March 2018 President's Message
Feed Your Brain!
Linda S. Beeber, PhD, PMHCNS-BC, FAAN
I’ve got the brain on my mind: how it develops, how it operates, how we care for it. And of course, because we are NURSES, how all of this knowledge helps our patients. There’s a great quote from Neil deGrasse Tyson, an American astrophysicist: “Everything we do, every thought we’ve ever had, is produced by the human brain. But exactly how it operates remains one of the biggest unsolved mysteries, and it seems the more we probe its secrets, the more surprises we find.” So true, and precisely why I’m so excited about this year’s Clinical Psychopharmacology Institute.
How the Brain Develops
“The adolescent brain is not broken.” explained Jay Giedd, MD in his Keynote presentation at the APNA Clinical Psychopharmacology Institute (CPI) West this month. "The enormous plasticity of the adolescent brain confers both vulnerability and opportunity." This session, Neurobiology of the Adolescent Brain: Behavior, Risk of Illness and Interventions, demystifies influences on adolescent brain development like gender differences, the role of environmental versus genetic factors, and the development of decision-making abilities. We look forward to his encore presentation at the flagship 16th Annual Clinical Psychopharmacology Institute this June.
The information is particularly relevant when taken in the context of recent events where adolescents have experienced trauma followed by intense media scrutiny. Current evidence shows that experiencing trauma produces profound biological effects and novel therapies are emerging in relation to this (see this article in JAPNA for one example). How do new scientific discoveries like these impact the care we provide? Our practice, as always, starts with weaving together the threads of internal factors, external factors, current science, evidence-based research and more, in order to determine and then meet the needs of our patients.
How the Brain Operates
The science of the brain is complex. As providers we need to understand the process of neural signaling and how current drugs affect neurotransmission to mediate symptoms. Barbara Limandri, PhD, PMHCNS-BC highlighted this importance to our practice in her session at CPI West (also to be presented as a pre-conference at CPI in June). “Drugs do not act on diagnoses…they’re chemicals that act on the neurophysiology of the brain…So, you have to know the brain.” Whether we prescribe or not, as care providers we need to look beyond diagnoses to specific symptoms and their relationship to brain anatomy and physiology.
Images speak volumes. So, what does a brain with dementia or major depressive disorder look like? Studies show inflammation in the brain of patients with Alzheimer’s disease, and it may also exist in the brains of a subset of patients with Major Depressive Disorder. PET imaging technology enables us to view inflammation and explore whether a novel CNS drug enters the brain and binds to the target. Robert Innis, MD, PhD, of the National Institute of Mental Health will speak to how this technology plays into the development of clinical targets for dementia and depression at CPI. It’s exciting stuff that has profound implications for how we look at treatments for our patients.
How We Care for the Brain
Did you know that digestive or gastrointestinal symptoms are one of the top ten reasons for outpatient visits? Wendy A. Henderson, PhD, MSN, CRNP, FAAN a nurse and principal investigator with the Biobehavioral Branch of the Division of Intramural Research at the National Institute of Nursing Research has therefore devoted her research to discovering the biobehavioral relationships between the gut-brain axis, where emotional and cognitive centers of the brain are linked to peripheral functions of the intestine, and the chronic effects of stress on intestinal health across the lifespan. This research is laying the groundwork for novel treatment options that will help our patients with digestive or gastrointestinal symptoms.
As the relationship between gut health, mental health, and overall health becomes more apparent through research, our approach to the mind-body relationship expands. “80% of serotonin is in the gut, not the brain,” observes Limandri in her CPI West session and upcoming CPI pre-conference. Henderson and Lorenzo Leggio, MD, PhD, MSc will further explore this microbiome of the gut, hormones, and brain connections and its relationship to mental health and addictions in a session on Friday morning at CPI this June.
These sessions and more will satisfy your curious brain with the current science and how it applies to your nursing practice this June 7-10 in Baltimore, Maryland. Register today for the opportunity to earn up to 22 contact hours in pharmacology while hearing from superb interdisciplinary speakers that value your perspective as a provider of psychiatric-mental health nursing care.
Linda S. Beeber, PhD, PMHCNS-BC, FAAN