Season 2 - Episode 5

Helpful Links

This podcast was inspired by the National Alliance on Mental Illness (NAMI). This is the nation's largest grassroots mental health organization. They have 650 chapters across the country. This organization is dedicated to improving the lives of millions of Americans affected by mental illness. This organization provides a national network of support and resources, both online and in communities across the country such as the call line, text line, and crisis support line. If you would like to donate or get involved click the link:

 https://www.nami.org/get-involved/donate-to-nami/⁠

For mental health support call 1-800-950-6264, Text “helpline” to 62640, Crisis Line (Call or Text) 988.

Transcript for the Podcast

Transcript: Hello, welcome to Mirroring Medicine! This episode will be covering Autism Spectrum Disorder and Schizophrenia. These conditions are very different but they are extremely fascinating and highlight the nuance of neurodivergency that exists in the human population. Individuals with autism and schizophrenia respectively have varying degrees of life impairment and these mental conditions manifest in different ways. This podcast provides a brief overview of these conditions, however we recommend researching them further. If you or someone you know may have these conditions please refer to a psychiatrist or clinical psychologist for further assistance.

So, firstly I would like to talk about molecular neurobiology and neurobiology on a cellular level. Neurobiology, neuroscience, and neuroanatomy are the studies of the brain as a whole including its biological functions, its physiology, and what corresponding properties each part of the brain has.On a cellular level, we have individual brain cells called neurons in which transmit electrical signals down these cells to propagate all along the body through “action potentials.” These action potentials are signals in which electrical signals are transmitted from neuron to neuron. Action potentials are signaled from release through surpassing the threshold in which these ionic differences allow for something called depolarization, in which sodium ions enter the cell. After this threshold is reached, this all-or-nothing signal is then reached to the top through more sodium ions entering before coming to an inactivation, after this the potassium ions go out of the cell allowing for repolarization, and then hyperpolarization effectively returning the neuron back in its normal state. This depolarization or repolarization or even hyperpolarization could come from neurotransmitters. 

Neurotransmitters like dopamine, serotonin, acetylcholine, GABA, glutamate, serve as signals that bind to the neuron later or post-synaptically in which it signals a cascade to allow for depolarization or the opposite. Specific conditions may include disfunctions in the release, synthesis, or binding of these neurotransmitters which include Parkinson’s or Alzheimer’s disease. These diseases respectively have abnormalities in the neurotransmitter mechanism of action in dopamine and acetylcholine. 

Additionally, with more action potentials and/or neurotransmitter release for a particular action, memory, or practice, these synapses can become stronger or weaker. So do you know the term “practice makes perfect” it’s because synapses grow more dendrites when we use that particular skill, action, or memory and synapses can decrease the dendrites that release a particular neurotransmitter when not using a particular skill. So this is in part the reason for why we can forget certain things or we can get better at stuff with more practice. 

However in neurodiverse conditions, this may be altered in the way that people may be biologically predispositioned to have less propensity of one skill or even more propensity of other skills. But we can think of this population that we live in as neurodiverse, as no one person thinks in the same mindset or has the same lived experiences in which they could replicate thinking. 

With this being said, I want to set the scene. Imagine you are at a prestigious school, there are some cliques and there are some loners. You try making friends with everybody of course because you are a kind and thoughtful person. And you join this club, like say a volunteer at a dog shelter. Say you meet this person named Michael. Michael acts just like everybody else, however he struggles to fit in communicating with others and engages with things that make him comfortable. He is in his safe spot when he is petting the dogs and getting to know the other animals. 

So what is the point that I am trying to make here? Autism spectrum disorder, while contrary to popular belief, is not usually obvious to point out, because there are different strengths that people with autism have, and not all autistic people have the same look or symptoms. Approximately 1 in 36 children and 1 in 45 adults in the united states today have autism according to the CDC [4]. Autism may arise in people that can speak, are nonverbal, or minimally verbal. Intellectual uniqueness may occur, support may be needed, or some are entirely independent. Contrary to popular belief, did you know a strong misconception about autism that people still have, is that vaccines give people autism. However this is not the case. Genetics play a huge role in autism. This is because rett syndrome or fragile X syndrome are associated genetic conditions that may be linked to autism according to the mayo clinic [5]. Environmental factors can play a role like infections, complications during pregnancy, or air pollutants may cause this problem as well. According to the mayo clinic, these are some symptoms that an autistic person may exhibit: 

• Fails to respond to his or her name or appears not to hear you at times

• Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world

• Has poor eye contact and lacks facial expression

• Doesn't speak or has delayed speech, or loses previous ability to say words or sentences

• Can't start a conversation or keep one going, or only starts one to make requests or label items

• Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech

• Repeats words or phrases verbatim, but doesn't understand how to use them

• Doesn't appear to understand simple questions or directions

• Doesn't express emotions or feelings and appears unaware of others' feelings

• Doesn't point at or bring objects to share interest

• Inappropriately approaches a social interaction by being passive, aggressive or disruptive

• Has difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice

Additionally, there are some methods that could help integrate people with autism within society for those who want to develop the skills to acclimatize to society which is ABA or applied behavioral analysis which helps people learn and sublimate behaviors using positive reinforcement and can create the tools for which one can become more independent and more communicative with others. 

Organization: This podcast was inspired by the National Alliance on Mental Illness (NAMI). This is the nation's largest grassroots mental health organization. They have 650 chapters across the country. This organization is dedicated to improving the lives of millions of Americans affected by mental illness. This organization provides a national network of support and resources, both online and in communities across the country such as the call line, text line, and crisis support line.

Which we will include in our shownote captions.

If you would like to donate or get involved click the link in the caption.

https://www.nami.org/get-involved/donate-to-nami/

Schizophrenia

We will now shift gears to discuss another common mental health condition: schizophrenia. According to the National Institute of Mental Health (NIMH), schizophrenia is characterized by disruptions in thought processes, perceptions, emotional responsiveness, and social interactions [1]. It is important to note that schizophrenia is not a one-size-fits-all condition. The disorder encompasses a wide range of symptoms, but not everyone with schizophrenia experiences all of them.

We can further categorize these symptoms as positive and negative:

Positive symptoms are symptoms that are “new” symptoms that one gains during the onset and progression of illness. These include:

• Delusions which are false beliefs about the world, others, or yourself. I was to specify that these beliefs are often not shakable, meaning that if you provide them proof they will not be able to lose the delusion.

• Hallucinations. These are seeing, hearing, feeling, smelling or tasting something that is not actually there. 

• Disorganized Speech which includes being unable to follow or understand what that individual is saying because of the disorganization of it.

• Disorganized Behavior is behaviour that does not make sense. This could include laughing during a serious conversation, not being able to care for oneself such as hygiene, and not responding to the environment [2].

Negative symptoms of schizophrenia are symptoms that are lost during the onset and progression of the disease. 

• Blunted emotion

• Avolition: a lack a motivation and loss of interest

• Lack of Speech

• Loss of Enjoyment

• Other symptoms that do not fall in these categories are [2]:

• depression

• anxiety

• suicidal thoughts or behaviors

• alcohol and/or other drug use problems

• difficulties functioning

• sleep disturbance – for example staying up all night

• cognitive problems such as difficulties with memory, concentration, reasoning, etc.

What is known about the cause of this condition?

At this time, the cause of this condition is unknown. It is known that there are genetic predispositions to this condition and well as environmental triggers that could increase the manifestation of this condition. 

The incidence of the condition is less than 1% in the U.S. When looking at household-based survey samples, clinical diagnostic interviews, and medical records, estimates of the prevalence of schizophrenia and related psychotic disorders in the U.S. range between 0.25% and 0.64%.

I wanted to also concisely discuss a recent randomized analysis that has contributed to the research of schizophrenia. The research is titled “Targeting the gut microbiota-inflammation-brain axis as a potential therapeutic strategy for psychiatric disorders: A Mendelian randomization analysis.” Researchers in this study looked at data from the largest genome-wide association study for the gut microbiota that looked at 18,340 people in conjunction with the 36,989 genomes of individuals with schizophrenia from Psychiatric Genomics Consortium (PGC).

The methodology of this study goes as follows:

This is a bidirectional analysis, meaning that this is looking at whether microbiota-inflammation-brain axis correlates to psychiatric disorders and if psychiatric disorders correlate to microbiota-inflammation-brain axis. 

So how do they do this? Through genomic analysis computational models identify single nucleotide polymorphisms, or SNPs.

A SNP is the most common genetic variation that exists between humans. A gene is a sequence of nucleotides that make us who we are, and all of our anatomy and physiology. But when one nucleotide is altered at a specific position this is called a SNPs. Like all genetic variation that allows humans to have different phenotypes, or qualities SNPs could be beneficial, harmful, or do nothing at all.

In short, this study is looking at whether a third variable inflammation is affecting the gut microbiome and psychiatric disorder. In recent history there has been evidence to suggest that the gut microbiome has a large effect on immune response and that elevated chronic inflammation is linked to mental health conditions, such as schizophrenia. 

This study found 15 gut microbiota that were suggested to be correlated with schizophrenia and the microbiota-inflammation-brain axis. 

Citations

1. National Institute of Mental Health (NIMH). “Schizophrenia.” National Institute of Mental Health, ⁠https://www.nimh.nih.gov/health/statistics/schizophrenia#:~:text=Schizophrenia-,Definition,be%20both%20severe%20and%20disabling⁠. Accessed 5 Mar. 2025.

2. "Symptoms of Psychosis." Early Psychosis Intervention Program, ⁠https://www.earlypsychosis.ca/symptoms-of-psychosis/⁠. Accessed 5 Mar. 2025.

3. Wu, Wenjing, et al. “Targeting the Gut Microbiota-Inflammation-Brain Axis as a Potential Therapeutic Strategy for Psychiatric Disorders: A Mendelian Randomization Analysis.” Journal of Affective Disorders, vol. 374, 2025, pp. 150-159. ScienceDirect, ⁠https://doi.org/10.1016/j.jad.2025.01.050⁠.

4. "What Is Autism?" Autism Speaks, ⁠https://www.autismspeaks.org/what-autism⁠. Accessed 5 Mar. 2025.

5. "Autism Spectrum Disorder – Symptoms and Causes." Mayo Clinic, ⁠https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928⁠. Accessed 5 Mar. 2025.