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Mental Illness: What's Going on Inside the Brain? (PART 1)

Our Sense of Community series on mental illness begins by lifting back the scalp and drilling through the skull to examine the most complex organ in the human body: the brain. KSMU's Jennifer Moore reports.

The National Institute of Mental Health reports that one in four adults in America suffers from a mental health disorder in a given year.

SOUND: WIND CHIMES

One of those individuals is Kathy Myers of Springfield, who takes time to jot her thoughts down in her journal on her back porch.

"I use different colors of ink when I journal. So when my thought changes, the different color of ink changes in my journal," she says.

When she was 18, Myers was diagnosed with Schizophrenia. More recently, that diagnosis was changed to Borderline Personality Disorder. That means she has difficulty controlling her emotions and she sees things in very black and white terms. She also has psychotic tendencies.

Myers: When I get really stressed, I’ll hear voices. Moore: What do the voices sound like and what do they tell you? Myers: A lot of it is my own voice, telling me I’m no good, that I’m a failure. And then I’ll hear a man’s voice, at times, too, telling me I’d be better off dead.

It’s not known what causes her mental illness.

She believes her childhood had a lot to do with it; she was in a military family, and growing up, attended 11 schools in 12 years.

But she also suffers from depression, and has been told that her brain doesn’t have enough serotonin.

“It’s a combination of both,” says Dr. David Lutz, professor of psychology at Missouri State University. He says mental disorders are almost always caused by both a person’s biology, and their environment.

“Some are more heavily biologically influenced, some more environmentally influenced. How much? We can get into all sorts of estimates of that, and that gets a little squishy. But both are involved. It’s just a question of how much,” he said.

But about that biology...what's going on in the brain that causes it to malfunction? Well, Lutz says that depends on the illness.

In some mental illnesses, like Schizophrenia, research has shown that the actual structure of the brain changes as the illness progresses. A person with Schizophrenia actually loses brain tissue, and his or her ventricles—those cavities which are filled with cerebrospinal fluid—are enlarged.

But besides those structural changes in the brain, there’s the issue of biochemical changes, too.

"Generally, they’ve got too much or too little of something," Lutz says.

Lutz says usually, those “somethings” are the neurotransmitters, which are responsible for carrying the message from neuron to neuron throughout the brain’s circuit.

Moore: [foosteps on bridge] I couldn’t think of a better way to illustrate this than to come out to the 562-foot long Jefferson Avenue Footbridge. It crosses 13 sets of train tracks, and right now I’m standing at the threshold of the south side of the bridge. I’m here to show the contrast between what happens in a healthy brain versus the brain of someone with a serious mental illness.

So let’s say I’m the electrical impulse, travelling along down the path it takes in its circuit through the brain. But remember anatomy class? Those nerve cells in the brain are not actually connected—the impulse comes to a gap which it must bridge somehow in order to keep going. That bridge is a chemical known as a “neurotransmitter.” It bridges the gap, and the impulse keeps travelling, much as I’m doing now, crossing the bridge by foot...and I’m afraid of heights, so I’m gonna try not to look down...

But many people with depression, for example, don’t have enough of the neurotransmitter known as “serotonin,” so that impulse can’t make it “across the bridge” like it’s supposed to. For someone with Schizophrenia, there may be too many neurotransmitters—perhaps we could compare that to if there were too many people trying to cross this bridge at the same time.

So while a person’s life experiences can, and often do, contribute to their mental illness, the chemicals in the brain also play a significant role. [footsteps]

"A lot of times, people will see this as it’s just some sort of a character issue. And people tend to go: it’s either a character issue, or it’s totally biologically based, and there’s no place in the middle. And actually, everything’s in the middle," Lutz says.

Lutz says many people think that if a person who’s mentally ill would just pick themselves up, they could snap out of it and essentially, heal themselves.

"They’ve tried to do a lot of that, and haven’t figured out how. And it’s kind of like, if I’m asked to go build a house. It’s not that I’ve got a character problem. It’s that I don’t know how to do it," he says.

Myers’ Borderline Personality Disorder is treated with a combination of medications, and coping skills she learned through therapy.

[Sound of medicine bottle]

Myers: Now, I was out of one of my mood stabilizers and one of my anti-depressants last weekend for three days, and I started having some suicidal thoughts.

Moore: Why didn’t you have your medicine?

Myers: I didn’t have the money to get it refilled.

As for her coping skills, she journals, crochets, and takes her landlord’s three dogs out for a walk.

And, she listens to music. One of her favorite songs is “Take it to the Limit” by The Eagles.

"Take it to the Limit is how I live sometimes, to see how close I can get, or vary from that “borderline” line without getting into serious trouble," she says.Moore: Can you sing a little bit for us? Myers: No. (Laughter) I can’t carry a tune in a bucket!Since she wouldn’t sing it for us, we’ll play a little of it for her. Join us this afternoon at 4:30 as we continue to explore how the brain works in the mentally ill.

For KSMU’s Sense of Community series, I’m Jennifer Moore.

[Sound of "Take it to the Limit" Fades Out]

The National Alliance for Mental Illness (NAMI) office in Springfield is just north of the intersection of Campbell and Sunshine. (Photo credit: Alex Crowder) KSMU's Jennifer Moore walks the Jefferson Avenue footbridge to demonstrate how an impulse travels throughout the brain. 
(Photo credit: Alex Crowder) The brain's neurotransmitters act as a bridge, carrying the impulse across the synaptic gap between neurons. But for some people with serious mental illnesses, these neurotransmitters malfunction, and the message gets lost, or distorted. (Photo credit:  Alex Crowder) These images show the difference between five years of patients with Schizophrenia, indicating a defecit of brain matter. (Photo credit: Alex Crowder) These images show how the ventricles of a person with Schizophrenia are enlarged. (Photo credit: Alex Crowder) These images show how the ventricles of a person with Schizophrenia are enlarged. (Photo credit: Alex Crowder) KSMU's Jennifer Moore walks the Jefferson Avenue footbridge to demonstrate how an impulse travels throughout the brain. 
(Photo credit: Alex Crowder)