Richard A. Friedman

Nota: Este archivo abarca los artículos publicados por el autor desde el 1 de febrero de 2009. Para fechas anteriores realice una búsqueda entrecomillando su nombre.

How to Be More Resilient

As a psychiatrist, I’ve long wondered why some people get ill in the face of stress and adversity — either mentally or physically — while others rarely succumb.

We know, for example, that not everyone gets PTSD after exposure to extreme trauma, while some people get disabling depression with minimal or no stress. Likewise, we know that chronic stress can contribute to physical conditions like heart disease and stroke in some people, while others emerge unscathed. What makes people resilient, and is it something they are born with or can it be acquired later in life?

New research suggests that one possible answer can be found in the brain’s so-called central executive network, which helps regulate emotions, thinking and behavior.…  Seguir leyendo »

Marijuana Can Save Lives

This week, Attorney General Jeff Sessions paused a discussion of the opioid epidemic to, once again, go after marijuana. He suggested that addictive pain medication wasn’t the only problem and that many heroin addicts start out “with marijuana and other drugs.”

There is a relationship between cannabis and opioids, but Mr. Sessions has it backward. Marijuana isn’t a gateway drug to opioid addiction; it’s a safer alternative to pain medicines. Mr. Sessions’s vow to crack down on marijuana will only make the opioid epidemic worse.

We know that 40 percent of all opiate overdose deaths involve a prescription opiate. So having legal access to cannabis as another option for pain relief may actually reduce consumption of opiates.…  Seguir leyendo »

Como psiquiatra, nunca he conocido a un paciente que disfrute ser drogadicto o comedor compulsivo. ¿Por qué alguien continúa consumiendo drogas a pesar de las consecuencias médicas y la condena social? ¿Qué hace que alguien coma cada vez más aunque corra el riesgo de afectar su salud?

Una respuesta a estas preguntas es que los humanos modernos han diseñado el ambiente perfecto para generar ambas adicciones.

A nadie le sorprenderá saber que el estrés posibilita que la gente busque consuelo en las drogas o en la comida. Sin embargo, persiste el mito de que la adicción es una falla moral o una conducta para la que se nace con una predisposición: que los adictos tienen el control por completo o que están mal de la cabeza.…  Seguir leyendo »

Hace poco estaba en un avión y practicaba KenKen, un acertijo matemático, cuando otro pasajero me preguntó por qué me molestaba en hacerlo. Le dije que era por la belleza.

Está bien. Admito que es un juego tonto: debes lograr que los números dentro de la cuadrícula obedezcan ciertos límites matemáticos y, cuando lo hacen, todas las piezas quedan juntas y eso te deja un sentimiento de armonía y orden.

Aún así, la pregunta me hizo cuestionarme sobre qué del pensamiento matemático es lo que resulta tan elegante y estéticamente atractivo. ¿Acaso es la lógica interna? ¿La mezcla única de simplicidad y poder expositivo?…  Seguir leyendo »

I was doing KenKen, a math puzzle, on a plane recently when a fellow passenger asked why I bothered. I said I did it for the beauty.

O.K., I’ll admit it’s a silly game: You have to make the numbers within the grid obey certain mathematical constraints, and when they do, all the pieces fit nicely together and you get this rush of harmony and order.

Still, it makes me wonder what it is about mathematical thinking that is so elegant and aesthetically appealing. Is it the internal logic? The unique mix of simplicity and explanatory power? Or perhaps just its pure intellectual beauty?…  Seguir leyendo »

“Quítese la ropa, entre en el contenedor y cierre la tapa. Tenga mucho cuidado de que no le entre nada de sal en los ojos”. Esas fueron las instrucciones que hace poco me dieron antes de entrar en un tanque de aislamiento sensorial en Seattle. Finalmente tendría la oportunidad de ver cómo se sentiría ser un cerebro en un frasco.

Acostado en el contenedor con solución supersaturada de sulfato de magnesio a temperatura corporal, jalé la tapa y oprimí el botón para apagar la luz violeta que iluminaba el contenedor.

Separado del mundo de los estímulos sensoriales, mi cerebro tenía toda la libertad para inventar cualquier experiencia que se le ocurriera.…  Seguir leyendo »

Think of the brain’s sensitive periods as blown glass: The molten glass is very malleable, but you have a relatively brief time before it cools and becomes crystalline. Put it back into the furnace, and it can once again change shape.

That is more or less what researchers have been able to do with the capacity for absolute musical pitch. Absolute pitch — the ability to detect or reproduce an exact note without hearing another note as a reference — is rare; only about 0.01 percent of the population has it.

Early musical training appears to be very important in the acquisition of this skill, and it is usually seen in people who started their training before the age of 6.…  Seguir leyendo »

Hay una razón por la cual los adultos no aprenden japonés ni kitesurfing. En agudo contraste, los jóvenes pueden aprender las cosas más difíciles de manera relativamente fácil. Polinomios, chino, skateboarding: ¡no hay problema!

La neuroplasticidad (la capacidad cerebral de formar nuevas conexiones neuronales y ser influido por el entorno) es mayor en la niñez y la adolescencia, cuando el cerebro aún está en desarrollo. Sin embargo, esta ventana de oportunidades es finita. En algún momento se cierra. O eso pensábamos.

Hasta hace poco, la sabiduría tradicional en los campos de las neurociencias y la psiquiatría indicaba que el desarrollo era un camino de ida únicamente, y que después de los años formativos era muy difícil, si no imposible, cambiar las experiencias y las capacidades.…  Seguir leyendo »

After six months, there was no significant difference in the symptoms of post-traumatic stress disorder in the groups. Disturbingly, though, the subjects with more hyperarousal symptoms — like anger and hypervigilance — at the start of the study had significantly more PTSD symptoms after receiving emotional debriefing.

This treatment was clearly harmful to these very symptomatic survivors, which doubtless would include many of the people at Pulse. This is probably because encouraging highly aroused trauma survivors to relive their experience activates the sympathetic nervous system and intensifies symptoms of PTSD, thereby retraumatizing them. (Other studies have found that debriefing after acute trauma is simply ineffective.)

Better than debriefing would be the support of loved ones and some basic education about the symptoms of PTSD.…  Seguir leyendo »

Attention deficit hyperactivity disorder is now the most prevalent psychiatric illness of young people in America, affecting 11 percent of them at some point between the ages of 4 and 17. The rates of both diagnosis and treatment have increased so much in the past decade that you may wonder whether something that affects so many people can really be a disease.

And for a good reason. Recent neuroscience research shows that people with A.D.H.D. are actually hard-wired for novelty-seeking — a trait that had, until relatively recently, a distinct evolutionary advantage. Compared with the rest of us, they have sluggish and underfed brain reward circuits, so much of everyday life feels routine and understimulating.…  Seguir leyendo »

Since the start of the wars in Iraq and Afghanistan, there has been a large and steady rise in the prevalence of post-traumatic stress disorder among our troops. One recent study of 289,000 Americans who served in those countries found that the rates of the disorder jumped to 22 percent in 2008 from just 0.2 percent in 2002.

Given the duration of these wars and the length and frequency of deployments, when compared with other wars, perhaps such high rates of PTSD are not so surprising. Prolonged exposure to a perilous and uncertain combat environment might make trauma common.

But there is another factor that might be playing a role in the increasing rates of the disorder, one that has escaped attention: the military’s use of stimulant medications, like Ritalin and Adderall, in our troops.…  Seguir leyendo »