Question:
Bob– You know I respect you. That given: The "Interpretation of Dreams" is the only "original" work of Freud. All of his other stuff, the unconscious, infantile sexuality, etc. can be traced, with good certainty, to prior thinkers. Unfortunately, Freud’s "Interpretation of Dreams", has yieleded NOTHING of value, and is considered, essentially, wrong. No therapist I know places much value on dream interpretation. Sometimes, obvious dreams are "interesting", but are not diagnostic, of anything that cannot be brought out by interview, but are subject to unpredicatable false positives. The history of psychology was a topic I loved in grad. school, and was fortunate enough to have a men like Solomon Diamond, and Vernon Kiker for that topic. They were true scholars, and recognized experts of the "finer" points of history. Jack (a licensed family therapist) http://howtorelax.com
Freud, in "The Interpretation of Dreams," published more than 100 years ago, called them "the royal road to a knowledge of the unconscious activities of the mind." – Hide quoted text — Show quoted text –
Response:
Bob, this article is right on. Thanks. Here are the parts I’m particularly interested in: "In order to be awake and aware," he said, "the brain needs two chemicals: noradrenaline and serotonin." During slow wave sleep (most of the sleep during the night), the levels of these chemicals fall by half. During REM sleep, the levels drop to nearly zero, and brain activity is dominated by neurons using another chemical: acetylcholine. According to Hobson, during sleep when acetylcholine systems dominate, the noradrenaline and serotonin neurons use this "downtime" to regenerate their transmitters. Acetylcholine systems remain active in both sleep and wakefulness, however.
This is as I suspected. My serotonin is depleted, and because my sleep is disrupted it’s not getting replenished. Now, it seems that this depletion of the serotonin is somehow triggering my cluster headaches. Why would the headaches be more likely to occur during sleep? Perhaps because the serotonin systems are turned off. Imitrex is a a serotonin receptor agonist. So stimulating the receptor aborts the headache. That would suggest that it’s the absence of serotonin stimulation which triggers the headache (or at least facilitates its triggering). Perhaps it would make sense to take L-Tryptophan (precursor amino acid of serotonin).
Response:
Matt, Here is an article that explains some of the basics…sleep/serotonin….I’m pasting the entire article here for reference for anyone interesed in joining the discussion rather than just posting the URL….(borrowed from OUCH) SINCE ANTIQUITY, dreams have evoked curiosity and wonder. Biblical characters found prophecies in them. Freud, in "The Interpretation of Dreams," published more than 100 years ago, called them "the royal road to a knowledge of the unconscious activities of the mind." Modern neuroscientists see the function of sleep and dreaming as slightly more mundane-but nonetheless critical to health. Without sleep, our moods and our memories-even our immune systems-would be profoundly compromised. Dr. J. Allan Hobson, professor of psychiatry at Harvard Medical School and director of the Laboratory of Neurophysiology at the Massachusetts Mental Health Center, has spent more than 40 years studying sleep and dreaming. He is author of "The Chemistry of Conscious States" (Little, Brown, 1994). He describes how our brain chemistry cycles from the dominance of one chemical system to another during wakefulness, slow wave sleep and REM sleep (rapid eye movement sleep, during which most, but not all, dreams occur). "In order to be awake and aware," he said, "the brain needs two chemicals: noradrenaline and serotonin." During slow wave sleep (most of the sleep during the night), the levels of these chemicals fall by half. During REM sleep, the levels drop to nearly zero, and brain activity is dominated by neurons using another chemical: acetylcholine. According to Hobson, during sleep when acetylcholine systems dominate, the noradrenaline and serotonin neurons use this "downtime" to regenerate their transmitters. Acetylcholine systems remain active in both sleep and wakefulness, however. The two systems work in contrast with each other, so if there is too much activity in one, the other will attempt to slow it down and vice versa with too little activity. The balance between these systems is lost during depression and other mood disorders, however-which is why sleep disturbances (either too much or too little) almost always accompany depression. Drugs used to treat depression-like Prozac-tend to increase the activity of the serotonin system. "The serotonin system is like the heart of the brain," said Hobson. "Its cells are like the pacemaker cells of the heart. They fire automatically and rhythmically and send axons all over the brain." In fact, the heart itself actually includes serotonin receptors, and some researchers believe this may account for the link seen between cardiac problems and depression. Hobson says that sometimes the serotonin antidepressants (SSRIs) like Prozac end up causing disruptions of their own. REM sleep disorder, in which people physically act out their dreams, has occurred in some patients taking these drugs. "SSRIs can raise hell with motor systems in sleep," said Hobson. "It’s appropriate to warn people at this point, but not to panic. There is just no free lunch if you play with sleep control systems." Serotonin and noradrenaline are also necessary for attention and memory. "In order to have this conversation, there are cells firing all the time," Hobson said. "The minute you start to lose attention, the levels of serotonin and noradrenaline start to fall." The disturbances of concentration and memory seen in depression are probably accounted for by this connection. Most dreams aren’t pleasant-raising another possible connection between sleep and mood problems. Hobson’s group has found that during dreams, three emotions dominate: anxiety, anger and elation, meaning your odds are two in three of feeling bad in a dream. "These emotions could fit into the depressive spectrum , but in dreams, the aminergic [dopamine and noradrenaline] deficit is acute and restored immediately upon waking. Depression takes days or weeks to develop." Dreams are hard to remember because noradrenaline and serotonin are virtually unavailable during REM sleep. These substances are needed to record memories. You can recall a dream that immediately preceded awakening, because the noradrenaline and serotonin systems come back online as you wake up. But if you shift your attention at all while you wake, you will often find that the memory of the dream vanishes. Recent research shows that during dreaming, the rational, decision-making part of the brain is quiet while emotional areas take over. "In dreams, you don’t know where you are, you can’t remember things, there is no analytic capability, but perception and emotions are very strong," said Hobson, explaining that this is linked to the lack of activity in the prefrontal cortex and increased activity in central brain areas. He also pointed out that dreams are "hyper-associative," with scenarios shifting from one to another via connections and associations probably known only to the dreamer. A body of evidence now shows that one function of dreaming and sleep is memory consolidation and processing, which might explain these weird associations. Sleep-deprived people remember less well, and skills learned before sleep actually improve (with no additional practice) upon awakening. "Memory is probably organized in several ways in the brain," Hobson said. "There is meta-knowledge [knowledge about how you know things and deal with them], orientation knowledge-which is probably emotionally guided so that when you walk out the door, you know whether a place is dangerous or not, and also procedural knowledge. Walking and other banal things we take for granted-these systems are not trivial to maintain. Try walking without a mechanism [for doing it without conscious thought]." Sleep and dreaming help maintain your brain’s information systems. "You run the system offline and tie in new information according to some rules," said Hobson. Though many say lack of sleep can’t kill you, in fact, if you went without for long enough, it could. Sleep is crucial to immune function, and animals deprived of it often die of infections. Evolutionarily, sleep has several purposes, though it might appear to make an animal more vulnerable to predators. "It makes sense to get animals off the street at night," Hobson said. "It is thermally efficient and it reinforces biologically significant connections between couples and families." Hobson’s next book will deal with psychedelic drugs. Interestingly, LSD acts on the serotonin system, though in a quite different way than antidepressants do. The book will examine how LSD trips are virtually "dreaming while awake" and what psychedelics can help scientists learn about the brain. For more on Serotonin and its relationships to clusters…check out the rest of the OUCH library at: http://www.clusterheadaches.org/library/serotonin/index.htm BTW, sansert is no longer manufactured in the US. You’ll have to order methysergide from Canada or Europe. It was quite effective for me on several cycles but didn’t work after taking one of the 30 day vacations from it to avoid the fibrosis.
Response:
Matt, I don’t have clusters but my boss does. We talked at length about this because he goes to bed anywhere from 2-4 a.m. and wakes up at 6. He rarely sleeps, says he just isn’t tired. When I showed him the discussions on this group about clusters and the sleep issues, he concurred. He thinks he has gotten used to little sleep because he is so afraid of it. He only gets about three cluster episodes in a month (I say only because I get my migraines so much more frequently). And he used to get them more at night before he went on Propranalol. Now he might get them on a Saturday afternoon and they’ll hit him off an on until maybe 24 hours later. So, not sure about that. I also know he has mood swings…can be happy one day and depressed the next. He’s an engineer and typically very logical in nature, but the depression surprises me. It is untreated…he hates drugs 
But that’s another possible seratonin issue. Just some thoughts, Michelle
– Hide quoted text — Show quoted text – I’d like to initiate a discussion of sleep and serotonin. I keep coming back to this because my cluster headaches occur more readily when I’m sleep-deprived. Since serotonin receptors are involved in sleep, but also in cluster headaches (and migraines), there’s a relationship here. It occurs to me that, when I sleep, something gets replenished. Could this be serotonin? If that’s the case, perhaps the headaches occur more readily when the serotonin level is low. So one treatment for cluster headaches would be getting a good 8 hours of sleep daily. It’s a vicious cycle, though, because the headaches come on during sleep. I find that I can’t sleep more than 2 hours without waking to a headache. I use the Imitrex injection, and it wakes me up. I have 2 hours of euphoria, then feel sleepy, go to sleep for an hour, and wake with another headache. Warm milk does something that induces sleep, and I think it’s related to Serotonin. Perhaps warm milk is a treatment for cluster headaches? I’m thinking Sansert (methylsergide) might be a good drug for me. I’ve always been hesitant to use it because of the risk of retroperitoneal fibrosis. But the mechanism of action is appealing: it’s a serotonin agonist. Anyway, I’d only need to use it for 2 to 3 months, so the risk of retroperitoneal fibrosis would be less.
Response:
I’d like to initiate a discussion of sleep and serotonin. I keep coming back to this because my cluster headaches occur more readily when I’m sleep-deprived. Since serotonin receptors are involved in sleep, but also in cluster headaches (and migraines), there’s a relationship here. It occurs to me that, when I sleep, something gets replenished. Could this be serotonin? If that’s the case, perhaps the headaches occur more readily when the serotonin level is low. So one treatment for cluster headaches would be getting a good 8 hours of sleep daily. It’s a vicious cycle, though, because the headaches come on during sleep. I find that I can’t sleep more than 2 hours without waking to a headache. I use the Imitrex injection, and it wakes me up. I have 2 hours of euphoria, then feel sleepy, go to sleep for an hour, and wake with another headache. Warm milk does something that induces sleep, and I think it’s related to Serotonin. Perhaps warm milk is a treatment for cluster headaches? I’m thinking Sansert (methylsergide) might be a good drug for me. I’ve always been hesitant to use it because of the risk of retroperitoneal fibrosis. But the mechanism of action is appealing: it’s a serotonin agonist. Anyway, I’d only need to use it for 2 to 3 months, so the risk of retroperitoneal fibrosis would be less.
Response:
That’s "probably" a different "kind" of delusion, but it would certainly involve (philosophically) the concept of "self". You’ve (once again, given me something to think about), as perhaps the same constructs, and/or intervening variables are involved. Do you think his BRAIN was "struggling" with who he was, and that the medicines for schizophrenia might affect receptors involved in the concept of self? Jack – Hide quoted text — Show quoted text – Thank you Jack. I’m not really sure why the author even opened the article with that except to "name drop" It really didn’t fit into the subject matter. That said, since I posted it, I guess I was, in effect, agreeing with all that was written. I should have done some snipping. I agree that dream interpretation has probably done much more harm than good. I can only imagine all the people told that they had a mother complex if they dreamed of milking cows. (Although Freud probably would have concentrated more on Bulls After watching A Beautiful Mind today for about the 5th time, I’m still trying to come up with an original thought of my own to answer your question regarding psychological vs. physical ailments. I think this may have been the question that caused Nash to suffer from delusions. 
You didn’t ask him that question 30 years ago did you? BobW Bob– You know I respect you. That given: The "Interpretation of Dreams" is the only "original" work of Freud. All of his other stuff, the unconscious, infantile sexuality, etc. can be traced, with good certainty, to prior thinkers. Unfortunately, Freud’s "Interpretation of Dreams", has yieleded NOTHING of value, and is considered, essentially, wrong. No therapist I know places much value on dream interpretation. Sometimes, obvious dreams are "interesting", but are not diagnostic, of anything that cannot be brought out by interview, but are subject to unpredicatable false positives. The history of psychology was a topic I loved in grad. school, and was fortunate enough to have a men like Solomon Diamond, and Vernon Kiker for that topic. They were true scholars, and recognized experts of the "finer" points of history. Jack (a licensed family therapist) http://howtorelax.com Freud, in "The Interpretation of Dreams," published more than 100 years ago, called them "the royal road to a knowledge of the unconscious activities of the mind."
Response:
Tryptophan (which many people think was/is banned in the US) is available. From what I understand, it is quite easily converted into serotonin and passes the blood-brain barrior readily, increasing the serotonin levels. Tryptophan is easily absorbed by the gut and eating tryptophan rich foods can increase the levels also. Some cluster people eat a lot of turkey just for this reason. When we men go for a nap on Thanksgiving, there is a very good reason for this. The tryptophan is readily absorbed and converted, relaxing your entire system, including your blood vessels….or so the theory goes. Other’s have/do try using 5-HTP supplements but as I understand, this is not easily absorbed by the gut and better results are seen when it’s given via an IV. BobW
That’s where Matt’s warm milk question comes in. It’s high in trytophan. Ginnie
Response:
I don’t relate clusters to migraine, but, then again, when women have clusters, they are often atypical, and this must also be accounted for. Are they, perhaps, having clustered migraines (or, migrainous clusters), which they often look like. When the treatments are very close (but, oxygen has never been shown to work in migraine), that further confuses the issue.
Adding confusion here is the fact [?] that the percentages of men vs. women has been steadily growing closer together. It used to be reported as an 8:1 men more often than women. The latest studies I’ve seen have the percentage just over 2:1 Conjecture as to why this is happening appears to be widespread. BobW
Response:
Taking serotonin precursers has not been shown effective…. I see. I don’t beleive serotonin "levels" are worthwhile had it’s considered spillage… Where does the spillage come in? What’s the idea behind that?
Spillage is often the word used, but it essentially refers to the fact that, serum levels may not reflect if the drug is where it anatomically needs to be. For instance, Imitrex does NOT cross the blood barrier, unlike Zomig, unless I’ve missed an AWFUL lot of new work. Yet, you have first hand knowledge of the efficacy of Imitrex. I just checked Medline, and found this, btw: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubM… I’ve attended lectures where it was said that migraines are caused by inflammation in the brainstem, specifically in association with the 5th cranial nerve, and that serotonin receptors mediate this inflammation in some manner.
Yes, but I was talking about clusters, and, that is the Moskowitz theory (about migraine), now, primarily advanced by Goadsby. I (and many HA docs, which I don’t pretend to be (my formal academic background is physiological psych.) have always had some doubts about that model, and the efficacy of Imitrex has not been answered to my satisfaction. Again, the mechanism of action of Imitrex, which works, does not fit the theoretical model upon which it is based (IMVHO). The interesting thing to me is that clusters respond so magically (in most cases) to Imitrex injection, yet have characteristitcs of a 7th n. problem, which is not a target of Imitrex. What characteristics of the 7th? It’s the 5th, I believe. 7th is the muscles of facial expression, which are not involved. But the muscles of mastication certainly are, and that’s 5th.
I think if you consult any recent neuroanatomy text, it will described the 7th n. as a "mixed" nerve with both motor and sensory components. I was also incomplete, because of my background in ANS, I almost always focus on its parasympathetic outflow. You were speaking from the standpooint of a physician which you are. Anyhow, of course, virtually ALL head pain ends up carried by the trigeminal, and I would certainly never dispute that fact. But, I have always felt that cluster involved the 7th n. parasympathetic (visceral, cholinergic MOTOR component). 7th n. ANS motor fibers control lacrimation (a symptom of cluster), nasal congestion (a symptom of cluster), the paranasal sinuses (another area close to the eye), etc. This component is pretty much under "direct" control of the hypothalamus (the circadian aspect of cluster), etc. If this were to storm out of control, one might have a cluster, as sensed by the 5th n. Just a conjecture. I don’t relate clusters to migraine, but, then again, when women have clusters, they are often atypical, and this must also be accounted for. Are they, perhaps, having clustered migraines (or, migrainous clusters), which they often look like. When the treatments are very close (but, oxygen has never been shown to work in migraine), that further confuses the issue. Finally, the teaching of the ANS as only a motor system is anatomically incorrect. Not only have ANS AFFERENTS been identified, but it only makes sense that they would work via a negative feedback control mechanism, as in the CNS. Jack
Response:
Taking serotonin precursers has not been shown effective….
I see. I don’t beleive serotonin "levels" are worthwhile had it’s considered spillage…
Where does the spillage come in? What’s the idea behind that? I’ve attended lectures where it was said that migraines are caused by inflammation in the brainstem, specifically in association with the 5th cranial nerve, and that serotonin receptors mediate this inflammation in some manner. The interesting thing to me is that clusters respond so magically (in most cases) to Imitrex injection, yet have characteristitcs of a 7th n. problem, which is not a target of Imitrex.
What characteristics of the 7th? It’s the 5th, I believe. 7th is the muscles of facial expression, which are not involved. But the muscles of mastication certainly are, and that’s 5th.
Response:
- Hide quoted text — Show quoted text – Bob, this article is right on. Thanks. Here are the parts I’m particularly interested in: "In order to be awake and aware," he said, "the brain needs two chemicals: noradrenaline and serotonin." During slow wave sleep (most of the sleep during the night), the levels of these chemicals fall by half. During REM sleep, the levels drop to nearly zero, and brain activity is dominated by neurons using another chemical: acetylcholine. According to Hobson, during sleep when acetylcholine systems dominate, the noradrenaline and serotonin neurons use this "downtime" to regenerate their transmitters. Acetylcholine systems remain active in both sleep and wakefulness, however. This is as I suspected. My serotonin is depleted, and because my sleep is disrupted it’s not getting replenished. Now, it seems that this depletion of the serotonin is somehow triggering my cluster headaches. Why would the headaches be more likely to occur during sleep? Perhaps because the serotonin systems are turned off. Imitrex is a a serotonin receptor agonist. So stimulating the receptor aborts the headache. That would suggest that it’s the absence of serotonin stimulation which triggers the headache (or at least facilitates its triggering). Perhaps it would make sense to take L-Tryptophan (precursor amino acid of serotonin).
Specifically though, Imitrex is a 5HT-51d(Alpha) agonist. The contribution of the various receptor sub-types involved in individual HAs is a tough problem, but Imitrex has around an 80% effective rate. Taking serotonin precursers has not been shown effective, unless lrobb knows something more on this. I don’t beleive serotonin "levels" are worthwhile had it’s considered spillage, jugular vein studies excepted. The interesting thing to me is that clusters respond so magically (in most cases) to Imitrex injection, yet have characteristitcs of a 7th n. problem, which is not a target of Imitrex. And, the 7th n. is a parasympathetic, cholinergic innervated bundle of fibers (cranial outflow). Perhaps, this fits in with what you are saying. The 7th nerve can also coarse very close to the 5th n. at the spenopalatine g. This is the putative site for the action of cocaine and lidocaine for clusters. Our work with migraine, btw, cannot be replicated double-blind by us, yet we have patients that responded magically to its use in migraine. This is could be due to an anatomical distinction based upon the closeness of the 2 nerves referred to above. Deva- I haven’t forgot that I owe you an answer. I always get the last work on that topic<G. Jack
Response:
- Hide quoted text — Show quoted text – Bob, this article is right on. Thanks. Here are the parts I’m particularly interested in: "In order to be awake and aware," he said, "the brain needs two chemicals: noradrenaline and serotonin." During slow wave sleep (most of the sleep during the night), the levels of these chemicals fall by half. During REM sleep, the levels drop to nearly zero, and brain activity is dominated by neurons using another chemical: acetylcholine. According to Hobson, during sleep when acetylcholine systems dominate, the noradrenaline and serotonin neurons use this "downtime" to regenerate their transmitters. Acetylcholine systems remain active in both sleep and wakefulness, however. This is as I suspected. My serotonin is depleted, and because my sleep is disrupted it’s not getting replenished. Now, it seems that this depletion of the serotonin is somehow triggering my cluster headaches. Why would the headaches be more likely to occur during sleep? Perhaps because the serotonin systems are turned off. Imitrex is a a serotonin receptor agonist. So stimulating the receptor aborts the headache. That would suggest that it’s the absence of serotonin stimulation which triggers the headache (or at least facilitates its triggering). Perhaps it would make sense to take L-Tryptophan (precursor amino acid of serotonin).
Specifically though, Imitrex is a 5HT-51d(Alpha) agonist. The contribution of the various receptor sub-types involved in individual HAs is a tough problem, but Imitrex has around an 80% effective rate. Taking serotonin precursers has not been shown effective, unless lrobb knows something more on this. I don’t beleive serotonin "levels" are worthwhile had it’s considered spillage, jugular vein studies excepted. The interesting thing to me is that clusters respond so magically (in most cases) to Imitrex injection, yet have characteristitcs of a 7th n. problem, which is not a target of Imitrex. And, the 7th n. is a parasympathetic, cholinergic innervated bundle of fibers (cranial outflow). Perhaps, this fits in with what you are saying. The 7th nerve can also coarse very close to the 5th n. at the spenogalatine g. This is the putative site for the action of cocaine and lidocaine for clusters. Our work with migraine, btw, cannot be replicated double-blind by us, yet we have patients that responded magically to its use in migraine. This is could be due to an anatomical distinction based upon the closeness of the 21 neerves are referred to above. Deva- I haven’t forgot that I owe you an answer. I always get the last work on that topic<G. Jack
Response:
– Hide quoted text — Show quoted text – Bob, this article is right on. Thanks. Here are the parts I’m particularly interested in: "In order to be awake and aware," he said, "the brain needs two chemicals: noradrenaline and serotonin." During slow wave sleep (most of the sleep during the night), the levels of these chemicals fall by half. During REM sleep, the levels drop to nearly zero, and brain activity is dominated by neurons using another chemical: acetylcholine. According to Hobson, during sleep when acetylcholine systems dominate, the noradrenaline and serotonin neurons use this "downtime" to regenerate their transmitters. Acetylcholine systems remain active in both sleep and wakefulness, however. This is as I suspected. My serotonin is depleted, and because my sleep is disrupted it’s not getting replenished.
I think that some (many?) migraineurs are only able to get relief after they’ve been able to fall asleep…getting a good night’s rest and waking up without a migraine. Many then slowly build up the pain again as the day goes on. Clusterers have a slightly different problem to contend with, that being the REM sleep triggering the attacks, making this "healing" sleep, nearly impossible. Often with my worst cluster cycles, they continue to get worse as I become more sleep deprived. Try as I do to get sleep, sometimes it just seems to get away from me and I end up with attacks every 2 hours, around the clock. Now, it seems that this depletion of the serotonin is somehow triggering my cluster headaches.
I’m sure there is more up to date info available but I think this is still true…. "Serotonin alterations are more subtle in patients with cluster headache than in migraine. Medina et al (1979) found modest elevations of serotonin in whole blood during attacks of cluster headache, whereas platelet serotonin levels fall precipitously during migraine attacks. Waldenlind et al, (1985) found low whole blood serotonin levels among cluster patients both during an active bout and during remissions, comparable to levels found among migraine patients." Whether or not any of these tests were done during a REM sleep attack, I don’t know. – Hide quoted text — Show quoted text – Why would the headaches be more likely to occur during sleep? Perhaps because the serotonin systems are turned off. Imitrex is a a serotonin receptor agonist. So stimulating the receptor aborts the headache. That would suggest that it’s the absence of serotonin stimulation which triggers the headache (or at least facilitates its triggering). Perhaps it would make sense to take L-Tryptophan (precursor amino acid of serotonin).
Tryptophan (which many people think was/is banned in the US) is available. From what I understand, it is quite easily converted into serotonin and passes the blood-brain barrior readily, increasing the serotonin levels. Tryptophan is easily absorbed by the gut and eating tryptophan rich foods can increase the levels also. Some cluster people eat a lot of turkey just for this reason. When we men go for a nap on Thanksgiving, there is a very good reason for this. The tryptophan is readily absorbed and converted, relaxing your entire system, including your blood vessels….or so the theory goes. Other’s have/do try using 5-HTP supplements but as I understand, this is not easily absorbed by the gut and better results are seen when it’s given via an IV. BobW
Response:
Thank you Jack. I’m not really sure why the author even opened the article with that except to "name drop" It really didn’t fit into the subject matter. That said, since I posted it, I guess I was, in effect, agreeing with all that was written. I should have done some snipping. I agree that dream interpretation has probably done much more harm than good. I can only imagine all the people told that they had a mother complex if they dreamed of milking cows. (Although Freud probably would have concentrated more on Bulls After watching A Beautiful Mind today for about the 5th time, I’m still trying to come up with an original thought of my own to answer your question regarding psychological vs. physical ailments. I think this may have been the question that caused Nash to suffer from delusions. You didn’t ask him that question 30 years ago did you? BobW
– Hide quoted text — Show quoted text – Bob– You know I respect you. That given: The "Interpretation of Dreams" is the only "original" work of Freud. All of his other stuff, the unconscious, infantile sexuality, etc. can be traced, with good certainty, to prior thinkers. Unfortunately, Freud’s "Interpretation of Dreams", has yieleded NOTHING of value, and is considered, essentially, wrong. No therapist I know places much value on dream interpretation. Sometimes, obvious dreams are "interesting", but are not diagnostic, of anything that cannot be brought out by interview, but are subject to unpredicatable false positives. The history of psychology was a topic I loved in grad. school, and was fortunate enough to have a men like Solomon Diamond, and Vernon Kiker for that topic. They were true scholars, and recognized experts of the "finer" points of history. Jack (a licensed family therapist) http://howtorelax.com Freud, in "The Interpretation of Dreams," published more than 100 years ago, called them "the royal road to a knowledge of the unconscious activities of the mind."
Response:
Spillage is often the word used, but it essentially refers to the fact that, serum levels may not reflect if the drug is where it anatomically needs to be.
Yes, point taken. For instance, Imitrex does NOT cross the blood barrier, unlike Zomig, unless I’ve missed an AWFUL lot of new work. Yet, you have first hand knowledge of the efficacy of Imitrex.
My understanding is that Zomig is unique in that it crosses the blood-brain barrier. As an oral agent, it works better for me than other oral triptans. Imitrex (and other agents as well) will cross the blood-brain barrier when it’s leaky, which it is at the onset of a migraine (when the inflammation is high, presumably). So Imitrex and other agents besides Zomig should work better at the onset of a migraine. But, I have always felt that cluster involved the 7th n. parasympathetic (visceral, cholinergic MOTOR component). 7th n. ANS motor fibers control lacrimation (a symptom of cluster), nasal congestion (a symptom of cluster), the paranasal sinuses (another area close to the eye), etc.
Okay, I see what you’re getting at. Horner’s syndrome. It’s mediated by the sympathetic chain, which comes from the thoracic spinal cord and comes back up through the neck, up into the head. Not really part of the 7th nerve, but perhaps associated with it when all the nerves get wrapped around each other in the face. This component is pretty much under "direct" control of the hypothalamus (the circadian aspect of cluster), etc. If this were to storm out of control, one might have a cluster, as sensed by the 5th n.
It occurs to me that the circadian aspect might just be the depletion of serotonin, and its failure to sufficiently replenish during the inadequate sleep we clusterers get. Also, the Horner’s syndrome could be the inflammation of the carotid artery affecting the sympathetic chain, which wraps around it. Today I got some pretty good sleep for a change. I had upped my dose of Coreg (a beta blocker). The beta blocker decreases the norepinephrine surges, thereby suppressing the migraine. So, it’s all coming together: The headaches are triggered by excessive norepinephrine and dopamine activity, and suppressed by adequate serotonin activity. Tyramine-containing foods increase norepinephrine and dopamine, so should be avoided. Sleep replenishes serotonin, so should be maximized. Beta blockers decrease norepinephrine, so are effective. Triptans increase serotonin, so abort the headaches.
Response:
That’s "probably" a different "kind" of delusion, but it would certainly involve (philosophically) the concept of "self". You’ve (once again, given me something to think about), as perhaps the same constructs, and/or intervening variables are involved. Do you think his BRAIN was "struggling" with who he was, and that the medicines for schizophrenia might affect receptors involved in the concept of self? Jack
Well, personally I think his mind was struggling with that which we all struggle. He seemed (s) torn between who he thought he was, who he thought he should be, and who his environment thought he should be. He being a problem solver…..tried to be all three and succeeded in some ways. From an untrained but interested observer, I tend to believe the following. We are born who we are, and left completely alone from birth, would develope in a predetermined way, making decisions as we go based upon our genetic makeup. However, from the minute we are born, our environment tries to mold us into its own preconceived notions of what we should be and how we should develope/act. I doubt we are in a very good mood the minutes following birth but the first thing we are "taught" is that we should be smiling, as Mom and Dad make their funny voices, telling us to smile, until finally some day we do. One of the biggest days in the life of new parents is the first day they see their baby smile. Makes them think they are providing a happy environment for their child. In a strange way, the environment may not be a very happy one, as most of us would describe, but the child then learns what they are "supposed" to be happy about. "Oh look, daddy is yelling at mommy and now mommy is over here picking me up telling me that everything is ok and that I should be happy. Maybe daddys are supposed to yell at mommy." I found the personas that Nash concocted were extremely interesting and telling. His friend, being society and his desire to fit in with the environment around him. (What he thinks his environment wants him to be) The little girl, his desire to teach and relate back to a time in his life when nothing was required of him. (What he wants to be, who he is, what makes him happy) The government agent, his desire to be an important factor in changing/participating in helping the world be a better place. To improve life. (What he "thinks" his environment wants of him. People with his attributes should make a positive impact on the world.) I think that the medications he was/is taking probably quiet down a couple of the voices. They probably don’t work "well" because we as a society try to quiet down two (in his case) of the voices, leaving only what society thinks he should be, and not who he really is. I think that with a mind such as Nash’s, his neural pathways are more open and active than we "normal" people, for lack of a better definition. If my mind is the Illinois River, his is the Mississippi. But, as his sense of self is probably much stronger than the average person, so too are those pathways that feed perception of the environment around him. Hence his strong desire to be what others think he should be (the perception of his disappointment of others would be magnified) and his view of what he should become, what he should accomplish, is magnified. I can’t imagine him not having similar problems no matter where/what his environment had been. Had he been born on an island and raised by monkeys, I think he would have gone nuts trying to make the monkeys talk and would have delusions of one monkey that could talk to him. Without drugs and a judgemental society around him, he probably would have lead a very happy life and we’d probably be importing wicker baskets from his island filled with more highly evolved monkeys as the laborers. BobW Please no remarks from my "fans" as to my mind being closer to a creekbed than the Illinois River. Remember, it’s Fathers Day…be nice to me. – Hide quoted text — Show quoted text – Thank you Jack. I’m not really sure why the author even opened the article with that except to "name drop" It really didn’t fit into the subject matter. That said, since I posted it, I guess I was, in effect, agreeing with all that was written. I should have done some snipping. I agree that dream interpretation has probably done much more harm than good. I can only imagine all the people told that they had a mother complex if they dreamed of milking cows. (Although Freud probably would have concentrated more on Bulls After watching A Beautiful Mind today for about the 5th time, I’m still trying to come up with an original thought of my own to answer your question regarding psychological vs. physical ailments. I think this may have been the question that caused Nash to suffer from delusions. You didn’t ask him that question 30 years ago did you? BobW Bob– You know I respect you. That given: The "Interpretation of Dreams" is the only "original" work of Freud. All of his other stuff, the unconscious, infantile sexuality, etc. can be traced, with good certainty, to prior thinkers. Unfortunately, Freud’s "Interpretation of Dreams", has yieleded NOTHING of value, and is considered, essentially, wrong. No therapist I know places much value on dream interpretation. Sometimes, obvious dreams are "interesting", but are not diagnostic, of anything that cannot be brought out by interview, but are subject to unpredicatable false positives. The history of psychology was a topic I loved in grad. school, and was fortunate enough to have a men like Solomon Diamond, and Vernon Kiker for that topic. They were true scholars, and recognized experts of the "finer" points of history. Jack (a licensed family therapist) http://howtorelax.com Freud, in "The Interpretation of Dreams," published more than 100 years ago, called them "the royal road to a knowledge of the unconscious activities of the mind."
Response:
It is news to me that this is happening. Do you have a citation? Maybe it’s a viral STD<G? Jack
Delayed diagnosis of cluster headache in African-American women. Wheeler SD, Carrazana EJ. Neurologic Center of South Florida, Miami, FL 33176, USA. The male-to-female ratio has fallen in cluster headache over the last several decades and is now 2.1:1. Unfortunately, women still are not diagnosed accurately. This lack of appropriate diagnosis appears related to the misconception that cluster headache rarely occurs in women. Compounding this misconception, there seems to be an ethnic bias. We report cluster headache in five African-American women in whom diagnosis was delayed due to gender, ethnicity, and, most importantly, an inability to make a correct diagnosis of cluster headache. Cluster headache diagnostic criteria are no different in men or women and have no ethnic boundaries. Clinical features such as disordered chronobiology and abnormal behavior often suggest the diagnosis. Migrainous features occur commonly in cluster headache and, when present, should not exclude the diagnosis. Likewise, neither race nor sex should exclude the diagnosis. The diagnosis of cluster headache is easily made by considering unilateral orbital, supraorbital or temporal location; short duration (15-180 minutes, untreated), and ipsilateral autonomic dysfunction involving the eye or nose. Manzoni GC Headache Centre, Institute of Neurology, University of Parma, Italy. Changes in the male-to-female (M/F) ratio of cluster headache (CH) over the years were investigated through a comparative analysis of the distribution of the disease by sex and decade of onset in 482 patients (374M and 108F). Variations over the last few decades were also investigated in the employment rate, level of school education, smoking habit, and coffee and alcohol intake of the population living in the same area as the CH patients. The M/F ratio has fallen from 6.2:1 for patients with CH onset before 1960, to 5.6:1, 4.3:1, 3.0:1, and 2.1:1 for patients with CH onset in the 1960s, 1970s, 1980s, and 1990s, respectively. Correspondingly, in those same decades, the M/F ratio has fallen from 2.6:1 to 2.4:1, 2.2:1, and 1.7:1, respectively, for the employment rate, and from 8.6:1 to 7.8:1, 3.3:1, 2.5:1, and 1.9:1 for the smoking habit. Such a close correlation suggests that the significant changes that have occurred over the last few decades in the lifestyle of both sexes–and particularly that of women–may have played a major role in altering the gender ratio of CH. I do have some doubts as to the studies findings. Wondering if the results were sought out to meet specific environmental components or if these components were never considered until "after" the results were available. Whatever the case, the ratio does appear to be falling, based soley upon my observations. BobW
Response:
Funny…..I was actually going to write that I hoped that clusters hadn’t evolved into an STD …LOL I’ll find some citations. BobW
– Hide quoted text — Show quoted text – It is news to me that this is happening. Do you have a citation? Maybe it’s a viral STD<G? Jack I don’t relate clusters to migraine, but, then again, when women have clusters, they are often atypical, and this must also be accounted for. Are they, perhaps, having clustered migraines (or, migrainous clusters), which they often look like. When the treatments are very close (but, oxygen has never been shown to work in migraine), that further confuses the issue. Adding confusion here is the fact [?] that the percentages of men vs. women has been steadily growing closer together. It used to be reported as an 8:1 men more often than women. The latest studies I’ve seen have the percentage just over 2:1 Conjecture as to why this is happening appears to be widespread. BobW
Response:
It is news to me that this is happening. Do you have a citation? Maybe it’s a viral STD<G? Jack – Hide quoted text — Show quoted text – I don’t relate clusters to migraine, but, then again, when women have clusters, they are often atypical, and this must also be accounted for. Are they, perhaps, having clustered migraines (or, migrainous clusters), which they often look like. When the treatments are very close (but, oxygen has never been shown to work in migraine), that further confuses the issue. Adding confusion here is the fact [?] that the percentages of men vs. women has been steadily growing closer together. It used to be reported as an 8:1 men more often than women. The latest studies I’ve seen have the percentage just over 2:1 Conjecture as to why this is happening appears to be widespread. BobW
Response:
>Actually, I wonder if uterine contractions occurring during REM sleep >are associated with a higher-than-expected % of women going into labor >during the night. 
— NEWS FLASH: Pacifists declare jihad on war toys! 
) Mike > > "Spike" <sp…@yvn.com> wrote in message > > news:mf1S8.394267$%y.29121215@bin4.nnrp.aus1.giganews.com… > > > I am still having problems. Have restrictive apnea but have a big > tongue > > > and severe allergies which we are unable to control. I am trying to > sort > > > out why I still feel bad, allergies or sleep. Oh I am on cpap with > > > humidifier. I have had only one very short dream since August of 2001. > I > > > have NEs I say maybe twice a week. Does this possibly mean that I am > still > > > not getting into a deep sleep? I feel a little better than when I don’t > use > > > the cpap. But still a long ways to go. Does anyone have any ideas > about > > > this? Those dreams last August came after a sleep study and pressure > > > adjustment but stopped abruptly three days later, never to return. > Thanks > > > for any ideas and help. 