Curated Paper 2 Adam Porter

The brain is extremely complex and not well understood by modern medical science. While we do understand some things such as the structure and function of individual neurons and the protective coverings associated with the brain, the larger cooperation that leads to our higher brain function and the sensation of consciousness is not well understood. We have some information about functional areas or lobes of the brain but even those ideas are challenged by special cases involving neuroplasticity. 

Recently I learned about a man who was born missing most of his brain but was still functioning and living a normal life. He was suffering from a rare neurological condition known as anencephaly. In most cases this condition is recognized in vitro and ends with the child dying within a year after birth. This man’s case was especially intriguing because it challenged everything we know about the regional functions of the brain and the limits of neuroplasticity. 

The gaps in our knowledge about the brain and neurological system make it extremely difficult to treat mental health disorders that to our knowledge are largely non-structural. For this reason, psychiatry and psychology are especially difficult medical disciplines. 

We do the best with what we do know, which allows modern medicine to help the lives of thousands of people every year who suffer with a variety of diseases and disorders. These fall into several categories based on the various pathophysiologies of these diseases. The first of these are neurological diseases such as Huntington’s disease which can affect motor skills, emotions and other cognitive processes. There are also storage disorders such as Tay Sachs disease that can lead to myoclonic movements, dysphasia and eventually death. 

Much more common are the behavioral disorders such as schizophrenia which can be characterized by an inability to control mood, behavior or the presence of either auditory or visual hallucinations. Developmental disorders such as autism or other spectral disorders can arise for a variety of reasons but mainly cause stunted emotional, physical or cognitive development. Prion diseases such as spongiform encephalopathy arise from eating or handling meat infected with prions and can end in major neurological deficits and death. While we can categorize and to some extent treat these diseases, many of the patients they afflict never improve or recover

An example of a lesser understood neurological disease is multiple sclerosis. Multiple sclerosis is a disease in which the myelin in our nervous system is broken down or otherwise lost. Much about the cause of multiple sclerosis is unknown. It is also somewhat of a medical oddity because there are spontaneous moments of remission in which the symptoms dissipate for a certain amount of time before returning, often intensified.

Several of these neurological disorders show the importance of the body's regulation of processes within the nervous system. Many of the behavioral disorders such as anxiety, depression, OCD and even bipolar disorder can be attributed to the overproduction or underproduction of various neurotransmitters. For example, depression and anxiety are often due to an underproduction of the neurotransmitter serotonin. Patients suffering with these conditions are often treated by taking selective serotonin reuptake inhibitors which enable for more use of the serotonin available in the body. My wife takes an SSRI for anxiety, and I can often tell when she has missed a dose. To me this is a testament to the effectiveness of these medications and the power they have to help many people in their lives. 

Certain classes of drugs, especially those used to treat mental health disorders, target the synapses between neurons to propagate or inhibit the effects of neurotransmitters. An example of this are SSRIs such as Lexapro and Prozac. These medications work by stopping the reuptake of serotonin in the synapse which allows the neurotransmitter to perform its action for a much longer duration. These medications work by directly affecting the neuron-neuron interactions which over time can affect the brain chemistry. 

While SSRIs do cause some changes in the function of our neurological system their effects are nothing when compared to the effects of other drugs such as LSD, Methamphetamine, PCP, Cocaine or opiates. Some of these drugs are hallucinogens that can hijack the auditory and visual centers of the brain. Over time these cause users to become erratic, nervous or out of touch with reality. Other drugs such as cocaine or opiates rewire the brain's pleasure centers to become reliant on the drugs. The users begin to lose the ability to find happiness in other aspects of their lives and become obsessive and dependent on the substance. 

Drugs can be transformative in either drastically improving or decreasing a patient’s health and wellness. These medications are often necessary or lifesaving but it is naive to believe that these medications come without systemic effects, unintentional side responses or potentially lasting changes to body chemistry. Apart from medicinal use drugs also have far reaching societal effects. 

Some drugs can be habit forming and cause addiction. Addiction is a disease with widespread societal impacts. Drug addicts often resort to violent crime to fund their addictions which leads to increased robbery, theft and murder. Organized crime is heavily linked to drug abuse and trafficking. Drug dealers are also targeting children as young as middle school to ensure that they will have a constant supply of buyers for their products. This perpetuates the cycle of drug abuse, violent crime, and addiction. 

Chronic conditions such as hypothyroidism, hypertension, gout, chronic pain and many others must be controlled or managed by medications that reduce symptoms or stop damage to the body. These medications are taken over a long period of time and due to this can have a large range of side effects. Because of this, family physicians are often tasked with managing these conditions and medications. Monitoring and managing these medications has effects on our healthcare system by increasing healthcare costs and the side effects caused by these medications can affect thousands of patients who already suffer with chronic conditions. While these side effects are to be considered and, if possible, mitigated, they are often much less severe than the conditions the medications are designed to treat. 

Drugs have a large impact on the balance in our bodies and as such have deep connections to ayurveda. Our bodies use an intricate network of chemical reactions, pathways and cascades to carry out our bodily processes. Drugs manipulate these systems to change something about the way our body is functioning. This will inherently disrupt the natural balance in our bodies and will come with some unintended consequences. An important part of drug development is understanding all of the effects of drugs and chemicals when they are introduced to our biological systems.

Antibiotics are critical in the treatment of many infections. These medications can cause imbalance in our gut microbiome that can be detrimental to our health. Gut bacteria are beneficial and even critical to our health in the right place and quantity but if they become overpopulated, they cause disease. An example of this in humans is when C. diff or E. coli overpopulates causing diahhrea and other symptoms. These are known as opportunistic pathogens because they only cause disease when antibiotics or other factors cause overpopulation or imbalance of those bacteria. 

C. diff and other diseases such as MRSA are known as Nosocomial or hospital acquired infections. Both of these are heavily monitored for and treated quickly. Occurrence of hospital acquired infections are seen as one metric for the quality of care and cleanliness that is available in a hospital or healthcare system. These diseases are often very difficult to treat because they can be drug resistant. This is the case with MRSA which stands for Methicillin resistant Staphylococcus Aureus. MRSA must be treated aggressively with very high dose antibiotics. 

These side effects are a big cause for distrust in pharmaceuticals. Due to this many consumers are looking for alternatives. Plant or natural pharmaceuticals are seen as a viable alternative that seemingly lacks side effects. This approach has several drawbacks. The first is that whether the medication is naturally or synthetically based it is still pharmaceutically active and will lead to changes in the body's natural and balanced process. The second issue with this is that natural supplements are often not regulated by the FDA and can contain potentially toxic substances.  

When studying the human brain, genetic code, and the treatments that are used to treat disorders within them it is readily evident that there are incredibly complex issues involving ayurveda, health effects and societal issues that need to be further studied and accounted for.