Why The Lateral Habenula Matters More Than You Might Think
You survived the monsters under your bed
You survived the monsters inside your friends
But there is more to life, you’ve many miles before the end.
Kate Spade. Anthony Bourdain. Robin Williams. Sawyer Sweeten.
Kurt Cobain. Marilyn Monroe. Simone Battle. Alexander McQueen
Forgot about some of those didn’t you
But you shouldn’t forget just yet
Because you aren’t immune from what ripped them away
Be you lesser known, iconic, or completely anonymous in life
There’s an epidemic but no vaccine
The illness is centuries old and the science brand new.
And what exactly is the new science?
When asked what the cause of depression is, some might say “sadness” and some who have bothered to do their research might respond “a chemical imbalance in the brain”. Recent studies point to a piece of the brain called the lateral habenula as a cause of depression’s many symptoms. So, there’s a reason why I wanted to kill myself and that reason is not me. It’s my malfunctioning lateral habenula.
In case you’re not a neuroscientist, I’ll give you a rundown of what I’ve found out. The lateral habenula is a region of the brain allowing communications to move from one part of the brain to another. This means it regulates different functions and behaviors ranging from pain and sleep to anxiety and depression (among several others); furthermore, it is thought to be a key player in processing information (what is negative and positive) and sending signals about it. Specifically, it can regulate the release of dopamine and serotonin by stopping neurons from bursting. Simply put, it tells other parts of the brain how things are going and how you should feel. In animal studies, the brains of test subjects with depression show this happening far too often and at the wrong times. In short, depression occurs in these animals when the signals go haywire, sending the wrong number at the wrong time and place. Treatment targeting this specific issue has proven quickly effective in recovery.
If you’re familiar with the illness, and if you’re reading this you probably are, you will know that there is no singular cause for depression. But, in practice, what I’ve just described produces feelings of negativity, abnormal stress, a lack of pleasure. and hopelessness. It disrupts interaction with others, appetite, and sleep patterns. Sound familiar? If a piece of the brain associated with regulating activity and mood is malfunctioning and altering this yields results in various animals, humans should find this an interesting hypothesis to pursue. So with this information, we find other treatment options that will produce similar results in people who don’t respond to some methods.
So there’s a new reason, but what about treatment?
This is where my own research surprised me. The answer is ketamine- a drug used by some as a horse tranquilizer and others recreationally. I wondered how an anesthetic and club drug is considered a safe option, but since 2006, doctors have been prescribing it to patients for whom other methods have proved insufficient. Thought to lift symptoms of depression almost immediately, ketamine poses a whole neurological issue in and of itself; it is considered safe in medical settings, but has adverse side effects that are hazardous and can lead to addiction. It is not approved by the FDA as a treatment for depression. However, the American Psychological Association does recognize that, though there is a potential risk, it may also be a beneficial treatment.
And it’s only recently that explanations have been available as to what is actually happening. It finds a hole in the brain channel that releases depressed neurons (caused by lower voltage resulting from low potassium, theoretically) in too high numbers at the wrong place or time and closes the hole. This means treatment options can be targeted to rebalance the potassium around those neurons, which will prevent them from firing when they shouldn’t and remedy what we know as depression.
Ketamine is typically used with another drug to counteract its negative effects as a hallucinogen and the side effects that come with it. It is a highly risky drug to use, and can only be prescribed by a doctor.
The question, I suppose, is whether this will really have an effect. For me personally, the answer is no because my treatment is different (you can read about it here). However, in more general terms, this could very well be a significant step in the right direction. Understanding depression is extremely important for us as a society and knowing more about the science behind it is a major part of that. Of course, there will always be ignorant people, but my concern is more with doctors than random people who don’t bother even trying to know what they’re talking about. Depression is a valid mental illness just like cancer is a valid physical illness, and understanding that it needs to be treated effectively on a case by case basis is crucial in dealing with it. Knowing the specific issue that causes it is the equivalent of knowing which cells in the body are cancerous or what cells are malfunctioning. So, maybe this is just something for scientists to tell each other that won’t make too much of a difference because there already is a widely known reason for depression, neurologically speaking. Maybe this is a stepping stone that will lead to something big. But on the way to that something big, does ketamine play a role and what does this mean for other treatment options? I don’t have answers. All I can do is write.
It will always be difficult for those on the inside to see the outside and vice versa. When we hear stories about what life is on the other side, we have two options. We can find ways to relate, see how we are similar, observe the paths we share in this human journey. Or we can marvel at all the differences. This has never led us to understand one another, but it really should because empathy is so unique. We’re moving forward right now in a lot of ways and among them are the new ideas and research being done to explain mental illness and to understand it. Mental illness, as I see it, is talked about so much that we are desensitized to it- see the expression “I want to kill myself” being accepted as a normal thing because people assume the speaker does not mean it- and at the same time so heavily stigmatized that huge numbers of people know nothing about it. The people who need to talk the most are afraid to talk and don’t even know how to explain what’ happening inside their mind because they themselves don’t understand it. Standing on the inside of mental illness, I want this to change and one of my biggest wishes is for understanding when it comes to the realities of mental illness and how we can treat it.
I cannot attest to the effectiveness of ketamine as a treatment, I have never tried it or discussed it with or mental health professional.
Here are some of the sources I used to help me write this:
https://www.medicalnewstoday.com/articles/302663.php → for details on ketamine
I mentioned in the piece that all I can do is write, so thank you for taking the time to read.