Pubdate: Sun, 20 Jul 2008 Source: Sunday Independent (Ireland) Copyright: 2008 Independent Newspapers Ltd Contact: http://www.independent.ie/ Details: http://www.mapinc.org/media/434 Author: Dr Harry Barry Note: Dr Harry Barry is author of 'Flagging the Problem: a new Approach to Mental Health' and is director of Aware Bookmark: http://www.mapinc.org/find?252 (Cannabis - Psychosis) Bookmark: http://www.mapinc.org/opinion.htm (Opinion) WHY SMOKING A JOINT COULD BE THE WOLF IN SHEEP'S CLOTHING Cannabis Does Far More Harm to Your Brain Than You Might Think, Says Dr Harry Barry RECENT research from Trinity College, Dublin, into the effects of chronic use of cannabis has confirmed what many GPs and psychiatrists have known for quite some time: namely, that it adversely affects the brain -- particularly the prefrontal cortex, our thinking, rational, logical brain. Their studies related to evidence of memory loss, but there has been plenty of clinical and research evidence to show how chronic use can lead to depression, psychosis and schizophrenia. I am particularly concerned about the use of hash in the under-25 age group. The brains of those aged from 12 to 25 goes through a maturing process and is very vulnerable to the effects of this drug and subsequent appearance of these illnesses. But there is another hidden epidemic that I would like to make many parents in particular aware of -- and it relates to a condition that therapists call the Demotivational Syndrome. It typically occurs in the early to mid-20s -- and I am seeing it increasingly in young males. It is caused by chronic use of cannabis, often over a period of years. In many cases, parents have been worried about their son or daughter's behaviour, but completely unaware of the cause -- for the presentation of the Demotivational Syndrome is often subtle and insidious. The signs will usually start to appear in the late teens or early 20s with a gradual appearance of a combination of apathy and seeming boredom. They seem 'chilled out'; don't really want to work or study; seem happy to sleep late; want to listen to their music and hang out with their peer group friends. They may start college courses and after a while 'drop out' -- usually informing their parents that it just 'didn't suit them'. In some cases they may have 'tried' a number of courses but keep dropping out. In other cases they may start jobs but never seem to remain, becoming bored very quickly. Sometimes they appear quite moody, becoming quite irritable if challenged about their behaviour. Parents may in turn feel anxious and frustrated. But in an era where male suicide is a major worry, they are afraid to challenge them too much. In some cases the parents will be aware their children smoke cigarettes or misuse alcohol, but may regard both as 'normal' behaviour for the age group. The major concern may be that the young male is depressed, and this may be the eventual reason they might arrive at the family doctor. In some cases the young person themselves may look for help as they may be suffering from bouts of feeling low or from anxiety. Unfortunately, in many cases, the young person may lie about their misuse of hash or may not even consider it to be a problem, saying cannabis is not "hard drugs". The reason for all these symptoms lies in the developing brain -- especially the dopamine system (our so called pleasure system). The key player lies in our limbic emotional brain, and I call it the pleasure box (nucleus accumbens). This box lights up when we have sex, drink alcohol or use drugs. But the dopamine system is also vital for motivation. When we continuously barrage it with substances such as hash, the system becomes less sensitive, and we no longer find normal life experiences rewarding or interesting. The dopamine receptors in our emotional brain have become, like the sufferer, jaded and uninterested -- and the longer this state continues, the more chronic it becomes. The most important part of treating this syndrome is, in my opinion, the recognition by parents of the enemy in their midst. The young male may genuinely not realise the dangers of chronic hash use or their lack of interest or motivation, or that their brief periods of low mood or anxiety are due to it. Many are looking for help but don't recognise the cause of their problems. This is where parents can play a role -- by making themselves aware of the possibility of chronic hash use in situations where the young person may be showing signs of the above. If you ever see scorch marks on the clothes of a young person, warning bells should sound, as normal cigarettes do not produce them. If suspicious, you have to gently but firmly broach the topic. It may save both you and the young male years of frustration and wasted life experience. The good news is that if the young person totally ceases to use the drug, their dopamine system will, over a six-to 12-month period, gradually return to normal and their natural enthusiasm and motivation will reappear. Any mood swings will usually settle and you will see the return of the young person you love. If any residual difficulties remain then I feel some CBT (cognitive behaviour therapy) should be the treatment of choice. - --- MAP posted-by: Richard Lake