Although Dr. Patrick Mbaya’s illness caused a lot distress and nearly took his life, the emotional symptoms of the depression he developed helped him understand and empathize with patients and how they feel when they become ill. In My Brain is Out of Control, Mbaya, fifty-five and at the peak of his career, shares a personal story of how he suffered from a brain infection in 2010 that caused loss of speech, right-sided weakness, and subsequent depression. He tells how he also dealt with the antibiotics complications of low white cell count and hepatitis. He narrates his experiences as a patient, the neurological and psychiatric complications he encountered, how he coped, and his journey to recovery. Presenting a personal perspective of Mbaya’s illness from the other side of the bed, My Brain is Out of Control, offers profound insight into battling a serious illness.

 

GUEST POST

CLINICAL DEPRESSION
 Clinical Depression is a common illness, different from ordinary sadness, which is a normal reaction. It can affect anyone, including doctors like myself, and indeed I suffered from this, during my illness. It is not a weakness.
It may occur spontaneously in vulnerable individuals, like someone with a family history of depression. Severe stress or traumatic events in childhood, may also make an individual vulnerable to developing depressive illness, later on in life. Recent research has shown that this could be due to the effect of stress hormone cortisol, on the developing brain. Severe stress or loss events (like losing a family member) can cause (precipitate) it. In my case the brain infection I suffered, affected the limbic/emotional brain (see below).
Emotions, and certain behaviours are controlled by the limbic (emotional) brain. This is like a circuit comprising of connections from the brain stem (stem of the brain), to the front part of the brain (prefrontal cortex, the part in front of the motor cortex), then to the medial (inner side) of the temporal lobe structures like amygdala and hippocampus. In my case, it is the left prefrontal cortex, which is next to the motor cortex (which caused weakness on my right side) and the speech (Broca’s) area.
There are different theories about the biological causes of depression within the brain. However, there is a lot of clinical, and research evidence that depression is associated altered levels of chemicals (neurotransmitters) that control emotions, and behaviours. The two main chemicals (neurotransmitters) being serotonin and noradrenaline (also known as norepinephrine). These chemicals are made by the brain from the food we eat, like bananas (I asked my daughter to get me bananas during my recovery phase). Emotions and behaviours like mood, sleep, appetite, enjoyment, concentration, short-term memory, energy, and some forms of thinking are controlled by these chemicals.
There is both clinical, and research evidence that these chemicals become imbalanced, causing symptoms of clinical depression including persistent low mood, tearfulness, poor sleep, lack of enjoyment, poor concentration, short term memory, reduced interest in things, poor appetite, feeling negative (like focussing on past traumatic or unhappy events, or being emotionally affected by current sad events) up to including suicidal thoughts. (Recent research has shown that amygdala become very active in clinical depression, negative traumatic past events tend to re-surface and the individual becomes pre-occupied with these events, feels hopeless, worthless, and has suicidal thoughts, and these symptoms are reversed by effective treatment of depression). These symptoms tend to be worse in the morning (diurnal variation, possibly related to high levels of the stress hormone cortisol) and can improve later on during the day. Like in my case, my mood was worse in the morning. “I was emotional and found myself crying without a moment’s notice.”
As depressive illness can affect confidence, energy, motivation, concentration, short term memory, level of functioning is impaired (the ability to carry out activities of daily living, even to the point of being unable to work, socialise or to go to school). The World Health Organization (WHO) found out in a study (1990), comparing medical illnesses, that depression was four in the league table, as a cause of health-related disability. They estimated that by 2020, it will rank second to heart disease!
Current research has shown that severe stress increases the levels of stress hormone cortisol, which in turn reduces serotonin, noradrenaline, and brain-derived neurotrophic factor (BDNF, also known as brain fertilizer, which protects against cell death by cortisol), in the brain, causing depression.
Antidepressants work by increasing these chemicals/neurotransmitters (improving symptoms, and level of functioning), and may protect against severe stress causing depression. Psychological treatment like cognitive behavior therapy (CBT), is also effective in depression, especially in combination with antidepressants. Current guidelines recommend psychological treatment for mild to moderate depression, and antidepressant medication, plus psychological treatment for moderate to severe depression.
Dr Patrick Mbaya MD FRCPsych.
www.drpatrickmbaya.com
References: Cancel reply
Duman Ronald. Depression: a cause of neuronal life and death. Biological Psychiatry, 1 August 2004, vol.56:140-145  Cancel reply
Global Burden of Disease, World Health Organization, 1990.
Mbaya Patrick. My Brain Is Out Of Control. Author House. September, 2016
Shimizu Fiji et al.  Cancel replyAlterations of serum levels of brain-derived neurotrophic factor (BDNF) in depressed patients with or without antidepressants; Biological Psychiatry, 1 July 2003,Vol 54(1): 70-75
Stahl Stephen M. Essential Psychopharmacology, Neuroscientific Basis and Practical Applications. Second Edition.  Cambridge University Press.
Stress and Plasticity in Limbic System, Robert M. Sapolsky; Neurochemical Research, Vol. 28, No. 11.
 
 
Dr. Patrick Mbaya is a medical doctor specializing in psychiatry. He is a consultant psychiatrist and honorary clinical lecturer in psychiatry at the University of Manchester, United Kingdom. He has a special interest in mood and addiction disorders.
 
 
 
 
 
 
 
 
 
 

 
 
 

 

 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
For over thirty years, World War II veteran and author Burt Hall assessed accountability in government and national security. Now, this seasoned, professional analyst delivers a tough account of what went wrong in our politics and system of government over the past two decades and what we can do about it. 
 
The right wing (not to be confused with Conservatism) has hijacked the Republican Party and wrecked havoc on our nation. It exploited basic flaws in our system to gain power and a series of major setbacks and a weakened democracy have followed. 
 
The Right-Wing Threat to Democracy lays out clearly what the basic flaws in our system are and how they can be fixed. The danger is that an ongoing shift of political power to the very wealthy and suppression of voting rights is silencing the voice of the average citizen. 
 
If elected officials do not fix the basic flaws, the American people have alternatives in our democracy and must take matters into their own hands.
 
 
 
 
After early careers in the aircraft electronics field and as a CPA, Burt Hall joined the USGovernment Accountability Office (GAO), where he served as group director analyst on national security and other matters. For more than thirty years, he reported to Congress and testified before its committees on behalf of the GAO. Mr. Hall graduated from the Harvard Advanced Management Program and was loaned twice for two years, once to a bipartisan congressional commission and later to the Reagan White House.

With Ed Asner, who also contributed to The Right-Wing Threat to Democracy, Hall coauthored Misuse of Power. He coauthored the bestselling book, How the Experts Win at Bridge, with his wife, Lynn.
 
 
 
 
 
 

 
 

 

 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 

In ENTER VENUS the Goddess of Love comes to earth to save a marriage that’s falling apart. In the course of her magical ministrations, the art masterpieces at the magnificent Frick mansion spring to life and into action and a torrential downpour sweeps characters from a New York City street to Venice, Italy.

 
 
 
 
Sondra Luger taught English in a New York City high school. Her first romantic novel, RICH, NEVER MARRIED, RICH was inspired by Jane Austen’s PRIDE & PREJUDICE, and her second, BACK FROM BORA BORA, was inspired by the business world of the young and the resilience and energy of the so-called aged. Her mysteries, DROP ME OFF IN HARLEM and MURDER ON BROADWAY, both of which feature the same female fashion model detective, are a tribute to the Roaring Twenties and to the author’s mother, who was a high fashion model. Sondra comes from an arts-oriented family with musical talent, and she has recorded a music CD with her sister, singer and songwriter Carolyn Luger. The songs were written by music icons of the twentieth century. The album is TAKING A CHANCE ON LOVE.
 
 
 

 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 

Parents and caregivers face the unhealthy messages of the media, advertisements, and peer pressure that negatively influence their children and teens, and they need to take action. In A Healthy Weight, Dr. R. Matheny provides practical advice to mothers and fathers, caregivers, and expectant mothers to prevent or correct obesity in infants, toddlers, children, and teens Based on the author's professional experience in the areas of infant and childhood nutrition and supported by research, she shares a host of health and diet information, including • recommended dietary intakes for infants, toddlers, children, and teens; • healthy eating practices for children, teens, and the family; • healthy physical activity practices; • normal growth, evaluating growth, and promoting a healthy weight in infants, toddlers, children, and teens; • helping your family become psychologically fit; and • setting healthy goals for the family and encouraging participation of children and teens in the family's meal-related activities. Incorporating basic information about foods, diet plans, and examples of healthier lifestyle choices, A Healthy Weight advocates the reinforcement of healthy practices while correcting unhealthy ones on the path to facilitating a fun and satisfying way of life.


 
 
 
R. Matheny, PhD, RDN, earned a PhD in nutritional sciences and is a registered dietitian with the American Academy of Nutrition and Dietetics. She also has a MPH with a double concentration in public health nutrition and maternal and child health. Matheny has worked for two county health departments as a nutrition counselor in maternal, infant, and childhood nutrition. She also continues to support animal welfare by donating to local and national organizations that provide help for domestic animals or wildlife.