CREATing a new approach to mental health services in the Arctic

Project CREATeS tackles mental health concerns facing Indigenous youth

CREATing a new approach to mental health services in the Arctic

Content warning: Discussions of suicide

A recent initiative named Project CREATeS, which stands for “Circumpolar Resilience Engagement and Action Through Story,” has been launched to involve Northern Indigenous youth in suicide prevention efforts. This helps mental health specialists juggle the difficult balancing act of implementing comprehensive solutions while also being cognizant of differing needs from different communities.

Rates of death by suicide in the Inuit communities of Nunatsiavut, Nunavik, Nunavut, and the Inuvialuit Settlement Region — particularly among youth —  are between five and 25 times that of Canada’s non-Indigenous population.

The scope of the epidemic certainly calls for widespread action, but launching a new large-scale suicide prevention initiative runs the risk of worsening the problem.

For generations, health care efforts in Indigenous communities have tried to fit the wide diversity of the population into one-size-fits-all solutions. In the Arctic Circle, these methods were imported directly from southern Canada, and did not utilize existing community supports and cultural practices.

A new initiative for Indigenous youth

Dr. Allison Crawford, a professor at U of T’s Department of Psychiatry and The Centre for Addiction and Mental Health, and the Scientific Project CREATeS Lead, spoke with The Varsity about the initiative.

During a recent meeting at the Arctic Council, an international organization made up of countries and Indigenous nations that occupy territory in the Arctic Circle, Crawford’s team brought together Indigenous youth for a series of writing and storytelling workshops in order to connect them with peers who faced similar experiences.

At the end of these workshops, participants from all six permanent member countries of the Arctic Council, chosen by their respective communities, turned their own stories about their Indigenous identities and experiences with mental health into short films. These films will be shown to the council to advise future mental health initiatives.

Many participants have expressed that the opportunity to tell their stories, in and of itself, has been very useful to their own mental health. In addition, the workshops have brought them together into an invaluable international community.

“Not all Indigenous people feel like a part of their community. And when you don’t have your community, you still have the modern society, but you still aren’t a part of it, because you’re an Indigenous person,” said Juhán Nikolaus Wuolab Wollberg of the Saami Youth Council, in a documentary about the project.

Now, Wollberg is connected to dozens of peers who share that exact experience.

But, for all the project’s successful outcomes, Crawford said that her team’s efforts cannot end there. “[Just] watching stories can be very voyeuristic… Stories are not an endgame in and of themselves. That’s my biggest learning [from the project].”

Instead, participants have been brought back to present the project’s results to the Arctic Council, who funded the project — not only to help the Council develop solutions that build on those results, but to train the new generation of youth to become advocates for their own mental health.

Crawford is looking into running programs that facilitate digital storytelling along the lines of Project CREATeS as mental health initiatives in themselves. In addition, she’s hoping to send the films the participants created back to their respective communities in order to start up community discussions about mental health and suicide prevention.

An important achievement that this project could entail is sparking intergenerational conversations about mental health. It’s also important to remember that the suicide crisis is not happening in a void, as Crawford noted.

“I think [the suicide crisis] has a lot to do with the process of colonization, of being coerced into settlement, of loss of livelihood, loss of culture, [and] some other historical traumas like residential schools, loss of language,” she said. “All of those things, I think, created the conditions that led to those rates, and so what that means is that the solutions need to take that into account.”

“Taking medication for depression is not going to undo all that stress.”

A number of the youth, through their stories, talked about how empowering it is for them to reconnect with their communities’ traditions.

If this project helps a community open up discussions about how to preserve generations of traditional knowledge and resources, it might help a new generation of Northern Indigenous youth find the support and connections they need.

If you or someone you know is in distress, you can call:

  • Canada Suicide Prevention Service phone available 24/7 at 1-833-456-4566
  • Good 2 Talk Student Helpline at 1-866-925-5454
  • Ontario Mental Health Helpline at 1-866-531-2600
  • Gerstein Centre Crisis Line at 416-929-5200
  • U of T Health & Wellness Centre at 416-978-8030.

Warning signs of suicide include:

  • Talking about wanting to die
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no purpose
  • Talking about feeling trapped or being in unbearable pain
  • Talking about being a burden to others
  • Increasing use of alcohol or drugs
  • Acting anxious, agitated, or recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

The more of these signs a person shows, the greater the risk. If you suspect someone you know may be contemplating suicide, you should talk to them, according to the Canadian Association for Suicide Prevention.

Tracking the effects of Alzheimer’s through a patient’s journal entries

Linguistic research shows changes in language use as disease progresses

Tracking the effects of Alzheimer’s through a patient’s journal entries

U of T researchers have found a correlation in a Canadian woman’s diary entries and her cognitive decline due to Alzheimer’s, inviting further research into the change of language choice in older adults.

This yet unpublished study — presented at New Ways of Analyzing Variation 48 conference in October 2019 — analyzed 97 diaries by the late Vivian White, spanning from 1985–2016, an incredible 31 years of raw data. Paired with White’s medical records and her daughter Sheila White’s support, it’s possible to draw a timeline of Vivian’s health in comparison to her diary entries.

Katharina Pabst, a PhD candidate at U of T’s Department of Linguistics, spearheaded the research study, in collaboration with Professor Sali Tagliamonte, the Chair of the Department of Linguistics and co-author of the study.

Changes in language over time

One of the significant surface level language changes was subject omission, such as dropping the ‘I’ pronoun at the beginning of a sentence. This happens frequently in a diary writing style, which may include sentences sentence like “fed the squirrels.”

All the subject omissions or lack of omission were marked in 97 diaries, and a decreasing trend was noticed, according to data compiled with the help of two undergraduate research assistants, Khadija Jagani and Christopher Legerme.

Subject omission rates were stable for the first two thirds of the writing, but after Vivian started using ‘I’ more frequently in her diary, her family noticed a decline in her memory. When the diagnosis of mild cognitive decline was made, the rate had almost halved.

As the diagnosis moved into severe dementia, there was a drastic drop, culminating in a complete lack of subject omission in 2016, the year she passed away.

Tagliamonte noted to The Varsity that a drastic decline in cognition is common in Alzheimer’s, and this drop in subject omission correlates with medical records, representing Vivian’s decline through her sentence structures.

Research supported by Vivian’s daughter

While this wealth of data only comes from one person, further conversation with Sheila revealed that Vivian’s maternal grandfather also kept a diary for roughly 58 years. Throughout, he had consistent subject omission rates with no evidence of cognitive problems, unlike Vivian. This provided more verification for the theory that Alzheimer’s was associated with Vivian’s style changes.

This surprise find of another stack of diaries could not have occurred without a good relationship with Vivian’s family. Sheila was, and is, tremendously supportive of the research opportunities that her mother created, according to Tagliamonte.

“The family has asked us to always use her real name,” said Tagliamonte. “This is the kind of work [people in the real world] can relate to.”

However, as the findings are confined within a single family, further research is needed. More in-depth analyses of other diary collections, as well as interdisciplinary research on cognitive decline will create knowledge in computing, medicine, and linguistics, and also help families affected by dementia.

By sharing her mother’s story through this scientific study, Sheila hopes more people can offer something and participate in research. It’s something Vivian wanted, after all.

“This diary will be partly an aid to memory, partly a goal to make me accomplish more, & partly something else — perhaps an attempt to assure myself that my life has some significance?” wrote Vivian on March 23, 1985, at the age of 59.

Editor’s Note (November 18, 10:12 pm): The article has been updated to include Katharina Pabst, lead author of the study, and the names of two undergraduate students who assisted with the research.

How psychedelics could reduce existential distress for end-of-life patients

In conversation with Dr. Daniel Rosenbaum on the clinical promise of psychedelics in Canada

How psychedelics could reduce existential distress for end-of-life patients

Psychedelics — substances that cause dramatic changes in thought and perception — could play a unique role in alleviating existential distress in patients with life-threatening illnesses like cancer, according to a recent review.

A University of Toronto-affiliated paper has explored the potential of psychedelic medication to improve patients’ quality of life and alleviate suffering in end-of-life care.

Facing existential distress in end-of-life care

“Existential distress relates to the kinds of concerns people often have as they face end-of-life, or cancer recurrence,” said Dr. Daniel Rosenbaum, one of the article’s co-authors, in an interview with The Varsity.

The feelings of hopelessness, demoralization, and burden associated with existential distress can cause depression, anxiety, and significantly reduced quality of life in patients facing life-threatening illnesses.

Some psychotherapies have been developed to treat existential distress and help end-of-life patients restore their sense of dignity and meaning in life; however, no medication or pill currently exists for alleviating this form of suffering — until recently as research has shown promising potential in psychedelic therapies.

Classic psychedelics include various compounds that bind to and activate 5-HT2A receptors in the brain, such as psilocybin — which is found in certain mushrooms — and lysergic acid diethylamide, also known as LSD. They can induce mystical, transcendent experiences and deep feelings of positivity, which makes them ideal to treat existential distress, according to Rosenbaum.

How psychedelics could address this problem

Studies from as early as the 1950s have suggested potential applications of psychedelics in psychotherapy. However, research has been bogged down by challenges in designing methodologies that could test the efficacy of psychedelic medicines.

There were also ethical and safety issues — some studies were completed without informed consent, and caused lasting harm to participants. By the mid-’70s, these issues, combined with controversy around the spread of recreational psychedelic use, caused most of the research in this area to be discontinued.

A ‘psychedelic renaissance’ is breaking this decades-long gap in research, accompanied by contemporary methodologies that strive to overcome the shortfalls of their predecessors. For example, today’s studies recognize the importance of components such as psychotherapy sessions before and after the drug treatment, as well as the creation of a safe and comfortable environment for the treatment sessions.

These factors can be crucial to how patients respond to the treatment and as such, must be carefully managed.

Modern studies on the promise of psychedelics

Notably, two studies from Johns Hopkins University and New York University found that psilocybin therapy reduced anxiety and depression levels in patients with life-threatening cancers and various psychiatric disorders. Patients also reported other beneficial effects, such as a reconnection to life, increased confidence, and acknowledgement of cancer’s place in life.

The treatment caused some temporary increases in heart rate and blood pressure, but these were generally well-tolerated and did not appear to cause any severely adverse symptoms. Careful participant screening in most contemporary research also helps to ensure that participants do not have any family history or personal predisposition for psychosis, and are able to undergo the treatment safely.

Moreover, the benefits of psychedelic therapy were shown to have an immediate and lasting impact. Beneficial effects were sustained for six months or longer after a single treatment. The drug’s rapid onset may also be advantageous compared to conventional antidepressant medications, which may take several weeks to have an effect.

“If someone is suffering from profound depression or anxiety, we may not have sufficient time for the alleviation of certain kinds of suffering with conventional medication treatments,” Rosenbaum said.

Next steps of psychedelic research

Further research in psychedelic-assisted therapy is underway at various institutions in Canada and around the world. A trial at the Princess Margaret Cancer Centre in Toronto is currently studying the treatment of depression in palliative care patients using intranasal ketamine.

MDMA-assisted psychotherapy for the treatment of post-traumatic stress disorder is another area of interest, with research ongoing at Ryerson University and a multi-site study from the Multidisciplinary Association for Psychedelic Studies taking place in cities across the United States, Israel, and Canada, including studies in Vancouver and Montreal.

“It’s an exciting time for the field in Canada,” Rosenbaum said. “I think, in the coming years, we will start to see a number of new trials.”

Self-insight is not as important as your teachers have taught

Impactful U of T paper could change common thought in academic psychology

Self-insight is not as important as your teachers have taught

Contrary to popular belief in psychology, there is no relationship between self-insight — how accurately you can judge your own abilities — and certain areas of adjustment, indicated by measures such as life satisfaction. These potentially groundbreaking findings are from a recent U of T study published in Nature Human Behaviour.

Various competing perspectives exist in psychology about the relationship between self-insight and adjustment. Self-insight refers to how well people’s self-view, or beliefs about their levels of ability, match with their actual levels, while adjustment is essentially how well people function in life.

Self-insight is valued in institutions such as schools and workplaces, where individuals may be given feedback on their work, and are often encouraged to reflect on their strengths and weaknesses to improve performance.

But is it really best for your life satisfaction to accurately know your levels of ability? Could overestimating yourself and ‘self-enhancing’ boost confidence and be more beneficial? Or would another combination of high abilities and accurate self-views be optimal?

These are the types of questions that inspired coauthors Joyce He, a PhD candidate at U of T, and her advisor, Professor Stéphane Côté, to begin this study nearly two years ago.

Results do not support existing theories

He and Côté tested five main competing perspectives. The first, the self-insight perspective, proposed that adjustment is highest when self-views and abilities match. This enables individuals to perform confidently in their strengths while being aware of their weaknesses.

The second, the optimal margin of illusion perspective, suggests that regardless of abilities, adjustment is highest when positive self-views exceed ability by a certain amount. This provides enough confidence to motivate individuals while remaining realistic to their actual abilities.

The third and fourth perspectives posit that only positive self-view or only high abilities are related to high adjustment, while the other variable is irrelevant. These are named the positive self-views-only, and high abilities-only perspectives, respectively.

The fifth perspective proposed that the relationship between abilities and self-views is non-existent — rather, both variables are independently related to higher adjustment. Named the positive self-views and high abilities perspective, the hypothesis suggests that one’s abilities and accurate self-views of one’s abilities are both positively related with adjustment, after controlling for one another.

But all five perspectives were unsupported by the co-authors’ high-powered study.

An implication of the lack of support for all five perspectives, according to the co-authors, would mean that providing feedback to students and workers about their cognitive and emotional abilities — or enhancing their self-views — may not enhance their adjustment.

The many competing perspectives on self-insight and adjustment exist mainly due to two limitations of past research.

First, some studies determined self-insight by assessing how well people’s self-views matched with peers’ perceptions of them — which can be biased or inaccurate — or with their views of other people. This is also problematic, because discrepancies between one’s ratings of one’s own abilities and others’ abilities might be due to actual differences between people’s abilities, and not a lack of self-insight.

A second limitation stemmed from how past researchers used the difference between self-view and ability, the square of their difference, or other measures, in statistical analyses. These “difference scores” can conceal information by merging variables, and the correlations found can interpreted in various ways.

How the researchers overcame these two limitations

Using an online recruitment source, He and Côté surveyed 1,044 participants from the United States. This large sample size was calculated to provide high statistical power, at 95 per cent.

“Statistical power is essentially how much power you have to detect an effect, if it is there,” He explained to The Varsity. The sample size and size of the effect are two important factors affecting power — the number of participants should be large enough to detect the effect being studied.

To address the first limitation, the researchers measured the abilities objectively through a timed test of emotional ability. The test required participants to identify the emotions expressed by 72 photos of actors with different facial expressions, as well as a 20-minute cognitive ability test with 15 perceptual problems.

Self-views were measured by asking participants to rate how they think they scored on these tests. The researchers measured levels of psychological, interpersonal, and institutional adjustment by requiring participants to rank aspects of their life satisfaction, quality of relationships, and career satisfaction, respectively, in a daily diary format.

To reduce error from different types of biases, these measurements were collected over the span of a week. If a participant was in a bad mood, for example, it might have affected their responses. But by taking multiple measurements at different times, the data would be more representative of the participant’s general situation.

To overcome the second limitation, He and Côté analyzed their data in a new way, using polynomial regression to model the data and response surface analysis to generate a three-dimensional plot, showing every possible combination of abilities and self-views, and their relation to adjustment.

Analyzing the response surface graphs revealed that they did not meet the conditions required to support any of the five hypotheses. They did notice some patterns that may support self-enhancement, a relatively new perspective not included in the hypothesis, which posits that individuals whose self-views exceed their abilities will be better adjusted.

This perspective is somewhat counterintuitive, as it predicts that individuals with low abilities and high self-views would be the most adjusted, while individuals with high abilities would be less adjusted because their self-views cannot exceed their abilities by as much.

“One possibility here is that these self-enhancers are rating everything on a higher level,” said He. “So they’re rating their abilities higher, their self-views about their abilities are higher, but they’re also rating their life-satisfaction, career satisfaction, and relationship satisfaction higher.”

Study was published as a Registered Report aimed for transparency

He and Côté’s study is one of the first two Registered Reports published in Nature Human Behaviour. Traditional papers are submitted to journals after the study has been completed, whereas Registered Reports have researchers submitting their introduction, proposed methods, and plans for analysis before conducting the study.

Following the submission, reviewers and editors then consider the proposals and can make suggestions. If a proposal is approved, researchers conduct the study, with guaranteed publication of their results — significant or not.

Registered Reports are part of a push for greater transparency in psychological research, according to He. This design can help studies that may face difficulty with publication if they produce non-significant results.

“With the Registered Report, the editors are really trying to put more emphasis on the research questions that you have,” He said. “A lot of authors, they might have this really important question, [and] they [design a study to] test it.”

“But [if] they find null results, then they [may not] actually end up publishing [them],” she continued. “Because in our field, at least, you’re kind of incentivized to publish interesting results.”

Future steps following the study

Next steps could include studies designed to confirm evidence supporting the self-enhancers perspective. These might measure adjustment with variables that are not self-reported, such as peer opinions and objective performance at work.

In terms of potential applications of these findings to policy, education, or management, He believes that more research needs to be done.

“Once we see from a few studies, or a bunch of studies, that we see the same patterns over and over again, then I think that that’s when we can actually draw the conclusion.”

Editor’s note (October 18, 2019, 6:15 pm): The article has been updated to reflect that the fifth hypothesis, which contends that the relationship between abilities and self-views is non-existent, is based on existing research literature.

How psychotherapy treats depression differently than antidepressants

A personal exploration into the science behind antidepressants and CBT

How psychotherapy treats depression differently than antidepressants

Content warning: discussions of depression and suicidal ideation.

The first time I walked through the door of my psychiatrist’s office, I was full of doubt. I had been feeling low for quite a while, and I had trouble believing that any treatment would truly help me feel better.

I had just completed my second year of university, and I felt broken and exhausted. A blend of burning out, experiencing depressive episodes, disengaging from pastimes I used to enjoy, and fantasizing about dying drove me to seek treatment at U of T’s Health & Wellness Centre.

As part of my initial assessment, which occurred over the course of several sessions, my psychiatrist asked me questions about practically every aspect of my life: recent events, medical history, sleep patterns, appetite, suicidal ideations, and more. After considering all my symptoms, she prescribed me Prozac, an antidepressant medication, and recommended cognitive behavioural therapy (CBT). Both are common treatments for depression.

I gave them both a try. I was fortunate to be able to see a therapist for CBT, which was covered by my family’s health insurance. At first, I was skeptical that it would work, but I decided to commit myself to at least a few sessions.

CBT, as I learned, is a short-term form of psychotherapy that helps people build skills for staying healthy. In essence, it helps people identify, question, and change distorted thoughts and beliefs they might have about themselves and the world. By recording their thoughts during upsetting situations, people examine how their unhelpful thoughts might contribute to problems like depression.

Research on how CBT compares to antidepressants

Dr. Zindel Segal, a U of T psychology professor and an expert in CBT, said in an interview with me that “when people are in certain mood states, they tend to have thoughts that are very compatible with those mood states. So, when someone’s feeling depressed, they’re more likely to feel hopeless, judge themselves, and be very critical.”

According to Segal, CBT provides a way of treating people’s thoughts and assumptions as hypotheses that can be tested, rather than as hard facts. “That can help people alleviate the impact that some of these thinking styles can have on their moods,” he elaborated.

For me, CBT was extremely challenging more so than any math or biochemistry course I have ever taken. Perceptions are simply hard to change. At the time, for example, I felt incredibly worthless and undeserving of love. In the face of this, CBT helped me stay objective and not always accept my perceptions as truth. Psychotherapy made me stand back from my thinking to consider situations from different viewpoints.

“In the face of [critical challenges], CBT helped me stay objective and not always take my perceptions as truth.”

However, distorted thoughts and beliefs are often not the only culprits of depression. Much is still unknown about the causes of depression, but researchers suspect that chemical imbalances in the brain play a role in maintaining low moods. Antidepressant medications are designed to address these chemical imbalances by boosting concentrations of neurotransmitters namely serotonin and norepinephrine in the brain.

At first, I was very reluctant to try antidepressant medication because I was wary of possible side-effects. However, my psychiatrist assured me that the starting dose was low, that I would be closely monitored, and that we could always adjust my treatment if the medication was not right for me. In the end, I experienced only minor side-effects and really benefited from the resulting stability in my mood.

The differences between CBT and antidepressants

So, what are the differences between CBT and antidepressants in treating depression, according to experts? Researchers like Segal, who recently co-authored a paper comparing the efficacy of CBT versus antidepressants, are working hard to answer this question.

Segal’s research team found that CBT and antidepressants target different symptoms of depression. Antidepressants were found to be best for treating symptoms specifically related to depressed mood, feelings of guilt, suicidal thoughts, and psychic anxiety.

On the contrary, CBT and antidepressants were equally effective in treating patients who struggled with other specific symptoms of depression, like changes in sleep and appetite. “This paper tries to address more of a symptom-to-patient matching approach so that people are getting antidepressants if they have a symptom profile that might be more responsive to the drug,” said Segal.

In my case, CBT and antidepressants were temporary treatments that helped me bounce back from a bout of depression and develop long-term skills in staying healthy. Each treatment helped me in different ways: CBT helped me build emotional resilience, whereas antidepressant medication gave me the extra energy to ‘get back on my feet’ and return to doing the things I love to do.

But whichever treatment people are prescribed, Segal stressed that depression is treatable. “Whether you have hypertension or depression, it is possible to get treatment.”

If you or someone you know is in distress, you can call:

  • Canada Suicide Prevention Service phone available 24/7 at 1-833-456-4566
  • Good 2 Talk Student Helpline at 1-866-925-5454
  • Ontario Mental Health Helpline at 1-866-531-2600
  • Gerstein Centre Crisis Line at 416-929-5200
  • U of T Health & Wellness Centre at 416-978-8030.

Warning signs of suicide include:

  • Talking about wanting to die
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no purpose
  • Talking about feeling trapped or being in unbearable pain
  • Talking about being a burden to others
  • Increasing use of alcohol or drugs
  • Acting anxious, agitated, or recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

The more of these signs a person shows, the greater the risk. If you suspect someone you know may be contemplating suicide, you should talk to them, according to the Canadian Association for Suicide Prevention.

The promise of ketamine in overcoming treatment-resistant depression

Therapeutic potential of ketamine discussed in review by U of T medical researchers

The promise of ketamine in overcoming treatment-resistant depression

Content warning: Discussions of suicide in the context of treating major depressive disorder.

Ketamine is a promising medication that brings hope to patients struggling with severe depression, offering potential therapeutic effects for those who are non-responsive to standard antidepressants.

The dissociative anesthetic is currently used by physicians and veterinarians to cause fast-acting insensitivity to pain during medical procedures. It is also used illicitly as a recreational drug, causing feelings of disconnection and relaxation among users.

Yet in controlled settings, ketamine also shows potential as a medication to help patients who are suffering from major depressive disorder. In April, a research review by U of T researchers found that ketamine offers significant effects as an antidepressant.

The lead author of the paper, Dr. Joshua Rosenblat, discussed the review’s findings with The Varsity. As a clinician-scientist in the Department of Psychiatry, Rosenblat is currently studying the antidepressant effects of ketamine.

He explained three major effects that differentiate ketamine from standard antidepressants: a different mechanism of action, a rapid onset of effects, and a response in patients who are not positively affected by commonly prescribed antidepressants.

Ketamine affects depression via a novel mechanism of action

For the past several decades, standard antidepressants have worked by affecting levels of serotonin, norepinephrine, and dopamine, explained Rosenblat.

In generalized terms, serotonin is a chemical messenger thought to regulate mood, while norepinephrine controls alertness and arousal. Dopamine affects attention and emotion.

But ketamine affects the brain differently. Rather than targeting these neurotransmitters, it instead changes levels of glutamate – the main excitatory messenger in the brain.

Ketamine’s unique mechanism of action could therefore explain why it may positively affect patients suffering from treatment-resistant depression, who do not respond to standard antidepressants.

Ketamine could provide a more rapid onset of affects, versus standard antidepressants

Ketamine also provides a rapid onset of effects. Standard antidepressants, said Rosenblat, usually take two months of prescribed usage to take effect.

He explained that with ketamine, alleviation of depressive symptoms can appear within two hours of consumption. This is especially promising as an option for patients suffering from suicidal thoughts.

A decrease in suicidal thoughts can plausibly reduce the number of suicidal attempts; however, Rosenblat noted that the evidence is currently too limited to make a conclusion. He explained that studies are lacking, as only a small percentage of patients affected by such thoughts attempt to commit suicide.

Ketamine could also be used for special applications. Depression is very common among patients facing terminal cancer, explained Rosenblat.

“If you were to start them on an antidepressant and they only have one month left to live, for example, [the patients may] only experience the side effects, and never get the benefits.”

Rosenblat is currently leading a clinical trial at Princess Margaret Hospital to research the use of ketamine for improving the final months of life for patients affected by terminal cancer.

The risks and drawbacks of ketamine as an antidepressant

While the prospect of applying ketamine for treating depression is promising, there are several discouraging factors to its application.

To start, ketamine carries the risk of substance abuse. While ketamine is not strongly addictive, said Rosenblat, recreational users of the drug can develop a dependence.

Ketamine may also be prohibitively expensive for potential patients, as it is not covered by OHIP. Furthermore, as a medicine that is only available for research study or private use, it cannot currently be prescribed by most physicians.

There are also limited studies on the rare side effects of ketamine. In the short-term, the main known side effects are disassociation, a daydream-like state, and nausea which may occur during the administration of ketamine.

“We don’t know what we don’t know,” said Rosenblat. It is unclear whether ketamine may cause rare, adverse reactions in some patients. Long-term side effects of ketamine are also unclear.

Rosenblat therefore does not encourage self-medication for U of T students suffering from mental health challenges, as ketamine is not sufficiently studied.

Only a “very small percentage” would likely positively benefit from ketamine, explained Rosenblat, compared to standard treatment options supported by a much wider body of research.

The future of ketamine research

Although ketamine is not fully studied and is currently only used in special situations, it still brings “a message of hope,” said Rosenblat.

While ketamine is still not approved as an antidepressant, the U.S. Food and Drug Administration has approved esketamine, a structurally similar compound, as a nasal spray antidepressant. This became the first antidepressant of its kind to be used in the United States.

While Rosenblat notes that much more future research needs to be done with ketamine, he agrees that preliminary results are “very promising.” With a new avenue of research in treating severe depression, the future of research in the field seems optimistic.

Monday psychology lecture at UTSC begins with a bang

Porn video played on projector screen startles students, ignites meme frenzy

Monday psychology lecture at UTSC begins with a bang

On September 24, a video surfaced that appears to show UTSC psychology professor Steve Joordens playing a pornographic video on the projector screen by accident.

The incident, which apparently took place at the start of the lecture, was recorded by one of the students in the class via a Snapchat video and subsequently posted onto Reddit, where, along with many memes made about the event, it instantly went viral.

“When I saw the [pornographic] video, I was surprised,” the original poster, a first-year student studying Philosophy, wrote to The Varsity.

“I was not expecting that especially this early in the morning… I found the whole situation funny and he made a lot of people laugh. ”

The class, which was reportedly PSYA01 — Introduction to Biological and Cognitive Psychology, had about 500 students in the lecture hall. As seen in the video posted by the student, many students in the class were laughing, though others could be seen walking out of the room.

In a statement to The Varsity, Joordens wrote, “With respect to the event that happened prior to my class on Monday the 24th, I want to be clear that what happened was completely unintentional and I feel absolutely terrible about it.”  

“I have apologized to my class and now I want to move on. Thanks to my students, colleagues and my amazing family for their support and understanding.”

Don Campbell, Media Relations Officer at UTSC, told The Varsity in a statement that the university is aware of the incident and are looking into it, but that they can’t discuss personnel matters.

“We encourage students who may be feeling unsettled by the incident to speak with their registrar or staff at the Health & Wellness Centre,“ Campbell said.

Joordens started teaching at UTSC in 1995. Since then, he has won numerous teaching awards including the Canadian Post-Secondary #EdTech Professor of the Year in 2017 and the 3M National Teaching Fellowship in 2015.

“Everyone makes mistakes so I can’t blame him,” said the student who posted the video. “I hope nothing bad happens in the future and this can just be a thing to laugh about, I hope his job isn’t affected or anything in his personal life either.”

Editor’s Note (September 25, 2:10pm): This article has been updated to include a statement from UTSC.

Editor’s Note (September 28, 12:20pm): This article has been updated to include a statement from Joordens.

Dude, what’s that smell?

U of T study explains link between smell and memory

Dude, what’s that smell?

I am sitting at my maternal grandmother’s house in New Delhi, India. Masi, my aunt, has prepared a dish for me that she promises I will love. I don’t particularly like surprises, but I wait outside the kitchen.

I catch a whiff of something sweet. I can’t place it but it’s familiar. I close my eyes and I know it’s a smell from my childhood. Then it hits me. My Masi is making an Indian confection called almond halwa using my grandmother’s recipe.

This connection that I made — that we all make — between odour and memories, is explained in a study published in Nature Communications. The study, led by Afif J. Aqrabawi, a PhD candidate in the Department of Cell & Systems Biology at U of T, sheds light on this connection and how it could help develop new diagnostic tests for Alzheimer’s disease.

The hippocampus (HPC) is essential to episodic memory. It organizes memories of sensory events, including smell, in terms of space and time. The HPC stores the condition of the brain when said events take place, and then retrieves and recreates cerebral cortex activity of the original memory’s context when we encounter the sensation again.

The anterior olfactory nucleus (AON) is the largest source of feedback projections in the olfactory cortex, and the anatomical junction where the connection between olfactory and contextual information is made. HPC projections into the AON can alter the way smells are perceived and what behaviours are associated with specific odours.

Aqrabawi and Department of Psychology Professor Jun Chul Kim had determined that inputs from the HPC to the AON are necessary for the retrieval of odour memory based on spatial and temporal contexts. They knew the AON played a role in connecting spatial and olfactory events, but they did not know the exact function of the AON-HPC junction.

Thereafter, Aqrabawi and Kim found a neural pathway between the HPC and AON and they were able to define its role in memory retrieval. This pathway is responsible for contextual retrieval of odours and is affected in patients with Alzheimer’s.

In the study, mice whose AON-HPC junction was blocked kept returning to investigate the same scent even after being exposed to it several times prior. This was an indication that the AON plays a significant role in memory retrieval.

On the other hand, mice whose junctions were left to function normally spent less time smelling familiar odours because of the episodic memories associated with them. Inhibition of the HPC-AON pathway results in a loss of the odour memory linked to a given context in space and time.

This is the first study that demonstrates that inputs from the HPC to the olfactory cortex are necessary for forming and retrieving episodic odour memories. Findings from the study also show that the anatomical location of AON behind the olfactory bulb is an ideal bridge between olfactory and contextual information.

Multiple studies have reported a loss of olfactory function in Alzheimer’s patients. In fact, diagnostic smell tests are currently used to detect the earliest symptoms of the disease. This olfactory dysfunction is due to the neurodegeneration of the AON, which stores episodic odour engrams, during the early stages of Alzheimer’s disease.

Future research involving these findings will likely aim to better understand the connection between smell and memory, and particularly the neural circuits involved in this association.