NZ Herald
  • Home
  • Latest news
  • Video
  • New Zealand
  • Sport
  • World
  • Business
  • Entertainment
  • Podcasts
  • Quizzes
  • Opinion
  • Lifestyle
  • Travel
  • Viva
  • Weather forecasts

Subscriptions

  • Herald Premium
  • Viva Premium
  • The Listener
  • BusinessDesk

Sections

  • Latest news
  • New Zealand
    • All New Zealand
    • Crime
    • Politics
    • Education
    • Open Justice
    • Scam Update
  • Budget 2025
  • On The Up
  • World
    • All World
    • Australia
    • Asia
    • UK
    • United States
    • Middle East
    • Europe
    • Pacific
  • Business
    • All Business
    • MarketsSharesCurrencyCommoditiesStock TakesCrypto
    • Markets with Madison
    • Media Insider
    • Business analysis
    • Personal financeKiwiSaverInterest ratesTaxInvestment
    • EconomyInflationGDPOfficial cash rateEmployment
    • Small business
    • Business reportsMood of the BoardroomProject AucklandSustainable business and financeCapital markets reportAgribusiness reportInfrastructure reportDynamic business
    • Deloitte Top 200 Awards
    • CompaniesAged CareAgribusinessAirlinesBanking and financeConstructionEnergyFreight and logisticsHealthcareManufacturingMedia and MarketingRetailTelecommunicationsTourism
  • Opinion
    • All Opinion
    • Analysis
    • Editorials
    • Business analysis
    • Premium opinion
    • Letters to the editor
  • Sport
    • All Sport
    • OlympicsParalympics
    • RugbySuper RugbyNPCAll BlacksBlack FernsRugby sevensSchool rugby
    • CricketBlack CapsWhite Ferns
    • Racing
    • NetballSilver Ferns
    • LeagueWarriorsNRL
    • FootballWellington PhoenixAuckland FCAll WhitesFootball FernsEnglish Premier League
    • GolfNZ Open
    • MotorsportFormula 1
    • Boxing
    • UFC
    • BasketballNBABreakersTall BlacksTall Ferns
    • Tennis
    • Cycling
    • Athletics
    • SailingAmerica's CupSailGP
    • Rowing
  • Lifestyle
    • All Lifestyle
    • Viva - Food, fashion & beauty
    • Society Insider
    • Royals
    • Sex & relationships
    • Food & drinkRecipesRecipe collectionsRestaurant reviewsRestaurant bookings
    • Health & wellbeing
    • Fashion & beauty
    • Pets & animals
    • The Selection - Shop the trendsShop fashionShop beautyShop entertainmentShop giftsShop home & living
    • Milford's Investing Place
  • Entertainment
    • All Entertainment
    • TV
    • MoviesMovie reviews
    • MusicMusic reviews
    • BooksBook reviews
    • Culture
    • ReviewsBook reviewsMovie reviewsMusic reviewsRestaurant reviews
  • Travel
    • All Travel
    • News
    • New ZealandNorthlandAucklandWellingtonCanterburyOtago / QueenstownNelson-TasmanBest NZ beaches
    • International travelAustraliaPacific IslandsEuropeUKUSAAfricaAsia
    • Rail holidays
    • Cruise holidays
    • Ski holidays
    • Luxury travel
    • Adventure travel
  • Kāhu Māori news
  • Environment
    • All Environment
    • Our Green Future
  • Talanoa Pacific news
  • Property
    • All Property
    • Property Insider
    • Interest rates tracker
    • Residential property listings
    • Commercial property listings
  • Health
  • Technology
    • All Technology
    • AI
    • Social media
  • Rural
    • All Rural
    • Dairy farming
    • Sheep & beef farming
    • Horticulture
    • Animal health
    • Rural business
    • Rural life
    • Rural technology
    • Opinion
    • Audio & podcasts
  • Weather forecasts
    • All Weather forecasts
    • Kaitaia
    • Whangārei
    • Dargaville
    • Auckland
    • Thames
    • Tauranga
    • Hamilton
    • Whakatāne
    • Rotorua
    • Tokoroa
    • Te Kuiti
    • Taumaranui
    • Taupō
    • Gisborne
    • New Plymouth
    • Napier
    • Hastings
    • Dannevirke
    • Whanganui
    • Palmerston North
    • Levin
    • Paraparaumu
    • Masterton
    • Wellington
    • Motueka
    • Nelson
    • Blenheim
    • Westport
    • Reefton
    • Kaikōura
    • Greymouth
    • Hokitika
    • Christchurch
    • Ashburton
    • Timaru
    • Wānaka
    • Oamaru
    • Queenstown
    • Dunedin
    • Gore
    • Invercargill
  • Meet the journalists
  • Promotions & competitions
  • OneRoof property listings
  • Driven car news

Puzzles & Quizzes

  • Puzzles
    • All Puzzles
    • Sudoku
    • Code Cracker
    • Crosswords
    • Cryptic crossword
    • Wordsearch
  • Quizzes
    • All Quizzes
    • Morning quiz
    • Afternoon quiz
    • Sports quiz

Regions

  • Northland
    • All Northland
    • Far North
    • Kaitaia
    • Kerikeri
    • Kaikohe
    • Bay of Islands
    • Whangarei
    • Dargaville
    • Kaipara
    • Mangawhai
  • Auckland
  • Waikato
    • All Waikato
    • Hamilton
    • Coromandel & Hauraki
    • Matamata & Piako
    • Cambridge
    • Te Awamutu
    • Tokoroa & South Waikato
    • Taupō & Tūrangi
  • Bay of Plenty
    • All Bay of Plenty
    • Katikati
    • Tauranga
    • Mount Maunganui
    • Pāpāmoa
    • Te Puke
    • Whakatāne
  • Rotorua
  • Hawke's Bay
    • All Hawke's Bay
    • Napier
    • Hastings
    • Havelock North
    • Central Hawke's Bay
    • Wairoa
  • Taranaki
    • All Taranaki
    • Stratford
    • New Plymouth
    • Hāwera
  • Manawatū - Whanganui
    • All Manawatū - Whanganui
    • Whanganui
    • Palmerston North
    • Manawatū
    • Tararua
    • Horowhenua
  • Wellington
    • All Wellington
    • Kapiti
    • Wairarapa
    • Upper Hutt
    • Lower Hutt
  • Nelson & Tasman
    • All Nelson & Tasman
    • Motueka
    • Nelson
    • Tasman
  • Marlborough
  • West Coast
  • Canterbury
    • All Canterbury
    • Kaikōura
    • Christchurch
    • Ashburton
    • Timaru
  • Otago
    • All Otago
    • Oamaru
    • Dunedin
    • Balclutha
    • Alexandra
    • Queenstown
    • Wanaka
  • Southland
    • All Southland
    • Invercargill
    • Gore
    • Stewart Island
  • Gisborne

Media

  • Video
    • All Video
    • NZ news video
    • Business news video
    • Politics news video
    • Sport video
    • World news video
    • Lifestyle video
    • Entertainment video
    • Travel video
    • Markets with Madison
    • Kea Kids news
  • Podcasts
    • All Podcasts
    • The Front Page
    • On the Tiles
    • Ask me Anything
    • The Little Things
    • Cooking the Books
  • Cartoons
  • Photo galleries
  • Today's Paper - E-editions
  • Photo sales
  • Classifieds

NZME Network

  • Advertise with NZME
  • OneRoof
  • Driven Car Guide
  • BusinessDesk
  • Newstalk ZB
  • What the Actual
  • Sunlive
  • ZM
  • The Hits
  • Coast
  • Radio Hauraki
  • The Alternative Commentary Collective
  • Gold
  • Flava
  • iHeart Radio
  • Hokonui
  • Radio Wanaka
  • iHeartCountry New Zealand
  • Restaurant Hub
  • NZME Events

SubscribeSign In
Advertisement
Advertise with NZME.
Home / Lifestyle

Trying to understand why some brains become haunted

By Aleszu Bajak
Washington Post·
16 Sep, 2015 01:16 AM7 mins to read

Subscribe to listen

Access to Herald Premium articles require a Premium subscription. Subscribe now to listen.
Already a subscriber?  Sign in here

Listening to articles is free for open-access content—explore other articles or learn more about text-to-speech.
‌
Save

    Share this article

When we make emotional decisions, a flurry of activity shoots through the brain, setting off a cascade of impulses that control our mood. Photo / iStock
When we make emotional decisions, a flurry of activity shoots through the brain, setting off a cascade of impulses that control our mood. Photo / iStock

When we make emotional decisions, a flurry of activity shoots through the brain, setting off a cascade of impulses that control our mood. Photo / iStock

"I hate myself, and my brain," Pam Tusiani wrote in her journal while under 24-hour watch on the fourth-floor psychiatric ward of Baltimore's Johns Hopkins Hospital.

"Nothing is worse than this disease."

When Tusiani wrote those words in 1998, doctors had little understanding of the disorder that was troubling her, and all these years later they have little more.

Trying to understand how the illness works - in hopes of finding a cure - strikes at the heart of psychiatry, indeed medicine in general. How does one replicate at the basic research level what one sees in a patient? How do you find the chemical root of a disease, especially one as complex and multifaceted as borderline personality disorder, or BPD?

Just as a smile takes dozens of facial muscles to execute, a particular emotional response to a stimulus requires a web of brain activity. The brain isn't a series of one-way streets. It's a hive of superhighways, and we can barely make out the cars, much less figure out where they came from, where they're headed, what they're carrying and why they're on the road. We barely understand a healthy brain, so how are we to understand one haunted by psychoses?

Advertisement
Advertise with NZME.
Advertisement
Advertise with NZME.

Some days Tusiani, a New Yorker who was attending Loyola University in Baltimore when she was hospitalised, would cut herself, usually on the arms and hands, not so much to inflict pain but rather to relieve inner turmoil. "Bleeding enough that I felt good," she wrote. One day she'd be curled up in the foetal position, unable to eat or speak; the next, she'd be pacing her house, berating anyone within reach and seeking drugs and alcohol - or a razor - for relief.

Hers is an all-too-familiar story in patients with BPD, a psychiatric syndrome that has gained recognition only in recent decades and that affects as many as 16 million Americans. What was once thought to be the result of child abuse or a manifestation of post-traumatic stress is now its own complex personality disorder. And it's deadly.

The suicide rate is higher for people with BPD than for those with major depression and schizophrenia; about 4 to 9 percent kill themselves. BPD is a tangle of psychiatric symptoms such as intense mood swings, anorexia and bulimia, drug abuse, suicidal thoughts and self-injury. And because it presents itself as a kaleidoscope of symptoms, it is frequently misdiagnosed.

Advertisement
Advertise with NZME.

For years, Tusiani was checked into and out of hospitals, family therapy sessions and meetings of Alcoholics Anonymous and Narcotics Anonymous. She was on a laundry list of medication: Klonopin for seizures, Ambien and Ativan to help her sleep, Xanax for anxiety. She also went through a lineup of antidepressants: nortiptyline, lithium, Zoloft, trazodone, Wellbutrin, Effexor, Prozac, Serzone, Paxil and Parnate. None could stabilise her condition. The young woman -- and her family -- were exhausted and confused by the barrage of treatments and medications. How were they supposed to cope with her nightmarish outbursts, her self-mutilation and suicide attempts, her destructive behavior?

Pam Tusiani died in 2001 at age 23 from a severe reaction to Parnate, the last in a long line of antidepressants she had been prescribed. Her parents, Bea and Michael Tusiani, were left traumatised, stunned by the drug's fatal side effects and horrified at the medical malpractice they uncovered: The treatment centre their daughter had been using was providing medical care without a license.

Despite their loss, they haven't lost hope for a cure. Using the settlement from their malpractice suit, the Tusianis started the Borderline Personality Disorder Resource Center at New York Presbyterian Hospital in 2003. And lately they've been courting researchers, hoping to drum up attention to the disease that took their daughter.

In July, the Tusianis hosted some of New York's top neuroscientists and psychiatrists at a day-long event to review the latest science on BPD and devise new avenues for research. The meeting, held at the Columbus Citizens Foundation on Manhattan's Upper East Side, opened with a plea from Pam's family for more research on the disease.

Discover more

Lifestyle

New app can predict suicide risk with startling accuracy - study

19 Aug 09:35 PM
Opinion

Seven warning signs you're in a dangerous relationship

20 Aug 10:10 PM
Lifestyle

Have our devices given us 'butterfly brain'?

21 Aug 10:30 PM
Lifestyle

60,000 Kiwis suffer from dementia

25 Aug 08:41 AM

More than two dozen scientists and clinicians hailing from Columbia University, Weill Cornell Medical College, Mount Sinai Hospital and New York University discussed the latest studies -- including research in mice and imaging of the human brain. They outlined neurobiological, behavioural and clinical directions that should be taken to improve psychiatry's understanding of the syndrome and perhaps yield novel treatments.

What causes BPD?

The scientists meeting in New York grappled with what clues they should be looking for in children and adolescents. "The real directions that we need to take are doing more longitudinal studies with at-risk individuals at a young age," said Antonia New, a professor of psychiatry at Mount Sinai who studies the neurobiology of BPD.

Within the oak-paneled walls of the Columbus Club, New and her colleagues debated how best to study emotion and cognition in the young. Is there a step in the development of a child's or adolescent's brain that is interrupted or exaggerated before the onset of BPD? How do we find it?

When we make emotional decisions, a flurry of activity shoots through the brain, setting off a cascade of impulses that control our mood, how we regulate our aggression, how we empathize. These reactions to such impulses are all altered in a person with borderline personality disorder.

For Pam Tusiani, a simple "no" from her mother or friends would result in severe feelings of rejection and abandonment. In other settings, a trivial remark would set off a raging tantrum. To illuminate the regions of the brain involved in regulating these emotions, BPD researchers are focusing on regions responsible for emotional and cognitive function - in particular, the amygdala. Imaging this part of the brain has shown that BPD patients have an overactive amygdala, meaning the "fight or flight" centre is kicked into overdrive, provoking stress, anxiety and fear faster and more easily than in other people.

Using functional magnetic resonance imaging (fMRI), which measures brain activity by tracking blood flow, researchers have shown that people with BPD experience abnormal connectivity between the amygdala and other regions of the brain than other people do. Even the most normal of stimuli -- looking at a photo of a serene scene in nature or a simple facial expression -- sometimes generated intense, long-lasting emotional reactions in patients with BPD. Their amygdala, it seemed, was overreacting.

Advertisement
Advertise with NZME.

Employing another brain imaging technology -- positron emission tomography (PET), which uses a radioactive tracer to examine tissue function and metabolism -- New has shown that BPD patients have abnormalities in the connections forged between the amygdala and other structures.

"It's not a question of an untethered amygdala," Daniel Salzman, a neuroscientist at Columbia University, explained at the conference. "We need to understand the intricate neurocircuitry that's mediating complex interactions between emotions and thoughts," said Salzman, who studies emotional processing in monkeys and mice. He contended that research should be focused on the level of a single cell rather than at a brain region as large as the amygdala. "If you can't get down to the single cell in animal models, you're not going to prove things at a mechanistic level."

But finding the precise neurotransmitters and chemical pathways responsible for a dysfunctional amygdala is a leap that science has not yet made. Only after making that leap will medicine begin to develop the cure the Tusianis are hoping for. Meanwhile, psychiatry will continue playing clinical whack-a-mole to control BPD symptoms.

"We have no medications to treat these patients," Barbara Stanley, a professor of medical psychology in psychiatry at Columbia University, said with a sigh. "We only have medications that treat individual symptoms, make them feel like junk and only give them partial relief."

Save

    Share this article

Latest from Lifestyle

Lifestyle

'Charlie bit my finger' star shares glimpse into life as viral video turns 18

22 May 03:08 AM
New Zealand

$20k triumph: How Taniwha Chasers captivated judges at portrait awards

22 May 01:55 AM
Lifestyle

McDonald's nugget claims scrutinised after viral marketing reveal

22 May 12:16 AM

Sponsored: How much is too much?

sponsored
Advertisement
Advertise with NZME.
Recommended for you
 The world’s best hotels for book lovers
Travel

The world’s best hotels for book lovers

22 May 07:00 AM
'Most vulnerable are invisible': Northland leaders give Budget 2025 mixed reviews
Northern Advocate

'Most vulnerable are invisible': Northland leaders give Budget 2025 mixed reviews

22 May 06:59 AM
How Manu Vatuvei is rebuilding his life after prison and drug scandal
New Zealand

How Manu Vatuvei is rebuilding his life after prison and drug scandal

22 May 06:51 AM
'Harder on the younger generation': Will Budget changes push Kiwis overseas?
New Zealand

'Harder on the younger generation': Will Budget changes push Kiwis overseas?

22 May 06:40 AM
Inside the mushroom mystery: Key evidence in triple-murder trial
World

Inside the mushroom mystery: Key evidence in triple-murder trial

22 May 06:10 AM

Latest from Lifestyle

'Charlie bit my finger' star shares glimpse into life as viral video turns 18

'Charlie bit my finger' star shares glimpse into life as viral video turns 18

22 May 03:08 AM

Charlie Davies-Carr is now 19, studies law and hasn't bitten any fingers 'in a long time'.

$20k triumph: How Taniwha Chasers captivated judges at portrait awards

$20k triumph: How Taniwha Chasers captivated judges at portrait awards

22 May 01:55 AM
McDonald's nugget claims scrutinised after viral marketing reveal

McDonald's nugget claims scrutinised after viral marketing reveal

22 May 12:16 AM
Premium
'King of fruits': How healthy are mangoes really?

'King of fruits': How healthy are mangoes really?

21 May 11:00 PM
Sponsored: Cosy up to colour all year
sponsored

Sponsored: Cosy up to colour all year

NZ Herald
  • About NZ Herald
  • Meet the journalists
  • Newsletters
  • Classifieds
  • Help & support
  • Contact us
  • House rules
  • Privacy Policy
  • Terms of use
  • Competition terms & conditions
  • Our use of AI
Subscriber Services
  • NZ Herald e-editions
  • Daily puzzles & quizzes
  • Manage your digital subscription
  • Manage your print subscription
  • Subscribe to the NZ Herald newspaper
  • Subscribe to Herald Premium
  • Gift a subscription
  • Subscriber FAQs
  • Subscription terms & conditions
  • Promotions and subscriber benefits
NZME Network
  • The New Zealand Herald
  • The Northland Age
  • The Northern Advocate
  • Waikato Herald
  • Bay of Plenty Times
  • Rotorua Daily Post
  • Hawke's Bay Today
  • Whanganui Chronicle
  • Viva
  • NZ Listener
  • What the Actual
  • Newstalk ZB
  • BusinessDesk
  • OneRoof
  • Driven CarGuide
  • iHeart Radio
  • Restaurant Hub
NZME
  • About NZME
  • NZME careers
  • Advertise with NZME
  • Digital self-service advertising
  • Book your classified ad
  • Photo sales
  • NZME Events
  • © Copyright 2025 NZME Publishing Limited
TOP
search by queryly Advanced Search