A small discussion is happening between the two authors of the pieces on the GABA/glutamate cycle. The first article is here. The second one here. Below is a response to the second one. It is responding to the use of a phrase in this paragraph.
I want to remind everyone that all these ideas are only that and nothing should be taken as 100% accurate when it comes to the theorizing on what these drugs do to our brains and bodies. No one really knows and the best hypothesis are just that. Educated speculation. I’ve met too many people who know a whole lot who have still hurt people with their theories. We all respond so differently to everything from the meds themselves, to the withdrawal, to what some folks take to relieve withdrawal symptoms. It’s hugely complex and those who don’t have a healthy respect for that complexity are apt to hurt themselves or those they treat in withdrawal even more.
So the article that was submitted today is in response to this bit in the last article:
Even among people suffering the most severe antidepressant withdrawal syndrome, repopulation of serotonin receptors probably occurs long before symptoms disappear. However, while the serotonin system is repairing itself, an imbalance occurs in the autonomic nervous system and the “fight or flight” glutamatergic system becomes more active than normal. This is called disinhibition of the glutamatergic system, and it generates symptoms that are awful: panic, anxiety, sleeplessness, and dreadful imagery among them.
The response, written by the author of the first piece in what has become a small series:
There’s a bit of wording in the GABA/glutamate piece that I’m worried could lead to confusion for people.
The piece refers to “the ‘fight or flight’ glutamergic system” and how it generates panic, et cetera.
I’m concerned that people may read this as saying that the glutamergic system is the same as the “fight or flight” response, or that “fight or flight” is what the glutamergic system is about.
In which case, afterwards they’ll always have trouble understanding either “fight or flight” or the glutamergic system, when people talk about them. They’re different things, but they’re both important to understanding withdrawal symptoms.
What is usually referred to as the “fight or flight response” is a response to stress or trauma. It’s mediated by adrenal hormones (epinephrine, adrenaline, etc, that family of stuff.) It’s a normal response. It’s what you feel when you’re in an auto accident, or nearly miss being in an auto accident. Hormones pour into your bloodstream and cause all sorts of physical and endocrine and neurological changes. (When it’s mild, some people even like it, hence roller coasters.)
The glutamergic system is simply a neurotransmitter system–our most important one by far. Its worker bees are the neurotransmitters “glutamate” and “GABA.” Between them they’re responsible for the majority of conversations in our nervous systems anywhere in our brains and bodies.
This system is involved in everything we experience or do, both stuff that revs us up and stuff that calms us down and anything else.
Glutamate is called an “excitatory” neurotransmitter, but that’s not like “excitement” as we use the word in everyday conversation. It just means that glutamate enhances signals and multiplies them and sends more of them on down the line. It’s balanced by GABA, an “inhibitory” neurotransmitter. It doesn’t “inhibit” us or make us feel “inhibited,” it just stops signals and makes them smaller and keeps them from moving down the line.
If you imagine that glutamate is the “gas pedal” and GABA is the “brakes” of signal-sending in your nervous system, you can see why it’s definitely involved in the “fight or flight” response. But glutamate’s involved in everything–muscle coordination, the senses and sensations, keeping our heart beating, pain signals–a lot of other stuff.
And glutamate is usually downregulated by psych meds, so when you’re going through withdrawal, your GABA isn’t able to keep up with the inhibition aspect; hence “glutamergic disinhibition.” Glutamate Gone Wild. Fun stuff.
Okay. I hope that’s clear for people. I know a lot of people are searching desperately for information about psych med withdrawal and I’d hate to see them stumble over a simple misunderstanding like this–there’s a lot to learn and think about, and the more learning and thinking that happens, the better off we’ll all be.