (MDD) is a leading cause of disability worldwide. Clinicians need to determine the most appropriate and effective interventions for patients who do not benefit from first-line treatment. A systematic review of the literature on augmentation strategies for major depression was conducted. A total of 32 eligible studies were included in the final review. Identified augmentation strategies included lithium, thyroid hormone, buspirone, stimulant drugs (methylphenidate and modafinil), and atypical antipsychotics (olanzapine, quetiapine, aripiprazole, and risperidone). Additional studies used other augmentation strategies (yohimbine, atomoxetine, inositol, testosterone, and lamotrigine), or combinations with a second antidepressant (mianserin, mirtazapine, and desipramine). There was no evidence of clinical efficacy as measured by response in augmentation with buspirone, testosterone, methylphenidate, yohimbine, inositol, and atomoxetine. Although some studies of combined antidepressant therapy and lithium augmentation did show statistically significant clinical effects, results were inconsistent across studies. The only eligible study of thyroid augmentation was positive, though this study evaluated patients treated with tricyclic antidepressants. It is possible due to small sample sizes, that some of the trials failed to detect significant differences versus placebo because of inadequate statistical power. Adjunctive therapy with atypical antipsychotics showed higher response rates compared with antidepressant monotherapy and placebo but also had more withdrawals due to adverse events. Given ongoing concerns with the longer term tolerability and safety of the atypical antipsychotics, future research will need to investigate optimal duration of augmentation therapy in patients with major depressive disorder who do not respond to first line therapy.”
PMID: 19752841 [PubMed - in process]
And then there’s the reality to which most of us have been relegated. We don’t even get to see a doctor much less a psychiatrist. Usually some type of nurse, FNP, NP… who knows what and WHO KNOWS WHAT? Very likely, very little about mood disorders or psychiatric meds. So we probably get an SSRI and directions to return in a month. If we are not all better, which is rarely likely, we might get an increase in the dosage and directions to return in a month or two. If upon our return we are not all better were likely to just be ignored and told to come back in a month or two. So that’s somewhere between three and five months that an individual has been feeling terrible and hopeless- the fabric of their life deteriorating, jobs, relationships, goals, dreams. I wish I could tell you it’s probably going to get better right away, but probably not. On your next visit you are likely to be switch to another medication. Then if that doesn’t work, four or five weeks later, you get the next med increase. Not all better! That would put you in a category, along with 50% of patients with depressive disorders. If you’re lucky you’ll get a little lithium or you might get a thyroid panel. Of course, if you get the thyroid panel it will be more weeks before you get the augmentation, which you might not get any way because they might decide that your thyroid is fine, not understanding that your thyroid is not the point of treatment. Time slips away, months, six months, a year-and you still feel like S____. The current system creates suicide candidates.
Talking to Myself and perhaps…..
I’m back. I was thinking, well, no one ever listens to me regularly anyway so it doesn’t really matter that I did not show up to this job for a week. I did have regular appropriate flashes of guilt whenever I thought about my blog. Then, I thought I should apologize for having been away for so long. Then, I checked my comments and someone said they looked forward to reading me every day. That was a surprise, that felt good. So, I am sorry for not being consistent and I will do better.
What has been happening is, I am very busy in an extremely progressive real world way to which I’m not accustomed. I used to live a totally reactive life, simply reacting to the people and situations encroaching upon me and trying to make a living. I developed more work than I could handle and had to acquired some help, in the form of a very nice man, who does an excellent job for me. I am entirely unaccustomed to having any kind of help or support. I’m surprised at how encouraging and confidence building it is to know I’m not struggling all alone. Amazingly, step-by-step I became qualified to buy a big house, so I have been very busy looking for that house and my timing seems to be incredibly good. Interest rates are way down, prices are very depressed and the bank likes ME!
The first offer I made, last week, was turned down. Tomorrow I will know about offer number two. This is exciting and fun. My Queen of anhedonia crown could be in danger, unless my meds don’t arrive in the mail soon. I’m also currently teaching two classes for NAMI and just had a yearly State inspection for my business. At other times, under similar stressors I have been a total wreck! Something is definitely working!
More about my online medication experience. The first order I put in it didn’t go through because the bank thought it might be a fraudulent sale, and did not send money. It took two days to get the information that the sale had not been completed, so I tried again. Now, “it’s in the mail.” As soon as this batch arrives I will be ordering the next backup batch to make sure I don’t get in this position again.
Aside from having help both in the form of an employee and an excellent peer support group, here is a list of the combinations that may be working for me. Metformin of 500 mg a day (brain protective), Lithium Carbonate 750 mg a day (prevents the manic/hypomanic phase of bipolar disorder), Selegiline 30 mg a day (antidepressant, brain protective), BuSpar 20 mg a day (anti-anxiety), Chlorphenamine maleate 12 mg a day. (“ In addition to being an H-1 histamine receptor antagonist, chlorpheniramine has been shown to work as a serotonin-norepinephrine reuptake inhibitor or SNRI. [1] A similar antihistamine, brompheniramine, led to the discovery of the SSRI zimelidine. Limited clinical evidence shows that it is comparable to several antidepressant medications in its ability to inhibit the reuptake of serotonin and also norepinephrine (noradrenaline).[2] However, extensive clinical trials of its psychiatric properties in humans have not been conducted. It inhibits serotonin reuptake less than norepinephrine reuptake, [3] however the literature is not consistent in this respect (compare Hellbom (2005) with Domino (1999)). From Wikipedia, the free encyclopedia”) It’s WAY cheaper than PRISTIQUE!! I also take Vitamin D 5000 iu (brain food), Melatonin 9 mg (for sleep), Valerian Root 1350 mg (for sleep), fish oil EPA/Omega 3, 4100 mg a day (10 caps, brain food). Some of you may have read, “Help My H. P. A. Axis has Crashed”, which I wrote a couple weeks ago. I believe it and I’m taking the rehabilitation of the very seriously. I just got my Adrenal 80 mg (whole desiccated glandular concentrate) , which I will be taking two of a day and my Porcine Thyroid 130 mg , which I will also be taking two of per day. Then there is the Emotional Freedom and Healing practitioner I saw last month, my success at exercising, intermittently (swimming laps) and my aromatherapy, a mixture of rosemary and lavender oils, which may well be contributing to my current, vastly improved level of comfort. Knock on wood. Cross my fingers…
DISCLAIMER : This is what I do. I do not recommend that anyone else do it or encourage anyone else to do what I do. I am an experiment. You are welcome to watch.
Got’ta go. I told the guys we would go get ice cream at seven.
Survival Poem — Sri Chinmoy Poetry
Survival Poem
I am not dreaming
Of a hope-victory-life.
I am just dreaming
Of a hope-survival-life.
~
Yesterday my need was world-conquest.
I failed.
Today my need is my own survival.
I am failing.
Tomorrow my need will be a surrendered life.
I shall fail.
By: Sri Chinmoy
via Survival Poem — Sri Chinmoy Poetry.
Almost every day feels like a fight against that “surrendered life”. As I fight I try not to think about it, how that “surrended life” would look, dependency, poverty, SSI disability. Trapped face-to-face with the term second-class citizen, no transportation no escape. Perhaps sharing a room with someone I don’t know and have no interest in getting know-and then a succession of someones. The glance is so bleak only suicide comes to mind to comfort me. They do that-they do that all the time. That is how it has been.
Then on Monday-I started crying-because I knew everything was OK. More precisely because I felt everything was okay. For decades I lived in some state of anxiety all the time and even when inside my head, I knew everything was okay, my body and my emotions could never be convinced. We are tight, we are afraid, we are ready, it will never really be okay. Monday my brain said everything is okay and my body said yes, everything is okay and my emotional body took a deep breath and whispered yes, everything is okay. I cried tears of overwhelming relief. I think my new medication is working.
Diane