A Neuroscientist Lost Her Mind From Cancer. Shes Not Alone.

Barbara Lipska was already a two-time cancer survivor when her hand disappeared in front of her face in 2015.

The neuroscientist and director of the Human Brain Collection Core at the National Institute of Mental Health specializes in studying schizophrenia. When she moved her right hand and it disappeared, she immediately predicted her eventual diagnosis.

I thought right away: brain tumor, she told The Daily Beast. But I quickly expelled it. I didnt have time for brain tumors.

Lipska, whose book The Neuroscientist Who Lost Her Mind: My Tale of Madness and Recovery was published on April 3, had already faced her own mental health challenges in the wake of battling breast cancer in 2009, then melanoma in 2011. She sought psychotherapy at the recommendation of her daughter.

Shes not alone in needing help as a cancer patient. According to the American Cancer Society, feelings of depression, anxiety, and fear are very common in people with cancer, and up to one in 4 people with cancer have clinical depression.

I didnt have time for brain tumors.
Barbara Lipska, neuroscientist and author

The mental health issues Lipska started experiencing in 2015 were extreme. There was the vision issue, her disappearing hand, and the suddenly unrecognizable faces of colleagues. There was also her memoryforgetting where she lived while out on a run and an impaired awareness of having to urinate, leading her to pee her pants. And there was also her changing personality, breakdowns and overall failure to see that she was experiencing these things. Lipska, whose entire career revolved around these kinds of behaviors caused by mental health disorders, suddenly started experiencing them herself.

Lipskas brain tumors were metastases, secondary malignant growths in the brain that were a result of her melanoma. Her largest tumor was the size of an almond. According to the American Brain Tumor Association, melanoma is a common cancer to metastasize to the brain, along with lung, breast, and colon.

One of Lipskas doctors, Ayal Aizer, M.D., a radiation oncologist at the Dana-Farber Cancer Institute, told The Daily Beast that there are a number of elements to consider when patients are diagnosed with metastases, namely the location of their tumors, which eventually defines how they manifest. Lipskas tumors inhabited her brains frontal cortex, which, she writes in her book, determines who humans are.

Even if theyre small, theres a psychological aspect of having cancer in the brain which is very difficult to digest and ultimately cope with, and in addition to that, some patients who have brain metastases actually have symptoms that can impair what we value most in life like vision, coordination or speech or walking and the ability to think clearly and digest information, he said.

It really can significantly impact the life.

Aizer said that a patients mental healthcare is dictated by what they want or express in their unique needs. Sometimes, patients like to stick to strictly medical facts when dealing with oncologists; other times, they want to have an all-hands-on-deck approach, with psychologists, psychiatrists, even family therapists. The goal is to help patients process their mental and neurological issues, digest it, cope with it.

Sometimes we can bring in speech and language and occupational therapists, and I think just having the opportunity to sit with a mental health professional in the office for an hour where were not talking about chemo or immunotherapy or radiation or surgery and its talking about what life is like, what challenges theyre facing and having someone to sort of listen, serve as a sounding board and come up with strategies to cope is really valuable, Aizer said.

Lipska underwent many different treatments for the metastases, like immunotherapy, radiation, steroids and targeted therapy. And slowly, her clarity came back bit by bit, but she was entirely unaware of how shed behaved, so much so that her family had to fill her in on her behaviors.

Today, Lipska is now in remission. Its been 16 months after the initial findings of her tumors, but shes aware there could be more cancer cells still in her body. Theres also the chance shell develop necrosis, an effect of radiation that destroys healthy brain tissue.

But mostly, Lipska is positive, thankful. Shes happy to have her memory and brain back and to have learned so much from her experience that she can use toward her own work.

Though shes regained her neurological function, she largely associates what she went through with what mentally ill people go through every day.

In the course of losing and regaining my sanity, Ive come to identify with other people who have known mental illnesses firsthand, Lipska said in her book, explaining that the symptoms she exhibited fall in line with diagnoses for dementia, schizophrenia, and bipolar disorder. Despite conducting research on mental illness for over thirty years, I believe it is my own suffering that truly taught me how the brain worksand how profoundly frightening it is when our minds fail.

Lipska said her compassion for those with mental illness is one of the many things this experience left her with.

The brain is an incredibly complex mechanism and we have no idea what happens in people with mental illness, so theres more empathy, it gives rise to more tolerance and more passion toward research in this field and more passion to find a cure, which I spend my life working on.

Read more: https://www.thedailybeast.com/a-neuroscientist-lost-her-mind-from-cancer-shes-not-alone

Party drug ketamine closer to approval for depression

(CNN)The Food and Drug Administration put the experimental drug esketamine (also known as ketamine) on the fast track to official approval for use in treating major depression, Janssen Pharmaceutical announced Tuesday. This designated “breakthrough therapy” would offer psychiatrists a new method for treating patients with suicidal tendencies and would qualify as the first new treatment for major depressive disorder in about half a century.

In some quarters, though, this potentially effective medicine can’t escape its reputation as “Special K,” a street drug known for producing a high similar to an out-of-body experience — and sometimes used as a date rape drug.
    As described in a published report by Coffman, she used ketamine when treating a patient who had treatment-resistant depression; none of the antidepressants he had tried alleviated his symptoms. A single oral dose of ketamine “had a very positive effect,” Coffman said, and helped improve his anxiety symptoms. “Even from his family’s standpoint. They noticed a marked improvement,” Coffman said.
    Janssen is working on clinical trials for two indications for esketamine: one for treatment-resistant depression and another for depression with suicidal thoughts. The company plans to present its phase III data for treatment-resistant depression in 2018 and file with the FDA that year.
    A concern with using ketamine to treat depression is that it can reverse tolerance to opioids, Coffman said. Essentially, patients will get a higher dose of pain medicines, she explained, so any psychiatric uses would require “close oversight” by a multidisciplinary team of doctors.
    Iosifescu said the short-term effects are known, but the long-term effects remain mysterious.
    Another concern is the similarity between prescription ketamine and the street drug, a substance of abuse.
    These are all reasons why Janssen’s formulation will be provided and administered in doctors’ offices or clinics, not distributed by pharmacies.
    “We want to make sure patients are protected,” said Dr. David Hough, a psychiatrist and medical leader for esketamine research at Janssen. He explained that when patients are treated with esketamine, their blood pressure may increase, they may feel dizzy, and there may be other physiological effects immediately after use, so experts would like patients to be observed for a two-hour period.
    There’s also the public’s perception of the potential for abuse, an important concern that Hough doesn’t want to interfere with the drug’s more important potential as a therapy for suicidal patients.

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    “I was a practicing psychiatrist for many years and saw many patients,” Hough said.
    “Over 41,000 people end up dying by suicide every year in the U.S.,” he said. That’s more than those who die from breast cancer every year. And suicide is increasing, he pointed out. “It’s sort of an un-talked-about thing.”
    Current oral antidepressants take four to six weeks to work, while esketamine takes effect in the first four hours. According to Coffman, the effects of ketamine are not only dramatic but also long-lasting, with some patients experiencing positive results for up to 30 days after a single dose.
    With suicide now a silent epidemic, will ketamine’s bad reputation prevent it from fulfilling its possible promise as a much-needed treatment gap for depression?
    “It’s really groundbreaking,” Hough said.

    Read more: http://www.cnn.com/2016/08/17/health/ketamine-depression-treatment/index.html