Upgrading your mind.

10 March 2011: Psychologists are historically focused on ways to elevate a patient’s negative mental state from minus five to zero, for example, with zero considered the benchmark of ‘normal’. A modern scientific ambition is to elevate one’s state of mind from zero to plus five.

In the film As Good As It Gets, Jack Nicholson portrays the role of Mr. Yudolf, a cantankerous, middle-aged bachelor who suffers from an obsessive-compulsive disorder. He is also clearly intelligent. His neighbour, whom he dislikes for no particular reason other than being gay, is injured in a robbery and becomes housebound. Even worse, due to the debt from his medical bills, falls on financial hardship and faces the threat of losing his apartment. Not surprisingly, this causes him to become rather depressed.

One day, the injured neighbour’s cleaning lady nervously asks Mr. Yudolf whether he’ll oblige with the daily task of walking the neighbour’s dog. To her great surprise, he agrees. She then pushes her luck by asking him to boost the neighbour’s mood with an assortment of pleasantries, i.e. smell the roses, be appreciative of all God’s good creatures, etcetera. With a look of disgust Mr. Yudolf demands where she learnt to speak like that. In worse language, he asks her whether it was in some “Panamanian go-go bar trying to pick up a sailor”.  He finally tells her to go “sell sick somewhere else”, since he was already “stocked up”, as he puts it, and slams the door in her face.
Although humoresque and slightly shocking, this scene is also painfully accurate. For Mr. Yudolf, the problems living at the coalface of life are tough and significantly more complex than what a few hearty comments can solve. On a bad day, they may easily be completely meaningless and patronising. This is when one needs something more substantial. (The cleaning lady, off course, although perhaps no Einstein, does deserve a thumbs up for being kind and considerate.)

The truth is that it is never easy to maintain the level of self-control to always keep a positive attitude or mindset. It is even more difficult to focus on your personal goals when hope starts fading and the playing field are for ever changing.   Mood plays a dominant role in our lives; a good mood makes us think and feel better. It makes us more optimistic and enthusiastic. It also improves the quality of our interpersonal relationships and strengthens our level of commitment, resolve and focus in life. The numerous negative emotions like stress, frustration, rejection and disappointment, on the other hand, have the opposite effect, tending to derail us and make us become withdrawn and introspective. In the process we give up and abandon our goals.

The body’s central processing unit.
Not unlike a computer, the brain is made up of billions of nerve cells or neurons that communicate with each other via minuscule electrical pulses that flow through an intricate web of microscopic fibres. Called dendrites, these fibres stretch great distances to reach neurons in other parts of the brain and connect with their dendrites, thereby creating a three dimensional network that spans across the entire brain. Dendrites connect with each other at a specialised end-organ, or synapse. This is where the brain keeps it store of neurotransmitters, those famous messenger chemicals that drugs like Prozac targets. The better known neurotransmitters are serotonin, dopamine and noradrenalin, to name a few, and they all share the same function, namely fulfilling the role of chemical messengers. All antidepressant medication has been designed to increase levels of neuro-transmitters in the synapse, either by stimulating their release or by preventing their breakdown.  Just like a computer, every thought, memory and emotion has an underlying chemical as well as electronic pathway. Whilst neurons and neurotransmitters form the hardware of your brain, emotion is the software.

 

Neural operating systems.
The word “emotion” comes from the Latin word, “motere”, plus the prefix “e”, implying “to move away”. Emotions are nothing more than primordial impulses to act. Emotions are automatic, implying that they are engrained into our subconscious minds like the basic operating system which runs your PC. This ability allows us to act without needing to waste time bothering about thinking. The benefit of this built in software program is that it enables us to jump out of the way of a speeding car, or dive into a pool to save a drowning child without giving it a second thought.

Emotions are crucial survival instincts that we have inherited from the dinosaurs. They are rather ingenious. With anger, for example, we release adrenalin into our systems. This increases our heart rate, thereby bringing more oxygen and energy to our bodies. We focus more clearly, our hands clench tightly, ready to grasp a weapon and strike. With fear, our minds stop thinking and blood rushes to our leg muscles in preparation for running.

Happiness has an opposite effect. The brain inhibits most negative feelings such as worrying, fear and pessimism. As with anger, we become more energised in the form of increased enthusiasm, thereby creating the drive and ambition to strive for greater goals.

The sensory or neocortex of the brain is like the processor of a computer with a high-speed, analytical function.  When we are calm and controlled, it will suggest an appropriate response to an event that requires emotional interpretation, for example: “If I smile at him, he will smile back at me”, or “If I say something nasty to him, he’ll become angry with me.” The amygdala is our primitive emotional brain and its function is to give the “fight” or “flight” command when we are in danger. For us, the same happens when we are stressed, not necessarily in danger.  But because our software has been programmed for survival, the sensory cortex’s analytic function is immediately bypassed by the amygdala when we feel confronted. This is when things can go very wrong.

The amygdala continuously scans its archives for stored information before it responds.  The information that it contains have been gathered over many years from our own past experiences, as well automatically inherited from the experiences that caveman had stored in his mind, in other words, our genetically imprinted memories. Of these, the most powerful memories always come from two main sources, namely either pleasant, or unpleasant childhood experiences. The earlier in life an unpleasant memory becomes imprinted, the more likely that it will be that it becomes part of our permanent memory.

Unfortunately, the amygdala or emotional brain is limited to fight or flight responses that are often totally inappropriate to the actual situation. Because the logic of the neocortex can be overruled by the amygdala, we regularly lose intellectual control over our emotions. After an ‘inappropriate’ amygdala response, however, like a temper tantrum for example, the neocortex’s logical function returns and then usually tries to rationalise or defend the emotional response. This is when it becomes acceptable to blame others. “If he had not provoked me like that, I would not have lost my temper and made such a terrible scene. It is therefore his fault that I behaved so badly.”

For an outside observer, of course, this excuse will not hold water and they will most probably end up thinking that the person is somewhat nutty.

 

Mental software 
IQ refers to intelligence. IQ has been taught and tested at schools for many centuries. EQ, on the other hand, refers to ‘emotional intelligence’, a term that two researchers, Salovey and Mayer, coined only as recently as 1990.  The world was awakened to the significance of EQ in the early 1990’s when research by clinicians and authorities on human development revealed the fundamental link between success in life and EQ. Ongoing studies, backed up by conclusive evidence from business, sporting and individual success sources, confirm that success in life has more to do with emotional intelligence (EQ) than pure intellect (IQ).

Research continuously reinforces the connection between wellbeing and EQ. People who are emotionally more intelligent are more effective at their jobs, achieve more promotions, take better care of their health and have more fulfilling family and personal lives. More often, they get what they want from life. If we become less distracted by our negative emotions and more able to rely on or make use of our positive emotions, we have a better chance to strive for and achieve our goals in life. The first step towards this goal is to become more emotionally aware.

Dr. Fredric Loomis, a busy gynaecologist has an inspiring story. It begins on a day that he receives a letter from an anonymous patient. Although she was admitted to one of his wards, she had been under the care of another doctor. She starts by telling him that he would not remember her. She had lost her baby at birth and he, having heard of her loss, spent a few moments with her by holding her hand and sitting beside her. He had not said much but his voice and eyes where kind and his mere presence comforted her. She never saw him again in spite of the fact that the nurses had told her that he practically spent all day and night at the hospital. This is an extract from her letter:

“This afternoon I was a guest in a beautiful Chinese home here in Peking. The garden was enclosed by a high wall, and on one side, surrounded by twining red and white flowers, was a brass plate about two feet long. I asked someone to translate the Chinese characters for me. They said: ENJOY YOURSELF. IT IS LATER THAN YOU THINK.

I began thinking about it for myself. I had not wanted another baby because I was grieving for the one I lost, but decided at that moment that I could not wait any longer. Perhaps it may also be later for me than I thought. Then, because I was thinking of my baby, I thought of you and the tired lines in your face, and the moment of sympathy you had given me when I so needed it. I don’t know how old you are but I am quite sure that you are old enough to be my father. I know that those few moments we spent meant little or nothing to you of course, but they meant a great deal to a woman who was desperately unhappy.

I may be presumptuous to think that in turn I can do something for you too, but perhaps for you it is later than you think. Please forgive me, but when your work is over on the day you get my letter, please sit down quietly, all by yourself, and think about it. Marguerite.”

The story continues with Dr. Loomis immediately taking a three-month sabbatical and going to South America with an old friend. For Dr. Loomis it was the stimulus he needed to prompt him into rearranging the priorities of his life. For many, however, the interest lies with the beautiful mind of Marguerite. Not only did she use the few words on the plaque, which thousands may have read without really appreciating, to change her mood from grief to hope, it also presented her with the opportunity to show compassion to another being that merely looked a bit weather-beaten.

Marguerite’s ability to view a crisis in the light of an opportunity is a talent and strength that few naturally possess. It is easy to become so self-absorbed and obsessed with your own misery that all other opportunities and duties, including the well-being of another, becomes irrelevant. Re-active people wait for opportunities to come along so that they can respond. Pro-active people, on the other hand, actively strive to create their own opportunities. The difference between taking the initiative and responsibility for making things happen, rather than wait for someone else to take the initiative, is like chalk and cheese, especially when measured over a lifespan.

 

Installing neurological upgrades
Scientists have been battling for years with the concept of what makes and keeps your mind working optimally. Psychologists are historically focused on ways to elevate a patient’s negative frame of mind, or mental state, from minus five, for example, to zero, with zero considered the benchmark of ‘normal’. A modern scientific ambition, however, is to elevate one’s state of mind from zero to plus five. This approach includes the concept of Emotional Intelligence (EQ) rather than IQ, as well as the use of certain chemical compounds that improves mental functioning and mood.

Seeing that a chain is only as strong as its weakest link, the best way to achieve this is with a combination of different strategies executed simultaneously. The first step towards optimising your brain function is to following a proper, wholesome diet. Fresh fruit and vegetables must be consumed of a daily basis to get the right micronutrients, minerals and vitamins, and the intake of toxic substances like alcohol and tobacco smoke must be minimised. Exercise is a wonderful and natural way of relieving the symptoms of stress. The next step relates to the use of biochemistry.

Accelerating neural processing speed
With the rising cost of prescription medication and their prevalence of unwanted side effects, many patients suffering from mood related disorders are exploring herbal and other natural remedies for the management and treatment of psychological conditions. Statistically, psychological disorders such as stress are one of the most frequent conditions seen by clinicians, often requiring a long-term regimen of prescription medications. Unfortunately, many patients experience a spectrum of behavioural and physical side effects that often accompany prescription medication. This includes the risk of weight gain in an already obese society. It is therefore not surprising that there is a universal interest amongst the scientific community to find effective anxiolytic and mood improving (anti-depressant) treatments that are more natural, has a lower risk of side effect effects and that displays fewer drug interactions.

Over the past decades, the use of complementary and alternative medications (CAM’s) have grown to such a degree that for many it has become part of everyday treatment. The use of CAM’s for mental problems have also increased significantly over the past two decades. In the field of alternative & complementary medicine, numerous plant-based extracts or nutraceutical compounds are used or have been tested. Proponents of evidence-based medicine, however, such as the Cochrane Collaboration, agree that all treatments, whether mainstream or alternative, ought to be held to standards of the scientific method.

Based on the available evidence, it appeared that certain nutritional and herbal supplements are effective when treating depressive and anxiety-related conditions. At the institute, however, our concern was that as with any drug trial, there is always the possibility that any positive effect could be due to the placebo effect, rather than a true benefit, especially in participants with an underlying mental disorder. Strong evidence, on the other hand, has emerged from both animal and human trials suggesting that certain nutraceutical compounds and plant extracts hold significant benefits above placebo, and that in some instances, some of these benefits are comparable with those of psychiatric drugs.

Over the years we used many of these agents to treat our patients at the chain of pharmacy clinics which we had initiated for the largest food retail chain, testing them for benefit versus side effects ratio’s, as well as experimenting to quantify the optimal dosage. The knowledge that we gained through this process also allowed us the opportunity to identify what we believe to be the most cutting-edged agents. Even more importantly, we figured out how to combine them so that their synergistic effects would work in harmony and enhance or complement one another, thereby developing the advanced formulation of NeuroVance, a more effective product and with a lower side effect profile. Designed to enhance brain function during times of stress, greater workloads, concentration difficulties and mood-related symptoms,  NeuroVance contains a patented and proprietary blend of plant extracts and nutraceutical agents which include Rhodiola rosea extract, inositol, magnesium and zinc.

Rhodiola rosea
Rhodiola rosea is a plant that grows in cold regions around the world, including the Arctic, the mountainous areas of central Asia, the Alps, Scandinavia and Iceland. Traditionally, Rhodiola rosea was used by Siberians and Scandinavians to improve vitality in harsh conditions presented by bitter cold climates and high altitude areas. To improve physical and mental endurance while persevering under stressful conditions, Rhodiola was routinely given to Soviet cosmonauts, KGB secret agents and special force soldiers. Various studies have assessed Rhodiola extract's effect on the neurological function of humans[7-22] and animals[23-32]. In particular, studies on human subjects have shown that it improves mood by displaying the rare and unique quality of alleviating both the symptoms of depression,[7,13] as well as anxiety.  Rhodiola's mode of action appears to be mediated by its influence on the levels of the two most important “happiness” neurotransmitters, namely serotonin and dopamine.[14]

Trials done with Rhodiola extract on patients suffering from mild to moderate depression showed a significant improvement regarding scores of insomnia and emotional instability as compared to placebo[7]. During another trial, participants with generalized anxiety disorder (GAD) showed a significant improvement in anxiety related symptoms with Rhodiola extract, as measured via three different psychometric scales, namely the Hamilton Anxiety Rating Scale (HARS), the Four-Dimensional Anxiety and Depression Scale and the Clinical Global Impressions of Severity/Improvement Scale[9]. Various studies have also demonstrated that Rhodiola rosea extract exerts an anti-fatigue effect that improves general mental performance and increases the ability to concentrate in healthy subjects[11,12,13]. One such double blind, cross-over study, examined this effect in healthy physicians during night duty. During this trial, a statistically significant improvement in perceptive and cognitive cerebral functions were measured in all the doctors that partook in the trail[10].

Despite these broad benefits, Rhodiola rosea features a remarkably low toxicity level. In standard clinical toxicity studies performed with rats, the lethal dose at which 50 percent of animals will perish was determined to be 28.6 ml/kg, which is approximately 3,360 mg/kg.  In human terms, a potentially lethal dosage for an adult man weighing 70kg will therefore be 235 kg, an extremely low toxicity level even when compared to many common herbal agents considered safe, but especially when compared to frequently consumed, over-the-counter pain and flu medications. However, when compared to the toxicity profile of tranquilisers, sleeping tablets and anti-depressants, Rhodiola’s side effect profile pales to insignificance.

Inositol
Inositol occurs naturally as phytic acid in the fibre component of certain plant foods, and as myo-inositol in meat.  Myo-inositol is found to bio-accumulate most abundantly in the central nervous system, where it plays an important role as the structural basis for numerous signalling and secondary messenger molecules. These play a crucial role in a number of biological processes, including nerve guidance, the modulation of serotonin’s activity, gene expression and the assembly of the cytoskeleton of neurons. Studies on inositol supplementation show promising results for people suffering from neuro-psychological conditions such as generalised anxiety disorder, panic disorder, obsessive-compulsive disorder, bulimia, agoraphobia and depression[1,2,3,4,5]. In a double-blind, controlled trial, inositol proved superior to fluvoxamine, a popular antidepressant belonging to the class of SSRI drugs, (serotonin selective reuptake inhibitors), for decreasing the number of panic attacks.[1]

Research has also indicated that many patients suffering from clinical depression have decreased levels of inositol in their cerebrospinal fluid, the liquid medium that encapsulates the brain[2].  It has been postulated that inositol produces positive clinical results in patients with depression due to the important role that it plays as a messenger molecule for the mood controlling neurotransmitter, 5-HTP (Hydroxytryptamine). In another double-blind, placebo-controlled study of depressed patients, inositol supplementation resulted in the significant improvement of symptoms [2]. Numerous trials have demonstrated that inositol has a low side effect profile. Gastro-intestinal irritation has been reported on occasion and there are currently no documented contra-indications or drug interactions.

Magnesium
Magnesium, in its ionic form, is crucial to the function of all living cells, playing a major role in regulating biological compounds like ATP, DNA and RNA. Over 300 enzymes require the presence of magnesium ions for their catalytic action. Historically, magnesium compounds are commonly used medicinally as laxatives, antacids and until recently, treatment-resistant depression (TRD)[30,31,32]. Magnesium-deficiency is known to lead to the dysfunctional opening of specialised calcium channels (N-methyl-d-aspartate /NMDA coupled), thereby causing neuronal injury and subsequent neurological dysfunction. It is postulated that this pathological development may present in humans with the symptom of depression[30]. Evidence from several studies strongly links magnesium with the intracellular and interneuronal processes associated with certain mood disorders, especially depression[30-41]. Studies have also demonstrated the mental benefits of magnesium supplementation[30,31,32]. In one animal study, magnesium supplementation was comparable to the anti-depressant drug imipramine[41]. A  randomized clinical trial done on humans, however, also showed that magnesium was as effective as imipramine when treating depression[30]. Magnesium may cause diarrhoea, nausea and abdominal discomfort on rare occasions. It should be given with caution to patients receiving digitalis.


Zinc
Zinc stimulates the activity of about 100 different enzymatic reactions in the body and like magnesium, is an important modulator of glutaminergic transmission in the brain. A growing body of evidence implicates a derangement of zinc homeostasis in the psychopathology as well as treatment of mood disorders[43-57]. Zinc’s antidepressant-like activity has been examined in a variety of tests and models in laboratory animals[57-61] as well as human studies[43-57]. A placebo-controlled, double blind study of zinc supplementation in imipramine therapy, an antidepressant drug, was conducted in sixty depressed patients fulfilling the DSM-IV criteria for major depression without psychotic symptoms. During this trial zinc supplementation significantly reduced depression scores and facilitated the treatment outcome in antidepressant treatment resistant patients. [43]

References available upon request.