Book Review: The Disordered Mind
“Self-awareness leads us to question who we are and why we exist,” writes Eric R. Kandel.
Seeking answers to questions like this is what makes us human, but how do we explain how our consciousness arises from the physical matter that is our brain?
In his new groundbreaking book, The Disordered Mind: What Unusual Brains Tell Us About Ourselves, acclaimed neuroscientist Eric R. Kandel looks not at the brain in function, but rather conditions such as schizophrenia, depression, post-traumatic stress disorder, Parkinson’s and addiction to help us uncover what it means to be human.
While disruptions of brain function can be traumatic and frightening, they can also give us tremendous insight into how the brain functions.
Just one example is the remarkable instances of creativity seen with schrizophrenia and bipolar disorder — which arise from the same connections between brain, mind, and behavior seen in everyone.
Kandel writes, “As research into the brain and mind advances, it appears increasingly likely that there are actually no profound differences between neurological and psychiatric illnesses and that as we understand them better, more and more similarities will emerge.”
Research with autistics has uncovered that integral to grasping the theory of mind is understanding both behavioral intention and facial expression — two abilities that are challenging for those with autism.
Insights such as this have led us to also understand the purpose of social interaction more completely.
Kandel describes the work of Leslie Brothers of UCLA School of Medicine, who argued that “social interaction requires a network of interconnected brain regions that process social information and together give rise to a theory of mind; she coined the term social brain to describe this network.”
Exploring the brains of autistics and schizophrenics through the lens of synaptic pruning has also given rise to new insights. In adolescents with autism, Kandel tells us, synaptic pruning, which begins in childhood and peaks in adolescence and early adulthood, is underactive, resulting in too many synapses in the brains of autistics. Interestingly, the opposite is true for schizophrenics, whose brains have too few synapses.
Synaptic connections, we also know, are vulnerable to stress. Kandel writes, “Excessive concentrations of cortisol destroy synaptic connections between neurons and the hippocampus, the region of the brain that is important in memory storage, and neurons in the prefrontal cortex, which regulates a person’s will to live and influences a person’s decision making and memory storage.”
Prolonged stress, which is implicated in the development of depression, also changes the functioning of the brain such that people with depression often present with an enlarged and overactive amygdala, which help may account for feelings of hopelessness, mental anguish, and sadness.
Interestingly, in patients with schizophrenia, exploring how antipsychotic medications work — and especially their undesired side effects — has helped to give some clues into the etiology of schizophrenia.
Kandel writes, “Since these drugs produced the same effects on movement as Parkinson’s disease, which is caused by a deficiency in the modulatory neurotransmitter dopamine, scientists reasoned that the drugs might act by reducing dopamine in the brain. They also reasoned, by extension, that schizophrenia might result in part from excessive action of dopamine.”
For autism, mood disorders, and schizophrenia alike, brain imaging has given way to incredible advances in our understanding, particularly of how psychotherapy might be effective.
“Imaging has also confirmed that psychotherapy is a biological treatment — that it physically changes the brain, as drugs do,” write Kandel.
Work on memory loss has uncovered just how exercise may preserve not just the body but the mind. Bone, we now know, is an endocrine organ that releases a hormone called osteocalcin, which acts on many organs and as Kandel writes, “also gets into the brain, where it promotes spatial memory and learning by influencing the production of serotonin, dopamine, GABA, and other neurotransmitters.”
“We know that aging is associated with a decrease in bone mass and that the resulting decrease of osteocalcin contributes to age related memory loss in mice, and possibly in us as well,” writes Kandel.
Much like how exploring the brain activity that explains some kinds of memory loss has uncovered new insights, epidemiological study into addictions has helped us understand just how some addictive drugs may pave the way for using other addictive drugs.
Kandel writes, “Exposing animals to nicotine modifies their dopamine-receiving neurons in such a way that they respond more powerfully to cocaine.”
Studies on creativity have also helped us understand the conscious and unconscious process that lead to aha moments.
Kandel describes how creative people experience moments where communication between the conscious and unconscious becomes possible. He writes, “Because unconscious thinking is freer and more likely to be associative — it is characterized by images as opposed to abstract concepts — it facilitates the emergence of aha moments that promote new combinations or permutations of ideas.”
Kandel’s insights have elevated the biological study of the mind to center stage and in doing so, changed the way we understand a host of psychiatric conditions, as well as how we view ourselves, others, and what it means to be human.
The Disordered Mind: What Unusual Brains Tell Us About Ourselves
Farrar, Straus and Giroux, August 2018
Hardcover, 304 pages