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2012年5月6日 星期日

Is There Such A Thing As Video Game Addiction?


You may have considered the questions "Is there such thing as a video game addiction?" for either yourself or someone you love. They have been playing for many hours and seem more interested in the game than in what is going on in real life or their school studies.

The quick response is to such a question is "yes a person can become addicted to video games". Although that is a quick answer, it does not explain many of the issues underlying the concerns of video game addiction. Some researchers are already labeling such behavior it as "Internet Addiction Disorder (IAD)". Although some researchers have a name for the phenomena, they do not have definitive data supporting the 'Internet Addiction Disorder' as a diagnosis. The research community is still debating the issue. The psychology field often views the behavior as connected with depressive or anxiety disorders, while downplaying the addiction aspect. Addiction experts look at the addictive behavior pattern and recognize what they see. The body of research that does exist that relates to video gaming has evolved using the criteria for gambling addictions. The two behaviors often share much in common.

Addiction experts know that a person can become addicted to many behaviors. Some behaviors have a higher addictive potential than others. Any behavior that can rapidly change our mood and mental state has a potential for addiction. Since playing video games often includes repetitive behavior routines to the degree that other areas of a persons life are suffering, it shares much in common with other addictions.

One of the factors that makes video games addictive is the action. Many video games have fast action. When action occurs quickly, it functions to reward the person playing the game. Much like gambling addictions the person is stimulated by the action occurring and wants more. Despite all the activity occurring on the screen, the real action is in their head. The person playing devises more ways to create more action. Despite all the activity observed at the control pad, the action going on in their head is even faster and more intensive. There is large scale planning and problem solving going on in their head. Those wanting the action are actually seeking stimulation of those parts of their brain involved in their game play. Each time the brain is stimulated, new brain cell connections are established. Those new connections are actually rewiring their brain and how it processes information. The more action and play, the more new neural connections are made. The person playing the video games is literally rewiring their brain.

If you could hook up a PET scan of a person's brain while they are playing video games, it would become very apparent what parts of the brain are being stimulated. The PET scan would also show the extent of that stimulation. The amount of brain chemicals being released is staggering. The addictionology experts who view 'video game addiction' from this perspective often see little difference in the brain activity of heavy video game users with those of gambling addicts.

Since the neurotransmitters are more powerful than street drugs, the mood change can be very dramatic. In many cases, the problem for the video gamer is more often associated with depressed moods or anxiety, rather than the game play itself. It is suspected that the video gamers are using their play to 'self-medicate' or avoid unpleasant emotional mood states. If you watch a video game addict, you will see the mood altering aspects of video games. The release of the neurotransmitters creates a visible mood change, and change in their thinking. Much like a person can become addiction to a street drug, they do so with their own self-produced chemicals. You will also see the drug/addiction seeking behaviors as well. Instead of "jonesing" for street drugs, they actively seek out video games for their fix. It is not by accident that people refer to World of Warcraft as "World of War Crack".

Unlike street drugs, drug screen will not provide indications of whether or not someone is addicted to video games. The addition of all the lights, sounds and vibrations add to the level of stimulation. With the improvements in 3-D technology, the level of stimulation provided by games has increased. Many gamers seek a total sensory experience. The more potential sources of stimulation the better. This desire for total sensory experience is part of what motivates vibrating controllers, three-dimensional effects and stereophonic sound. They want to 'feel' the experience in as many ways as they can. Rather than the lack of stimulation as found in sensory deprivation tanks, they are seeking stimulation at the opposite end of the sensory spectrum.

The problems arise when the amount of play becomes destructive. When the person neglects hygiene, daily activities, sleep, eating and other self-care, they are well on their way to addiction. Since video games are more acceptable stimulation than gambling or drugs, many addictive personalities often resort to this activity to hide or mask their addictions. Instead of overcoming their previous addiction, they have transferred it to another object. If you watch serious video game players you will see the many mood altering experiences they go through when playing their games.

Does this mean that anyone who plays video games is addicted? The answer to that is "no". What it does mean is that when their activities of daily living are significantly impacted, they are playing too much. Before you assume that someone you know is addicted to video games, you will need to consider the big picture of their functioning. The real problem may be family related, loneliness, depressed mood or anxiety. The gaming is their way of dealing with it. When video gaming is identified as the problem, the underlying issues are often not addressed. It is often easier to blame 'War Craft" or "Grand Theft Auto" as the problem rather than address what makes such games so attractive to the gamer, or what problems they are experiencing.




Jeff Murrah, LPC, LMFT, LCDC is a counselor with experience in dealing with many types of disorders including addictions. He can be contacted through his website at http://www.RestoreTheFamily.com





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2012年3月30日 星期五

Chemo Brain, Is There a Natural Therapy?


I. Abstract

Chemo brain is a form of cognitive impairment that is found in 25-80% of patients who have received chemotherapy. Studies show that the syndrome is related to an increase in inflammatory cytokines and the problem can last for 10 years or more. No traditional therapies are identified to treat chemo brain. Natural approaches, which are often ignored by medical experts, have known effects in the prevention and treatment of dementia. These include gingko biloba which improves circulation and early dementia by producing anti-inflammatory cytokines and dietary changes. Diets high in fruits and vegetables are known to decrease the risk of dementia while omega-3 fatty acids are known to be anti-inflammatory. These are the keys to prevention and treatment of chemo brain.

II. Introduction

Loss of memory or dementia is one of the greatest fears of aging people. This affliction is by no means limited to the elderly. Cancer survivors can also develop loss of memory. Loss of memory in cancer patients has different names; dementia, cognitive dysfunction, but the most recently coined terms chemo brain and chemo fog suggest chemotherapy may play a major role in its cause. What is chemo brain and how can it be treated? The problem has been recognized for a decade but these important questions have only recently been the focus of experts in the field. Although research into this condition is ongoing and unfortunately many questions remain unanswered and we will discuss that it is not only found in patients who have received chemotherapy.

III. Definition

Chemotherapy causes many acute symptoms such as low blood counts, nausea, hair loss or diarrhea. These often resolve soon after the chemotherapy is stopped. There are however other symptoms that are more chronic. These include fatigue and loss of memory or chemo brain. Common complaints described in studies include not only poor memory but an inability to concentrate at work or juggle multiple tasks. This is very distressing to a patient who has already had to endure a diagnosis of cancer and the physical effects of surgery, chemotherapy or radiation therapy. Although depression, anxiety, and anemia can contribute to these problems, the symptoms of chemo brain remain after these other problems have been corrected.

Chemo brain is more than a subjective complaint. Measurable abnormalities can be found on formal neuropsychological tests and measures. These tests can evaluate a variety of parameters including attention and concentration, verbal memory, visual memory, visual-spatial and speed of information processing. Published studies have demonstrated a broad range of cognitive deficits thus identifying this as an authentic medical problem.

IV. Incidence

Review articles on chemo brain have demonstrated that this is a common problem. There have been approximately eleven groups that have published reviews on this subject mostly in patients with breast cancer but others are also included. Symptoms of chemo brain can be found in 25% to 80% after their therapy. Interestingly, chemo brain has been found in 35% of patients before chemotherapy is ever given suggesting that there may be a predisposition to the illness in addition to effects produced from the cancer itself and possibly surgery. This appears to be a problem that is more complex but far reaching. Many of the 10 million cancer survivors have received surgery, radiation and chemotherapy and 35% to 80% may exhibit some cognitive dysfunction.

V. Etiology

The cause of chemo brain is thought to be the result of vascular, metabolic, or inflammatory changes in the brain. Sophisticated radiology scans have found interesting and provocative changes in the brain. Magnetic resonance imaging (MRI) has demonstrated widespread decrease in gray matter of the brain suggesting atrophy of the brain related to a toxic effect of chemotherapy. More recently, researchers have measured metabolic activity in the brain with positron emission topography (PET) scanning. Studies utilizing PET scans have demonstrated decreased metabolism in the frontal cortex, prefrontal gyrus, Broca's area and their corresponding contralateral areas in the brain. Interestingly, these areas are responsible for memory and concentration. When patients were given simple memory tests to perform, abnormalities in these areas were again demonstrated whereas there were no abnormalities found in people without cancer.

The cause of the metabolic abnormalities in the brain may very well be the same problem that has been implicated in Alzheimer's Dementia, namely inflammatory cytokines (IC's). Inflammatory cytokines are substances secreted by the immune system to help fight infections. When IC's are chronically elevated they lead to a variety of chronic diseases such as heart disease, cancer, strokes, chronic fatigue, rheumatoid arthritis and dementia. Multiple studies in both animal and human models have demonstrated the correlation of chemo brain with inflammatory cytokines. Although inflammatory cytokines do not consistently increase with the administration of chemotherapy, the presence is chemo brain is found when the inflammatory cytokines are elevated. Curiously, fatigue is also a common chronic complaint in cancer patients and inflammatory cytokines are also elevated in these patients.

VI. Therapy

The treatment of chemo brain should target the root causes. Of course, problems such as anemia, depression, infection, anxiety must all be addressed and treated. Methylphenidate or Ritalin has been recommended by some experts but it only treats the symptoms of the disease.

Since inflammatory cytokines seem to be a major contributing factor to the etiology of the disease, therapies aimed at decreasing these should be offered. Steroids such as prednisone or dexamethasone are commonly used to treat inflammatory diseases such as rheumatoid arthritis. There is no proof they are useful in chemo brain and some researchers have suggested they might cause chemo brain. Additionally, they have too many side effects to be useful for long term use. Non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen have been found to be helpful in delaying the onset of dementia in patients with Parkinson's disease and Alzheimer's disease. This may be a possible therapy for chemo brain but is not likely to be a curative modality.

There are two therapies that are overlooked by modern medicine that can effectively treat dementia and chronic inflammatory cytokines these are gingko biloba and diet.

Gingko biloba has been used in traditional Chinese medicine for thousands of years. It has many beneficial effects including improving blood circulation which is helpful in patients with claudication. It has also been found to improve function in early dementia due to either vascular disease or Alzheimer's disease. Gingko improves circulation by increasing anti-inflammatory cytokines. Therefore it seems reasonable to suppose that gingko would be beneficial to patients with chemo brain since their form of dementia is caused by inflammatory cytokines.

Perhaps the most forgotten therapy to prevent and treat diseases is diet. Too often patients look for a pill to treat their illness when a change in diet can be very beneficial. The typical American diet is high in animal fats, trans-fats, corn oil, refined sugars, and carbohydrates and it lacks fruits and vegetables. This type of diet leads to an increased risk of heart disease, stroke, and cancer. We know that inflammatory cytokines play a major role in the etiology of these diseases. Multiple studies have shown that a diet rich in fruits, vegetables, and omega-3 fatty acids can prevent theses diseases by their anti-inflammatory and anti-oxidant actions. In many ways, we are causing the very chronic diseases that plague us.

The treatment or prevention of chemo brain is a simple process that focuses on the root cause of the dementia namely inflammation. We already know that certain diets and gingko can treat and prevent certain diseases caused by inflammatory cytokines. The most prudent approach to treating or preventing chemo brain is a diet rich in omega-3 fatty acids, fruits, vegetables, and gingko biloba.




Robert Avery MD, is a practicing oncologist in the St. Louis area. He has a keen interest not only in cancer care and therapy but also nutrition and how is helps prevent cancer. He is owner of Citrine Sun, an online company dedicated to helping cancer patients through every stage of their illness through education and natural supplements. An interesting newsletter and information about helpful supplements are available at his website, http://www.citrinesun.com Contact Dr. Avery through his email, AskDrAvery@citrinesun.com





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2012年3月5日 星期一

Is There a Better Way to Treat Arthritis?


Bone and joint pain is on the rise, especially with increased fitness activities, injuries and the aging population of baby boomers. Management of bone and joint disorders and chronic bone pain can be very difficult. Follow up is frequently needed for established and chronic problems for the best management. Proper evaluation is essential and there are multiple ways to protect and improve your joint health.

I am including general information about bone & joint health including arthritis. I find that reducing inflammation, no matter what the cause, is always helpful for joint pain. The major purpose of drugs/medications has been to reduce inflammation. Changing your diet is helpful. Exercise of some sort, especially resistance exercises are very important. Weight management is important as obesity is a major risk factor for the well being of your joints.

The evaluation process must consider previous injuries/surgery, tendonitis, congenital disorders, arthritis, degenerative joint disease, osteoporosis, bone spurs, disc problems, fibromyalgia, neuromuscular and autoimmune disorders, multiple myeloma, bone cancers, rotator cuff tears, pelvic instability syndrome, vascular problems, etc. requires a thorough and ongoing review of your history and a (repeat) physical exam.

A review of family history for arthritis and autoimmune disorders, injury and work history for possible wear and tear or overuse problems, previous surgery, a dietary and nutritional review, weight issues such as chronic obesity, and a smoking history is important in the evaluation of bone, joint and muscle disorders.

Diagnostic tests might include x-rays of affected joints, a bone density test to rule out osteoporosis, DEXA scan, a bone scan, BIA (bioelectrical impedance analysis) test, and lab tests that include bone markers including calcium, phosphorus, alkaline phosphatase and vitamin D (25-OH D3 levels), thyroid and parathyroid studies, hormone studies, immunoglobulin studies, a PET scan, a bone scan, RHEUMATOID FACTOR, an ANA and possibly an MRI, and an EMG, or biopsy, as indicated, just to name a few.

Nutritionals include: Omega three fatty acids -fish oil-- (epa/dha) Higher doses from two to five grams) , SAMe, hyaluronic acid (collagen type II), strontium, chondroitin sulfate, glucosamine, and natural progesterone support bone health. In addition, adequate intake and a good source of Vitamin D (not milk (100 IU) and at least 1000-2000 IU (testing is recommended for the best dose) of vitamin D3 (and sunshine, if tolerated--20 minutes without sunscreen is 25, 000 IU) are now recommended, calcium, magnesium and vitamin K are very useful for bone health. Vitamin K cannot be used if on blood thinners, such as coumadin. Glutathione (IV, inhaled or via oral liposomal products) and it's precursors (alpha lipoic acid, glutamine and cysteine/N-acetylcysteine) along with Vitamin C, are very useful for helping to reduce pain.

Additional supplements that are very useful for bone and joint health are Kaprex, Kaprex AI, EC Matrixx, Cal Apatite and Ostera which are all made by Metagenics.

Acute pain management needs the immediate attention of your doctor, a specialist or the emergency department. For more resources, or product information, please email me.




Dr. Shelby-Lane is a board-certified anti-aging and regenerative medicine physician. To learn more about Dr. Cynthia Shelby-Lane check out the services she offers at http://www.elanantiaging.meta-ehealth.com or http://www.diagnose-me.com





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