Diseases of Stress and the lateral habenula

Ketamine-Salt-Lake-City-Park-City-Winter.jpg

Stress is a major tool of assault to the average modern brain. There are few of us who do not understand intimately the teeth-gnashing mental grind of being late for work, being late on taxes, or watching one’s children learn with desperate helplessness of the latest mode of teen bullying and sexual predation, let alone the latest mode of presidential antics triggering whichever gut-wrenching response your citizenship requires of you.

Stress acts through many neural and personality mechanisms, both subtle and coarse. We divide the patterns of personality response into the categories that we name depression, anxiety, and PTSD. They are much of the same disease in that progression of the process of dealing with stress leads to a tipping point in a critical brain organ whose responsibility is depression and despair. That dark and life-compromising organ is the lateral habenula, and its mighty sword of anti-salvation is a pattern of neuronal firing termed the “lateral habenular burst mode.”

When your lateral habenula goes into burst mode, it has sent a message to your “happy center,” your VTA = ventral tegmental area, which then shuts down. When your VTA shuts down, you don’t get your dopamine, and when you don’t get your dopamine you are no longer capable of even the thought of sniffing the flowers or tip-toeing through the tulips because, in the dopamine-free depths of your depression, the only thing your mind can think about is the tiger around the corner.

Though medical folks only learned of the lateral habenula and its burst mode a few months ago in the February 2018 issue of Nature, we’ve known of ketamine’s effects on the stress diseases for more than a decade, especially in its acuity of action. We all know that no other medicine acutely deflates the danger of acute suicidality like ketamine.

The article shows us a micro-mechanism of acute despair as it also reveals the specific calcium ion channel blocking by ketamine that reverses that despair and gets us back to sniffing the roses that is our due.

This habenular burst mode is a final mechanism for all three of the stress diseases. Anxiety can be thought of as stress that is recognized, feared, and constantly struggled against; but whatever the stage of the battle, the lateral habenula is recording every negative thought, every assault no matter how small, and every daily frustration as it marches toward the dreaded state of burst mode.

PTSD is like anxiety in providing constant negative stress for the lateral habenula to record in its role as “Dooms Day Book for the Average Citizen,” but the stressor here doesn’t derive from the rigors of daily living. The source of bad feelings with PTSD is usually a well-defined, intense and threatening event in the past. Incoming artillery, childhood sexual assault, or serious physical trauma are some the common forms of this uncommonly severe variety of stress. Whether PTSD persists in the “anxiety” mode of hyper-vigilance, or progresses to full major depression, the actual measure of despair is defined by the lateral habenula.

And once we have entered the lateral habenular burst mode, we seldom escape. Major depression has been a nearly untouchable disease for most of Humankind’s time on the planet. Psychiatry’s SSRIs get many patient’s out the door, but not by addressing their depression; Prozac has no more anti-depressant action than a sugar pill.

Psychiatry’s pushing worthless SSRIs when the truly remarkable antidepressant ketamine is available is sad testimony to capitalism’s ability to encroach negatively on medical healing by employing  the creepy modes of confusion, coercion and outright misinformation.

And shocking a brain? “Just a little memory loss,” they say? Excuse me, here, but comparing electroshock to ketamine is like shaving with a Bowie knife vs. a Norelco safety razor, or maybe dating Stormy Daniels vs. your childhood sweetheart.

The common final pathway of depression, anxiety, and PTSD is the despair induced by VTA shutdown signaled by the lateral habenula burst mode. Only ketamine is known to reverse this burst mode, thereby ending the despair of the human brain’s most feared and destructive disease, major depression.