Separation Distress PANIC and Social Bonding Affiliative Love Systems of the Brain

Every newborn mammal is socially dependent. Brain evolution has assured that parents (especially mothers) exhibit strong urges to take care of their offspring, which is suggestive of a basic affiliative-love system in the brain. Likewise, all infants have intrinsic emotional systems to facilitate care and attention when they are distressed.

One of the most distinct outputs of this care-soliciting system, quite easy to study in animal models, is crying or emission of separation calls when socially separated from caretakers. Based on the possibility that precipitous arousal of this circuitry, which courses between the PAG and more rostral brain areas (preoptic, septal, bed-nucleus of the stria terminalis, and anterior cingulate cortex) via medial thalamic corridors, may contribute to panic attacks, this system was originally designated the PANIC system (Panksepp, 1982). This and several other working hypotheses await empirical evaluation (Chapter 12).

A better neurobiological understanding of this circuitry is bound to have important implications for biological psychiatry. An enormous number of emotional disorders are related to feelings of social loss and deficits in the ability to relate socially (Schmidt and Schulkin, 1999). Indeed, the psychotherapeutic enterprise is a social process, and the sociophysiological aspects of brain organization are gradually being revealed (Carter et al., 1999, and Chapters 20 and 21).

The first neuroscience hypothesis concerning the neurochemical regulation of this system was based on the recognition that opioid-based social addictive processes may exist in the brain. Social dependence/bonding and persistent opiate use share three critical features: (1) an initial addiction, emotional attraction-euphoria, phase; (2) a spontaneously emerging tolerance-habituation process whereby the affective potency of narcotics diminishes, as does the power of certain social attractions, which may lead to weaning of the young and the breakup of established adult bonds (e.g., as in divorce); and (3) a robust withdrawal response arising from the severance of attachments. In short, opioids are very effective agents in reducing separation distress, partly by direct dampening of the emotional circuitry that promotes crying. Thus, one reason opiate addiction may be especially prevalent among emotionally distressed individuals is that they derive pleasure pharmacologically from brain systems that normally generate positive affect as a result of prosocial interactions.

It is now clear that brain oxytocin systems also promote the construction of social bonds (Carter et al., 1999; Insel, 1997; Nelson and Panksepp, 1998). Oxytocin is the most potent agent known to alleviate separation distress in animal models. Although this response is not dependent on opioid systems (as indicated by the fact that it is not naloxone reversible), oxytocin does tend to block the development of opiate tolerance (Kovacs et al., 1998). Thus, it remains possible that when oxytocin is released during social activities, as it is during nursing, a secondary benefit may be the maintenance of sensitivity in opioid-based social-reward activities within the brain.

One of the clearest neuropeptide facilitators of separation distress has been corti-cotrophin-releasing hormone (CRH). Whether such knowledge will lead to new drug development for the treatment of severe separation distress (e.g., CRH antagonists) remains to be seen (Chapter 21).

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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