Trump: Insomniac in chief?

Donald Trump is known for his lack of sleep (tweeting in the small hours of the morning). Problem is he's got a growing nation of insomniacs, frightened awake at his erratic, upsetting behavior. What is sleep and why do we need it to maintain health? This article from the Dana Foundation gives an overview. Learn about brain essentials in our book, Healing the Brain.

A good deal of progress has been made recently in understanding why sleep is so important. Recent studies have shown that both acute sleep deprivation (staying awake all night) and chronic sleep restriction (sleeping only a few hours/night for 1-2 weeks) impair many cognitive functions, from vigilance and attention to speech and humor appreciation. 

We also know that it may take more than one or two days to recover after chronic sleep loss, so oversleeping during the week-end may not be enough, if the accumulated sleep debt is large. There is also strong evidence that sleep need varies significantly among individuals, although why some of us can function well with much less sleep than others remains unclear. Other studies show that a night of sleep benefits the acquisition of new information the next day (new learning during sleep, instead, remains largely a dream). 

Sleep also leads to the consolidation and integration of memories, both declarative memories - those one can recollect consciously, such as lists of words or associations between pictures and places, as well as non-declarative memories such as perceptual and motor skills. These experimental results fit the common observation that after intensive learning, say practicing a piece over and over on the guitar, performance often becomes fluid only after a night of sleep. It is likely that when we learn and repeatedly activate certain brain circuits, many synapses end up strengthening, not only when you play the right notes well, but also when you do it badly, or fumble other notes. The result is that, while by practicing you get better and better on average, your performance remains a bit noisy and variable. 

After sleep, it is as if the core of what you learned had been preserved, whereas the chaff is eliminated - that is, sleep seems to notch-up the signal-to-noise ratio. Something similar may happen also with declarative memories: in the face of the hundreds of thousands of scenes we encounter in waking life, memory is particularly effective at gist extraction, where the details (the noise) may be lost, but the main point of what happened to us (the signal) is preserved. So far, it seems that the memory benefits of sleep, especially for declarative memories, are due primarily to NREM sleep, but in some instances REM sleep or a combination of NREM-REM cycles may also play a role. One should not forget that memories can also consolidate during wake. Moreover, to some extent sleep helps memory consolidation simply because it reduces the interference caused by later memory traces.

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Carolina Panthers' player cries after concussion; Crowd, media gasps

In a recent NFL game against New Orleans, Carolina Panthers star player Luke Kuechly suffered a concussion. According to reactions by fans in attendance and media, they were questioning Kuechly's manhood. Notably, one year ago, Chris Borland of the San Francisco 49ers walked away from a lucrative contract because he saw the large risk of permanent brain damage from continued football head trauma. In Healing the Brain, we look at concussions. Here is an excerpt:

Understanding Concussions and CTE

MontanaPrepFootball.wordpress.com Public attention has focused on the vulnerabilities of young football players to head injuries.

It is fairly remarkable that “Concussion,” the movie, exists. Ten years ago, the public did not know much about concussions and other forms of brain trauma. People weren’t watching football games and thinking about the long-term neurological effects of the brutal body contact. A veil was lifted on a topic rarely discussed as more and more football players reported disturbing neurological symptoms after their careers had ended. A disturbing series of suicides were reported. Around 2009, the National Football League (NFL) started getting criticism for its outdated concussion policies. In 2013, a book and corresponding documentary that tackled the issue, “League of Denial,” were released. At the end of 2015, Hollywood brought us a major motion picture that stars Will Smith as a neuropathologist fighting to reveal the truth about head trauma in football players.

Parents around America began to reconsider their willingness to allow their children to play the sport, one that plays a major role in the sports and cultural life of the country.

A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells and creating chemical changes in the brain.

Concussions Are Serious

Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious.

Chronic traumatic encephalopathy (CTE) is the term used to describe brain degeneration likely caused by repeated head traumas. CTE is a diagnosis only made at autopsy by studying sections of the brain.

CTE is a very rare condition. It has been found in the brains of people who played contact sports, such as football, as well as others. Some symptoms of CTE are thought to include difficulties with thinking (cognition), physical problems, emotions and other behaviors.

The condition is a very controversial condition that is still not well-understood. Researchers do not yet know the frequency of CTE in the population and do not understand the causes. There is no cure for CTE.

Some of the possible signs and symptoms of CTE may include: difficulty thinking (cognitive impairment), impulsive behavior, depression or apathy, short-term memory loss, difficulty planning and carrying out tasks (executive function), emotional instability, substance abuse, and suicidal thoughts or behavior

Other suspected symptoms may include: irritability, aggression, speech and language difficulties, motor impairment, such as difficulty walking, tremor, loss of muscle  movement, weakness or rigidity, trouble swallowing (dysphagia), vision and focusing problems, trouble with sense of smell (olfactory abnormalities), and dementia

The full list of symptoms of people with CTE at autopsy is still unknown. It is unclear what kind of symptoms, if any, it may cause. Little is known right now about how CTE progresses.

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Trump Watch: Swatiskas, Slurs, Hate Epic Rise in Our Schools

The Southern Poverty Law Center has documented an alarming rise in hate crimes and language in our schools post-Trump. These incidents appear in The Trump Effect, just published by the SPLC. Read them and support A Thousand Moms' new publishing effort, Healing the Brain.

“Since the election, every single secondary school in our district has had issues with racist, xenophobic or misogynistic comments cropping up. In the week since the election, I have personally had to deal with the following issues: 1) Boys inappropriately grabbing and touching girls, even after they said no (this never happened until after the election); 2) White students telling their friends who are Hispanic or of color that their parents are going to be deported and that they would be thrown out of school; 3) White students going up to students of color who are total strangers and hurling racial remarks at them, such as, ‘Trump is going [to] throw you back over the wall, you know?’ or ‘We can’t wait until you and the other brownies are gone’; 4) The use of the n-word by white students in my class and in the hallway. Never directed towards a student of color (that I’ve been told yet), but still being casually used in conversation.” — MIDDLE SCHOOL TEACHER, INDIANA

“The slurs have been written on assignments. ‘Send the Muslims back because they are responsible for 9/11.’” — HIGH SCHOOL TEACHER, MINNESOTA

"’I hate Muslims.’ (Student blurted this while the class was learning about major religions.)” — MIDDLE SCHOOL TEACHER, WASHINGTON

“I’ve had a lot of students repeat the phrase ‘Trump that bitch’ in my class, and make jokes about Hispanic students ‘going back to Mexico.’” — HIGH SCHOOL TEACHER, GEORGIA

“A proud proclamation of racism was made by a student after the election: ‘Bet those black people are really scared now.’” — HIGH SCHOOL TEACHER, MICHIGAN

“White males have been overheard saying, ‘screw women’s rights, fag lover liberal, build the wall, lock her up.’ The rebel flag is draped on the truck of a popular student, and the p-word has been used very casually, citing Trump as the excuse.” — HIGH SCHOOL TEACHER, MICHIGAN

“Kids saying, ‘Trump won, you’re going back to Mexico!’ Boys grabbing girls, cornering girls against lockers. Kids yelling, ‘Trump won, so [there will] be less people here soon.’” — HIGH SCHOOL TEACHER, KANSAS

“Today I photographed vandalism in the boy’s bathroom that mentioned a specific black student (1 of 7 in a school of 200). It repeatedly mentioned the KKK, used the n-word and joining Jews. A student drew a swastika on my board a few days ago. A black female ran out of a room crying after being racially harassed by multiple students during two different classes. One student … reported asking two different Latina students if they were ready to move back to Mexico now that Trump is president. I have witnessed an increase in racist and sexist jokes by students who support Trump. I personally spent most of the day putting out fires related to these issues, including documenting and reporting them. Multiple white males also expressed anger over the school wanting to post signs stating we are a sanctuary school.” — HIGH SCHOOL TEACHER, OREGON

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Schools Post-Trump: Slurs, Trauma, and Tension

The Southern Poverty Law Center has conducted an extensive survey of school tensions and climates after the election of Trump. Find out how stress and trauma impedes learning and leaves emotional scars in Healing the Brain, our new book.

In the first days after the 2016 presidential election, the Southern Poverty Law Center’s Teaching Tolerance project administered an online survey to K–12 educators from across the country. Over 10,000 teachers, counselors, administrators and others who work in schools have responded. The survey data indicate that the results of the election are having a profoundly negative impact on schools and students.

Schools In The Aftermath: Targeting, Trauma, and Tension

The election of Donald Trump is having a major impact on American schools, but how students are affected — and how educators are addressing the impact — depends largely on demographics. American schools are increasingly segregated along racial, ethnic and economic lines. Although individual experiences will vary, looking at the proportion of students who are African American, Hispanic and white is a generally dependable indicator of what each school is experiencing, regardless of whether it is located in a red or a blue state. We found that how a school reacted ultimately depended on whether it is a white-majority school, a "minority-majority" school, or a diverse school with no single group in the majority. This is a generalization, of course, and there are exceptions, which we discuss later.
Overall, our public schools serve mainly low-income students of color. But students are not evenly distributed among schools. Here are a few important facts:

• Total number of public schools: 98,454
  
• Percentage of students who are from low-income families: 51
  
• Percentage of students who are Hispanic: 25
  
• Percentage of students who are African American: 16
  
• Percentage of students who are students of color: 50
  
• Percentage of schools that are 70% or more minority: 26
  
• Percentage of schools that are 70% or more white: 42
  
• Percentage of schools with less than 70% of one racial group: 32
  

TARGETING AND RACIAL BIAS
The increase in targeting and harassment that began in the spring has, according to the teachers we surveyed, skyrocketed. It was most frequently reported by educators in schools with a majority of white students.
The behavior is directed against immigrants, Muslims, girls, LGBT students, kids with disabilities and anyone who was on the “wrong” side of the election. It ranges from frightening displays of white power to remarks that are passed off as “jokes.”
Here’s a small sampling of the thousands of stories teachers told us that illustrate post-election targeting.
“A group of white students held up a Confederate flag during the pledge of allegiance at a school-wide assembly.” — HIGH SCHOOL COUNSELOR, ARIZONA
“Since the election, every single secondary school in our district has had issues with racist, xenophobic or misogynistic comments cropping up. In the week since the election, I have personally had to deal with the following issues: 1) Boys inappropriately grabbing and touching girls, even after they said no (this never happened until after the election); 2) White students telling their friends who are Hispanic or of color that their parents are going to be deported and that they would be thrown out of school; 3) White students going up to students of color who are total strangers and hurling racial remarks at them, such as, ‘Trump is going [to] throw you back over the wall, you know?’ or ‘We can’t wait until you and the other brownies are gone’; 4) The use of the n-word by white students in my class and in the hallway. Never directed towards a student of color (that I’ve been told yet), but still being casually used in conversation.” — MIDDLE SCHOOL TEACHER, INDIANA
“The slurs have been written on assignments. ‘Send the Muslims back because they are responsible for 9/11.’” — HIGH SCHOOL TEACHER, MINNESOTA
“’I hate Muslims.’ (Student blurted this while the class was learning about major religions.)” — MIDDLE SCHOOL TEACHER, WASHINGTON

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Ecstasy (Molly) for PTSD?

From the New York times comes news of possible use of Ecstasy for Post-Traumatic Stress Disorder, PTSD. In our new book, Healing the Brain, we take a close look at PTSD, what it is and how it affects people of all ages. 

F.D.A. Agrees to New Trials for Ecstasy as Relief for PTSD Patients

By DAVE PHILIPPS NOV. 29, 2016

C.J. Hardin, a veteran who served three tours in Iraq and Afghanistan, at a memorial in North Charleston, S.C. He is a patient in the study of MDMA, also known as Ecstasy, as a treatment for post-traumatic stress disorder. Credit Travis Dove for The New York Times

CHARLESTON, S.C. — After three tours in Iraq and Afghanistan, C. J. Hardin wound up hiding from the world in a backwoods cabin in North Carolina. Divorced, alcoholic and at times suicidal, he had tried almost all the accepted treatments for post-traumatic stress disorder: psychotherapy, group therapy and nearly a dozen different medications.

“Nothing worked for me, so I put aside the idea that I could get better,” said Mr. Hardin, 37. “I just pretty much became a hermit in my cabin and never went out.”

Then, in 2013, he joined a small drug trial testing whether PTSD could be treated with MDMA, the illegal party drug better known as Ecstasy.

“It changed my life,” he said in a recent interview in the bright, airy living room of the suburban ranch house here, where he now lives while going to college and working as an airplane mechanic. “It allowed me to see my trauma without fear or hesitation and finally process things and move forward.”

 

Based on promising results like Mr. Hardin’s, the Food and Drug Administration gave permission Tuesday for large-scale, Phase 3 clinical trials of the drug — a final step before the possible approval of Ecstasy as a prescription drug.

If successful, the trials could turn an illicit street substance into a potent treatment for PTSD.

Through a spokeswoman, the F.D.A. declined to comment, citing regulations that prohibit disclosing information about drugs that are being developed.

“I’m cautious but hopeful,” said Dr. Charles R. Marmar, the head of psychiatry at New York University’s Langone School of Medicine, a leading PTSD researcher who was not involved in the study. “If they can keep getting good results, it will be of great use. PTSD can be very hard to treat. Our best therapies right now don’t help 30 to 40 percent of people. So we need more options.”

But he expressed concern about the potential for abuse. “It’s a feel-good drug, and we know people are prone to abuse it,” he said. “Prolonged use can lead to serious damage to the brain.”

The Multidisciplinary Association for Psychedelic Studies, a small nonprofit created in 1985 to advocate the legal medical use of MDMA, LSD, marijuana and other banned drugs, sponsored six Phase 2 studies treating a total of 130 PTSD patients with the stimulant. It will also fund the Phase 3 research, which will include at least 230 patients...

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Should kids play football? No.

In this excerpt from the Dana Foundation's blog post by Dr. Guy McKhann, he looks at the choice faced by parents regarding letting their kids play football. We cover this topic in our new book, Healing the Brain.


“Don’t Let Kids Play Football” is the title of a New York Times OpEd column by Bennet Omalu. Dr. Omalu gets credit for being the first to recognize the distinctive neuropathology associated with repeated head injuries in an NFL player. Omalu was on call when an autopsy was needed for former Pittsburgh Steeler Mike Webster.

Not being a football fan, Omalu was one of the few adult males in Pittsburgh unfamiliar with Webster, a star center for 17 seasons. Some time after Webster’s retirement in 1990, he gradually began to deteriorate mentally, first with depression and paranoia, then gradual loss of cognition, so that at the time of his death, he was essentially demented. Because of his football notoriety, his troubles were documented in the local newspapers.

Omalu realized that he was seeing a very unique pathology. The gross brain appeared normal, but when he cut into it and made stained sections, he noted the marked accumulation of the protein tau. Tau, in the form of tangles, is one of the hallmarks of Alzheimer’s disease, as is the accumulation of another protein, beta amyloid, in the form of plaques. In Webster’s brain there were very few amyloid-containing plaques and the tau accumulation was in a different distribution than what one would see with Alzheimer’s. Omalu and his colleagues published two papers in the journal Neurosurgery: one on Webster and another on fellow Steeler Terry Long. They described their findings, suggesting that repeated head injuries might be associated with this pathology. All hell broke loose. The NFL powers that be were not happy that their sport might be associated with brain damage. Several physicians involved with NFL teams wrote the journal asking that the papers be withdrawn. (Withdrawing a paper rarely happens, and is done when there is clear misconduct such as fraud). The papers were not withdrawn.

Deciding that challenging the powerful NFL was an impossible task, Omalu left Pittsburgh and became a medical examiner in California, out of the limelight. However, Dr. Ann McKee, a well-regarded neuropathologist in Boston, picked up the slack and let the world know she and her colleagues were available to do the neuropathology on athletes, and military personnel, with head injuries. She was joined by a neurosurgeon, Robert Cantu, and Chris Nowinski, a former Harvard football player and professional wrestler, who became concerned about his own history of head injuries. Chris has become the liaison between the Boston investigators and the athletic world, active in obtaining permission and access for the Boston group to do autopsies.

As of September 2015, they’ve analyzed the brains of 91 former NFL players and found the distinctive pathology in 87 (96 percent).

The clinical course in the others is much like that of Mike Webster: exposure to a series of head injuries over years, a period of normal functioning after retirement, and gradual decline in cognitive functions. What’s going on in these brains? We really don’t know. However, one possibility is that the accumulation of tau is initiated by head trauma. Even after the trauma stops, the accumulation continues until tau reaches a level that is toxic to nerve cells. This process may take years and might be exacerbated by the person’s use of alcohol or drugs.

So should kids play football? I have nine grandchildren. My youngest, twin seven-year-old boys, are into gymnastics and swimming, so they’re not at risk of head injuries (though they enjoy pummeling each other). The others are into soccer, lacrosse, mountain climbing, and cross country skiing. What would I tell them? I think that there is a lot of hand-waving about the susceptibility of the developing brain. In some instances the younger brain is more resistant to injury. An eight-year-old can survive and make a remarkable recovery from a stroke, while a similar stroke in an 80-year-old would be devastating. However a diffuse injury (one that is spread more widely), associated with a head injury, may have effects on brain development.
I don’t know where to draw the line regarding age. I suggest that prior to age 18 kids play less violent forms of football, like touch or flag football, to significantly reduce the chance of head injury.

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Was Nancy Reagan right?

Nancy Reagan championed her "Just Say No" program in the '80s, drawing praise and criticism. In one way she was right. For an addicted brain, saying no is incredibly difficult. However, for a non-addicted brain, saying no may be the only effective prevention option. Read this excerpt from Healing the Brain.

III. PREVENTING DRUG ABUSE: THE BEST STRATEGY

Why is adolescence a critical time for preventing drug addiction?

As noted previously, early use of drugs increases a person’s chances of developing addiction. Remember, drugs change brains—and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks. If we can prevent young people from experimenting with drugs, we can prevent drug addiction.

Wikimedia Commons

In high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used.

Risk of drug abuse increases greatly during times of transition. For an adult, a divorce or loss of a job may lead to drug abuse; for a teenager, risky times include moving or changing schools. In early adolescence, when children advance from elementary through middle school, they face new and challenging social and academic situations. Often during this period, children are exposed to abusable substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used.

At the same time, many behaviors that are a normal aspect of their development, such as the desire to try new things or take greater risks, may increase teen tendencies to experiment with drugs. Some teens may give in to the urging of drug-using friends to share the experience with them. Others may think that taking drugs (such as steroids) will improve their appearance or their athletic performance or that abusing substances such as alcohol or MDMA (ecstasy or “Molly”) will ease their anxiety in social situations. A growing number of teens are abusing prescription ADHD stimulants such as Adderall® to help them study or lose weight. Teens’ still-developing judgment and decision-making skills may limit their ability to accurately assess the risks of all of these forms of drug use. Using abusable substances at this age can disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control.  So, it is not surprising that teens who use alcohol and other drugs often have family and social problems, poor academic performance, health-related problems (including mental health), and involvement with the juvenile justice system.

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