Dopamine and depression

After last night's posting about Nicotine, Serotonin and Dopamine, something is still not quite settling in me... sort of like, the rationale was built half-way...

Even with bullshitting, the arguments gotta be cogent enough...

Then, I came across the following postmortem study of them courageous lab rats, depressive or not...

Essentially, there were two groups of rats used in this study: the depressive rats and the normal rats. It seemed like the authors measured the binding of chemicals to DA transporters and dopamine receptors at different brain region. Based on their results, they concluded that, in rats, "DA depletion in rats can induce a reduction in the DA transporter and an upregulation of D2/D3 receptors, our data are consistent with the hypothesis that major depression is associated with a deficiency of mesolimbic DA."

And, of course, association is like correlations.... it is not necessarily causation.

Could it have anything to do with the depression I am trying to come out from?

God knows... I guess...

Nicotine, Serotonin and Dopamine

I don't know about you. However, this question just occurred to me a bit earlier that....

OK... it sounds like a pretty good theory that the reduced level of nicotine resulted in the lowered level of dopamine in the reward pathway....

This has something to do with my being depressed.... no nothing ain't so rewarding no more...

Yet, it suddenly occurred to me that while psychosis is commonly linked to L-Dopa and depression associated with low serotonin level....

How on earth does nicotine, Serotonin and Dopamine, together, creative in me the existential vacuous state of being?

Out of curiosity, I did a bit of search on relevant literature and found the following article....

"Depression and self-medication with nicotine: the modifying influence of the dopamine D4 receptor gene." Link

Based on my understanding-- dopamine D4 receptor, depressive people and smoking

1. The rewarding properties of nicotine are largely mediated by its effects on dopamine transmission
2. The dopamine D4 receptors are highly loaded in the reward center
3. Depressive people with certain variant of the dopamine D4 receptor gene might have the propensity to use smoking to stimulate themselves and to reduce negative affect

So what is the role of serotonin?

I haven't found any specific journal article yet daueber... therefore it doesn't mean such knowledge doesn't exist...

I assume-- conventional wisdom says... there is a linkage between low Serotonin level and depression....

Then, the next question I have is that... so how do all these interrelationships have anything to do with my psychotic symptoms?

Based on what I gathered from some other articles I encountered... them experts are not quite sure which variant of Dopamine D4 receptor gene (DRD4) might be related to schizophrenia shall such a variant really exist...

One thing I think they are much more sure is da relationship between L-Dopa and things like schizophrenia...

Interesting to ponder about all them things related with the naming called Dopamine, be them receptors or neurotransmitters... It is sort of like, I guess, all Asian are Asian except for Taiwanese are not Japanese or Korean.... 8-O lol

Just some schizoaffective layperson's mumble jumble... lol

We mentals and them smokes

Went to see my counselor today about my smoking cessation...

An interesting topic came up concerning the plausible benefits of nicotine in my system and the possibility that the decrease level of nicotine in my system could be one of the contributing factors for my recent trip into the hit-by-a-truck grade of depression...

Interesting idea that I have never entertained before....

So I did some simple Google search and came across a report with the following as the introduction paragraph paired with a figure showing the prevalence of Tobacco use in individuals with psychiatric disorder...

"While the prevalence of smoking in the total U.S. population is about 25 to 30 percent, the prevalence among people with schizophrenia is approximately three times as high - or almost 90%, and approximately 60% to 70% for people who have bipolar disorder."

http://www.schizophrenia.com/smokereport.htm


Granted, the sample size might be a bit on the small end and there might be a need for future research to include more subjects in the studies.

Yet, for me, since I am 100% sure that I can be classified as part of the schizophrenia, bipolar disorder and major depression groups, and, I might also have panic attacks, shall the theses of the related research be valid.... No wonder I am such a smoking gun...

Blame me not for my lack of stamina to just say no....

Blame me on them mental conditions of mine to make me more predisposed, genetic or not, to the use of tobacco as a means of, so they say, self-medication.... (some good excuse, I would say.... 8-O lol 8-X )

At some point in the report, it was mentioned that...

"the average person who has schizophrenia smokes approximately 24 cigarettes per day"....

So I thought.... finally I find evidence that I have actually been part of the norm, whatever the norm is.... and God... give me the strength to be the abnormal of the abnormal... 8-O lol

In another article, based on literature review, the authors stated that...

"In patients with a history of major depression, smoking cessation may lead to re-emergence of major depressive symptoms (Covey et al., 1997; Glassman et al., 1990), although a recent study has questioned this phenomenon (Tsoh et al., 2000)."

Regardless whether whether the evidence is conclusive or not, interestingly, I did go into depression and I am still trying to climb my way out of it... although other factors such as them minor inconviniences in life might also have their share of contributions....

At the same time, this reminds me of how my attempt to quit cold turkey back in late 1997 and early 1998 shuffled me right into major depression and got me stuck with this tension headache that would not go away.... Gotta be something sort of true about this line of research, I guess....

In addition, some authors have also attempted to link the presence of nicotine with negative symptoms...

"nicotine has been shown to increase the release of dopamine in the nucleus acumbens and the prefrontal cortex (5,6,7). Glassman (8) suggested that the apathy and lack of motivation characteristic of negative symptoms is what one would expect with diminishing activity of the brain's reward system."

Interesting way of explaining my amotivated state of being...

What it be like if the lower level of nicotine in my system is actually the culprit which resulted in the decreased drive for me to maintain 4 smokes a day schedule? 8-O

In another article, the authors found that...

"nicotine levels of smokers with schizophrenia or schizoaffective disorder were 1.3 times higher than control smokers despite smoking a similar number of cigarettes per day."

In other words, people like me really get our money's worth since the we actually could retain more nicotine out of the same number of smokes we go through when comparing to them normal people. 8-O 8-$

And, of course, if one ever wonder why I went off the wagon on them cigarettes when trying to finish the class I was taking this past few weeks while trying to pull myself out of da depressed state of being... Other than smoking is a means of calming myself down, it also help me think better.... sort of like what they said...

"Nicotine helps schizophrenics with attention and memory."

Essentially, a means to counteract the side effects of the antipsychotic medication we are on.... because as the antipsychotic medications stalls our thinking, nicotine sort of helps us think....

A good example would be, my head was sort of going through the withdrawl and I was staring at the previous sentence not knowing what else to say.... Then, I put this piece of nicotine lozenge into my mouth.... Immediately, I felt the thoughts flowing and, in no time, this last paragraph formed.... regardless whether there is any substance in it or not... 8-O lol

And, the scariest thing that could happen is for me to experience what they have said in the literature as well....

"some smokers with schizophrenia experiencean acute increase in symptoms during attempts to quit smoking."

8-X

For those of you who would like to learn more about the relationship between smoking and mental health disorders, please visit the following site for more information...

http://www.schizophrenia.com/smoke/schizophrenia.smoking.res.htm

Or, use google scholar to look for some more academic grade kinda articles...

(By the way, of course, I won't really suggest the non-mentals to be calling us mentals mentals... because, coming out of your normal mouth, it is called discrimination; coming out of my mouth, it is but a term of endearment... 8-O lol)

Why quit?

One question my doctor asked me yesterday was something like...

"Why drives you into quitting smoking this time?"

Another good question... I have been contemplating about it for months if not years... but what is the driver behind this attempt?

It's been two weeks and I am not 100% sure...

Yet, I know it has something to do with this scary delusional thought I got in my mind when my delusions told me something like...

"You are gonna die young if you don't quite smoking..."

You see... this sentence by itself or on them quitting smoking kind of programs sounds very health conscious and adds a tinkling of scary feeling... but only this little amount...

Yet, this sentence in them delusional dasein moments could be REALLY SCARY.... no joke... REALLY SCARY.... 8-O

So, I guess... it is not me.... my delusions and hallucinations made me do it.... 8-O lol

And, perhaps, how could I have made it this time this far?

It might have something to do with the fact that I have been feeling so very detached from real life that I have so very often forgotten what my life is like including that minor component called... smoking.... an different perspective of functional amnesia... I guess... 8-O lol

So, I guess... again, it is not me... it is the overdosing on Seroquel that helped it... 8-O lol

And, doesn't this make you wonder whether there really is something true in the following saying....

"Things happen for a reason." 8-O lol

Da Dissociation

I spoke of this state of existence I have been trapped in with my shrink during our meeting back a few weeks ago...

Everyday, after work and on my way home, I would be walking down Broadway, having this curious sense of dissociation.... the feeling that the world outside is evolving by itself... independent on my existence...

It is as if I am traversing down them Manhattan blocks in my dream.

Not in reality but in a dream... for... the world surrounding me is to much detached from me to be the reality in life... the opposite state, I fiure, for low-latent inhibition....

So my doctor asked me this good question....

When does it happen?

Since I have, up to that point, observed such state of detachment after work, so I must have answered... "around the time after work..."

That question itself prompted me to observe whether such experiences only occur after work...

It was then did I realize that such a state actually has been affecting me far more globally then I had thought before expect for, because my initial observation had occurred on my way home, I might have been more prone to sense da state of dissociation when it is the time after work when comparing to other times...

And, after my doctor popped the question, I started to observe my state of being at times other than after work... such as when I am on my way to work...

And, I came to the realization that it is actually a constant state I reside in.... including when I am on my way to work, at work... and after work...

Perhaps, it is self-fulfilling prophecy that drives me into a more global state of dissociation....

It could also be that my initial observations were too limited in its scope...

Regardless...

Then, there came the time when I started to work on this smoking cessation thing... and the prolonged state of physical withdrawal that I have been living in....

The interesting thing is that...

One of the withdrawal symptoms I have experienced so far is tensions.... from head to toe.

The tension in my head somehow causes some sort of memory leak, I guess, and resulted in a sort of numbing kind of feeling.... which, to a certain degree, makes me feel even more dissociated.... 8-O lol

Depression might also have some contribution to the experiences of dissociation and detachment... especially after I started to go into state within which I have to seriously doubt whether my life so far is but a dream.... like this kind of dream...

In any case, this sense of detachment is getting more and more difficult for me to handle. As a result, when I went to see my shrink again yesterday, I requested to lower the dosage of Seroquel by 100 mg... and, as of yesterday, I am on 500 mg of Seroquel.

So, has the decrease of dosage led to the dedissociation of my detached mode?

The matter of the fact is that... be it placebo effect of now... life as it is today seems to be a bit more like real... though the change might be a good .0000000000x... 8-O lol

New phase

The tension remains as I continue with my scheduling of 4 smokes a day... 4 of the Marlboro light 72s more exact...

In addition to more restricted cognitive capacity, something new I am observing in recent day is the sense of fatigue, lowered energy level together with the irritability I have already reported... all of these could be plausible indications of depression.

Considering that nicotine could serve as stimulants, it does make perfect sense for the sudden and gradual decrease of nicotine level to bring up the severity of depression kinda symptoms.

Granted, existing literature seems to have found a higher propensity for female patients with depression to encounter worse withdrawals, including depression symptoms, when comparing to others during the process of smoking cessation.

Yet, I am not going to jump right into the conclusion that I am going to go in the dire of depression and stay there...

Things change and I am not gonna give myself a label so that I can live up that labeling that I get myself assigned....

In addition, although the sense of fatigue and lack of energy has gotten stronger recently, when I was hanging out with my good friend yesterday, I was happy and relaxed and didn't really have the time to be worrying about them sense of fatigue... On the other hand, it might have something to do with the fact that we walked about 70 Manhattan blocks the entire afternoon... in other words, so they say, exercise helps...

72s and withdrawal

My good friend came into town to spend some time with me today....

Given the amount of withdrawal symptoms I had to go through yesterday, I was fairly afraid last night that we might not have a good time together because my withdrawal symptoms might be worse since less and less of the accumulated nicotine is present in my system....

As I have mentioned in an earlier posting, the withdrawal symptoms were still pretty bad earlier today up to about 12 o'clock--- at which time when much of the tension starts to clear away.... up to the point when I took my smoke for the early afternoon.... and when I actually got a real buzz out of da second smoke for the day... (and... ain't it so nice to be able to actually get a buzz out of a smoke? lol)

I had gotten the 72s or the shorter cigarettes instead of them normal size cigarettes.... as an attempt to cut down on the nicotine consumption...

Interestingly, the decrease amount of nicotine intake did not seem to make the withdrawal symptoms much worse...

More accurately, the severity of the withdrawal symptoms seems to have decreased quite a bit later in the day today when compared to those of yesterday or earlier this morning....

Hopefully, things could get stabilized by the end of this week so that I could start planning on cutting my smoking down to 3 a day....

Hallucinations

I think it was two days ago....

One day, as I was getting ready to go to sleep right after I took my last smoke of the day, this voice all of a sudden started to repeat itself in my head....... and loud...

"Stop smoking... stop smoking... stop smoking...." and on and on and on....

Just when I thought that the tension induced by nicotine withdrawal was taking its toll and left little room for psychotic symptoms...

Right after that smoke...

My psychotic symptoms came out preaching me to quit them smokes..... 8-O lol sigh...

Light and heavy

I started to have this strange feeling since around 5-6 o'clock yesterday...

It feels as if I was having cold sweat.... and my it feels as if my forehead and arms are colder than they are supposed to be...

Then, when I was going to borrow the vacuum cleaner earlier on and as I was in the elevator, this strange sensation intensified....

Gradually, the tension started to clear up.... and the majority part of my head and body feels mostly light... although there are still parts of my head and body that feels really tense or tight....

what da talking about?

If anyone wonder... what da talking about these past few days...

I guess... the dasein moments formal smokers who got hit hard by withdrawals knows.... involving quite a few of the following....

http://www.quitsmokingsupport.com/withdrawal1.htm

The state of the head

Today is the second day for me to smoke 4 cigarettes only in a day.

Other than the tension I feel all over my body, the longer I stay without a smoke, the crankier I become and the worst my mood is...

If you think that the tension was simply some physical discomfort, rethink it again...

The matter of the fact is that... when I was feeling my body is all tensed up... it is not only the body that experiences discomfort... rather the "tensing up" also seem to take up a majority amount of my cognitive processing power....

So, before I went out for my second smoke at around 1 o'clock this afternoon, 5 hours after the smoker's first cigarette.... I was supposed to get some stuffs done before going to get myself replenished with nicotine....

So, there was a script in my head.... or, in my mind, I expected myself to arrive at a classroom, collect payments from students, and, asked the students to go to the office to pick up their receipts after class...

Funny enough, as I arrived at the classroom, the real life scenarios did not match up with the scenario I foreseen based on the script I have in my mind....

Although the real life scenario did not impose more work on me, interestingly, it made me feel far more stressed out... simply due to the fact that the real events have deviated from my expectation...

Eventually, I took a detour and went out to take my second cigarette for the day....

After a drag or two, magically, the tensions were alleviated, the sense of crankiness decreased and I was able to smile again....

It was then did I realize that...

The state of my head right before I smoked was almost similar to a state of anxiety or panic attack..... I had no control over no nothing at all...

It was as if the entire world was coming down.... all them little events deviating from the expectations....

The smoke... or the nicotine replenished through smoking... somehow worked as a non-prescription grade kind of anti-anxiety medication..... which asserts its power literally in split second....

p.s. if my writing sounds a bit incoherent, it might have something to do with my trying to finish this posting before my take my last smoke for the day. To be honest, the head is so tight and the cognitive capacity is so limited that... I could only think of one thing or one word at a time... insufficient mental capacity to process anything more...

hiding out

As the withdrawal is driving me up the wall, after I got off work today.... I thought to myself...

I need to go hide out in my room.... clearing myself from all forms of human contacts.... before I do anything else under the influence of nicotine withdrawal....

Since the really bad physical withdrawal is deemed to last for a couple more days, I also had this plan in my head that I was to take my day off tomorrow to stay away from all human contacts and to spend one more of the miserable day on my own studying them math equations... the first time in my life planning anything as such...

Then, this good friend of mine contacted me and told me that she is coming into the city tomorrow at noon and will be stay with me over night.... which, apparently, annuls that plan of mine to hide out and be on my own....

Another day in nicotine withdrawal

Today is yet another day for me to be in a seemly eternal state called nicotine withdrawal...

So far, I have smoked only 3 cigarettes today....

The first was the smoker's first smoke in the morning.... at around 8:00 o'clock...

Despite the sense of discomfort, I was able to make it till about 1:00 o'clock, 5 hours later, to take the second one...

It was not until around 7 or 7:30 did I take the third cigarette of the day.... over 6 hours after....

Within the 6+ hours between the 2nd and 3 rd smokes, I actually did quite a bit of reading on maximum likelihood estimation, attended the class on item response theory, went to do some grocery shopping, and, came home to do my swinging exercise...

Since I started to be in a constant state of withdrawal, sometimes, time seems to be going much slower....

Yet, I find the following two things to be fairly useful in helping me killing time...

The first is the act of trying to following equations such as following.... and, of course, when my head is capable of concentrating despite of the withdrawal...



The swinging exercise I do is the second activity that seems to help me putting the sensation of withdrawal away....

At the same time, although I have been trying to go to sleep early, I seem to have some trouble falling asleep recently... which makes me wonder whether this has something to do with the potential neurochemical imbalance introduced by my cutting down on the nicotine intake...

Eating mucho mucho mas is one other intensified propensity of mine... I guess this goes along with the common experiences shared by quitters...

In general, I think the severity of my withdrawal symptoms is gradually going down....

The funny thing about them withdrawal symptoms involving the sense of tightening sensations is that... my head would be so very tense and I would feel that my head is really tense that there doesn't seem to be room for my hallucinations and delusions when the withdrawal is bad.... 8-O lol

In addition, during the day time, strangely, I hardly sense the psychological or behavioral kinda withdrawal symptoms... However, when the night falls, the desire for me pick up a smoke absolutely gets far stronger.... such observations seem to coincide with the fact that I used to smoke far more in the night when I am along in my room....

I am also fairly happy about the fact that I would have smoked for only 4 cigarettes by the end of today...

In addition, there will be 2 more smokes left in this pack for tomorrow... which means... this pack of cigarettes would have lasted me for 5 days... Something I possibly might not have done in my entire life... for a pack of cigarettes usually could last for no more than a day... not to mentione 5 days.... 8-O lol

So... as I was walking back home... with antenna over my head searching for other smokers' in the vicinity so that I could get some nicotine replenishment through second hand smoking....

I thought to myself...

How could I approach the day after today?

And, I thought... for the sake of my mental health, I think I am going to switch to ultra-light and stayed on the 4-cigarette schedule for a few days more... maybe till the end of the week...

From then on, I could further work on cutting down to 3, 2, and 1 smoke a day... till, eventually, hitting that big 0....

Nicotine... From bitch from hell

In stead of using patches, I decided these two day to try to cut my smoking down to 4-5 cigarettes instead...

Coming down from a pack a day, I assume this is much more appropriate...

The physical withdrawal though... is driving me crazy....

The sensation of the tightening of the entire body... from head to toe....

The feeling that my head is all flaky.... the similar kind of flaky feeling I would feel when my psychotic symptoms are going overboard... which makes it diffuclt for me to use my head...

And, the dangerous amount of irritability...

All work together to drive me into a major league Bitch from Hell...

The second smoke I had for the day was at around 1:40....

After I supplemented my body with nicotine, I immediately felt so much more relaxed and was able to use my head for a while...

Then, as I tried to do some more reading involving a whole lot of math.... including scary looking thing, at least for me, like what lies below...



You see... to begin with, it is difficult to teach an old dog like me new tricks...

In addition, with the symptoms of withdrawal, I simply couldn't use my head at all...

So, I had my 3rd cigarette for the day just now...

And... it made me feel more "normal" and it seems like I could get back trying to study the texts again...

It was then did this question pop up in my head again...

"If there is anything I could change in life, what would I change?"

So I thought... and, possibly, for the first time in my life....

Perhaps, if I could turn back the clock and if there is anything I could change in my life... I would not pick up the first cigarette I smoked in my life... as long as there is nothing worse I have to pick up in exchange.... 8-O lol sigh...

I want a cigarette

Forgetting about things smoking related?

To be honest, every time I hear this song and since the very first... I hear Beyoncé singing... "I want a cigarette"...... owing it to my ESL status 8-O lol

This also reminds me of my ingenious psychotic propensity to perceive information the way they are NOT... 8-O lol

Beyoncé - New Music - More Music Videos

Withdrawal

I had some really bad nicotine withdrawal symptoms yesterday.... among which, the worst, tension headaches...

The headache was so bad.... and real bad...

The strange thing is that... I actually was able to live through the majority of the day not thinking about cigarettes...

So I think... this might have something to do with my feeling that I am getting overdosed on Seroquel.... Essentially, I lived through day by day feeling more and more detached from the surrounding world... One key element of da sense of detachment I am speaking of is... feeling unable to use the environmental cues to help retrieving information in my long term memory.... and it feels as if there is an invisible wall resting between me and the outside world...

So, in addition to walking around in my neighborhood having the feeling that I am not really there, somehow... these two days, as I was moving around, I actually have been able to not remember me myself as a smoker and somehow it was very difficult for me to remember what it felt like to be a smoker...

It is also as if I have developed some strange kind of situation-specific amnesia--- rendering me able to forget smoking related memories... and I hope it could continue to remain so...

At some point during the day, as I walked outside for some more coffee and fresh air... I saw smokers around... and, for reasons unknown, I could not retrieve that sense of membership as a smoker no more...

Strange state of being I would have to say because, in my previous attempts, I would continue to have the "habitual or psychological" kinda withdrawal despite the lack of physical withdrawal...

This time... the worst parts of my experiences so far are physical withdrawal...

to be or not to be and what..

Recently, I am seriously considering this thing called cutting down on smoking... if not quitting...

If I could quit successful, may God bless me so that I don't have to quit again... 8-O lol sigh

So, I cut my daily smokes down to about 10-11 cigarettes a day on Wednesday....

Yesterday, Thursday, I put on the patch at around 11 o'clock.... only to find myself tormented by the unbearable tension headache from 5-6 o'clock on...

The tension headache was so bad that I was started to feel noxious at some point... It felt so awful that I wish I could change for a new head without the tension that was killing me more and more...

So I took my patch off since it felt as if the amount of nicotine being released to the blood stream was not enough...

Then, I decided to go hang out and had a drink or two...

Some time later... I came to the realization that...

OMG... the tension headache was mostly gone... though did not disappear...

So was I told by this friend of mine...

"Why don't you try for a while to be having a drink every other night until you could get done with your nicotine withdrawal?"

This is quite some interesting kinda suggestion.... for... given my propensity to be obsessive compulsive.... comparing between having one too many a cigarette and alcoholic beverage on a daily basis.... which is lesser expansive and less evil?

Since neither one seems to be a good option, what kind of bad habit shall I pick up? 8-O lol