Curated Paper 2

The brain serves as a great intersection between how biology, including genetics, and our experiences sculpt each of our own worlds. It is arguably the most complex organ and exhibits some very unique characteristics compared to other organs found within the body. A single neuron within the brain can make upwards of tens of thousands of connections to other neurons which drives our minds to continually update its connections and adapt. Because of this, structures within the brain are highly susceptible to change, even by outside influence. Through the lens of disorder and damage, we have an opportunity to better learn how the brain functions from the biochemical level of neurotransmitters to the complex processes of body regulation and thought formation. Conversely, with such a complex organ, the dysfunctional possibilities are immense and cause great affliction to individuals and society.

As scientific knowledge grew about brain anatomy and psychological activity, the debate between holism and localism became elevated. Through the work of brilliant researchers, like Paul Broca, and the use imaging technology, the argument for localism looks to have taken first place in many scientific spheres. Classic cases, such as Phineas Gage, demonstrate how specific brain structures are responsible for certain behaviors and skills. Additionally, genetic related disorders give us invaluable knowledge on how neural signals are propagated through the brain and throughout the rest of the body. These pathway disruptions give us motivation to explore pathways and the interconnections between different mental processes.  

Neurodegenerative diseases and their pathologies are quite fascinating to me. From a biochemical standpoint, it is makes a lot of sense that mutated, dysfunctional proteins can cause such destruction. Yet, I am astonished that small changes, even in post-translational protein modifications, can become completely debilitating for someone’s cognitive function and overall life. In recent years, the prevalence of neurodegenerative diseases have increased. In particular Alzheimer’s disease has seen an increased death rate of 145% between 2000 and 2017 and has become the sixth-leading cause of death within the United States. Additionally, longer life expectancies paired with the large baby boom cohort is leading to an increase in Alzheimer’s dementia diagnoses which is predicted to grow to 13.8 million by the year 2050 ("2019 Alzheimer's disease facts and figures", 2019). Today, the burden of care associated with Alzheimer’s disease is already high and will only continue to worsen.

 From a 2018 study, over 16.2 million unpaid caregivers, including family members, “provided an estimated 18.5 billion hours of care to people with Alzheimer’s and other dementias,” which is valued at nearly $234 billion. Though this monetary cost is quite staggering, it is limited and does not consider the “caregivers’ increased risk for emotional distress and negative mental and physical health outcomes”, actual paid care costs, and the institutional pressures healthcare systems, particularly long-term care facilities, face ("2019 Alzheimer's disease facts and figures", 2019). Having worked as a caregiver in skilled nursing facilities and memory-care units, I can honestly report that it is exhausting work caring for people who are experiencing significant cognitive declines. Beyond the physical labor, the emotional impact is great. In my experience, I take on the worry of each resident’s wellbeing; it is on me to keep the twenty-two residents safe, to comfort them in their moments of great confusion or moments of devastating clarity, and to become a broken record answering their repeated question of “When are we having breakfast?” when it is 3:30 in the afternoon.

Currently, there is no cure for Alzheimer’s disease, but there are opportunities for better outcomes. Early detection is key to minimizing the detrimental medical, emotional, and financial costs on impacted families and society as a whole. Cognitive assessments are the main and most easily accessible form of early detection for Alzheimer’s disease, yet there is limited use of these tools. Physicians across the country report that they are important, but only half of seniors have ever received any type of assessment ("2019 Alzheimer's disease facts and figures", 2019.) Tests like the MoCA or the Mini-cog test can be easily integrated into primary care visits. By working with insurances and altering yearly physical examination standards, the implementation of quick, in-office or at home cognitive tests could be quite promising. Within the US healthcare system, there needs to be increased advocacy for early detection or else our society is going to be overwhelmed by the burden of this disease and other dementias.

On a very different note, use of psychoactive drugs and the corresponding substance use disorder can cause great strain on individuals and community wellbeing. In general, drugs seem to walk a very fine line; they can be upheld as miracles and life-saving, but are often blamed for destroying lives. Drugs are powerful and highlight the chemistry that truly drives life and function. Though often contained in a small pill, there is nothing small or insignificant about how drugs act within our bodies to alter our condition. With technological advances and the ability to make large monetary gains, some miracle drugs have been developed while creating a society that is over-medicated and dependent on drugs whether illicit or not.

Growing-up in Idaho, methamphetamine was the main drug that was talked about and that I would see many PSAs against its use. “Not even once” was the phrase that was implanted into my mind about meth. I think this narrative is talked about with other drugs, but with meth it is very true, as people experience tolerance immediately. This characteristic makes it so very addictive and harmful. For Idaho, methamphetamine was the biggest drug problem the state faced for years. The trafficking networks were quickly established throughout the state because of the immediate addictions that wanted to be fed. Additionally, there is very little success on treatment/sobriety on methamphetamine use, which is so devastating for individuals who have used it and their loved ones. In the book Beautiful Boy: A Father’s Journey Through His Son’s Addiction, David Sheff, the father, wrote, “I tried everything I could to prevent my son’s fall into meth addiction. It would have been no easier to have seen him strung out on heroin or cocaine, but as every parent of a meth addict comes to learn, this drug has a unique, horrific quality. In an interview, Stephan Jenkins, the singer in Third Eye Blind, said that meth makes you feel “bright and shiny.” It also makes you paranoid, delusional, destructive, and self-destructive. Then you will do unconscionable things in order to feel bright and shiny again.” This quote colors in the detail the devastating nature of methamphetamine use. Though not all drug use darkens an individual’s future as much as meth, it is a problem that is plaguing the US. It is obviously not an easy fix, but maybe we should start examining our society for why many people are medicating and abusing drugs. Additionally, we can work to establish research-backed methods in social and justice systems to better address mental health disorders and give aid to those who suffer from substance abuse disorder.

In conclusion, our minds are vulnerable to a broad spectrum of disorders that require more attention and adherence to proven methods of treatment and prevention.

References

2019 Alzheimer's disease facts and figures. (2019). Alzheimer's & Dementia, 15(3), 321-387.      doi:             10.1016/j.jalz.2019.01.010