A new study by Neil Harrison and colleagues published in Biological Psychiatry suggests that a brain reward center, the striatum, may be directly affected by inflammation and that striatal change is related to the emergence of illness behaviors.
It all comes down to the reward center and dopamine, always. Vindication once again. I have these hypotheses about things and then studies come out that validate them. It happens a lot. I told a doctor years ago I had an overactive limbic system and she scoffed. And of course now research has come out that bears out that hunch, that yeah, an overactive limbic system is a thing, your amygdala freaking out is definitely a thing. Another doctor laughed when I said an fMRI would show important info about my mental illness – LAUGHED. And then of course it came out in studies that gee, fMRI is precisely the technology to use, they can see illness on an fMRI, a brain of a bipolar person is markedly, physically different in several ways than that of a “normal” person. Surprise surprise. I mean, really? Yes, of course it is. Because there’s this weird thing about mental illnesses, in that they originate in the organic brain. Not the mind, mind you. The brain, itself. As in, that grey and white thing in your noggin that inhabits the world of the physical. The meatball in meatspace. Because for all of our knowledge, some people still think that mental illness is a character flaw. And act accordingly towards those who have it. Philistines, I think they’re called.
Anyway. Normal. What a word. Normal is synonymous with average, incidentally. The norm, the average, it means the same thing, doesn’t it? Not to get into an etymological discussion, but seeing as how I do in fact have large amounts of inflammation in my blood (per my latest blood tests), more than likely due to the abscessed tooth at least in part, and from stress (which itself can cause inflammation, dontchaknow ), I am thus in possession of a deprived reward center – and my natural state is that of a deprived dopamine system anyway, so in short, besides being flat-line anhedonic, I am also a bit grouchy, so I think I can call this out, this so-called normalcy, and say, normal is that which does not stand out. (Jeebus, that was all ONE SENTENCE. Talk about RUN-ON.)
Not that standing out is such a great thing. It can be an uncomfortable thing. And this is why my blog is called Everything I Say Is Wrong, Maybe. Because sometimes I have two contradictory thoughts at the same time that try to cancel each other out, and both seem equally valid, but I choose the one side, and then the other side comes up and says, Hey, you forgot something. You could be wr-wr-wr-wrong. Caveat, schmaveat. (Yiddish Latin is now also a thing.)
Well, whatever. The important thing here is not my blather, but rather, the reward system is hijacked by inflammation. Which is why chronic pain patients, for instance, have co-morbid depression in most cases. Inflammation leads to depression, says this study. Of course, there are many other roads to depression, which is so horribly named, because people mix it up with feeling “bummed out” over something situational, like “gee, I’m so depressed my team lost the game”, when that’s not actually the same thing. But calling it depression makes it easier to think it is, that people should just pull themselves up by their bootstraps, as the saying goes.
You assume I have boots, should be the standard reply to that. It’s like Marie Antoinette all over again. No, we don’t have cake. We don’t have boots. And we don’t have that convenient ivory tower, either. Yes, we have no bananas, we just are bananas. Pass the mucuna pruriens, please. Because the D2 receptor seems to have a lot to do with that. A tiny, microscopic thing could make you crash your car into a tree on purpose! Something that you need a microscope to look at rules my life! Isn’t that amazing? So a tiny microscopic organic thingy is responsible for whether you’re happy or sad or, like me, flat-line. Thanks, D2! Let me shower you with Abilify. But not too much – tardive dyskinesia is not our friend, after all. And myoclonic jerks are not my favorite thing.
Of course, there may be co-conspirators. Let’s not heap all the blame on D2, as there are other (named) dopamine receptors, and I will say publicly that I personally feel norepinephrine is involved in the avolition part – I’m saying there is a direct cause-effect to lack of norepinephrine and lack of motivation, even though most people count motivation as a dopamine thing. Personal experience and experimentation with my norepinephrine and dopamine levels tells me otherwise.
Yeah, shrinks just fucking love me. I go in and tell them, this is what I need. Not, can you help me? They can’t help me. They can only provide a service that will make life a tolerable evil. Like the common cold, there is no cure for the sickness known as Time. But there are things that can relieve the symptoms, temporarily. Some better than others.
If you’ve made it this far through this rambling diatribe, I congratulate you. I admire your bravery and resolve. Now go do whatever you can to lower your levels of inflammation – anti-inflammatory diet is a good start, but watch out for those NSAIDs, they’ll kill your kidneys. (No one ever listens when I tell them that, and some people even get mad, like how dare I try to make sure they don’t die. So now I post unsolicited advice on my blog and if you want it you may have it, but if you don’t, luckily for you this blog post is over.)