Wednesday, July 3, 2024

By Courtney Wise

Greetings, MindSite News Readers! In today’s Daily, military families and researchers are trying to spread the word about fatal brain damage affecting soldiers – despite poor communication in the brass. Premenstrual dysphoric disorder, or PMDD, is more than a little irritability and anxiety during one’s menstrual cycle. Plus, can relationships with chatbots be healthy substitutes for human relationships?

Many Navy SEALs paying a steep price for their service: brain damage, leading to suicides

Ten years ago, retired Chief Petty Officer David Collins returned some library books, paid his son’s kindergarten tuition, and then drove to a secluded side street and shot himself. His wife, Jennifer Collins, has been on a mission ever since to help other families avoid the same horror.

Mr. Collins was a retired Navy SEAL, a highly organized and respected soldier, who was never injured in combat.

But, the New York Times reports, his exposure to blast waves during training likely led to his demise. In the years since her husband’s death, Mrs Collins has committed her time to meeting with families whose loved ones died in the same way, pleading with them to donate their beloveds’ brains to science. 

“I told the police — I was adamant — that I wanted his brain donated to research,” Collins said. “I wanted to try to find some answers.” Mr. Collins had tried to find those answers for years before his death. He even got his brain scanned, but doctors saw nothing abnormal. Instead, they diagnosed him with depression, anxiety and post-traumatic stress disorder, and gave him prescriptions for pills to improve his sleep and mood. Nothing worked, Mrs. Collins said. “He was super anxious, almost paranoid,” she said. “He was nothing like my husband.” 

In fact, his brain was severely damaged. Much like the brains of a half dozen other Navy SEALS who died by suicide, Collins was suffering from something called interface astroglial scarring. It’s identified by scar tissue everywhere tissues of different density or stiffness meet in the brain and is distinct from chronic traumatic encephalopathy, associated with football players and others who have been regularly hit in the head. In two other SEALS who ended their lives, researchers found severely damaged astrocytes, or helper cells in the brain that had been repeatedly injured to the point they barely functioned.

Studies suggest the damage occurs when energy waves coursing through the brain reverberate off of brain tissue boundaries and, in less than a millisecond, create a vacuum that sparks liquid explosions in the brain which eviscerate brain cells in a process known as cavitation. Repeated exposure to blasts from the military’s own heavy artillery, most of it during hundreds of days of training per year, is likely the cause. Blast waves cause brain injuries that don’t show symptoms right away, said Daniel Daneshvar, chief of brain injury rehabilitation at Harvard Medical School. “But over time, it can add up.”

As researchers gather more evidence about the issue, the next battle may be fixing the communication disconnect between research labs and the military itself. The Times report found that at least a dozen current or former Navy SEALs have died by suicide in the last decade. Eight of their brains were delivered to a state-of-the-art Department of Defense lab which found the damage. But apparently, privacy guidelines at the lab, combined with poor communication in the bureaucracy kept the findings hidden from military leadership. It wasn’t until The Times reached out to the Navy during its reporting that the department’s leadership was informed of the problem, the service said in a statement. “That’s the problem,” said one unnamed Navy officer in apparent shock and frustration. “We are trying to understand this issue, but so often the information never reaches us.”

Premenstrual dysphoric disorder: a serious health condition with severe mental health effects

A whole lot of the time, Cori Lint was fine, happy even. She enjoyed her job, had great hobbies, and better friends. She was healthy too, which is why she couldn’t understand why her mood tanked dangerously low a few days per month. Sometimes she’d have panic attacks and suicidal thoughts would creep in.

Doctors diagnosed her with anxiety and depression, but that didn’t seem right with mood extremes so vast, she told the Tampa Bay Times. “When I felt better, it was like I was looking back at the experience of someone else, and that was incredibly confusing,” Lint said. After more time with her own thoughts, she realized the issue was cyclical. Doctors hadn’t asked her about it before, but Lint noticed her mood shifted along with her hormones during her monthly menstrual cycle. The issue, it turns out, was premenstrual dysphoric disorder, or PMDD. 

Current research suggests that 5% of people with periods experience PMDD. It’s much worse than the premenstrual symptoms most women experience, with mood swings, tender breasts, food cravings, fatigue, irritability and depression. PMDD is so severe that symptoms disrupt daily life, making it difficult for people with the condition to work, attend school, or even function in their close relationships. A recent study of PMDD patients found that 72% of study participants experienced suicidal thoughts in their lifetime and another 34% had once attempted suicide, compared with 3% of the general population. PMDD remains largely underdiagnosed and misunderstood, mostly because women’s health is so understudied. Indeed, the lack of research led President Joe Biden to sign an executive order in March to advance women’s health research and innovation.

Very few health care providers even know they can get training in reproductive mental health, said Jaclyn Ross, a clinical psychologist who studies premenstrual disorders. In a 2022 survey, more than a third of PMDD patients said their primary care physicians knew little about the disorder or how to treat it; 40% said the same of their mental health counselors. “If you’re not considering the menstrual cycle, you’re at risk of misdiagnosing and missing what’s actually going on,” Ross said. The condition was added to DSM in 2013 and officially recognized by the World Health Organization in 2019.

There are treatments: SSRI antidepressants taken regularly or in the week or two that symptoms typically occur helps some; hormonal birth control can alleviate symptoms and, for others, talk therapy and tracking menstrual cycles can help women build their mental resilience during challenging weeks.

In other news…

Gratitude, gentleness, and grace come with age: The only thing bothering writer Anne Lamott about getting older, she says, is cognitive decline — and for now, that remains slightly amusing. “It’s tough and lovely to be alive,” she writes in the Washington Post. But there’s much appreciation for a body and mind that still works. “Older age can be a balancing act — how much to put out, how hard to try, how much to let go. And if things aren’t working, how to accept that with grace…The miracle is not high dives and Segways but appreciation, and knowing the great miracle: decades of love and loyalty.”

Antidepressants and weight gain: Weight gain has long been a side effect of taking antidepressants, so researchers at Harvard conducted a study to determine which ones are more likely to promote weight gain than others. The study, published earlier this week in Annals of Internal Medicine, analyzed the health records of more than 183,000 first-time antidepressant users in the US and tracked their weight over two years. It found that patients who took Lexapro, Paxil or Cymbalta were 10 to 15% more likely to gain a clinically significant amount of weight, defined as 5% of one’s baseline, compared to Zoloft users, although they also gained some weight. Wellbutrin users were the least likely to gain weight but had other side effects like dry mouth and caffeine-like stimulant effects. “It doesn’t matter dramatically which ones you choose,” psychiatrist David J. Hellerstein, who is unaffiliated with the study, told the New York Times. “It’s the same problem across the board.”

Relationships are critical to our wellbeing; does it matter if they’re with a chatbot? That’s the essential question being asked in this 26-minute episode of Body Electric on NPR. MIT sociologist and psychologist Sherry Turkle studies relationships with technology and calls them artificial intimacy. A married man in one of her studies said his relationship with a chatbot offers a connection that he misses with his wife due to the demands of their life. The chatbot, he said, validates his feelings, allows him to express vulnerability, and work through his thoughts, desires, and fears. 

Turkle worries the bots could set unrealistic expectations of human relationships. “I call this pretend empathy, because the machine does not empathize with you. It does not care about you,” she said. “What AI can offer is a space away from the friction of companionship and friendship. It offers the illusion of intimacy without the demands. And that is the particular challenge of this technology.”

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.