*** The emotional night-time tale of Scheherazade, the elder daughter of the vizier, who has crazed a manic psychosis, accompanied by a sense of one’s own chosenness, irresistible and intellectual superiority over the world that pushed her, risking her head, go to the mad king Shahriyar to make the unjust world fair and stop the senseless daily penalty young beautiful Persian virgins.
The expression “attention deficit” in psychiatric practice is usually seen in terms of the symptoms of ADHD (attention deficit hyperactivity disorder, F90 ICD-10). It is believed that the instability of the attention of these patients is a pathology requiring correction. The rest, complaining of poor concentration - just lazy. And some psychiatric reasons for this position are available. Although the question remains uncrossed is where to include lazy people and slobs who do not want to be lazy and slobs who are experiencing obvious sufferings, but who do not succeed in the endless struggle for "better themselves." However, I have an answer to this question.
The diagnosis of ADHD, especially in adults, is still widely debated in psychiatric circles. But I am not a psychiatrist, but a psycho, so I pause in this series of articles to dot the i's and eliminate all stumbling blocks. But the attitude to the material I ask is critical. Reasoning, the hasty conclusion, and the Dunning-Kruger effect are regular satellites for ADHD.
One of the main problems with the diagnosis of ADHD is that its symptoms are extremely diverse and vary greatly. Symptoms of ADHD creep over asthenic-type schizoid personality disorder with one edge of their spectrum, and passing through the “golden classics of ADHD”, the other end of the spectrum enters specific forms of BAR-2.
Resoners tend to write treatises. Including ADHD, but, unlike schizoid hypersthenics and schizophrenics, ADHD does not add them. So I myself have no illusions about 1001 articles in this series. But the topic of the principles of our mental apparatus and the functional characteristics of the brain associated with the mechanisms of attention is really extensive.
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In general, ADHD patients see the root of all their problems only in an unstable focus of attention and low ability to concentrate, but, to tell the truth, this is not quite so. ADHD accompanies a whole bunch of specific cognitive distortions, high expectations, reassessment of one’s abilities, and inadequate behavioral outputs.
Some of these problems are explained by schizophrenic patterns of thinking, some by features of the functioning of the limbic system, part by the calibration of the reward system, and finally by impulsivity.
ADHD is not primarily about the focus of attention. This is about schizophrenia and thunderstorm lightning sweeping across megavolt discharges through a low-current logic system from the prefrontal cortex to the reticular formation, piercing all fuses and interlocking relays in its path.
Schizophrenia, we owe for all the achievements of our civilization, the most terrible pages of our history and comments on LJ conspiracy in LiveJournal. Schizophrenia inspires, gives the phenomenon a special meaning and drives us to the great construction of the kingdom of heaven on earth. Schizophrenia is beautiful and consistent, until an observer looks at it. I would like to start with it.
Since severe forms of schizophrenia are not the subject of this series of articles, let's talk about schizophrenia “light”.
***
- What a strange question. What can make me pray? Many things. A huge number of things can make me pray.
- Well, for example?
- Baseball bat in your hands. Steel reinforcement. Brass knuckles. Pistol. AK-47. Garden knife ...
“No, I mean, personal testimonies of healing, or how people couldn’t get pregnant for years ...”
- And as soon as they ordered a zirconia bracelet, charged in the Temple of the Holy Sepulcher, they immediately flew.
- In short, only the resurrection from the dead before your eyes ?!
- Even if the heavens open up before my eyes, and the Lord God himself comes to me surrounded by archangels, I am without any fuss, but I will immediately go to the doctor for neuroleptics.Schizoid is a fashionable term today in popular articles on psychology. Most of the authors describe schizoids as dreamy, self-contained individuals with strange hobbies from the point of view of a normal person. Intuitively it seems like typical geeks as they are.
And this intuitive understanding of the phenomenon, oddly enough, generally corresponds to reality. With the only clarification that, of course, every real geek is a schizoid, but not every schizoid is a geek.
When studying the phenomenon of psychologists and psychiatrists tried to identify the main factors by which a person could be classified as a schizoid. The main points were obsession with their own ideas and emotional isolation from the external environment. But any further refinements led to an infinite growth of subtypes, which differed significantly in their emotional constitution and behavior. In one heap there were also hypersensitive asthenics and cold hypersthenics.
To give examples of such typing is a waste of time.
Specification: The term “sthenichnost” (from the Greek. Sthenos - force) in relation to mental mechanisms should be understood as willpower, goal-orientedness, ability to withstand difficulties and adverse circumstances on the way to the goal. “Asthenia” is a weakness and the complete opposite of sthenichnost.
The term "schizoid" is introduced into psychiatry to refer to individuals who are close to schizophrenic in nature. Most hypotheses of the pathogenesis of schizophrenia have only recently revolved around dopamine, which, apparently, was an oversimplification. Dopamine is not the only player here, albeit the main one. It affects the limbic system, and, therefore, our emotions. Emotions affect our thinking, and this is indisputable. Also, the direct action of dopamine on thinking processes is carried out along the mesocortical path leading to the region of the prefrontal cortex responsible for the planning and overall management of mental activity. But the whole picture as a whole only dopamine was difficult to explain. Because the exuberant nature of dopamine, which cannot be confused with anything, clinical psychiatry learned very well by the sixties with the example of amphetamine psychosis, which at that time was treating everything from rhinitis to depression. From depression, amphetamine, paradoxically, helped worse than from a cold. Otolaryngologists were satisfied. Psychiatrists are not.
Recent neurobiological studies in mice suggest that endogenous cannabinoids, in particular anandamide, are involved in the pathophysiology of schizophrenia. Anandamide is a braking mediator. But in some cases, it inhibits the main inhibitory mechanism of the brain through the activation of CB1 receptors in GABA-ergic neurons. Brake mediator, which inhibits another brake mediator ... It excites me.
Also, deviations in the work of GABA receptors are associated with some aspects of attention deficit disorder. Gamma-aminobutyric acid (GABA) is the main inhibitory mediator of the brain. The predominance of excitation processes over inhibition processes can have very different effects. With a large bias in the local area of the brain, an epileptic focus may occur. Moreover, a lesion that does not affect the motor areas of the brain can lead not to convulsive activity, but to manifest itself in the form of psychosis, hallucinations, fear, aggression or delusions, depending on what functions are performed by the part of the brain in which it is located. A more moderate bias can produce an overly dreamy, suspicious, hyperactive, anxious ... enthusiastic type of psyche. However, the role of GABA in the central nervous system on the one hand is too global, on the other, it is only one of the most important mediators of the central nervous system. But about others and especially about dopamine, we'll talk another time. For now, just pay attention to the anandamide regulation of the GABA-ergic system.
Since the paragraph above I mentioned endogenous cannabinoids, the article will probably be incomplete without a short story about exogenous cannabinoids.
The brain is partly a machine of interpretations. It is probably the suppression of the inhibitory mechanisms of certain parts of the brain that generates the breadth of interpretations characteristic of schizoids.
And THC, the main cannabinoid contained in cannabis, which is a direct agonist of CB receptors, causes a wide range of interpretations similar to schizoid thinking. Only you need to understand that the nature of thinking is only one of many components. Another of many is previous experience and learned models. Therefore, its natural breadth of interpretations of technology can lead to the idea to make a programmable moonshine with the control of the Arduino and experience delight. And an ordinary person who smoked weed, a temporarily extended interval of interpretations would rather lead to the thought: “But let us smoke a cat!” And also experience the characteristic delight of this mind-blowing idea.
But most importantly, when exogenous cannabinoids are released into the blood, the brain does not act selectively. And the characteristic excitement with the whole breadth of interpretations can be obtained through the alarm channel. Then the whole creative search will be focused on the interpretation of threats with their rapid and intense experience. In addition, cannabis contains more than 80 cannabinoids. And the main after THC is CBD. Unlike the first, the second is an indirect CB receptor antagonist. That is, THC and CBD act opposite to each other! This, by the way, explains the nature of cannabis intoxication - primary excitement, enthusiasm and a flurry of ideas and associations in the first phase and sedation, relaxation and drowsiness in 30-60 minutes. Although it is possible to talk about some kind of cannabis intoxication only conditionally, because unlike many other psychoactive substances, the effect of cannabis is very individual for each individual person due to the complexity and complexity of the effects. The effect can be expressed in the fact that the TV show about Ukraine suddenly became incredibly interesting. In addition, all studies clearly indicate that cannabis use worsens short-term memory and attention. Controversial for creativity, especially requiring detailed study.
In addition to the breadth of interpretations, schizoid thinking, as a rule, is characterized by the presence of supervaluable ideas. However, supervaluable ideas are already the work of dopamine. Without dopamine (with moderate dopamine activity), the nature of thinking is somewhat different. I call it “an overvalued idea for an hour.” That is, the emotions associated with a particular thought are very intense, the thought is perceived as extremely important, but the process is unstable.
The anandamide suppression of the GABAergic system of the higher parts of the brain generates a surge and “curliness” of thoughts, which, if there is insufficient dopamine activity along the mesocortical path, results in an acute attention deficit, uncontrollable dreaminess, planning problems and a general lack of coordination of thinking. The focus of attention in this case is extremely unstable, since the mechanisms of active suppression of competing processes do not cope, which results in an asthenic type of schizoid disorder. Such people are difficult to realize in life. Their psyche is very vulnerable to the effects of the external environment and easily falls into social maladjustment. An example would be hikikomori. But that is if such a schizoid has parents who are ready to support him. Otherwise, without correctional training, his life will be difficult and sad. In addition to lack of coordination, low willingness to violence (both physical and psychological), inability to stand up for themselves and resist aggression most often lead to chronic depression and depression of the psyche. Welcome to Planet of the Apes.
At the other extreme, we will observe a very different picture. With dopamine hyperstimulation along the mesocortical path, we will see a concentrated schizoid, stubborn as a ram, covered by supervaluable ideas. The whole life of such an individual will be subordinated to his main interest, or rather the main dominant. At this pole of the schizoid spectrum, it is much more often possible to meet a successful fanatic ready to work hard for a hundred or more hours a week in the name of an idea. But, despite the general sthenic nature, this type of psyche is also vulnerable, and with an unfavorable external environment it has a tendency to develop protective reactions resulting in social disadaptation.
In general, it is impossible to reduce all the peculiarities of schizoid thinking (actually not only schizoid, but anyone else) only to the activity of GABA and dopamine.
First, to avoid confusion, it should be said that dopamine is not a rival to GABA on the tennis court. The rival of GABA is glutamate, which is the main excitatory neurotransmitter of the nervous system. Dopamine is more likely a judge sitting on a tower and giving orders to tennis players, which particular sector of the stands are now to throw balls and which one to jam on the head with rackets. Dopamine is not only arousal, but also active inhibition (inhibition).
Secondly, you need to be aware that even a single neuron is affected by dozens of factors that counteract, correct, transform, or reinforce each other, on which it depends whether the action potential arises or not. I will not continue that these neurons in the amount of more than 80 billion pieces, differing in specialization, form thousands of subsystems combined into a bizarre single structure of our brain. We will talk a little about some of these factors when it comes to such an important characteristic of the psyche as impulsivity.
Remember! Any complex multifactorial phenomenon has a simple wrong explanation.
And even the most primitive process of the brain cannot be reduced to one or two factors, not to mention such a process as thinking.
I seem to have just discredited all of the above, or it seemed to me?
In addition to thinking, schizoids are characterized by their isolation from society. It seems to be. But with this statement is also a problem. A careful study of the phenomenon of psychologists have found many examples of quite socialized and even hypersocial schizoids. And they gave birth to the concept of “secret schizoid”. Well, ok, let it be secret. What psychologists would not tease ... just not to measure the skull.
The fact is that the main driver of establishing strong social ties are emotions experienced together. It is not surprising that people who have been jointly fighting, maintain friendly relations for much longer than office colleagues. And this is by the way why team-building with trips to paintball shooters or climbing walls in general really works. Joint feasts, games, hiking ... All those collective actions that are accompanied by intense emotions. One of the main mechanisms of empathy is the general interest in something: be it a booze, a series or a certain direction of pop music ...
If all the interests of an individual are focused around one or several topics and are so intense at the same time that they develop into unhealthy passion, then this leads to a breakdown in social contact with other members of society who do not share this interest. In this case, the emergence of such a dominant, as a rule, leads to the weakening or complete loss of all other interests.
At the same time, within the subculture such people are quite capable of establishing fairly strong social ties. Although, in any case, when a person has something to do alone with himself, the need for external interaction is greatly reduced. Especially when his egocentricity scratches the clouds.
There is no doubt that the emotional apparatus of schizoids is somewhat different. But the picture of detachment and isolation, which psychiatric reference books draw, is probably not only or not so much a natural property of schizoids, but rather it is a defensive reaction.
To all the above, I will add that I am very skeptical about typing ”Schizoid - Paranoid - Hysteroid ...” Obviously, although with a superficial look at the phenomenon (very superficial), the concept seems to be working, in practice schizoids can be paranoid and hysterical ... That is show mixed type.
In the next article, we’ll continue to analyze in more detail the peculiarities of thinking and the behavioral outcomes that such brain chemistry has. For now, remember that the schizoid disorder of the asthenic type contains a pronounced component of attention deficit associated with the weakness of the mechanism of suppression of competing processes in the brain.
Shakherizada’s manic verbal diarrhea continued until dawn. And now her life depended entirely on whether the almighty king wanted to hear the continuation of this story or orders to execute ...