Complementary and Alternative Medicine Methods in Addiction Treatment
Stephen M. Dolle
CEO, Dolle Communications
Neuroscientist, Drum Circle Facilitator, and Hydrocephalus Survivor
Presented Sept. 9, 2015
Sovereign Health, San Clemente
Presentation on CAM in Addiction
Overview of Addiction
Medical Sequela in addiction
Prospects in Managing Health Complaints thru mHealth
Cognition and Addiction
Sensory Processing Disorder (SPD)
Neurotransmitters of the Brain
Brainwave States of the Brain
Types of CAM/Alternative Medicine Therapies
Alternative Therapies in Addiction Treatment
Most Promising CAM Therapies per my Research
There are many types of addictions, and many different approaches to the physical and psychological needs of individuals affected by addiction. In this presentation, I examine complementary and alternative medicine and CAM methods in drug & alcohol and other addiction treatment. Sovereign Health is a full service addiction treatment organization serving Orange, Los Angeles, and San Diego Counties.
My affiliation with addiction treatment is mostly through my work as a drum circle facilitator, where group drumming, or drum circles, is used as an efficacious method of treatment, and with very good success. My other connection is in living with the condition, hydrocephalus, where I share similar cognitive, sensory processing, and chronic fatigue complaints to addiction.
One of the notable neurological sequela is sensory processing disorder, or SPD. It is often secondary to many neurological and learning disorders. I discuss how alternative modalities might bring relief to SPD complaints in addiction, where I have had very favorable outcomes with drumming and drumming therapy. I am hoping a new detailed look at these modalities might reveal some new prospects.
Cognitive dysfunction in addiction (and neurological disorders) raises additional challenges with cognitive accessibility and intolerance to sounds, lights, scents, and motion, and difficulty understanding instructions, web pages, and product labels. A myriad of protections are possible in mitigating adverse exposure, and in rendering instructions, web sites, and facilities more understandable, and thus accessible.
Complementary and Alternative Medicine, or CAM, is the term designated by the National Institutes of Health (NIH). It generally refers to the array of modalities used in adjunct to traditional or Western medicine. Other terms such as alternative medicine, mind-body medicine, and healing medicine, are then used more broadly. I have followed and adopted a number of alternative medicine methods since my early years in mindfulness study (1973). I was influenced by early books from Dr. Wayne Dyer and Norman Vincent Peele, articles about nutrition, philosophy, and spiritual healing.
My Conclusions found the following offer the greatest potential as adjunct treatment:
2. Alpha Theta Brain Wave Therapies
3. Spirituality, Faith & Belief
4. Psychotherapy guided sensory & movement therapies
5. Therapies (drumming, basketball) coupled with EEG biofeedback*
6. Neurotransmitter (nootropic) supplements
I did not review and discuss supplements and homeopathy. But will be adding these as separate blogs in the coming months.
Current studies report very favorably on meditation and alpha-theta brainwave biofeedback methods – as it allows participants to lower brainwave states into the alpha phase (8-15 Hz), where improved recall of memories necessary for processing trauma & healing is possible.
Favorable results are reported in movement, sensory, and touch (massage) therapies, particularly when a practitioner interacts with dialog and affirmations. This helps to overcome trauma and negative emotions about an illness. It includes EMDR therapy.
The increased availability of EEG reader technology coupled with mobile phones and tablets can be added to therapies and allow enhanced biofeedback in alpha brainwave states. I am excited to try adding EEG wave assessment to basketball and drumming. I currently only track eye and body movements as an estimate of brainwave states.
Nootropic supplements of neurotransmitters is intriguing today with what we know about brain science and the 8-10 neurochemicals at play in behavior, cognition, mood, and energy levels. What is often difficult to ascertain, is determining which neurotransmitters an individual might be deficient in. Nootropics offer consumers the ability to supplement these for improved brain health and performance. An mHealth app might further this assessment to more strategically target low levels.
I’ve practiced spirituality, faith, and belief methodologies since the 1970s with good outcomes, while also witnessing some in my earlier nuclear medicine work. Faith/belief, like so many alternative modalities, can be difficult to corroborate due to user bias to a particular doctrine, practitioner, or technique. Still, my experience and studies report favorable some very outcomes with faith healing. The specific faith or belief is one of personal preference. Between 1981-1992, I interviewed several thousand patients on illness and belief, and channel that into my mindfulness methods in drumming today.
Photo at Top: The image, while it appears to be from a 1960s record album, is actually created from one of my MRI brain images. I created it as a tribute to EMI Records (record label for The Beatles & Frank Sinatra), who funded the development of the first CT brain scanner in 1971, that garnered the Nobel Prize. It was a testament to innovation!
On November 13, 2015, I published this blog on Nootropics Supplements:
I published earlier information on alternative medicine and CAM on this blog:
Please check back for updates. I will be adding “Discussion” and “Conclusions” sections.
Stephen M. Dolle
Types of Addiction
Addictions to Substances (DSM-IV-TR)
•Opioids (like heroin)
•Prescription drugs (sedatives, hypnotics, or anxiolytics like sleeping pills and tranquilizers)
•Amphetamines (like methamphetamine, known as meth)
•Phencyclidine (known as PCP or Angeldust)
•Other unspecified substances
Addictions of Behavioral (DSM-IV-TR)
•Pornography (attaining, viewing)
•Using computers / the internet
•Playing video games
•Spiritual obsession (as opposed to religious devotion)
Impulse Control Disorders (DSM-IV-TR)
•Intermittent explosive disorder (compulsive aggressive and assaultive acts)
•Kleptomania (compulsive stealing)
•Pyromania (compulsive setting of fires)
Types of Mental Illness (www.NAMI.org)
Borderline Personality Disorder
Posttraumatic Stress Disorder
*ADHD/autism listed as mental health
Schizophrenia Related Conditions
Common medical sequela in addiction
- Sleep disorders
- Irrational/aggressive behavior
- Cognitive dysfunction (memory & learning)
- Array of neurological complaints, incl. balance & sensory
- Dual diagnosis mental health disorders
- Co-occurring general health lung, liver, GI, and other disorders
Dual Diagnosis vs Co-occurring Disorder Influences
More than 1/3 of people with mental illness also have substance abuse problems. More than 1/2 of drug abusers also report experiencing mental illness.
Individuals living with a substance abuse disorder, often have one or more physical health problems such as lung disease, hepatitis, HIV/AIDS, cardiovascular disease, and cancer, plus mental health disorders. Great site
My View on Co-occurring Disorders
Underlying brain pathology is so common and often difficult to detect, and can include undiagnosed prior brain injury, concussion, genetic & environmental disorders. These can occur both as dual and co-occurring disorders, and contribute to cognitive and sensory dysfunction, and can markedly diminish outcomes and likelihood of relapse. Identification of these is often limited by sensitivity & specificity of the diagnostic procedure, competence of medical staff, and practices in the field, i.e. politics of sensory processing disorder (SPD). Dolle recommends your treatment approach should account for underlying hidden pathology. Stephen M. Dolle, online writings; Addiction and Cognition, Thomas J. Gould Ph.D., Dec 2010
Management of Complaints and Co-occurring Disorders thru mHealth
I designed an earlier mHealth app for hydrocephalus, and write about mHealth apps today for the care of neurological disorders. Some of these Apple & Android apps include PTSD, migraine, sleep, pain management, diaries, diabetes & asthma, etc. Some are discussed on the blogs and web pages below.
Cognition and Addiction
Drug addiction manifests clinically as compulsive drug seeking, use, and cravings that can persist and recur after extended periods of abstinence. From a neurological perspective, addiction is a disorder of “altered cognition.”
The brain regions and processes that underlie addiction overlap with those involved in essential cognitive functions: learning, memory, attention, reasoning, and impulse control. Drugs alter normal brain structure and function, and produce cognitive shifts that promote continued drug use thru maladaptive learning.
First Stage: drug use increases and becomes uncontrolled, resulting in drug-induced deregulation of the brain’s reward system (Feltenstein and See, 2008). Normally, dopamine is associated with pleasurable feelings, activities, and sex. Drugs hyperactivate this system and trigger abrupt increases in dopamine and sensations, cueing the user to take more, and promoting a new maladaptive drug association (Feltenstein and See, 2008).
Second Stage: the addictive process poses new clinical symptoms, withdrawal, vulnerability to relapse, with alterations in decision making and cognition. Kalivas and Volkow (2005) reported that drug-induced alterations in signals by the neurotransmitter glutamate from the brain area associated with judgment, the prefrontal cortex, which disrupts cognitive and other processes needed for abstinence.
Drug use causes changes in the brain and cognition, affecting the striatum, prefrontal cortex, amygdala, and hippocampus (Jones and Bonci, 2005; Kalivas and Volkow, 2005; Kelley, 2004; Le Moal and Koob, 2007). These regions underlie declarative memory, which are key in maintaining a concept of self (Cahill and McGaugh, 1998; Eichenbaum, 2000; Kelley, 2004; Setlow, 1997). Research suggests drug use impact on cognition is far-reaching.
These drugs increase cognition in the first stage: amphetamine, nicotine, and cocaine. (Del et al., 2007; Kenney and Gould, 2008; Mattay, 1996).
The increase can also be a reversal of withdrawal. (Swan and Lessov-Schlaggar, 2007). Cocaine produced similar effects in a study of rats (Devonshire, Mayhew, and Overton, 2007).
Studies show many drugs reshape the communication pathways between neurons (synaptic plasticity), which can contribute to the formation and persistence of maladaptive drug-stimulus associations.
Cocaine and nicotine induce one form of synaptic plasticity, strengthening neural connections via long-term potentiation (LTP; see Learning in the Mind and Brain on page 8 and Table 1) (Argilli et al., 2008; Kenney and Gould, 2008). Amphetamine can enhance LTP (Delanoy, Tucci, and Gold, 1983).
Marijuana activates the endocannabinoid system, resulting in inhibition LTP and long-term depression (LTD), a form of synaptic plasticity in which connections between neurons become less responsive (Carlson, Wang, and Alger, 2002; Nugent and Kauer, 2008; Sullivan, 2000). Ethanol consistently disrupts LTP while enhancing LTD (Yin et al., 2007).
Morphine inhibits LTP of neurons that exhibit inhibitory control of neural activity via the neurotransmitter gamma-aminobutyric acid (GABA) (Nugent and Kauer, 2008). Inhibition of GABA activity can lead to an increase in neural activity throughout the brain, stronger associations, and maladaptive drug-context associations.
Drugs produce cognition-related withdrawal and makes abstinence more difficult
- cocaine—deficits in cognitive flexibility (Kelley et al., 2005);
- amphetamine—deficits in attention and impulse control (Dalley et al., 2005);
- opioids—deficits in cognitive flexibility (Lyvers and Yakimoff, 2003);
- alcohol—deficits in working memory and attention (Moriyama et al., 2006);
- cannabis—deficits in cognitive flexibility and attention (Pope, Gruber, and Yurgelun-Todd, 2001); and
- nicotine—deficits in working memory and declarative learning (Kenney and Gould, 2008).
These cognitive deficits with withdrawal are often temporary, but long-term use can lead to lasting cognitive decline, depending on the drug, the environment, and the user’s genetic makeup (see Genes, Drugs, and Cognition on page 11).
Long-term cannabis use causes impaired learning, retention, and retrieval of dictated words, with both long-term and short-term users showing deficits in time estimation (Solowij et al., 2002).
Chronic amphetamine and heroin users show deficits in verbal fluency, pattern recognition, planning, and the ability to shift attention from one frame of reference to another (Ornstein et al., 2000).
Prenatal alcohol exposure is the leading cause of mental retardation in the United States (Centers for Disease Control and Prevention, 2009). Fetal alcohol exposure increases susceptibility to later substance abuse (Yates et al., 1998).
Prenatal drug exposure can have significant effects on cognition and behavior in a developing child.
Nicotine use is strongly associated with ADHD, where cognitive symptoms are similar to those during nicotine withdrawal, and both have alterations in the acetylcholinergic system (Beane and Marrocco, 2004; Kenney and Gould, 2008). Acute nicotine use can also reverse some ADHD attentional deficits (Conners et al., 1996).
Genetic makeup also influences the way a drug alters cognitive processes.
Prescription Drugs used in Addiction
FDA has approved three newer medications for treatment of substance abuse:
- a) buprenorphine to treat opioid addictions in 2002
- b) acamprosate to treat alcohol addiction in 2004
- c) extended-release naltrexone to treat alcohol addictions in 2006 and opioid addiction in 2010.
Sensory Processing Disorder
First defined by occupational therapist Anna Jean Ayres in 1972 as the neurological process that organizes sensation from one’s body and environment, sensory processing disorder makes it difficult to use the body effectively within the environment.
WebMD: Sensory processing disorder is a condition in which the brain has trouble receiving and responding to information that comes in through the senses. It used to be called sensory integration dysfunction.
Article explores the convergence between two fields: clinical field of sensory integration, and a branch of neuroscience that uses the term to describe specific types of sensation disorders.
Newer technology has allowed a new focus on multisensory integration (MSI), which studies the interaction of two or more sensory modalities.
SPD today includes a variety of subtypes depending on the senses involved and functional impairment.
The clinical field is not unified on the subtypes, one group proposes six subtypes (Miller, 2006; Miller et al., 2007), but individuals may also have a combination of subtypes (R. Picard and E. Hedman). Miller proposes three main categories:
A. Sensory Modulation Disorder (SMD): difficulty regulating responses to sensory stimulation. Three subtypes are proposed:
1) Sensory over-responsive (responds too much, for too long, or to stimuli of weak intensity)
2) Sensory under-responsive (responds too little, or needs strong stimulation to be aware of stimulus)
3) Sensory seeking/craving (responds with craving for more or stronger stimulation). All three modulation subtypes have in common difficulty grading or regulating responses to sensory stimuli.
B. Sensory Discrimination Disorder (SDD): Sensory discrimination disorder refers to difficulty interpreting the specific characteristics of sensory stimuli (e.g., intensity, duration, spatial, and temporal elements of sensations; Miller, 2006; Miller et al., 2007a).
Sensory discrimination disorder can be present in any of the seven sensory systems (i.e., vestibular, proprioceptive, and the five basic senses).
C. Sensory-based Motor Disorder (SMD): Within sensory-based motor disorder, two subtypes are proposed:
1) Postural disorder, which reflects problems in balance and core stability, and
2) Dyspraxia, which encompasses difficulties in motor planning and sequencing movements.
*No NIH or governmental organizations
I became very involved in sensory processing disorder in the years following my treatment of hydrocephalus. My initial complaints were vestibular, and sensitivity to sound and light, especially real chaotic sources. As you will read from my efforts below, I had already been doing research with medical devices and cognition when I became involved in music therapy. I also recall in the first few years following my initial surgeries, doing tai chi, yoga, swimming, chiropractic, and trying a variety of supplements. But, I was very involved in alternative medicine and healing back in the 1980s. And in 1981 while working as a nuclear medicine technologist, I serendipitously developed skills as a medical intuitive. SEE more about my past efforts in alternative medicine in this 2012 blog.
In 2002, I undertook my first study of sensory integration, and two years later, I became involved in drumming, or drum circles. You will read in the following paragraphs of my extensive efforts in sensory processing, and my efforts today in its future of “cognitive accessibility.”
I view sensory processing disorder as a group of neurological (sensory) complaints, or sequela, associated with dysfunction of the brain & body sensory centers as described by Miller et.al. The specific sensory center involved then determines the type of functional limitation the patient will suffer. But, sensory processing also involves balance & movement, verbal & non-verbal communications, social integration, and independence.
In my experience, the three most common SPD sub-types are: sensitivity to sound, light, and motion. And, it is environmental “triggers” of these affected senses that can put you in an SPD crisis. Learn to be aware what your specific triggers are, and the levels needed to affect you. You can keep written notes, or there are PTSD and pain management mobile apps today that can serve as a journal.
Common complaints typically triggered by susceptibility to SPD include:
•irritability/ behavioral challenges
•nausea & vomiting
•loss of balance, disorientation
•inability of function
Disorders commonly associated with SPDs include: post-concussion, post TBI, hydrocephalus, migraine, autism, PTSD, ADHD, post tumor, dementia, and varying degrees of drug & alcohol addiction.
I have had limited exposure to SPDs in drug & alcohol addiction. But I know they are somewhat common thru addiction’s long term connection with PTSD. But there’s not much published about it. In fact, there are few studies on SPD outside of PTSD and autism.
I estimate SPD today affects about 1 in 5 Americans, when you include seniors with varying degrees of dementia. The challenge is in raising the level of research and awareness that can lead to new treatments. Over the years, I developed my own methods in warding off the effects of SPD as best I could. And in hydrocephalus like in many of the disorders, SPD seems to be more problematic when migraine and other neuro complaints are at their minimum.
Strategies to moderate SPD levels:
1. Adequate sleep, well managed stress.
2. Regular exercise, esp. one’s w/ changing posture
3. Good diet & nutrition
4. Drink lots of water
5. Have an outlet or activity you find enjoyable
6. Play or listen to music, learn compensatory methods to your triggers
Learn how to engage/focus your attention on other things during exposure to triggers
My 2002 SPD study led to my becoming involved with music therapy, and later, drumming. After many years of research and efforts in SPD, I created a separate page on the Cognitive Neurosciences with the identified sub-pages.
2002 Sensory Processing Disorders (SPD) Study
The above link is to my 2002 study of SPD I undertook with the metronome on this Boss Recording unit. I confirmed that it is the lack of rhythmic pattern that renders sound much more problematic. I also affirmed that melodic patterns of the same sound were more pleasing, as was also reported in the Mozart Effect. SEE also my blog and web page on sensory processing in football where stadium levels can become problematic.
In 2014, I created the following web page on the cognitive neurosciences so as to organize my related online content. Further below are my key web pages that related to sensory processing disorder.
Myself and others have worked to explain sensory processing disorder or SPD. The next step is in protecting cognition in one’s environment, and the “triggers” that make one ill.
It is my contention that specific disability accommodations are protections from triggers and should apply to individuals with SPDs by virtue of a disability, and moderation of known triggers like adverse sounds, lights, scents, etc in public place, affects the individuals use of facilities. Therefore, accommodations via management of adverse triggers should come under the American’s with Disabilities Act (ADA) and Section 508 of the Rehab Act. Loud TV commercials and sound exposure in one’s home should also be regulated, just as is wheelchair and visual accessibility. Cognitive accommodations should apply to web sites, buildings, and user instructions for a wide range of products. Examples of noise exposure protections are identified below.
Reasonable SPD Accommodations
1. Protection from sudden load audio of TV commercials & programs
2. Construction noise at home, work, and school.
3. Loud music & machinery noise in public places, buildings, health clubs, restaurants, etc.
From 1950-1980, while there were no efforts to make information and technology more user friendly for cognitive accessibility, there were established information practices as a “courtesy” so the user wouldn’t get stressed wondering what was happening to their TV set. This was a common image broadcasters displayed on your TV screen in the event of a problem. Today – you get nothing of the sort. It’s more your problem. Figure it out.
http://www.CognitiveAccessibility.org – This domain I own currently points to my page above.
Of course, screen ads like the Yelp screen image below is a common accessibility issue today. Such ads diminish accessibility of a web page, and I hope they cease.
Or if you have a cognitive disability and are out shopping for toothpaste, and come across a busy aisle like that below, with similar packaging – prepare to be in that aisle for a while. Hopefully in the future, stores will better organize these displays.
This cognitive accessibility organization is affiliated with the U.S. government and offers the most up to date information in web design and issues with the internet
Individuals with cognitive disabilities are also eligible for special TSA assistance at airports and on airplanes. SEE my blog below on Meet & Assist TSA services.
My blog below includes several YouTube videos of problematic machinery noise:
U.S. Policy & Insurance Politics
There is a tremendous amount of disinformation in SPD, which seems more about politics and insurance reimbursement, than science. I suspect it originates from earlier claims of PTSD from combat, and in children with autism. The way to offset this is with public awareness, activism, and research.
Problematic PR in Addiction, Mental Health, and Neurological Disorders
-the need to turn the image around (esp for cog access), turn a negative into a positive
-compare what Viagra & Sen. Bob Dole did for the embarrassment of ED (erectile dysfunction)
Portugal Legalized all drug use in 2001
Portugal dramatically improved its ability to encourage drug addicts to avail themselves of treatment. The resources previously devoted to prosecuting and imprisoning drug addicts are now available for treatment programs. Portugal now has the lowest rates of marijuana usage (10%) in people over 15 in the EU. Drug use of all kinds declined.
Neurotransmitters of the Brain
The article below discusses 7 key neurotransmitters or molecules of the brain and their role in cognition, happiness, sleep, etc. The author writes on sports psychology. I’ve pasted in a few key paragraphs from the article.
1. Endocannabinoids: these molecules work on the CB-1 and CB-2 receptors of the cannabinoid system. Anandamide (from Sanskrit “Ananda” meaning Bliss) is the most well-known endocannabinoid. There are at least 85 cannabinoids that have been isolated from the Cannabis plant. It is felt that each of these alters perception and states of consciousness in various ways. It is likely we self-produce many variations of endocannabinoids.
Endocannabinoids act to control neurotransmitter release in a host of neuronal tissues, including the hippocampus, amygdala, basal ganglia, and cerebellum.
A recent study at the University of Arizona published in April 2012 suggested that endocannabinoids are most likely the source of “runner’s high.” The study showed that humans and dogs significantly increase endocannabinoids following sustained running. It not address the potential role of endorphins in runner’s high. Other research has focused on the blood–brain barrier (BBB), which reported that endorphin molecules are too large to pass freely across the BBB, and are probably not responsible for the blissful state in runner’s high.
This latest study offers a more definitive connection with this neurochemical. You have the option to read or download the full study.
2. Dopamine: it is a reward-driven neurotransmitter for pleasure. Every type of reward that has been studied increases the level of dopamine transmission in the brain.
Dopamine plays a key role in the limbic system, which is involved in emotional function and control. It also plays a part in movement, alertness, and sensations of pleasure.
Many addictive drugs, such as cocaine and methamphetamine, act directly on the dopamine system. Cocaine blocks the reuptake of dopamine, leaving these neurotransmitters in the synaptic gap longer. There is evidence people with extraverted, or uninhibited personalities, tend to have higher levels of dopamine than those with introverted personalities. Try and increase your levels of dopamine naturally by being a go-getter idea person.
3. Oxytocin: “Bonding Molecule” (hormone) is directly linked to human bonding, social trust, and loyalty. High levels of oxytocin correlate with romantic attachment in men. When a couple is separated, the lack of physical contact lowers oxytocin and drives the feeling of longing to be with that person again. Oxytocin levels are typically higher in women. In men, vasopressin (a close cousin to oxytocin) may be more the “bonding molecule.” It is said that those who engage in philanthropy and volunteerism have higher levels of oxytocin.
The strong emotional bonding between humans and dogs may have a biological basis in oxytocin too. And is likely why seniors and widowers live longer happier lives when they keep a dog. If you don’t have a partner to offer you affection and increase oxytocin, pets, dogs and cats fill a key void.
Oxytocin is involved in the control of maternal behavior. A large amount of oxytocin is made in the hypothalamus, transported to the posterior lobe of the pituitary and released into the blood.
4. Endorphin: Resemble opiates in chemical structure, and have analgesic properties too. Serum β-Endorphin is an endogenous opioid neuropeptide found in the neurons of both the central and peripheral nervous system. It is one of five endorphins found in humans, the others of which include α-endorphin, γ-endorphin, α-neoendorphin, and β-neoendorphin.
β-Endorphin release in response to exercise has been known and studied since at least the 1980s. Studies have demonstrated that serum concentrations of endogenous opioids, in particular β-endorphin and β-lipotrophin, increase in response to both acute exercise and training. The notion of β-endorphin release during exercise is colloquially known in popular culture as a runner’s high.
Research has shown that acupuncture needles at specific body points can trigger the production of endorphins. In another study, higher levels of endorphins were found in cerebrospinal fluid after acupuncture.
5. GABA: “Anti-Anxiety Molecule” is an inhibitory molecule that slows the firing of neurons and creates a sense of calmness. You increase GABA naturally by practicing yoga, meditation, relaxing activities. Benzodiazepines, such as Valium and Xanax, are sedatives that increase GABA. But these drugs have side effects and pose risks of dependency.
A study in the “Journal of Alternative & Complementary Medicine” found a 27% increase in GABA levels among yoga practitioners after a 60-minute yoga session, compared to participants who just read a book for 60 minutes. Meditation also lowers beta brain waves to theta waves, reported to aid calm and clear recall of memories.
6. Serotonin: Plays many different roles in the brain. High serotonin aids self-esteem, feelings of worthiness and a sense of belonging (salience). For this reason, serotonin is mimicked in drug and alcohol addiction, and also in prescription drugs for depression, where they are termed Serotonin-Specific Reuptake Inhibitors (SSRIs). Drugs include Prozac, Celexa, Lexapro, and Zoloft. The main indication for SSRIs is clinical depression, but SSRIs are frequently prescribed for anxiety, panic disorders, obsessive compulsive disorder (OCD), eating disorders, chronic pain, and post-traumatic stress disorder (PTSD). Serotonin also helps regulate sleep.
SSRIs got there name because it was once thought they worked by keeping serotonin in the synaptic gap for longer and make people happier. However, some people never respond to SSRIs. But they do respond to medications that act on GABA, and dopamine or norepinephrine.
7. Adrenaline: real name is epinephrine, and plays a key role in the fight or flight mechanism. The release of epinephrine creates a big surge in energy. It increases heart rate, blood pressure, causes less important blood vessels to constrict ,and increasing blood flow to larger muscles. An “Epi-Pen” is a shot of epinephrine used in the treatment of acute allergic reaction.
An adrenaline rush comes at times of distress or facing fear. It can be triggered on demand with activities that terrify you, or a situation that feels dangerous like a movie. You can also aid an adrenaline rush by taking short rapid breathes and contracting muscles, as weightlifters and athletes often do. The jolt is healthy in small doses.
The chart below list the key neurotransmitters and their role in the human body. I’ve also shared some information from Wikipedia further below.
Glutamate is the most common neurotransmitter. Most neurons secrete glutamate. Glutamate is excitatory, meaning that the release of glutamate by one cell usually causes adjacent cells to fire an action potential. (Note: Glutamate is chemically identical to the MSG commonly used to flavor food.)
Acetylcholine assists motor function and is involved in memory.
Nitric oxide also functions as a neurotransmitter, despite being a gas. It is not grouped with the other neurotransmitters because it is not released in the same way.
Eicosanoids act as neuromodulators via the Arachidonic acid cascade.
The table below discusses the effect of drugs & alcohol on brain neurochemicals:
Brainwave States of the Brain
The human brain elicits brain wave signals across neurons which, along with neurochemicals and oxygen blood flow, helps carry out the various functions of the brain. Historically, these brain waves were studied by EEG medical instruments in patients suffering seizures. But today, it has been shown that certain brain waves are most optimal for specific types of activities. Ordinarily this was not something that we could control. But with more recent brain wave research in areas like yoga, music and drumming therapy, EEG biofeedback, and mindfulness, practice has shown that you can execute more control over your brain waves to be happier, healthier, and more productive. Still, brain wave science serves important roles in health and addiction disorders, where along with abnormalities in neurochemicals and behavior, abnormalities occur in brain waves which can be treated with a variety of biofeedback, meditation, music, and other therapies, which I cover in later sections.
Below, is information on the four (4) primary brain wave states recognized today. The chart (further below) identifies additional brain waves on the upper and lower ends of the range. The chart identifies brain waves associated with the primary neurotransmitters.
Beta Waves: frequency range between 12 and 30 Hz. They awaking awareness, extroversion, concentration, logical thinking, active conversation.
Alpha Waves: frequency range of 8-12 Hz arising from synchronous and coherent (in phase / constructive) electrical activity of thalamic pacemaker cells in humans. They are also called Berger’s wave in memory of the founder of EEG. They place the brain in states of relaxation times, non-arousal, meditation, hypnosis
Theta Waves: 4-8 Hz. Day dreaming, dreaming, creativity, meditation, paranormal phenomena, out of body experiences, ESP, shamanic journeys. A person driving on a freeway, who discovers that they can’t recall the last five miles, is often in a theta state – induced by the process of freeway driving. This can also occur in the shower or tub or even while shaving or brushing your hair. It is a state where tasks become so automatic that you can mentally disengage. The ideation that can take place during the theta state is often free flow and occurs without censorship or guilt. It is typically a very positive mental state.
Delta Waves: high amplitude brain waves between 0-4 hertz. Delta waves associated with deepest stages of sleep (3 and 4 NREM), known as slow-wave sleep (SWS), and aid in characterizing the depth of sleep.
Meditation increases activity in the left prefrontal cortex. The changes are stable over time. If you stop meditating for a while, the effect lingers.
In my work as a drum circle facilitator, I have been actively involved in altering brain waves since 2010. In group drumming, there is a group “brain wave entrainment” or BWE, where the brain waves of members of the group can act alike, in as little as 8-10 minutes of drumming. BWE in drumming was first identified by Dr. Barry Bitman et. al.
My 2015 blog (and web page) on Drumming in the Workplace describes how drumming can alter brain waves and lead to increased productivity, less stress, and healthier employees at work. The article below discusses how brain waves affect mental health.
Neuroscientists have made a correlation between an increase of alpha brain waves—either through electrical stimulation, mindfulness, or meditation—and ability to reduce depression & increase creative thinking. The issue is too much Beta wave activity esp related to stress. SEE brainwave feedback info on altering these waves.
(Wikipedia) Binaural tones are auditory processing artifacts, or apparent sounds, caused by specific physical stimuli. This effect was discovered in 1839 by Heinrich Wilhelm Dove and earned greater public awareness in the late 20th century based on claims coming from the alternative medicine community that binaural beats could help induce relaxation, meditation, creativity and other desirable mental states. The effect on the brainwaves depends on the difference in frequencies of each tone: for example, if 300 Hz was played in one ear and 310 in the other, then the binaural beat would have a frequency of 10 Hz.
The brain produces a phenomenon resulting in low-frequency pulsations in the amplitude and sound localization of a perceived sound when two tones at slightly different frequencies are presented separately, one to each of a subject’s ears, using stereo headphones. A beating tone will be perceived, as if the two tones mixed naturally, out of the brain. The frequencies of the tones must be below 1,000 hertz for the beating to be noticeable. The difference between the two frequencies must be small (less than or equal to 30 Hz) for the effect to occur; otherwise, the two tones will be heard separately, and no beat will be perceived.
Binaural beats are of interest to neurophysiologists investigating the sense of hearing.
Binaural beats reportedly influence the brain in more subtle ways through the entrainment of brainwaves and provide other health benefits such as pain relief.
Types of CAM/Alternative Medicine Therapies
The National Center for Complementary and Integrative Health (CAM), a Division of NIH, provides the following:
Complementary and Integrative Health or CAM is the term created by NIH to identify alternative medicine therapies used together, or in adjunct to, traditional Western medicine.
The above list the most recognizable modalities. For modalities outside of NIH and Western medicine, more can be found under alternative or mind-body medicine. You can sign up for emails at: NCCIH@public.govdelivery.com
Western medicine has been critical of alternative modalities, offering very limited support to reports of effectiveness. But a few, they do endorse, namely meditation, biofeedback, acupuncture, music therapy, and some movement and proprioceptive therapies, i.e. equine or horse therapy. As much as I like Wikipedia, they exhibit a bias against alternative medicine, though perhaps some modalities deservingly so.
1.Alternative Medical Systems
3.Biologically Based Therapy
Big web site affiliated with Western medicine, redundant in places.
My updated 2012 Blog on CAM, Alternative Medicine, and Healing
Dolle Proposes (6) Categories, (11) Classifications of Alternative Medicine
Each identifies a sensory “pathway” to effect the individual.
Dolle Proposes (11) Classifications of Alternative Medicine
2. Brain/brain wave
3. Heart & Breath work
6. Meridian Therapies
*Each identifies a “mechanism” in the body thru which the modality effects.
One of my favorite web sites for information on alternative medicine*
The major rhythmic disruption in PTSD and complex trauma is circadian rhythm; the 24 hr. sleep/wake cycle that follows the dark/light cycle of the sun’s rising and setting.
Types of Alternative Therapies in Addiction Treatment
The list of alternative medicine therapies below is a comprehensive list from AddictionRecoveryGuide.org – a very intriguing site. I cannot speak to the effectiveness of many of these in addiction treatment. Still, they are therapies that are in use in the treatment of addiction, and must have some effectiveness.
CAM Therapies most Recognized in Addiction
Neurofeedback – alpha-theta brain wave therapy
Spirituality/Faith & Belief
Individual & Group Psychotherapy
Auricular therapy – Auricular therapy is a healing practice dating back to the third century where the practitioner uses needles at acupuncture points on the outer ear that correspond to specific parts of the human body.
Breath Therapy – breathing techniques to help reduce stress, get more energy, feel better, and lose weight.
Creative Arts Therapy
Massage & Bodywork
Spirituality/Faith & Belief
Psychodynamic & Educational groups
Equine Assisted Psychotherapy – (EAP) incorporates horses for mental, behavioral health, and personal therapy. It is a collaborative effort between a licensed therapist and a horse professional to address treatment goals.
Rapid Eye Technology – RET is a natural, safe way to release stress and trauma. RET simulates REM sleep, your body’s own natural release system. Home care method: http://rapideyetechnology.com/selfcare.htm
Recreation & fitness*
Somatic therapy – studies the relationship between the mind and body in regard to psychological past, past trauma, and dysfunction of the autonomic nervous system (ANA)
Sweat Lodge ceremony
Step curriculum is designed to build competencies in four key areas recognized as vital to professional success.
Leadership & Management: Identify, communicate, and influence future outcomes, risks, and impacts. Recognize opportunities for yourself and for others. Implement successful organizational processes in areas such as planning, budgeting, and performance management.
Communication & Relationship Building: Assess situations, identify meaningful solutions, and communicate these solutions to others. Create collaborative environments and offer constructive feedback to help a team achieve its goals.
Personal & Professional Management: Apply self-management techniques to achieve career and personal goals using the process of life-long learning, self-development and managing behavior.
Entrepreneurialism: Identify professional surroundings as a potential marketplace. Acquire the tools to take advantage of one-of-a-kind opportunities within that marketplace, whether as an employee or an individual starting a business.
•Sports and Recreation
•Reading and Creativity
•Aerobics and Fitness
Spirituality and Belief: My Personal Experiences
RESULTS: Available evidence suggests that music-based interventions may have a positive impact on pain, anxiety, mood disturbance, and quality of life in cancer patients. Advances in neurobiology may provide insight into the potential mechanisms by which music impacts these outcomes.
The somatosensory systems inform us about objects in our external environment through touch (i.e., physical contact with skin) and about the position and movement of our body parts (proprioception) through the stimulation of muscle and joints. The somatosensory systems also monitor the temperature of the body, external objects and environment, and provide information about painful, itchy and tickling stimuli.
Drumming Therapy – How effective is it in addiction?
-Dolle 2010 paper on addiction
-Dolle blog & web pages on drumming
-Guided methods in drumming mimic Alpha-theta biofeedback
The Brain Science of Basketball – mindfulness, movement, and proprioception therapy
Dr. Amen: Alcohol and Drug Abuse Services – known for SPECT Brain Scan Imaging
She highlights acupuncture, brain wave biofeedback, and meditation with dramatic success rates.
-acupuncture, electro acupuncture
Acupuncture – Auricular, or ear, s based on points in the ear are associated with specific parts of the body. Thus acupuncture needles placed in the ear can achieve a therapeutic effect anywhere in the body. Acupuncture is often used to reduce symptoms related to withdrawal and detoxification and may also have a role in relapse prevention by reducing anxiety, craving, irritability, the inability to focus, and muscle aches.
-discussed more methods over 30 yrs of study as outcomes have been so mixed.
-more effective in pain management, less in smoking, ltd in addiction
Group hypnosis treatment of drug addicts – can be done with drumming
RESULTS: One patient did not complete treatment due to a major operation, the remaining 9 (90%) completed treatment. All patients (100%) completely stopped use of any street drugs and results remained stable for 6 months after end of treatment. Two years after end of intervention, 7 out of the 9 (78%) remained clean of use of heroin, but 2 (22%) returned to partial use; 6 (67%) of the patients returned to partial use of benzodiazepines, none (0%) showed permanent use of marijuana or cocaine.
BrainWave Therapies in Addiction
Neurofeedback mimics Zen monks (meditation increased alpha, reduced to theta).
Dr. Thomas Budzynski found theta states made subjects ‘hyper-suggestable’ (as if in a hypnotic trance) to suggestions for positive changes to behaviour and attitudes.
Brain Wave Biofeedback* (neurofeedback) – Patients learn to alter their brain wave patterns. Training involves restoring a normal pattern of alpha and theta waves disturbed by long term substance abuse. Brainwave biofeedback has shown dramatic success in several studies to prevent relapses from drug and alcohol addiction.
Alpha-theta Biofeedback: “Peniston Protocol” – great results, uses EEG
The bulk of literature to date regarding EEG biofeedback of addictive disorders is focused on alpha-theta biofeedback. The technique involves the simultaneous measurement of occipital alpha (8–13 Hz) and theta (4–8 Hz) and feedback by separate auditory tones for each frequency representing amplitudes greater than pre set thresholds. The subject is encouraged to relax and to increase the amount of time the signal is heard, that is to say, to increase the amount of time that the amplitude of each defined bandwidth exceeds the threshold. A variety of equipment and software has been used to acquire, process, and filter these signals, and there are differences in technique inherent with equipment and software.
The protocol described by Peniston at the Fort Lyons VA is similar to Twemlow and Elmer Green at the Menninger Clinic, with two additions, i.e., (1) temperature training and (2) script. Peniston introduced temperature biofeedback training as a preconditioning relaxation exercise, along with an induction script to be read at the start of each session. This protocol (described as follows) has become known as the “Peniston Protocol” and has become the focus of research in subsequent studies. Subjects are first taught deep relaxation by skin temperature biofeedback for a minimum of five sessions that additionally incorporates autogenic phrases. Peniston also used the criteria of obtaining a temperature of 94° before moving on to EEG biofeedback. Participants then are instructed in EEG biofeedback and in an eyes closed and relaxed condition, receive auditory signals from an EEG apparatus using an international site O1 single electrode. A standard induction script employing suggestions to relax and “sink down” into reverie is read. When alpha (8–12 Hz) brainwaves exceed a preset threshold, a pleasant tone is heard, and by learning to voluntarily produce this tone, the subject becomes progressively relaxed. When theta brainwaves (4–8 Hz) are produced at a sufficiently high amplitude, a second tone is heard, and the subject becomes more relaxed and according to Peniston, enters a hypnagogic state of free reverie and high suggestibility.
Applied kinesiology use the principle of muscle strength to evaluate subconscious thoughts, body energy, and meridians for signs of manifesting physical and mental health disorders. Seems to also access meridian & hypnosis mechanisms.
*critical of AK per American Academy of Allergy, Asthma and Immunology
Definition: A manual muscle test in AK is conducted by having the patient resist using the target muscle or muscle group while the practitioner applies a force. A smooth response is sometimes referred to as a “strong muscle” and a response that was not appropriate is sometimes called a “weak response”. This is not a raw test of strength, but rather a subjective evaluation of tension in the muscle and smoothness of response, taken to be indicative of a difference in spindle cell response during contraction. These differences in muscle response are claimed to be indicative of various stresses and imbalances in the body.
The mind can only really think of one thing at a time. When you concentrate your attention on one thing, you inevitably engage the parallel act of ignoring other things.
The February 2015 study “Attention Drives Synchronization of Alpha and Beta Rhythms between Right Inferior Frontal and Primary Sensory Neocortex,” was published in the Journal of Neuroscience.
The researchers at Brown identified how the brain achieves optimal inattention by changing the synchronization of brainwaves between different brain regions. The researchers hope that by harnessing the power to ignore, that people with chronic pain will have new cognitive tools for reducing pain.
People can learn how to manipulate their alpha rhythms in the somatosensory cortex as they switch their attentional focus though mindfulness training. The results of their latest research expand our understanding of how mindfulness might possibly operate using the mechanism of redirecting attention via control of alpha rhythms in the brain, which can help people ignore depressive thoughts.
Two opposite ways to forget bad memories. During memory suppression, a brain structure called dorsolateral prefrontal cortex inhibited activity in the hippocampus, a region critical for recalling past events. Understanding these mechanisms may help understand disorders of memories, such as post-traumatic stress disorder.
If suppression doesn’t work, you might want to put on your “rose-tinted glasses” and try substitution by using your imagination to pretend you’re in a different place or experiencing something else.
The researchers at Cambridge found that memory substitution was supported by caudal prefrontal cortex and midventrolateral prefrontal cortex. These are two regions typically involved in bringing specific memories into awareness in the presence of distracting memories.
Meditation significantly improved functional connectivity in the brain’s network active during introspective thought such as retrieving memories. They also observed trends of less atrophy in the hippocampus.
Fadel Zeiden is exploring the specific brain mechanisms that influence meditation’s ability to reduce perceptions of pain and the experience of anxiety.
Best CAM for Pain Management
Yoga, Acupuncture, EEG biofeedback, Massage Therapy, Tai Chi, Deep Tissue Massage
A new analysis of data from the 2012 National Health Interview Survey (NHIS) has found that most American adults have experienced some level of pain, from brief to more lasting (chronic) pain, and from relatively minor to more severe pain. The analysis helps to unravel the complexities of a Nation in pain. It found that an estimated 25.3 million adults (11.2 percent) experience chronic pain—that is, they had pain every day for the preceding 3 months. Nearly 40 million adults (17.6 percent) experience severe levels of pain. Those with severe pain are also likely to have worse health status.
23.4 million adults (10.3 percent) experience a lot of pain.
126 million adults (55.7 percent) reported some type of pain in the 3 months prior to the survey.
Pain is one of the leading reasons Americans turn to complementary health approaches such as yoga, massage, and meditation—which may help manage pain and other symptoms that are not consistently addressed by prescription drugs and other conventional treatments.
Reduced gray matter volume can lead to memory impairment, emotional problems, and decreased cognitive functioning. Hyper-connectivity of white matter tracts between brain areas associated with negative emotions and pain perception can hardwire these corresponding states of mind.
The researchers used diffusion tensor brain imaging to analyze gray matter volume and the integrity of white matter tracts. Bushnell hypothesizes that increased size and connectivity of the insular cortex is probably the most important brain factor regarding changes in an individual’s pain tolerance and thresholds.
Yoga appears to bulk up gray matter through neurogenesis and strengthen white matter connectivity through neuroplasticity. After assessing the impact of brain anatomy on pain reduction, Bushnell believes that gray matter changes in the insula or internal structures of the cerebral cortex are the most significant players involved in chronic pain.
Rest & recreation – many of the massage therapies plus eg. reading, fishing
Social Integration – BWE, help love & trust
Movement Therapy, proprioception, athletics, Tai chi, basketball (adding rewards, fun sounds to baskets)
Touch therapy, massage, Watsu, (Dog Whisperer techniques)
CAM for Sleep Irregularities
Insomnia & Circadian Rhythm sleep irregularities
-Valerian root, melatonin, Acupuncture, meditation, exercise
Bright light therapy is the treatment method most often recommended for patients with Seasonal Affective Disorder (SAD), a form of depression that occurs as a result of reduced exposure to sunlight in the fall, winter and spring.
Relaxing the mind & body before bedtime
Conclusion – (to be finalized soon)
The two most promising CAM therapies from my review are Alpha-Theta brain wave biofeedback, and Nootropics Supplements. On Nov. 13, 2015, I published a separate blog on Nootropics – linked below.
1. Meditation aided with sensory interventions
2. Alpha-Theta Brain Wave Therapy – Peniston protocol w/ EEG, meditation,
3. Spirituality, Faith & Belief
4. Psychotherapy guided sensory & movement therapies
I may be reached in Newport Beach, California at:
Stephen M. Dolle
Neuroscientist and Drum Circle Facilitator
Dolle Communications – Newport Beach, CA