Addiction or, more appropriately, substance use disorder (SUD) is defined as one’s recurrent use of drugs and/or alcohol leading to significant clinical and functional impairment. This impairment may be reflected in the areas of physical and mental health, employment, school, relationships, finances, and more.
One thing is for certain – the vast majority of those struggling with SUD also have underlying challenges with learning and behavior, and may have one or more mental health disorders. While the reasons for these underlying challenges are likely as many as the number of challenges themselves, this shifting of perspective away from the genetic view of addiction offers great hope for those seeking progressive therapies that, in many cases, can have a profound impact on the underlying disorders and the problem behaviors and outcomes associated with SUD.
Newer thinking also dictates that addictive tendencies can be due to factors such as concussion and traumatic brain injury, and metabolic imbalances caused by food allergies, environmental toxicities, nutrient deficiencies, and the like. And let’s not forget stress…
In order for progressive brain-based modalities to be delivered effectively, which provide a tremendous complement to standard mental health strategies implemented during both in-patient and out-patient programs alike, one needs to understand that SUD is not a disease as we would normally think of one (e.g. cancer, Parkinson’s, etc.), and it is not a moral failing or a character flaw on the part of the user. SUD can affect anyone… of any class, race, gender, and ethnicity.
SUD is in fact a ‘brain problem’ that, in many respects, can be measured and needs to be approached as such for maximum gains. Let us consider 5 areas of measurement related to brain function that reveal a great deal about learning, behavior, and mental health status; and, more importantly, let us realize that something can be done to improve upon function in any or all of these areas:
- Brainwave Activity (EEG) – In our brain we have networks related to attention, vision, sensations, relaxation, emotions, vital functions, and more. How much delta, theta, alpha, beta, and gamma brainwave activity we have under different circumstances dictates how well various parts of these networks perform. Quantitative EEG (qEEG) is gaining popularity in select mental health circles as an extremely viable diagnostic tool that can enable us to peer into the inner workings of the brain and these brain networks that make us uniquely human.
- Cognitive Testing – Executive function, cognitive flexibility, simple and complex attention, and processing speed are just a few of the tests of higher cognitive function that can reveal a great deal about how one’s brain interacts with its environment. They are also excellent diagnostic tools for monitoring progress when treating the various subsets of learning and behavioral issues underlying SUD.
- Metabolic Function – Blood sugar, amino acids, urine organic acids, food antibodies, heavy metals, environmental toxins, hormones, neurotransmitters, vital nutrients, genetic variants, and so much more are a mix of both classic and progressive ‘biomarkers’ of brain function. How our bodies handle fuel, utilize nutrients, process hormones, and react to toxins in our environments determines how well our brains handle what is presented to them on a moment to moment basis.
- Eye Movements – Generally ignored in the mental health arena from a diagnostic perspective, eye movements of all types are directly related to the brain regions that control them. From primitive abilities of finding visual targets that involve parts of the brainstem and emotional centers like the amygdala (fear response), to fast eye movements controlled by our higher functioning frontal lobes; eye movements deliver a wealth of information related to SUD and its underlying causes. Videonystagmography (VNG) is one type of diagnostic tool used to measure these types of functions.
- Balance and Coordination – More and more, addiction based programs are implementing movement based activities such as Tai Chi and yoga. From both balance and relaxation standpoints, there is good reason to do so. Our sense of self is largely influenced by our ability to physically interact with our environment. When one has severe balance or coordination impairment, as is seen in conditions like schizophrenia, mental function and behavior will likely be impaired. Measurement tools such as dynamic posturography and standard tests of movement and coordination can be utilized to measure these abilities.
The inherent beauty of any of these tools, that can reveal a wealth of information about cognitive, behavioral, and mental functions, is that they can in turn be utilized to track progress when one enters into a collaborative treatment program with their mental health specialists and qualified functional neurologist. The blending of the ‘brain’ and the ‘mind’ sciences is long overdue and is proving to be clinically effective with regard to its impact on addiction and SUD, and the underlying disorders that are being shown with greater clarity to be the root cause of them.
At the time of presentation to APEX Brain centers in Asheville, NC in late 2015, Jackie was a 55-year-old, soon to be retired professional female. Post-concussive symptoms of debilitating headaches, memory loss, learning and behavioral issues, fluctuations in heart rate, and difficulty handling visual stimulation such as driving, busy public places and computer screens were preventing her from leading a normal life. Prior to traveling to APEX from Charlotte, NC, Jackie had sought care from several different doctors in her area. Vestibular therapy and chiropractic care had given her some relief of symptoms, although her other experiences were not so positive. At one point a provider told her that she was mentally ill. Jackie was outraged and, as many with post-concussion syndrome report similarly, she offered this statement: “I’m not crazy. I didn’t have any of these symptoms before I had the injury and I am definitely not making them up”. This is the unfortunate reality of many who suffer with brain injury.
Intervention for balance and cognitive decline
Jackie underwent comprehensive Brain Training at a frequency of 3 times per day over the course of 15 days (with 2 days off between each week for much needed rest and recovery). Her brain function was carefully monitored throughout the training process with measurement of EEG brainwaves, vital signs, eye movements, balance, mental and physical timing, and more to ensure she was receiving the proper amount of therapy to be effective without exceeding fatigue limits that could potentially promote worsening of her symptoms. Modalities implemented included, but were not limited to: neurofeedback, Interactive Metronome, vestibular rehabilitation, metabolic/nutritional therapies, eye movement and neurological rehabilitation, electrical stimulation, breathing exercises and home care therapies.
Outcomes after Brain Training
Jackie reported prior to brain training that she would have a constant headache of 6 on a 0-10 scale (0 being no pain and 10 being the worst possible pain) that would escalate into an 8-9 of 10 by the end of the day. The week after her program she reported the headaches were finally manageable at a level of 3-4 of 10 and would not escalate. Jackie has had continued success and reported at 3 weeks after her program that she is headache free, unless she spends too much time in front of a screen or in a busy public place. She also reports that when this occurs, her ‘at home’ brain exercises will relieve them. Aside from headaches, Jackie has reported that she no longer feels like she is in a constant brain fog. Her heart rate has also normalized and no longer fluctuates or spikes.
Actual, measurable objective improvements recorded with post-intensive diagnostic testing include, but are not limited to:
- Cognitive Testing: Jackie showed an increase in her Neurocognition Index of 11%. This is a standardized overall score of cognitive performance. Significant improvements in specific areas of memory (one of her biggest concerns) are as follows: 65% in composite memory, 33% in verbal memory, and 67% in visual memory.
- Interactive Metronome: 56% improvement in motor timing accuracy and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. premature response to a specified reference tone).
- Videonystagmography (VNG): Significant improvements in numerous aspects of oculomotor (eye movement) functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.
Implications for others:
Diagnostic and functional tests can be used to direct an effective Brain Training program and improve post-concussion symptoms. Increased sensory and environmental sensitivities are common symptoms of post-concussion syndrome. There are several areas of your brain that process information from your environment and from your body. If these areas are damaged then it becomes difficult for the brain to process sensory input, resulting in fogginess, memory and cognitive issues, impaired processing of pain, and the many other symptoms seen after concussions. The frustration felt by individuals being made to feel they are “crazy”, as Jackie noted, is entirely unnecessary and driven by a health care system that is largely focused on diagnostic testing and lacking significantly in functional treatment options. There is great hope for partial and full recovery in most cases of concussion given a thorough investigation and functional interventions addressing the physical, cognitive, metabolic and lifestyle factors that influence brain health.
If you or someone you care about is experiencing ANY of these symptoms, or anything out of the ordinary related to a head or brain injury, call APEX Brain Centers now at 828.708.5274. You may also email us at [email protected] for more information and to set up a free consultation.
Google defines ‘boot camp’ as: a short, intensive, and rigorous course of training. Aside from the obvious military style boot camp, many are seeking out boot camps in all shapes and sizes to help with everything from fitness to addiction.
Why not boot camp for your brain???
A basic understanding of how the brain works will help you realize that a boot camp is the most effective way to train your brain. From those with neurological issues, to those looking to elevate their level of performance to new heights, a well-trained brain will help ensure you are functioning at your highest possible level (both physically and mentally).
Neuron Theory, 101
Your brain’s sole purpose in life is to receive and transmit information. Sensory information from the environment and your body travels up to your brain to be processed; and thoughts, actions, hormone circulation and more are the end result of that input. The brain receives and transmits information through neurons (nerve cells), more specifically networks of neurons, in the brain and body. The more powerful the information traveling in those networks, or pathways, the stronger they become. In short, from a theory developed in the mid-20th century by the psychologist, Donald Hebb: cells that fire together, wire together!
What determines if cells get ‘wired’ together is the intensity and frequency of the stimulation delivered to them. There can be equal parts frequency and intensity, or more of one or the other. Using the example of learning how to play a guitar; one can play 10 minutes per day, 5 days per week – representing moderate frequency and low intensity – and could expect slow gains in the ability to play guitar. The same individual could participate in a ‘guitar boot camp’ playing for 1-2 hours, 3-5 times per day, for 5 days – very high frequency AND intensity – and expect to make much larger gains in their skills on 6 strings.
Now, About that Brain Boot Camp
Paying respect to the understanding that cells that fire together, wire together, it should now make good sense that training of brain function would yield the greatest outcomes in this high frequency, high intensity boot camp model. Every brain is different and unique, and faced with its own sets of strengths and challenges; and the frequency and intensity of individual aspects of Brain Training can be adapted to fit these unique needs.
Another added benefit of the boot camp training model is that of fitting a great deal of learning into a very short period of time. Moms and dads, sons and daughters, athletes and CEOs, brain injured and infirmed – time is a valuable commodity, and to compress months (if not years) of benefit and improved quality of life into a 5, 10, or 15 day period of time is something most folks could not put a price tag on. Further, the longer we wait (and the longer it takes) to train our brains, the less benefit we will gain from the experience.
To learn more about our Asheville, NC based Brain Boot Camps for learning and behavioral issues, peak performance, concussion and brain injury, and more; contact us at 828.708.5274 for a FREE 15 minute consultation.
Everyone that signs up for a 5 or more day full intensive training program at APEX Brain Centers in Asheville, NC, that is! (Unique offer details below).
While technology and all that come with it can cause significant impairment for many, it can also be used to provide an extreme advantage when it comes to Training your Brain. The ever-growing list of hi-tech applications (apps) for mobile devices and tablets is astounding, many of which hold significant promise for re-training brain dysfunction, and for improving upon already strong performance in those looking to reach their peak potential. As with anything, there is a downside – apps used improperly and not under expert guidance can, in some cases, be counter-productive, and even harmful!
The following are the main areas of apps for brain performance:
- Memory and Attention: We have all heard of that brain training program that begins with ‘L’ that most folks pronounce incorrectly! While this and many other similar apps are quite useful and largely without side-effects, they may not be providing all they claim in the absence of a comprehensive brain health program.
- Eye movements: The secret is out, eye movements are directly related to our higher, more human, cognitive brain functions. A simple Google search of ‘eye movements and cognition’ should get you rolling there! The challenge is that these sensitive windows into higher brain function can very easily be trained incorrectly, leading to further dysfunction or significantly limiting peak performance. User beware: Expert direction is essential with these type of apps!
- Neurofeedback/Biofeedback: By far the newest and most concerning area of mobile brain training, app stores are piling up with programs that will help you regulate your brainwaves, heart rate, muscle tension, and more. Common sense should let you know that training your brainwaves in the absence of higher education in neurophysiology and neuroplasticity might not be a very wise choice. Once again, user beware!
Although just a sampling of what’s available in the various app stores in the cyber world, the take home message here is that ANY effort in training your brain should be directed by a qualified health care provider trained in these areas of brain performance for maximum benefit and decreased probability of side-effects.
Enter the iPad…
All clients entering into a 5 or more day full intensive training program at APEX Brain Centers in Asheville, NC through May 31, 2015 will receive a FREE iPad Mini with Retina Display (or comparable device) as a valuable aid to your brain training program, and to help you continue progress once discharged. All you would need to do is have an iTunes account to purchase any needed applications (typically less than $35.00), and the desire to make your brain the best possible brain it can be.
This special offer is not to be combined with any offers and you must reference this post at the time of consultation or admission for validation purposes. Let us help you harness the power of technology and put you in the driver’s seat on your journey to Building a Better Brain!
While one of the biggest buzzwords in the learning and behavioral disorder treatment arena, among others, is ‘Intensive’; there are numerous takes on this seemingly simple term. For some it conjures up images of multiple treatment modalities being delivered concurrently; and for others, one modality delivered at a very high frequency and/or duration. With regard to duration of care, some may consider 3 times per week as being intensive, and others may feel nothing less than 2-3 times per day should be labeled as intensive.
At Apex Brain Centers, we focus on a ‘Brain Intensive’ approach towards a host of learning and behavioral concerns, as well as TBI and human performance. Our definition of ‘Brain Intensive’ is delivering multiple research-based brain training modalities (both hi and low tech) over short periods of time (1-2 weeks) at a high frequency (average of 3 times per day) with absolute respect paid to ‘neurological fatigue’. These protocols are directed by, and neurological fatigue measured by, objective testing data (i.e. neurological examination, electrodiagnostic testing, autonomic monitoring, etc.), as well as subjective feedback.
The foundation of our methodology, as in many programs, is the concept of neuroplasticity – the brain’s ability to change and grow (for better or worse) dependent upon the environment in which it is kept. The key difference, in addition to the high frequency/high intensity delivery model, with our approach is the ability to deliver sensory feedback (i.e. auditory, somatosensory, visual, olfactory, etc.) specific for the neurological deficit/s uncovered by examination and testing to correct the underlying brain dysfunction. Research supports the fact that most, if not all, learning and behavioral challenges can be looked at as aberrations in hemispheric symmetry, lateralization and integration, as well as disconnection and hypo/hyper functioning in and between the various lobes of the brain. Working within the context of neuroplasticity, we understand there are 3 critical components with regard to creating positive plastic changes within the brain: the frequency and intensity of the sensory experience, and fuel delivery (i.e. metabolic functions). Given the brain is a sensory-driven entity, delivering protocols specifically for the neurological deficit/s identified at a heightened frequency and intensity, while addressing challenges in metabolic function (i.e. poor diet, poor oxygenation, disease states, etc.), allows for more successful client outcomes.
Our strategy complements the wonderful world of residential and intensive outpatient programs, wilderness programs and transitional living facilities as we have observed time and time again over the years that improving and/or fixing the specific underlying brain dysfunction allows for more successful outcomes with behavioral modification, counseling, education; and nearly any other treatment, educational, or re-integration modality the client will partake in, if any.