BLOG No. FORTY FIVE

Welcome back to my blog on anxiety and depression. I wanted to push a little farther down the unmarked highway of personality disorders. I would like to first talk a little bit about historical attempts to understand personality. Many ancient religious texts describe personality based on divine and demonic qualities.

Astrology, which began around 3000 BC in Mesopotamia tried linking personality traits to the particular planetary and stellar positions in the sky, around the time of childbirth. It all but died out once Copernicus proved that the earth revolved around the sun. It was revived once the medium of newsprint reinvented it.

Hippocrates tied four personality types to the “humours” cursing through the body. There was yellow bile, blood, black bile, and phlegm. Yes, perfectly disgusting. Later, Descartes separated mind and body, calling the former Res Cogitans (thinking) and the latter, Res Extensa (body).

Lots of other philosophers weighed in, up to the 19th-century, which began to overlap with the advent of modern psychiatry—namely Freud and Jung. But it wasn’t until the 1950s where the thoughts of neurotransmitters and receptors began to accelerate. The discovery of simple antihistamines for allergies led to the molecule called Thorazine (chlorpromazine). From here, many drugs were created, all able to change the personality of patients. An unruly schizophrenic could now sit down and have a conversation with you.

More drugs with less side effects followed, and then, modern brain imaging burst on the scene with the first positron emissions scanners, or PET for short. PET revolutionized the way we could watch and follow neurotransmitters via sugar uptake in cells.

A psychiatrist comes into a patient room and exclaims, “After six months of aggressive treatment, you are cured. So why the sad face?”

“Well, six months ago I was Julius Caesar! Now, I am nobody!”

I engaged you in the history of personality to give you this perspective of how long mankind has been trying to unravel it. Only in the last 70 of the 5000 preceding years are we making any progress on delineating the chemistry of personality and its disorders. I strongly disagree with the DSM-V notion that behavior can be separated from neurotransmitters.

For instance, how do you separate obsessive-compulsive personality disorder behavior (blog 44) from D2 caused OCD? Isn’t one just an outward manifestation of an inward disease? Isn’t borderline personality disorder with its self image issues, difficulty managing emotions, unruly behavior, and problematic relationships, just the outward manifestations of bipolar disorder? Of course it is!

And where does the impulsivity of borderline personality disorders come from? Peanut butter on the Pons? And is that where the paranoia of cluster 1 personality disorders comes from? Perhaps, it is jelly in the jejunum.

D2 dopamine can explain all of these personalities disorders, and I know that, because when I treat them with D2 lowering medications, the behaviors STOP! Why one patient has more paranoia, and another becomes more narcissistic is unknown, however I still feel it is just how high D2 levels work on different individuals, along with the fact that most diseases have numerous symptoms. Why does one diabetic get blurry vision while another suffers from neuropathy? We are different people, you and I, and abnormal levels of substances can manifest a little differently in each of us.

Well, it is 95° here in Dayton so I traded my chard for a Fat Boy pale ale! It’s not just a good beer, it is actually predictive of what happens to you when you keep drinking them! Until next time, this is Dr. G saying, keep the faith!