Note: This story is a fun look at what mental illness detection and prevention might be like in the future. None of the screening methods described in the story are up and running yet, but they are all based on actual research in the field. Check the links at the end to find out more.
Timmy dribbled the basketball down the court, ten steps behind another dribbling student. The student did a right handed layup into the basketball hoop. A few seconds later, Timmy’s ball bounced off the rim and fell through the net.
It was basketball week at sixth grade gym class. The P.E. teacher drilled them on the fundamentals for the first three days before the next two days of games.
“Timmy Johnson!” a female voice hollered from a door on the other side of the gym.
A female student ran away from the school nurse and Jimmy ran towards her.
“Hi Mrs. Woolridge,” Timmy said.
“Hi Timmy,” she replied. “I’ve just got a few quick tests for you. All of our students have to take them during their sixth grade year.”
“Mr. Cory told us all about it.”
“Great, it’ll just take a few minutes. Start by sitting down and putting on a headset and glasses.”
Timmy took a seat then slipped on the Electroencephalography (EEG) headset and the dark glasses.
Mrs. Woolridge looked at the screen in front of her to make sure the EEG sensors on the headset had a clear read of Timmy’s brain waves. She turned the system on. “Do you see the blue dot?”
“Good. All you have to do follow that dot with your eyes. When it moves left, you look left. Got it.”
After completing the eye movement test, Timmy stood in front of a screen and copied the movements of a little cartoon boy. The cartoon boy raised his left foot. Timmy raised his left foot. The cartoon boy rotated his arms in circles. Timmy rotated his arms in circles. A motion sensor instantly recorded and analyzed Timmy’s gross motor skills.
Then Timmy moved over to the table in front of a small black computer that measured fine motor skills. The computer timed Timmy while he rotated a round sensor between each of his fingers. After finishing that test, Timmy had to trace a line through a circular maze on the computer as fast as possible without touching the borders of the maze. Finally, he tapped the screen each time a purple frog appeared. The purple frogs started appearing slow, then they sped up. Timmy’s hand moved across the screen tapping frogs wherever they appeared.
After running through the frog test three times, Mrs. Woolridge let Timmy go back to class.
One week later, Timmy and his parents sat in chairs in Mrs. Woolridge’s office.
“First of all, I want to let you know that this isn’t something that should scare you. Timmy did come up on one of our health screening tests as vulnerable to serious mental illness, but there’s no reason to be frightened.
Timmy’s mother put her hand on Timmy’s father’s knee. “Stan’s mother had schizophrenia. He died from suicide when Stan was just a boy.”
Mrs. Woolridge nodded, “We have a lot of families with mental illness susceptibility. With a little prevention, there’s no reason to worry.”
Mrs. Woolridge handed each of them a piece of paper. “I screened Timmy’s eye movements, skin conductance, gross motor skills, and fine motor skills last week. His eye movement and gross motor skills were fine, but Timmy’s skin conductance was a little low and had some difficulty with his fine motor skills.”
“Stupid frogs,” Timmy grumbled.
“Stupid frogs,” Mrs. Woolridge agree with a wink.
Mrs. Woolridge continued, “Mental illnesses are basically disruptions in neural circuits in the brain. If you think of the brain as a big set of wires with information passing through them, sometimes things go wrong with the wires. Those disruptions affect how people, think, feel and act. They also affect overall nervous system through the basal ganglia and other areas.”
“The basal what?” Timmy’s father asked.
“The basal ganglia. It’s a group of nerves in the center of the brain. You’ll see that it’s highlighted in red on your picture. When something affects the basal ganglia, it can impact a person’s ability to control their muscles. So basically we test the students eye movements, galvanic skin response, major body movements and delicate finger movements as a way of checking the function of the basal ganglia.
“So problems with fine motor skills mean somethings wrong with the basal ganglia?” Timmy’s mother asked.
“Not for sure,” Mrs. Woolridge responded, “But it is an indicator that something may be going on. Same thing with the galvanic skin conductance. After Timmy’s failed the fine motor portion of that exam, we ran some of his blood that you deposited with the school health center at the beginning of the year through a genetic scan for mental illness susceptibility.
“Not surprising that it turned something up,” Timmy’s mother said. “I’ve also got depression and anxiety issues on my side.”
“So I have mental illness?” Timmy asked.
“Not full blown mental illness, but maybe the beginning stages. We can’t say that for sure Timmy without a full brain scan. You could run one of those, but it’s not necessary. The medical field is pretty hesitant in scanning young brains. There’s a lot of radiation in a scan so we try to avoid them if possible.”
“So what can we do?” Timmy’s father asked.
Mrs. Woolridge pointed to the sheet. “We’re basically trying to prevent any potential neural disruptions into expanding into a major brain disruption event - psychosis. Some of the ways to avoid that are pretty simple. You can start off by eating well, taking Omega 3 vitamins, exercising and keeping regular sleep patterns. Oh, and don’t do any recreational drugs. Seriously, anything that messes around with the brain to make a person feel high could be really, really dangerous for you. That includes marijuana.”
“We’ll pick up some Omega 3 vitamins on the way home,” Timmy’s mother said. “The rest of it shouldn’t be a problem. Timmy’s a good kid, but we’ll keep an eye on him.”
“I will too,” Mrs. Wooldridge said with a smile. “Timmy, I’ve got a present for you.”
Mrs. Woolridge pulled a box out from under her chair. The box had a picture of a boy wearing a headset while looking at a small handheld video game tablet. “It’s a fun way to make sure that you’re brain is doing okay. It’s got one of the EEG headsets that you used when you put on the goggles and followed the dot. Basically, you just put on the headset, breath in the holes on the side of the machine, play the video game, then breath in the holes in the side of the machine again.”
“What kind of games do you have,” Timmy asked.
“They’re fun,” Mrs. Woolridge promised. “Way more fun than the dot and frog tests. It’s basic cognitive training along with some relaxation through mindfulness and neurofeedback.”
“How often does he have to use it?” Mrs. Johnson asked.
“We’ll start out with just twice a week, maybe Monday and Thursday. If he’s doing well, then we’ll drop it down to once. If things aren’t going well, then we’ll boost it up to three times. The exercises are great for the brain even if you don’t have a susceptibility to mental illness.”
“What do you mean if I’m doing well?” Timmy asked.
“The machine will automatically report back to me on your galvanic skin response, brain waves, stress hormone levels and cognitive skills. It’ll wave the flag if there’s excess anxiety, depression, or other dramatic changes in thought processes. We’ll increase the frequency of the exercises if either of those variable suggests we need to. If things really get out of line, I’ll recommend a therapist for relaxation and communication skills training. If the neurons are still struggling to talk with each other, then you’ll have to go to a psychiatrist to take a closer look at what’s going on and maybe even prescribe something.”
“Prescribe something? I remember my mother’s medication had some pretty horrible side effects,” Mr. Johnson said.
“There probably won’t be any need for medication.” Mrs. Woolridge said. “But in the worse case, the medication that they give before psychosis now doesn’t have anywhere near the same side effects as the old ones. The ingredients in one of them, that focuses on the neurotransmitter glutamate were even sold over the counter to treat people that had taken too much aspirin.”
“Thank God,” Mr. Johnson said.
Timmy wasn’t listening anymore. He already had the box half open. “This looks awesome,” he mumbled.
Eye Movement - http://www.iovs.org/content/28/2/366.full.pdf
Motor Proficiency in Children with Psychosis - http://ptjournal.apta.org/content/63/2/194.full.pdf
EEG Symmetry Patterns Predicting Anxiety and Depression - http://www.ncbi.nlm.nih.gov/pubmed/16223557
Basal Ganglia - http://en.wikipedia.org/wiki/Basal_ganglia
Prospective Biomarker for Schizophrenia - http://psychcentral.com/news/2012/03/29/prospective-biomarker-for-schizophrenia/36687.html
Using Biomakers to Identify and Treat Schizophrenia - http://www.sciencedaily.com/releases/2012/07/120711134557.htm
Cortisol levels Increased in Youth with Psychosis - http://www.medwire-news.md/47/101079/Psychiatry/Cortisol_levels_increased_in_youth_at_high_risk_for_psychosis_.html
Attention, Memory and Motor Skills as Childhood Indicators of Risk of Schizophrenia - http://ajp.psychiatryonline.org/article.aspx?articleID=174316
Palau Early Psychosis Study: Neurocognitive Functioning in High Risk Adolescents - http://www.ncbi.nlm.nih.gov/pubmed/17005375
Neurocognition in Early On-Set Schizophrenia and Schizoaffective Disorders - http://www.ncbi.nlm.nih.gov/pubmed/20215926
Electrodermal Predictors of Functional Outcome and Negative Symptoms in Schizophrenia - http://www.ncbi.nlm.nih.gov/pubmed/16008777
Distinguishing Youths At Risk for Anxiety Disorders From Self-Reported BIS Sensitivity and its Psychopsysiological Concomitants - http://www.ncbi.nlm.nih.gov/pubmed/23016527
Effects of Stress, Depression, and Their Interaction on Heart Rate, Skin Conductance, Finger Temperature, and Respiratory Rate: Sympathetic-Parasympathetic Hypothesis of Stress and Depression - http://www.ncbi.nlm.nih.gov/pubmed/21905026
Glutamate, Shizophrenia and other CNS Disorders - http://www.promentispharma.com/technology/Glutamate/index.html