Describe the diagnostic criteria for substance use disorders, Identify the neurotransmitter systems impacted by various categories of drugs, Describe how different categories of drugs affect behavior and experience, Understand the similarities and differences of hypnosis and meditation. Methadoneis a synthetic opioid that is less euphorigenic than heroin and similar drugs. Natural opioids, calledopiates, are derivatives of opium, which is a naturally occurring compound found in the poppy plant. In addition, sleep deprivation often results in depression-like symptoms. If you get peritoneal dialysis, peritonitis symptoms also may include: Cloudy dialysis fluid. There are now several synthetic versions of opiate drugs (correctly called opioids) that have very potent painkilling effects, and they are often abused. This is known as the REM rebound, and it suggests that REM sleep is also homeostatically regulated. Upset stomach and vomiting. Like hypnosis, meditation also shows promise in stress management, sleep quality (Caldwell, Harrison, Adams, Quin, & Greeson, 2010), treatment of mood and anxiety disorders (Chen et al., 2013; Freeman et al., 2010; Vllestad, Nielsen, & Nielsen, 2012), and pain management (Reiner, Tibi, & Lipsitz, 2013). Generally, narcolepsy is treated using psychomotor stimulant drugs, such as amphetamines (Mignot, 2012). Historically, heroin has been a major opioid drug of abuse (Figure 4.17). This chart illustrates the circadian change in body temperature over 28 hours in a group of eight young men. One complete menstrual cycle takes about 28 daysa lunar monthbut many biological cycles are much shorter. Causes. Methadone clinicshelp people who previously struggled with opioid addiction manage withdrawal symptoms through the use of methadone. This campaign is sponsored in part by the National Institute of Child Health and Human Development. (credit a: modification of work by Jim Epler; credit b: modification of work by Caleb Roenigk), video about circadian rhythms and how they affect sleep, video that gives sleep tips for college students, video about the relationship between sleep and memory, instructional video about using Buddhist meditation techniques to alleviate stress, video about the results of a brain imaging study in individuals who underwent specific mindfulness meditative techniques, https://openstax.org/books/psychology-2e/pages/1-introduction, Creative Commons Attribution 4.0 International License, Cocaine, amphetamines (including some ADHD medications such as Adderall), methamphetamines, MDMA (Ecstasy or Molly), Increased heart rate, blood pressure, body temperature. Insudden infant death syndrome (SIDS)an infant stops breathing during sleep and dies. It is often prescribed for minor pain, and it is available over-the-counter in some other countries. If you lie down to take a nap and fall asleep very easily, chances are you may have sleep debt. Furthermore, slow-wave sleep after learning a new task can improve resultant performance on that task (Huber, Ghilardi, Massimini, & Tononi, 2004) and seems essential for effective memory formation (Stickgold, 2005). Like many other stimulants, cocaine agonizes the dopamine neurotransmitter system by blocking the reuptake of dopamine in the neuronal synapse. Two sleeping children are depicted in this 1895 oil painting titled. The axons of light-sensitive neurons in the retina provide information to the SCN based on the amount of light present, allowing this internal clock to be synchronized with the outside world (Klein, Moore, & Reppert, 1991; Welsh, Takahashi, & Kay, 2010) (Figure 4.3). Access for free athttps://openstax.org/books/psychology-2e/pages/1-introduction. You were capable of engaging in the all of the complex tasks involved with operating a motor vehicle even though you were not aware of doing so. In her case, the fact that her cataplexy was confined to the right side of her body was quite unusual. How does hypnosis work? Awareness of external stimuli includes experiences such as seeing the light from the sun, feeling the warmth of a room, and hearing the voice of a friend. While individuals suffering from sleep apnea may not be aware of these repeated disruptions in sleep, they do experience increased levels of fatigue. Some people also experience altered states of consciousness through meditation, hypnosis, or alcohol and other drugs. As an individual continues through stage 1 sleep, there is an increase in theta wave activity. Sleepis a state marked by relatively low levels of physical activity and reduced sensory awareness that is distinct from periods of rest that occur during wakefulness. Thus we sleep in safe areas to reduce the chance of harm. The smokable form reaches the brain very quickly to produce an intense euphoria that dissipates almost as fast as it arrives, prompting users to continuing taking the drug. Our lives involve regular, dramatic changes in the degree to which we are aware of our surroundings and our internal states. Whilecaffeineis generally considered a relatively safe drug, high blood levels of caffeine can result in insomnia, agitation, muscle twitching, nausea, irregular heartbeat, and even death (Reissig, Strain, & Griffiths, 2009; Wolt, Ganetsky, & Babu, 2012). Recommendations like these have helped to decrease the number of infant deaths from SIDS in recent years (Mitchell, 2009; Task Force on Sudden Infant Death Syndrome, 2011). Thepineal gland, an endocrine structure located inside the brain that releases melatonin, is thought to be involved in the regulation of various biological rhythms and of the immune system during sleep (Hardeland, Pandi-Perumal, & Cardinali, 2006). They were ALL my fault. In addition, the appearance of K-complexes is often associated with stage 2 sleep. As you will learn when you study social roles, peoples behavior can be shaped by their expectations of how they should act in a given situation. One of the most common treatments for sleep apnea involves the use of a special device during sleep. The sleep and dreaming researcher Rosalind Cartwright, however, believes that dreams simply reflect life events that are important to the dreamer. Recent adaptations (e.g., Hobson, 2002) continue to update the theory based on accumulating evidence. This section will consider these questions and explore various explanations for why we sleep. This final section will consider hypnotic and meditative states as additional examples of altered states of consciousness experienced by some individuals. The participant is encouraged to use his or her imagination. While hypnosis may be useful in enhancing memory or a skill, such enhancements are very modest in nature (Raz, 2011). For example, people who undergo chemotherapy will often be prescribed marijuana to stimulate their appetites and prevent excessive weight loss resulting from the side effects of chemotherapy treatment. She indicated that she had fallen asleep at inappropriate or dangerous times, including while eating, while socializing with friends, and while driving her car. Meditative techniques have their roots in religious practices (Figure 4.21), but their use has grown in popularity among practitioners of alternative medicine. People who suffer from insomnia might limit their use of stimulant drugs (such as caffeine) or increase their amount of physical exercise during the day. Site has information/education resources on a broad range of topics, including asthma, birth defects, radiation, sanitation, lead in blood, and more. Physical dependenceinvolves changes in normal bodily functionsthe user will experience withdrawal from the drug upon cessation of use. One important regulator of sleep-wake cycles is the hormonemelatonin. Elements that are known to make PTSD more likely are the following: Perceived life threat Personal injury Interpersonal violence, particularly perpetrated by a caregiver Past and present vulnerability, including genetics, childhood trauma, insufficient emotional support, concurrent causes of stress Example: Childhood abuse and rape In fact, it has been suggested that there is no reason to think that energetic demands could not be addressed with periods of rest and inactivity (Frank, 2006; Rial et al., 2007), and some research has actually found a negative correlation between energetic demands and the amount of time spent sleeping (Capellini, Barton, McNamara, Preston, & Nunn, 2008). Sleep-wake cycles seem to be controlled by multiple brain areas acting in conjunction with one another. On January 16, 1997, Scott Falater sat down to dinner with his wife and children and told them about difficulties he was experiencing on a project at work. These symptoms include fatigue, sluggishness, irritability, andinsomnia(i.e., a consistent difficulty in falling or staying asleep for at least three nights a week over a months time) (Roth, 2007). Our states of consciousness change as we move from wakefulness to sleep. In general, these drugs are not thought to possess the same sort of abuse potential as other classes of drugs discussed in this section. Another theory regarding why we sleep involves sleeps importance for cognitive function and memory formation (Rattenborg, Lesku, Martinez-Gonzalez, & Lima, 2007). Rotating shift work has pervasive effects on the lives and experiences of individuals engaged in that kind of work, which is clearly illustrated in stories reported in a qualitative study that researched the experiences of middle-aged nurses who worked rotating shifts (West, Boughton & Byrnes, 2009). Once awakened from a narcoleptic attack, people report that they feel refreshed (Chokroverty, 2010). When we do this, we often experience jet lag. This is similar to the kind of paralysis experienced by healthy individuals during REM sleep (Burgess & Scammell, 2012; Hishikawa & Shimizu, 1995; Luppi et al., 2011). They can be helpful for people working night shifts or for people affected by seasonal variations in light. Not able to pass stool or gas. It may seem counterintuitive that stimulant medications are prescribed to treat a disorder that involves hyperactivity, but the therapeutic effect comes from increases in neurotransmitter activity within certain areas of the brain associated with impulse control. For example, a person may work from 7:00 a.m. to 3:00 p.m. on Monday, 3:00 a.m. to 11:00 a.m. on Tuesday, and 11:00 a.m. to 7:00 p.m. on Wednesday. Homeostasisis the tendency to maintain a balance, or optimal level, within a biological system. Sleep apnea is much more common in overweight people and is often associated with loud snoring. Moreover, these impairments become more severe as the amount of sleep deprivation increases (Alhola & Polo-Kantola, 2007). If someone stays awake for 48 consecutive hours, they could start to hallucinate. The 20th century Swiss psychiatrist Carl Jung believed that dreams allowed us to tap into the collective unconscious. Caffeine is found in many common medicines (such as weight loss drugs), beverages, foods, and even cosmetics (Herman & Herman, 2013). Rotating shift workrefers to a work schedule that changes from early to late on a daily or weekly basis. Many people experience disturbances in their sleep at some point in their lives. 1. The average EVD case fatality rate is around 50%. Indeed, we know sleep deprivation results in disruptions in cognition and memory deficits (Brown, 2012), leading to impairments in our abilities to maintain attention, make decisions, and recall long-term memories. Some people might turn to over-the-counter (OTC) or prescribed sleep medications to help them sleep, but this should be done sparingly because many sleep medications result in dependence and alter the nature of the sleep cycle, and they can increase insomnia over time. When he told me, I made him go see the college therapist. Insleepwalking, or somnambulism, the sleeper engages in relatively complex behaviors ranging from wandering about to driving an automobile. Clonazepam, an anti-anxiety medication with sedative properties, is most often used to treat RBD. The typical positive symptoms of schizophrenia , such as hallucinatory experiences or fixed delusional beliefs, tend to be very upsetting and disruptivenot a positive experience at all for you or someone you care about who is experiencing them. Sleepwalking, restless leg syndrome, and night terrors are all examples of parasomnias (Mahowald & Schenck, 2000). As mentioned earlier, lack of sleep can result in decreased mental alertness and cognitive function. The decade from 20102019 brought many changes in laws regarding marijuana. Our sleep-wake cycle, which is linked to our environments natural light-dark cycle, is perhaps the most obvious example of a circadian rhythm, but we also have daily fluctuations in heart rate, blood pressure, blood sugar, and body temperature. Some newer CPAP masks are smaller and cover only the nose. The brain waves associated with this stage of sleep are very similar to those observed when a person is awake, as shown inFigure 4.11, and this is the period of sleep in which dreaming occurs. Acetylcholine functions as a neurotransmitter in motor neurons. Methamphetamine addiction produces an intense craving that is difficult to treat. These individual differences in circadian patterns of activity are known as a persons chronotype, and research demonstrates that morning larks and night owls differ with regard to sleep regulation (Taillard, Philip, Coste, Sagaspe, & Bioulac, 2003). Avoid anything stimulating for an hour before bed. Theta waves still dominate the activity of the brain, but they are interrupted by brief bursts of activity known as sleep spindles (Figure 4.9). Many of these drugs act as agonists of the dopamine neurotransmitter system. According to Jung, certain symbols in dreams reflected universal archetypes with meanings that are similar for all people regardless of culture or location. Awareness of internal stimuli includes feeling pain, hunger, thirst, sleepiness, and being aware of our thoughts and emotions. That includes exercise and bright light from devices. Typically, individuals suffering from night terrors will fall back asleep again within a short time. (a) This is a statue of a meditating Buddha, representing one of the many religious traditions of which meditation plays a part. Aches and pains, such as severe headache and muscle and joint pain. Originally reported as a safe alternative to the known cancer-causing agents found in cigarettes, vaping is now known to be very dangerous and has led to serious lung disease and death in users. When we are very young, we spend up to 16 hours a day sleeping. REM sleep behavior disorder (RBD)occurs when the muscle paralysis associated with the REM sleep phase does not occur. However, all of their somnambulistic patients who also suffered from sleep-related breathing problems showed a marked decrease in sleepwalking when their breathing problems were effectively treated. Still, people experiencing opioid withdrawal may be given methadone to make withdrawal from the drug less difficult. Vaping uses battery-powered devices, sometimes called e-cigarettes, that deliver liquid nicotine and flavorings as a vapor. Mindfulness meditation has recently become popular. For example, most people sleep during the night and are awake during the day. Nicotine is highly addictive, and the use of tobacco products is associated with increased risks of heart disease, stroke, and a variety of cancers. Alertness is associated with higher body temperatures, and sleepiness with lower body temperatures. It is not uncommon for people suffering from undiagnosed or untreated sleep apnea to fear that their careers will be affected by the lack of sleep, illustrated by this statement from another patient, Im in a job where theres a premium on being mentally alert. In addition, stage 1 sleep involves a marked decrease in both overall muscle tension and core body temperature. Some people who have injected many times into their arms will show track marks, while other users will inject into areas between their fingers or between their toes, so as not to show obvious track marks and, like all abusers of intravenous drugs, have an increased risk for contraction of both tuberculosis and HIV. In addition, these individuals may wake up several times during the night only to find that they have difficulty getting back to sleep. A person who has a substance use disorder often uses more of the substance than they originally intended to and continues to use that substance despite experiencing significant adverse consequences. In some cases, though, there may be no symptoms of inflammation at all. Two theories attempt to answer this question: One theory views hypnosis as dissociation and the other theory views it as the performance of a social role. This causes blood vessels to dilate, and the skin may feel warm and flushed. d. both b and c. 2. Complete the following multiple choice quiz covering chapters 1, 6, and 9. Following the initial rush, users experience 46 hours of going on the nod, alternating between conscious and semiconscious states. Narcoleptic episodes take on other features of REM sleep. Until recently, the United States Department of Justice routinely arrested people involved and seized marijuana used in medicinal settings. As the dose increases, people report feeling sedated. Users can experience physical symptoms that include nausea, elevated blood pressure, and increased heart rate. Early attempts to treat her condition with a stimulant drug alone were unsuccessful. Parasomnias can occur in either REM or NREM phases of sleep. Generally, and for most people, our circadian cycles are aligned with the outside world. Wakefulnessis characterized by high levels of sensory awareness, thought, and behavior. MDMA (3.4-methelynedioxy-methamphetamine, commonly known as ecstasy or Molly) is a mild stimulant with perception-altering effects. Awareness of internal stimuli includes feeling pain, hunger, thirst, sleepiness, and being aware of our thoughts and emotions. Given that college students are notorious for suffering from significant sleep debt (Hicks, Fernandez, & Pelligrini, 2001; Hicks, Johnson, & Pelligrini, 1992; Miller, Shattuck, & Matsangas, 2010), chances are you and your classmates deal with sleep debt-related issues on a regular basis. Some animals never sleep (e.g., some fish and amphibian species); other animals sleep very little without apparent negative consequences (e.g., giraffes); yet some animals (e.g., rats) die after two weeks of sleep deprivation (Siegel, 2008). The brain waves associated with REM sleep, outlined in the red box in (a), look very similar to those seen (b) during wakefulness. Primary signs and symptoms of Ebola often include some or several of the following: Fever. Narcolepsy is associated with reduced levels of the signaling molecule hypocretin in some areas of the brain (De la Herrn-Arita & Drucker-Coln, 2012; Han, 2012), and the traditional stimulant drugs do not have direct effects on this system. While many users snort cocaine, intravenous injection and inhalation (smoking) are also common. Comparative research indicates, however, that the relationship that exists between predatory risk and sleep is very complex and equivocal. Lucid dreamsare dreams in which certain aspects of wakefulness are maintained during a dream state. This hypnogram illustrates how an individual moves through the various stages of sleep. One of the nurses said, If youve had a partner who does work regular job 9 to 5 office hours . Marijuana may also have some promise in the treatment of a variety of medical conditions (Mather, Rauwendaal, Moxham-Hall, & Wodak, 2013; Robson, 2014; Schicho & Storr, 2014). In other words, dreaming involves constructing a virtual reality in our heads that we might use to help us during wakefulness. As a group, hallucinogens are incredibly varied in terms of the neurotransmitter systems they affect. In general, smoking cessation programs may be effective in the short term, but it is unclear whether these effects persist (Cropley, Theadom, Pravettoni, & Webb, 2008; Levitt, Shaw, Wong, & Kaczorowski, 2007; Smedslund, Fisher, Boles, & Lichtenstein, 2004). Sleep is not a uniform state of being. The heart rate slows . His children and his wifes parents all agreed that Falater had an excellent relationship with his wife and they couldnt think of a reason that would provide any sort of motive to murder her (Cartwright, 2004). For example, repeated use can lead to overall depletion among the monoamine neurotransmitters (dopamine, norepinephrine, and serotonin). Thirst. Generally, treatment for night terrors is unnecessary unless there is some underlying medical or psychological condition that is contributing to the night terrors (Mayo Clinic, n.d.). AK-complexis a very high amplitude pattern of brain activity that may in some cases occur in response to environmental stimuli. Think meditation might help? While disruptions in circadian rhythms can have negative consequences, there are things we can do to help us realign our biological clocks with the external environment. For example, she and her colleagues published a study in which women going through divorce were asked several times over a five-month period to report the degree to which their former spouses were on their minds. For example, Hobson (2009) suggests that dreaming may represent a state of protoconsciousness. Therefore, it is quite likely that new medications that are developed to treat narcolepsy will be designed to target the hypocretin system. Insomnia, a consistent difficulty in falling or staying asleep, is the most common of the sleep disorders. The early portion of stage 1 sleep producesalpha waves, which are relatively low frequency (813Hz), high amplitude patterns of electrical activity (waves) that become synchronized (Figure 4.8). While medical marijuana laws have been passed on a state-by-state basis, federal laws still classify this as an illicit substance, making conducting research on the potentially beneficial medicinal uses of marijuana problematic. 22. In the variation of mindful meditation, the meditators attention is focused on some internal process or an external object (Zeidan, Grant, Brown, McHaffie, & Coghill, 2012). Physiologically, the body can become addicted to opiate drugs in less than a week, including when taken as prescribed. For example, irritability, distractibility, and impairments in cognitive and moral judgment can occur with fewer than four hours of sleep. Remarkably, Falater insisted that he had no recollection of hurting his wife in any way. 1. A neighbor called the police after witnessing Falater standing over his wifes body before dragging her into the pool. If people are deprived of REM sleep and then allowed to sleep without disturbance, they will spend more time in REM sleep in what would appear to be an effort to recoup the lost time in REM. A sleep deprived individual generally will fall asleep more quickly than if she were not sleep deprived. There is a tremendous amount of variability among sufferers, both in terms of how symptoms of narcolepsy manifest and the effectiveness of currently available treatment options. Given the central role that sleep plays in our lives and the number of adverse consequences that have been associated with sleep deprivation, one would think that we would have a clear understanding of why it is that we sleep. Sleep is also associated with the secretion and regulation of a number of hormones from several endocrine glands including: melatonin, follicle stimulating hormone (FSH), luteinizing hormone (LH), and growth hormone (National Institutes of Health, n.d.). A hypnogram is a diagram of the stages of sleep as they occur during a period of sleep. describes our awareness of internal and external stimuli. Medical marijuana is legal in over half of the United States and in the District of Columbia (Figure 4.19). While caffeine may have some indirect effects on dopamine neurotransmission, its primary mechanism of action involves antagonizing adenosine activity (Porkka-Heiskanen, 2011). Abnormal Motor Behavior. Low doses increase relaxation, decrease inhibitions. Signs of inflammation help healthcare providers in making a diagnosis. A number of risk factors have been associated with SIDS including premature birth, smoking within the home, and hyperthermia. It may feel like alcohol helps you sleep, but it actually disrupts REM sleep and leads to frequent awakenings. Some of these areas include the thalamus, the hypothalamus, and the pons. The hypnogram below (Figure 4.12) shows a persons passage through the stages of sleep. In fact, this relationship is so robust that some view the presence of RBD as a potential aid in the diagnosis and treatment of a number of neurodegenerative diseases (Ferini-Strambi, 2011). People vary in terms of their ability to be hypnotized, but a review of available research suggests that most people are at least moderately hypnotizable (Kihlstrom, 2013). My sophomore college housemate got so stressed out during finals sophomore year he drank almost a whole bottle of Nyquil to try to fall asleep. In Hilgards experiments, he induced participants into a state of hypnosis, and placed their arms into ice water. Consider a patient who believed that as a result of his sleep apnea he had three car accidents in six weeks. Psychological dependence, or drug craving, is a recent addition to the diagnostic criteria for substance use disorder in DSM-5. Ethanol, which we commonly refer to as alcohol, is in a class of psychoactive drugs known as depressants (Figure 4.15). (a) A typical CPAP device used in the treatment of sleep apnea is (b) affixed to the head with straps, and a mask that covers the nose and mouth. Some of these approaches, such as using a bright light as shown inFigure 4.4, have been shown to alleviate some of the problems experienced by individuals suffering from jet lag or from the consequences of rotating shift work. Tolerance can cause the user to increase the amount of drug used to a dangerous leveleven to the point of overdose and death. Diarrhea. If you cannot fall asleep, leave your bed and do something else until you feel tired again. c. absence of subjective symptoms of disease. Unlike Freud and Jung, Cartwrights ideas about dreaming have found empirical support. NCEH provides leadership to promote health and quality of life by preventing or controlling those diseases, birth defects, or disabilities resulting from interaction between people and the environment. High doses increase agitation, paranoia, can cause hallucinations. The prevalence rates for somatic disorders are often difficult to determine; however, overall estimates of somatic symptom disorder are around 4-6%. The crisis actually began in the 1990s, when pharmaceutical companies began mass-marketing pain-relieving opioid drugs like OxyContin with the promise (now known to be false) that they were non-addictive. c. Unlike the other sleep disorders described in this section, a person withnarcolepsycannot resist falling asleep at inopportune times. Withdrawal from opioids includes pain, which patients often misinterpret as pain caused by the problem that led to the original prescription, and which motivates patients to continue using the drugs. Sleep is characterized by certain patterns of activity of the brain that can be visualized using electroencephalography (EEG), and different phases of sleep can be differentiated using EEG as well. In the therapeutic setting, a clinician may use relaxation and suggestion in an attempt to alter the thoughts and perceptions of a patient. For individuals who are especially open to the power of suggestion, hypnosis can prove to be a very effective technique, and brain imaging studies have demonstrated that hypnotic states are associated with global changes in brain functioning (Del Casale et al., 2012; Guldenmund, Vanhaudenhuyse, Boly, Laureys, & Soddu, 2012). Nicotine is most commonly used in the form of tobacco products like cigarettes or chewing tobacco; therefore, there is a tremendous interest in developing effective smoking cessation techniques. (West et al., 2009, p. 114). Furthermore, these types of behaviors ultimately disrupt sleep, although affected individuals have no memories that these behaviors have occurred (Arnulf, 2012). This discomfort is relieved by deliberately moving the legs, which, not surprisingly, contributes to difficulty in falling or staying asleep. Thus, K-complexes might serve as a bridge to higher levels of arousal in response to what is going on in our environments (Halsz, 1993; Steriade & Amzica, 1998). As we grow older, we sleep less. Alcohol, barbiturates (e.g., secobarbital, pentobarbital), Benzodiazepines (e.g., Xanax). A person withrestless leg syndromehas uncomfortable sensations in the legs during periods of inactivity or when trying to fall asleep. We experience different states of consciousness and different levels of awareness on a regular basis. Often, we are not completely aware of our surroundings, even when we are fully awake. By the late 19th century, German psychiatrist SigmundFreudhad become convinced that dreams represented an opportunity to gain access to the unconscious. B) the cause of the problem. These effects can occur as a function of accumulated sleep debt or in response to more acute periods of sleep deprivation. Hypnosisis a state of extreme self-focus and attention in which minimal attention is given to external stimuli. It is also associated with paralysis of muscle systems in the body with the exception of those that make circulation and respiration possible. For example, around one third of individuals diagnosed with narcolepsy experience vivid, dream-like hallucinations during narcoleptic attacks (Chokroverty, 2010). Jet lag is a collection of symptoms that results from the mismatch between our internal circadian cycles and our environment. . Guilleminault et al. You don't have to be a psychologist to know that conditions like hunger or fatigue have an impact on thinking and decision-making; these are examples of internal states. Historically, hypnosis has been viewed with some suspicion because of its portrayal in popular media and entertainment (Figure 4.20).