Tuesday, July 22, 2014

The Creativity Pill

People taking dopamine for Parkinson's disease sometimes begin to generate a lot of artwork. New research differentiates their expressiveness from obsessive or impulsive tendencies.

by

 Various artists/Parkinson's Disease Foundation/The Atlantic
Neurologist Rivka Inzelberg recently noticed that her patients with Parkinson’s disease seemed to be authoring more novels than older people tend to author.
Looking closer, poems and paintings also seemed to be pouring out of afflicted patients, in a relative sense—specifically those treated with a synthetic dopamine-precursor pill, levodopa (L-DOPA).
So Inzelberg, a professor at Tel Aviv University's Sackler Faculty of Medicine, asked around. She wasn’t the only one in her field to have noticed as much. She examined the correlation in a comprehensive 2013 review study, which found creative thinking in medicated Parkinson’s patients to be higher than in their unaffected peers.
This week she published new research that breaks down the relationship in the journal Annals of Neurology, and whether the observed creativity—which she defines as a combination of originality, flexibility, and inclination to combine novel and practical ideas—might be due to obsessive tendencies.
“Because the medication can cause a loss of impulse control—let's say, obsessive painting, obsessive hobby-ism—we wanted to check if there was a correlation between creativity measures and impulsivity and compulsivity measures,” Inzelberg told me by phone from Israel. (She very courteously warned me that she may have to hang up abruptly to take shelter if a missile alarm goes off, as has been happening at her Tel Aviv medical center. “Would it be better to talk later?” I asked, dumbly. “There is no later. This is how we’re living.”)
Development of uncontrollable artistic urges has been documented in medical case studies. One 41-year-old woman with Parkinson's disease who began taking levodopa developed what neurologists called a "devastating addiction to painting." Her home became a gathering place for artists, and she began compulsively buying painting materials. She described the spiral earlier this year in a medical journal: "I started painting from morning till night, and often all through the night until morning. I used countless numbers of brushes at a time. I used knives, forks, sponges … I would gouge open tubes of paint–it was everywhere. But I was still in control at that point. Then, I started painting on the walls, the furniture, even the washing machine. I would paint any surface I came across. I also had my 'expression wall' and I could not stop myself from painting and repainting [it] every night in a trance-like state. My partner could no longer bear it. People close to me realized that I crossed some kind of line into the pathological, and, at their instigation, I was hospitalized. Today, my doctors have succeeded in getting my medication under control, and my creativity has become more tranquil and structured."
 "When people are psychotic they think faster and might have less inhibition about extravagant ideas."
So Inzelberg’s current study tested for symptoms of impulse control disorder, as well as creativity—which it did in a variety of ways. One exam asked people to mention as many different words beginning with a certain letter and in a certain category as possible. In a remote association test, people were given three words and had to name a fourth. Another test required interpretation of abstract images and assessed imaginative answers to questions like, "What can you do with sandals?" Subjects were also asked to interpret novel metaphors.
In the end, there was no relationship between the creativity Inzelberg has been noticing and any degree of compulsive behavior.
The patients with Parkinson’s disease did significantly better than their unafflicted peers in terms of verbal and visual creativity, divergent thinking and combinational novelty.
“We also found that patients taking higher doses of dopaminergic medication had more creative answers,” Inzelberg said.
“These results support a genuine change in neuropsychological processes underlying creativity,” the Annals study concluded. That’s of interest not just to Parkinson’s patients, but an entire field of neurobiology grasping at an understanding of the chemical processes that fuel the so-desired trait.
A possible mechanism mediating the relationship between dopamine and creativity is known as novelty-seeking behavior, a tendency linked to neural areas like the ventral striatum, substantia nigra, and hippocampus, that are especially modulated by dopamine. It has been proposed that an increased in novelty seeking only occurs in Parkinson’s patients with impulse-control disorder, though, which this study did not find, suggesting that creativity is not (solely) an expression of obsessive creative drive or enhanced productivity brought about by medication.
Another proposed mechanism lies in the nucleus accumbens, the part of the brain that moderates a person’s ability to filter out irrelevant stimuli. That is called latent inhibition, and it has been associated with creative achievement. It is reduced in people suffering psychosis but it increases when those people are given antipsychotic medications. Reduced latent inhibition might enhance divergent thinking by widening (or loosening) the associative network, enhancing creative thinking. 
“It is actually the other side of the coin,” Inzelberg said, “that when people are psychotic they think faster and might have less inhibition about extravagant ideas.”
Vincent van Gogh had psychotic spells, she noted, during which he painted masterpieces.Ernest Hemingway and Virginia Woolf, among other great writers, seem to have had bipolar disorder, which is now treated with medication that blocks dopamine.                 
In order to observe the creative effects of taking dopamine, it may be necessary to have the combination of Parkinson's disease and the medication, Inzelberg told me. “It is possible that there is a need to have a diseased dopaminergic system, where the D2 or D3 receptors [sites where dopamine binds in the brain] are abnormally sensitive.” In Parkinson’s disease, D2 and D3 receptors become abnormally sensitive because they are deprived of dopamine.
“If a normal person takes these medications and tries to become creative,” Inzelberg said, as if anticipating my question, “well, we don't know if that would work.”
"Do you think we're going to see people trying that?"
She laughed. “I would not recommend it.”
After Inzelberg’s first paper, she helped organize exhibits of patients' paintings that have raised money for Parkinson's research. She also sees it as therapeutic for patients, especially those with neurological conditions, to have artistic outlets to express themselves.
Dopaminergic stimulation is also used in women who have recently given birth and would like to stop lactation, and in people with Restless Leg Syndrome. "I don't think anyone has checked," Inzelberg said, "if people in treatment for Restless Leg Syndrome become creative."

Thursday, April 24, 2014

More Art Walkabout Photos















How to Shut Your Brain Off When You Just Can't Sleep


By Shelby Freedman Harris

As our societal demands get even greater with each passing year, we find that we are "on" 24 hours a day, seven days a week. This results in greater rates of insomnia, with more and more people reporting that they just can't turn off their brains at night.

Mental over-activity is a big problem for many people, but there are some helpful techniques that might aid in quieting things down at night.

1. Give yourself some mental and physical wind-down time. We are so busy nowadays that there's just not enough time in the day to get everything done. As a result, many people are working (housework, schoolwork, job tasks, managing finances) up until bedtime. The problem with this is that sleep isn't simply an on/off switch. We need to unwind and dim our mind in order to set the stage for sleep. Allow for at least an hour before bedtime to be protected, relaxing, wind-down time. This can help create closure for the day and allow your brain to begin the process of shutting off. Wind-down should take place somewhere outside of your bedroom. Keep the lights dim and avoid using anything with a screen (tablets, phones, computers, TV), as this can make your brain think it's still daytime. Reading, light stretching, journaling and meditating are all great options. Find what works best for you and make it a nightly routine.

2. Don't worry in bed. Lying in bed with an overactive mind only serves to teach the body that the bed is a place to continue to be awake and think. Leave the bed if your mind is active and you're unable to sleep. Don't wait longer than 20 minutes to do this -- try to ballpark the time since it's best not to look at a clock during the night. When it's obvious your mind is active and you can't sleep, get up, go into a different room and sit in dim light, doing something quiet, calm and relaxing, such as repeating something you did during the initial wind-down. The act of just getting up and out of bed -- regardless of what time at night it is -- can be really helpful to stop those racing thoughts.

3. Focus on mental imagery. Believe it or not, there's something to be said for counting sheep. When we get in bed and our minds are overactive, it's hard to focus on anything else. Plus, the more you try not to think about all of the things on your mind, the more you actually think about it! Try finding something to imagine that takes a little effort to focus on. For example, outline the map of the United States in your mind or count backward by threes from 100. There's even been research looking at people who say the word "the" over and over again and notice how the letters and sounds morph with time as you focus on it: "the the the the the." This type of repetition can help keep constant mental chatter at bay.

4. Separate productive worry from unproductive worry. Worry is meant, ideally, to motivate us to complete certain tasks and get things done. Productive worry is adaptive -- when we feel anxious about something and worry about it, we take the necessary steps to solve the issue. Unproductive worry, though, is just that... unproductive. Lying in bed at night and worrying about all of the same things you stress about during the day likely doesn't help you come to any solutions. To-do lists can be really helpful in getting these things off your mind.

Shortly before wind-down time begins, which is set for at least an hour before your bedtime, take out a piece of paper. Fold the paper in half. On the top of the left column, write "Tasks/Worries" and on the top of the right column, write "Next Step Solution." Jot down all of the things that you have to do or concerns you might have on the left side and prioritize them, with one being the most important and so on. Then on the left side, think about what the next step solution might be. It is highly unlikely to be the final solution for many concerns, but it is at least the next step. For example, if you are currently unemployed and need to find a job for financial reasons, the next step solution can simply be, "Look through the help wanted ads online," or, "Send out my resume to five people." Breaking it down into smaller, more achievable goals can help keep unproductive worry from taking hold.

If it is something such as a "take out the garbage" task, write that in the next step solution: "Take out the garbage tomorrow morning." If there's no identifiable next step solution to the problem, then writing just that can help bring some acceptance to the issue: "There's nothing I can do about this, so continuing to worry about it is only serving to make me more anxious and less able to fall asleep."

Keep the paper next to your bed at nighttime, and if you begin to have an overactive mind again, remind yourself that you've written it all down and there's nothing else that can be done at night to take care of the problem. It takes practice, but this technique can be very helpful.

When To See A Specialist If you find that you have tried some of the above techniques and they just aren't helping, consider seeing a specialist in behavioral sleep medicine (BSM). BSM specialists are specifically trained in these issues and may be able to help you sleep better on a regular basis. 

Tuesday, April 22, 2014

How to Manage Worry

11 Habits Of People Who...
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11 Habits Of People Who Never Worry

Worry is, sadly, an inevitability of life. Bad things are bound to happen, and the natural human reaction is to think about the negative consequences that could potentially arise.
However, worry is rarely productive -- "it's something we do over and over again, without much resolution, and it's typically of the worst-case scenario of the future," explains Jason Moser, Ph.D., an assistant professor in the Department of Psychology at Michigan State University, who has conducted studies on worry.
"There’s always an element of uncertainty, always an element of catastrophe," he tells HuffPost. Unlike fear, which has a more pin-pointable source (like a spider on the wall), people worry over "an amorphous, future uncertain threat -- something bad that mighthappen."
While the research isn't clear on the extent to which people are predisposed to worry, it is clear that there are some personality types that are more linked to worrying than others. Neuroticism seems to be tied to worrying, for instance, as is general intolerance of uncertainty, Moser says. And while everyone worries from time to time, it is possible to worry so much that it starts to have a noticeable impact on your daily life.
But even if you are a worrier, you're not doomed -- there are a number of effective strategies that worriers can use to stop the cycle. Moser and Christine Purdon, Ph.D., a licensed psychologist, professor and executive director of the Centre for Mental Health Research at the University of Waterloo, shared some of the most effective habits and strategies for squelching worry, as well as some common traits shared by people who aren't bogged down by it:
They focus on the present.
Perhaps one of the biggest differences between worriers and non-worriers is the ability to stay in the present, and not get bogged down by things that have yet to happen. Purdon calls it a "worry chain" -- the idea that one worry will spur a "what if," which spurs another worry and another "what if," and so on. Non-worriers are able to look at a problem and recognize what solution needs to be implemented, "but a worrier isn't able to get that kind of distance," she explains. "The mind goes a lot faster."
For instance, say your son comes home with a bad grade. If you're a worrier, you might then worry that this will cause your son to fail the class, which will then impair him from getting into college. However, if you're a non-worrier, you'll realize that the immediate issue at hand is just that your son needs to study harder in this particular class -- and that's that. "I'm able to say, 'He usually does really well, he's smart, he’s dedicated, he’ll be fine; this is a blip, not a pattern,'" Purdon says. Whereas when worriers become anxious, their "intentional focus narrows to threat cues. They can get themselves very anxious very quickly."
They practice mindfulness.
meditation
Because staying in the present is so fundamental to squashing worry, practicing mindfulness can help you to steer focus away from a hypothetical issue that could develop down the road. "It keeps you in the here and now and it helps you be more aware of your thoughts," Purdon says.
And therapy, such as cognitive behavioral therapy (CBT) and acceptance and commitment therapy, can also help worriers stop the negative cycle, since they focus "on the idea of not wrestling and disconfirming the worries, but getting people to focus on their life and values and focus on the present moment so they can make decisions," Moser adds.
Their brains actually function differently in a worry-inducing event.
Moser recently had a study come out in the Journal of Abnormal Psychology, showing that the brains of worriers and non-worriers actually work differently in a stressful event. For the study, Moser and his colleagues had 71 female study participants answer surveys that indicated whether they were generally positive thinkers or negative thinkers/worriers. Then, the participants looked at negative images -- such as a woman having a knife held to her throat by a masked man -- as their brain activity was monitored and recorded.
Moser found that the brains of the positive thinkers were less active than those of the negative thinkers/worriers. In fact, "the worriers actually showed a paradoxical backfiring effect in their brains when asked to decrease their negative emotions,” he explained in a statement. “This suggests they have a really hard time putting a positive spin on difficult situations and actually make their negative emotions worse even when they are asked to think positively.”
They're more willing to take chances.
While worriers have a hard time making decisions -- they take a long time because they can become crippled by all the potential negative outcomes -- non-worriers are more willing to test out solutions to a problem even if a bad outcome is possible, Moser says. In that same vein, non-worriers are also more flexible in the way they think about things, so they don't get stuck in a negative thinking rut.
They have a sense of perspective.
perspective
Non-worriers are able to distance themselves from a situation in order to gain perspective. However, worriers can increase their perspective, Moser explains. One method for doing this is thinking of all the worst possible scenarios, and then evaluating how likely each of them is to really happen. For example: If a worrier is concerned about losing her job, she may jump to the worst-case scenario, which is that she will end up living under a bridge, homeless and alone. But Moser says that talking a worrier through a scenario like this helps her understand how unlikely that outcome is to happen.
Moser suggests another simple strategy to gain perspective: Using your own name instead of "I" when referring to your emotions. For instance, saying "I'm going to fail" is harsh and doesn't allow any distance between you and the thing you're worried about. But "if you talk about yourself in the third person, you can take better perspective," Moser says.
They get to the root of their worry.
The problem with worrying is that it can spin out of control until the thing you're worried about is 10 steps removed from your immediate issue. That's why it's so important to figure out what the real problem is in order to stop the worry cycle.
"When I work with worriers, I try to work on them with problem identification, and to help them be comfortable doing that," Purdon says. "Yes, there are some problems that could lead to something else, but [let's] not worry about that right now because it's not happening right now."
It's important to move from problem-generation, which is what worriers are prone to do, to problem-solving. "Worriers think what they're doing is constructive -- that by anticipating [the future problems], it's helpful in some way," Purdon says. "It's reasonable, to some extent, to do that, but they can't stop themselves once they get started."
They don't stop worrying -- they just designate time for it.
clock
"One of the reasons why people engage their worry is they think, 'This is an issue I must sort out now, I have to anticipate and plan against these outcomes.' It grabs attention off what they need to be attending to, whether it be job, spouse, kids, whatever," Purdon explains. So, she recommends using a strategy called the "worry chair." It works like this -- reserve a 15-minute time during the day where you can just think and ponder over your worries on your own. Don't worry outside those 15 minutes, and make sure that you're spending your worry session in the same spot (hence the term "worry chair"!) each day.
"What that means is when you're worried during the day, you can say, 'I'll think about that later. I can switch my attention off that and go on to other things,'" Purdon says. "And what they find is, 'I'm not even worried about that anymore.' But giving them permission to worry about it, but later, allows them to switch the attention away from the thought."
They have confidence they can handle whatever comes at them.
"People with high worry not only generate ideas about what could go wrong, they also lack confidence in their ability to cope with what could go wrong," Purdon explains, adding that this is ironic considering worriers actually perform quite well in a crisis since they've spent so much time thinking about the worst-case scenarios and have normal coping abilities. Non-worriers, on the other hand, possess the confidence that if something were to happen, they'll just ... handle it.
They have the ability to see positive outcomes in seemingly bleak situations.
Take the graphic image Moser used in his Journal of Abnormal Psychology study, described earlier. If you were to look at an image of a woman being held at knifepoint by a masked man, what do you think the next immediate outcome would be? A worrier would likely only think of the worst-case scenario, while a non-worrier would have the capacity to think, "That woman is in distress, but maybe she breaks away from her assailant and runs to safety," Moser explains. Non-worriers are able to see that there could be a positive outcome to a negative event.
They ask themselves the right questions.
thought bubble
Worriers who are trying to tamp down on their worrying tendencies could find it useful to ask themselves a series of questions when they're going down a negative path. "Ask, 'Is it my problem?" And secondly, 'Do I have any control over it?'" Purdon says. "Thirdly, the next question people can ask themselves is, 'Have I already done everything about it that I can? And is it imminent?' If it's not imminent, then there's no reason to worry about it now."
They know how to perceive their negative emotions. "The most severe chronic worriers [are] less accepting of their emotions, which means they're intolerant of uncertainty and also find negative emotions in particular to not be very acceptable," Moser explains. Meanwhile, people who have a healthier psychological outlook tend to look at negative emotions as a sign that whatever is causing those emotions -- whether it be relationships, or work, or bills -- needs attention. They use emotions to make informed decisions.

Wednesday, April 16, 2014

Monday, April 14, 2014

Art Walkabout "Street Photography"

Don Mangus, Street 1, iPhone photograph, 2014


Don Mangus, Street 2, iPhone photograph, 2014


Don Mangus, Street 3, iPhone photograph, 2014


Don Mangus, Street 4, iPhone photograph, 2014


Don Mangus, Street 5, iPhone photograph, 2014




Friday, April 11, 2014

Art Walkabout iPhone Photos

Here are some more art walkabout iPhone photos I have lensed recently:

Don Mangus, Lakewood Theatre, iPhone photo, 2014


Don Mangus, Highland Park Pharmacy, iPhone photo, 2014


Don Mangus, L Street Traffic Sign Shadow, iPhone photo, 2014


Don Mangus, Knox Street Walkabout 1, iPhone photo, 2014


Don Mangus, Hillside Walkabout 1, iPhone photo, 2014


Don Mangus, L Street Walkabout 7, iPhone photo, 2014