All my mental demons

The Publishing House "Mann, Ivanov and Ferber" represents the book by Yao Nightin "All my mental demons. Scientificly proven ways to combat depression, insomnia, ADHG, anxious, bipolar and other disorders ”(translation by Natalia Vlasova).

The lack of concentration, anxiety, depression, insomnia - these mental demons can pursue us everywhere. But how do you know with what demon you are dealing with? How to deal with the onslaught of rapidly changing life and psychological difficulties in growing up? How to maintain your mental health in the modern world? There are answers to these questions in the book of Yao Nightin. You will learn how to diagnose symptoms of anxiety, depression, obsessive-compulsive disorder and other common psychological problems. You will understand what the basics of the cognitive functions of the brain are, including concentration, memory and creativity, and how to help them recover. Read about how to defeat stress and emotional challenges.

Yao Nailin is a neurologist, she specializes in the field of mental health. Doctor of Psychiatry University of Hong Kong, post -core, psychiatry of Yale University. For many years it has been working in the field of neuronauk. It uses JAMR-spectroscopy and FMRS to study mental disorders, such as hallucinations, bipolar dyskinesia and Parkinson's disease. Researcher at the National Institute of Health on Human and Computer Human Connectome Project. As part of this project, Yao worked with more than 50 research groups around the world on the creation of cerebral cards, which comprehensively reflect neural ties.

We offer to read one of the chapters of the book.

Hallucinations and nonsense are not only in mentally ill

Then they saw thirty or forty windmills stood in the middle of the field.
Noticing them from afar, Don Quixote told his squire:
- A favorable fate sends us good luck. Look in that direction, friend Sancho! There, giants gathered on the plain there. Now I will enter the battle with them and will kill them all to one. They own imperceptible treasures; Having won over them, we will become rich. This is a righteous battle, for God himself pleases that this evil seed is erased from the face of the earth.
- But where are these giants? - asked Sancho Pansa.
- Yes, here they are, in front of you! - answered Don Quixote. - See what huge hands they have? Others have almost two miles in length.
“Believe me, your mercy is not at all great, but windmills.” And what you call hands is not at all hands, but the wings that spin from the wind and drive the millstone.
“You can see right away,” said Don Quixote, “that you are still inexperienced in knightly adventures.” These are giants! If you are scared, then step aside and read prayers, and in the meantime I will enter with them a fierce unequal battle!
Don Quixote (per. B. M. Engelhardt, edition: Eksmo, 2014)

By the type of symptoms of the problem with the brain, you can divide into emotional and cognitive. Emotional include depression, anxiety, obsessive-compulsive and bipolar disorders. Cognitive can be divided into two types - those in which cognitive functions deteriorate (for example, cognitive decrease), and those in which the methods of perception are distorted (for example, hallucinations and delirium). Hallucinations mean that you see non -existent things or hear unreal sounds, and nonsense - distorted thoughts in the head that do not correspond to reality. For example, people with schizophrenia often “hear” how nasty things speak of them, or even “hear” their voices in their heads, who whisper that they are useless, or forced to do what they do not want. It is difficult to get rid of this, and as a result, patients feel panic.

You might think that hallucinations and nonsense - two typical symptoms of schizophrenia - will never occur in a normal person. Or vice versa: if a person has hallucinations and nonsense, it means that he suffers from a mental illness. In fact, everything is not so clear, and healthy people also sometimes suffer from hallucinations and delirium. Medicines, lack of sleep and other factors can cause them in normal and healthy people.

What are hallucinations similar to?

During the defense of the doctoral dissertation, I had to conduct clinical interviews with hundreds of older people, some of them suffered from hallucinations. In one case, the patient with whom the interview was conducted experienced visual hallucinations. It was a woman of about fifty, and we sat in a small room with an area of ​​two square meters and conducted a survey.

I asked the patient: "Do you see recently what really is not?" She replied: "Yes, when I just entered this room, I saw a man behind you." She said it completely calmly and did not look frightened, knowing: what she sees is unrealistic, this is just her hallucination. But for a moment I felt a chill ran along my spine. The fact that she was calm about hallucinations meant that that “benign” and with perception everything is in order. And what is a "poor -quality" hallucination? This is when a person loses its ability to introspection and thinks that the hallucination is real, sometimes even interacts with it or scares it.

Once I met a 93-year-old patient with Parkinson's disease, who said that he often had hallucinations: supposedly his wife came to him, although in fact she died several years ago. When he was left alone at home, he saw how his wife washes the dishes, and talked to her. He also often felt that his wife hugs him when he went to bed at night. The doctor wanted to increase the dose of medicine in order to reduce hallucinations, but the old man abandoned this option, justifying this by the fact that he likes his vision and he does not want to lose his wife’s society and the opportunity to communicate with her.

There are also several interesting stories about hallucinations in clinically documented cases. One 72-year-old patient with Parkinson's disease had periodic hallucinations: at night he often saw a certain woman slip into the bedroom and lays naked between him and his wife. The doctor wanted to know if he could move during hallucinations, and asked: "If you touch that woman, she will disappear?" Without hesitation, the old man replied: “Of course not! But if I move, the wife will wake up! " There is a special type of hallucinatory experience, called extraordinary when a person feels that he allegedly leaves his body. People with migraine, epilepsy or mental disorders are prone to such hallucinations, but also healthy experiences are also healthy experiences. Scientists have investigated healthy people who survived off -body experience, and found abnormal excitement in the temporal lobes of their brain - areas responsible for processing information about the body position in space. Perhaps, since the brain of these people is not able to determine where they are in space, they can feel outside the body.

Hallucinations are not only visual and auditory, but also involving other senses - for example, tactile and olfactory: a feeling of touch and the smell of what is not. There is a type of nonsense called “dermatozoic”: when it seems to people that insects, snakes or parasites crawl along their skin. They are afraid that under their skin, especially in the holes of the body (such as anus), stomach or intestines, there are parasites, and believe that their house and clothes are also infected with parasites. In these people, tactile hallucinations are accompanied by unrealistic delusional ideas. Since such patients sincerely believe that they are infected with parasites, they often go to a dermatologist for help, providing “evidence” (for example, dust, skin scales).

You can also sometimes experience hallucinations. For example, when water is noisy in a loudly rustle, it may seem that music is playing or that your mobile is calling, although it is not there. But when the water turns off, you find that there are no sounds. Another common type of visual hallucinations arises when you are going to fall asleep. You can see bright scenes in front of your eyes, and if someone is nearby and reminds you of them, you will find that they are decorated with you. Such experiences are in normal people.

Hallucinations and nonsense are characteristic not only of mentally ill. Often there are hallucinations in healthy people. The frequency of schizophrenia in the world as a whole is only 0.4 %, and the frequency of hallucinations and delirium reaches 7.5 %. This means that about one of the 14 people who saw what was not, heard non -existent voices or had delusional ideas that did not correspond to reality, in fact “normal”.

Dr. John McGrath and other specialists from the University of Queensland in 2001-2009 examined more than 30 thousand adults from 18 countries and found that 5.8 % of normal people experienced hallucinations or nonsense, and hallucinations were noted four times more often. The results of this study, which participated in a large sample of individuals with a variety of characteristics, is convincing evidence that hallucinations and delirium are not an exceptional feature of mentally ill, but a widespread phenomenon among ordinary citizens.

About a third of the people who came across visions experienced only one episode of hallucinations or nonsense, about a third of another third, and the remaining ones - at least six or even up to a hundred. In normal people, these phenomena are usually sporadic and fleeting, although in a small fraction of the population more often arise.

Causes of hallucinations in the brain

Why does the brain actually give rise to hallucinations?

In chapter 11 I will describe how the brain processes external stimuli. He perceives the outside world as a combination of two aspects, including two areas of processing: from the bottom up and from top to bottom. In case of vision, processing “from the bottom up” means a method by which the eye perceives the light stimulus and transfers the signal to the primary visual cortex of the brain, which allows it to perceive external visual stimuli. In the “top -down” option, the brain processes information using knowledge and experience stored in the bark, predicting in advance what it will see. For example, when you observe a flower, the brain extracts various records of the flower stored in the brain, before you “realize” that it is it, and when these records largely coincide with images of light and shadows, perceived eyes, the brain decides that this is a flower. The descending processing helps you more quickly and more efficiently perceive external information.

When you look at the object, on the one hand, the light from its surface falls into the eyes and is projected into the visual cortex of the brain; On the other hand, the brain foresees what this object is thanks to previous experience (this process plays a secondary role). But there is a special situation in which the descending process prevails - when there is little external light. Since the eyes do not receive sufficient signals, images, so that the brain can determine what it actually sees, the descending processing should take on a leading role. There are few tips, the brain “guesses” incorrectly, which leads to hallucinations.

How to "create" hallucinations

If you want to create your own hallucinations, try this method: stand in front of a large mirror with a dull candle burning behind you, and turn off the light. Look at yourself in the mirror for a minute, and you may have strange illusions: you will see how your face is distorted or even turns into someone else. This is because with weak lighting, the brain is not able to combine features into a holistic face, creating an illusion, and the frequency of such phenomena reaches 70 %. That is why visually impaired people are prone to hallucinations. When there are not enough objective details to conclude about what they see, the brain builds guesses based on internal signs. Therefore, the more you tend to think of all sorts of horrors, the higher the likelihood that you will see something terrible.

Hallucinations experienced by patients of psychiatric clinics arise in a similar way. My research project during the defense of the doctoral dissertation was devoted to the study of the mechanisms of hallucinations in patients with Parkinson's disease. This is a neurological disease in which motor disorders prevail, and about 20 % of patients experience visual hallucinations. We studied the brain of patients with Parkinson's disease with and without them with MRI with the help of MRI to find out how they differ structurally and functionally. I suggested that since patients with Parkinson's disease have reduced visual abilities, they receive less visual signals from the environment, and in order to compensate for this deficiency, visual memory causes hallucinations.

The results were just the way I expected. On the one hand, the network responsible for the introduction is more active in the brain of patients with hallucinations than in patients without them; On the other hand, the primary visual cortex (responsible for taking external visual stimuli) is less active in patients with hallucinations, and the highest visual crust (responsible for storing memory components associated with visual perception) is more active. This suggests that hallucinations in patients with Parkinson's disease are really caused by a weakening of the visual perception of the outside world and a too frequent “brainstorm”. In general, patients with hallucinations tend to use the "guesses" of the brain to determine what they see.

In 2017, the University of Yale published a study on auditory hallucinations in the Science journal. Scientists compared the brain of four groups of people: mentally ill with auditory hallucinations, mentally ill without them, normal with auditory hallucinations and normal without them. Researchers wanted to understand what activity in the brain is associated with hallucinations and why some people experiencing hallucinations are mentally ill, while others are not. Lying in an MRI scanner, the participants first heard a sound with a fixed frequency and at the same time saw a flash of light. After the process was repeated several times, the sound gradually calmed down, and sometimes completely disappeared, only a flash of light remained. In flashes without sound, those who usually experience auditory hallucinations (both mentally ill and healthy) reported that they hear the sound when the auditory bark and the anterior belt of their brain were activated. This resembles the hyperactive brain of people with auditory hallucinations.

Then the researchers simulated the results of brain activity for everyone and found that people suffering from hallucinations, during the perception of the world, were more reliable on subjective forecasts “from top to bottom” than objective data “from the bottom up”. Among those suffering from hallucinations, the difference between people with psychosis and without it is that the former are less likely to admit that they heard something wrong, even if they have hallucinations. This indicates that mentally ill people are less capable of introspection and most hallucinations are not “benign”.