Dr. Paul Tabor
OK, here are the questions:
1. Although we could choose to investigate many substances that affect the nervous system, whose use is abused and can cause addiction, we need to look at alcohol because of its prevalence and the magnitude of alcohol-related problems. Alcohol is of course a part of our society. Do you think that there are significant differences in the way societies address the use of alcohol? Do you think there is a relationship between the degreee of a society's acceptance of alcohol use and the level of alcohol abuse? What happens, basically, when alcohol reaches the brain? Does alcohol consumption bring about the same behavior each time a person drinks? At the cellular level, alcohol acts on the nervous system (at this site select 4. Mechanisms of Action) by disordering and "fluidizing" the cell membranes of neurons. This action of alcohol is non-specific in that it alters the characteristics of several neurotransmittor receptors in the cell. The behavior effects caused by alcohol are due to interaction of alcohol with GABA receptor complexes (find the section on GABA at this site). GABA is an inhibitory neurotransmittor for neurons. If GABA receptors are activated by alcohol, does that have anything to do with the relaxing feeling or mild euphoria that is experienced when blood alcohol concentrations are low after drinking alcohol? As you probably know, the level of blood alcohol concentration is influenced by sex and body size (at this site select 2. Stages of Alcohol Intoxication in the Figures and Tables section). Women are particularly affected by alcohol. Many colleges offer support to give women better opportunity to become aware (select alcohol and other drugs at this site). Fetal Alcohol Syndrome (at this site select 5. fetal alcohol syndrome) is the leading cause of birth effects in the US. How much more at risk is the fetus of an alcoholic mother than the national average risk? It is interesting to note that of all the psychoactive drugs that have been studied with respect to affects on behavior, only alcohol abuse has a positive correlation with violent behavior. Besides physiological differences, we have alluded to the idea that the environmental circumstance is an important factor in the results from alcohol use. Are there correlations between regional patterns of alcohol use and prevalence of alcohol-related deaths? Have the cycles of change in alcohol comsumption in the past correlated with numbers of alcohol-related deaths?
We have all heard the term, but what is alcoholism? Is the reason for alcohol addction known? Is there a difference between alcohol abuse and alcohol dependence? How can the difference be determined? For those addicted to alcohol, withdrawal can be very difficult. By understanding the biochemical basis for how alcohol makes a person feel when drinking, some of the symptoms of withdrawal can be understood. This understanding can be used to develop drugs for relapsing alcoholics. Do effective treatments for alcoholism exist? Here is a site that lists many resources on alcoholism and alcohol abuse.
2. Everyone of us has felt depressed at on time or another. We may have been so depressed that it inhibited our daily activities for a time. But some individuals suffer from illnesses that are as real as diabetes whose major symptoms are despression. For these individuals, depression is a part of their life. What are the characeristics of the illness called Depression? Often we can gain information from asking questions of experts directly. Can you discover how an individual might recognize if she or he is suffering from depression -the illness- from this interview with a clinical psychiatrist? If depression is an illness there must be some etiology or biological basis for it. Although depression may be the result of a number of phyiological changes, one of the most often mentioned is the relation between low levels of the neurotransmitter serotonin and depression. It is hard to show strong evidence that low levels of serotonin is the cause. Recently however, evidence has been found from brain imaging that lack of serotonin activity is associated with depression. It is not feasible to pump serotonin into the cells that need them, so treatments have been designed to make the most out of the serotonin that is available. Using the background you may have about signalling of nerves, can you suggest two ways to make existing molecules of serotonin more efficient? Is it possible to inhibit the removal of serotonin from the active site? Is is possible to protect serotonin from enzymes that would normally destroy it? There are web sites that provides current lists of information on all aspects of depression
A related illness of special interest is bipolar mood disorder (also known as manic depressive illness). It is known that there are 2 million suffers but actual numbers may be more than six million. The National Institutes for Mental health has a web brochure that is a good introduction to bipolar mood disorder. Those with bipolar disorder experience periods of depression that can be extremely severe and then they experience periods of boundless energy and confidence called mania. Many with bipolar disorder are reluctant to seek treatment because of the exhilarating condition of mania. Here is a quote that describes the allure of the manic aspects from a leading researcher on manic depressive illness who, herself, has the illness. The clinical description of bipolar mood disorder is based on the pendulum of mood swings from severe depression to mania. Now that you are familiar with the symptoms, do you think bipolar mood disorder is readily diagnosed in children? The National Institutes of Mental Health web brochure on bipolar disorders includes the description of the illness by patients. The neurobiological basis for the depression side of bipolar disorders may be similar to the causes of depression that we explored above. The cause of mania is less understood. For about 25 years, the element lithium has been effective in reducing the mood changes of persons suffering from bipolar disorder, but no one knew how the drug worked. Very recent evidence has provided a possible explanation of the cause of mania by recognizing how lithium acts in cells (select Lithium from the index at this site). We mentioned that when you feel depressed -even if you do not have an illness- that you can not carry out routine activities. What are the costs to those suffering from mood disorders if they do not seek treatment (under 2. Guidelines: Overview of Mood Disorders look in the section Costs of Untreated Major Depressive Disorder). Most devastating to the families as well as those with bipolar disorder is the fact that without treatment, one of every five will attempt suicide. Do you think that seretonin levels could be used to predict the increased risk of suicide attempts? There has been a strong interest in determining the cause of bipolar mood disorder and for more than 100 years there has been an indication that this is an inherited illness. Unfortunately, it has been very difficult to establish reliable systems to study the inheritance of this illness because the symptoms are based on behavior which can vary significantly with the individual. Some studies have reported that there may be multiples genes on three different chromosomes including the X chromosome that are responsible. Better evidence has indicated the genes are on chromsome 18.
It is often important for those who have questions about bipolar mood disorder - whether persons suffering from or those that are close to a person suffering from this illness to be able to ask for information that will be helpful. There is a web site for frequently asked questions about bipolar disorder. There is also a site that lists many other sites with information onbipolar mood disorder