Ecstasy and Depression: Risk Factor or Potential Cure


Ecstasy Popularity

After several years of falling popularity, ecstasy use has once again been increasing in clubs and on college campuses. As this recreational drug first appeared on the arena, it gained popularity fast among adolescents and young adults in the nightclub scene or dance parties known as “raves.” However, the profile of the typical ecstasy user has been changing now. The drug is widely used by all demographic groups because so many young people believe that ecstasy is a safe drug. A person may experience feelings of mental stimulation, emotional warmth, empathy towards others, a general sense of well-being and decreased anxiety.

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The reason ecstasy popularity has increased might be lying under its main traits, outlined above. The research made on the reasons of sudden increase in Ecstasy Popularity show that some people turn to it as a temporary means of escaping the problem. It is also been observed that young people have started taking the MDMA as a part of their lifestyle. Ecstasy popularity studies also shows that recently people have tendency to take ecstasy more than other drugs because, it has very few direct effects, almost all the effects are indirect and hence it is considered as harmless by many users.

Young adults are not aware that ecstasy can produce a variety of adverse health effects, including nausea, chills, sweating, involuntary teeth clenching, muscle cramping, blurred vision and, in some cases, death due to overdose. Ecstasy can affect the brain by altering the activity of chemical messengers, or neurotransmitters with symptoms such as high blood pressure, faintness, panic attacks, and in severe cases, a loss of consciousness and seizures.

In this publication, we will not review in details all negative effects on health and wellbeing, which ecstasy may cause to its consumers, but we will focus on the scientifically proven facts, that its use can lead to the severe consequences to the mental health, causing clinical depression.


What is Ecstasy?

Ecstasy is a slang or street name for Methylenedioxymethamphetamines (MDMA) It is a synthetic, psychoactive mind-altering drug with hallucinogenic and amphetamine (stimulant) like effects. It alters perception of time and distance.  MDMA was first developed in 1914 as an appetite suppressant or diet drug. It was a legal substance up until 1985. 

As Ecstasy was considered as a natural antidepressant, doctors used to prescribe it to the patients until it was banned by UN and USA. Prior to this ban, the MDMA was one of the main tools against depression, the doctors had. It was also widely used for treating post traumatic stress disorder.

MDMA/Ecstasy is produced in clandestine laboratories, and is seldom pure.  The amount in a capsule or tablet is likely to vary considerably, which could lead to overdoses.  Now, MDMA is under a Federal Drug Enforcement Administration (DEA) -- Schedule I Substance -- meaning that it has no medical use and high abuse potential. The Federal penalty for manufacturing or selling can lead to fines up to four million dollars.  A ringleader or head manufacturer could receive life in prison. 

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What does ecstasy do to the brain?
                    
Ecstasy works by stimulating the production of a brain chemical called serotonin, key in the regulation of mood and emotion. The rush you get comes from the release of much higher levels of serotonin than normal. But by artificially messing with this production process, some scientists believe users are diminishing their brain's ability to produce serotonin in the future.

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Mid-week Hangover

Ecstasy works by changing the way the brain produces and handles the neurotransmitter serotonin that, among other things, regulates your mood. 

"Experts agree that once the initial serotonin rush produced by the drug (the 'high') has passed, levels of serotonin in the brain will fall," says Ruth Goldsmith from the independent drug information and expertise centre DrugScope. "This seems to account for the 'mid-week hangover' or 'Tuesday blues'; the short period of depression experienced by many ecstasy users in the days following their use of the drug." 

There are several possible reasons why ecstasy my cause the short-term depression. MDMA works by releasing from certain brain cells large amounts of the brain chemical, serotonin. This release of serotonin is what causes Ecstasy’s mood elevation effect, as well as the feelings of empathy, self-acceptance, and emotional closeness with others that so many people find valuable and rewarding about the drug. But in releasing large amounts of serotonin, MDMA also depletes the brain’s supply. It then takes some time for the brain to replenish what was released. How long does it take for serotonin levels to be fully restored after someone takes Ecstasy? This depends on the individual’s diet, general heath, genetic make-up, how much ecstasy the person took, and other random factors. There’s no way to tell for sure, but based on animal studies, scientists say that it could take anywhere from 48 hours to an entire week. The mild depression some people feel after taking Ecstasy could be related to this temporary depletion of serotonin.

Somehow similar theory states, that the release of serotonin also causes serotonin receptors in the brain to down-regulate, which basically means turn themselves off for a while. The up-and-down regulation of receptors is one of the primary ways the brain tries to achieve homeostasis, or balance. These receptors work in conjunction with the amount of serotonin around and are just as important in the regulation of mood as serotonin itself. In trying to maintain a balanced mood, these receptors respond to the amount of serotonin around by turning themselves on and off (up-regulation and down-regulation). When they are flooded with serotonin as a result of taking Ecstasy, many of them down-regulate.

The majority of these receptors will up-regulate again as soon as the excess serotonin is metabolized away. However, some of these receptors may stay down-regulated longer, perhaps days, weeks, or even months. The depression some people feel after taking ecstasy may be a result of these serotonin receptors staying down-regulated too long. Whether, how much, or how often this happens may largely be a genetic factor unique to the individual.

Some people may simply be genetically pre-disposed towards Ecstasy-related depression. Some ecstasy users who experience depression might have been depressed before they started using ecstasy. Depression is a common illness that often goes undiagnosed and untreated. This is particularly true for teenagers and young adults who suffer from mild to moderate depression. It is likely that many compulsive ecstasy users are unconsciously trying to self-medicate their depression. However, ecstasy use may play unfavorable role in depression treatment, since by directly affecting serotonin, it may trigger getting your neurotransmitters out of balance, especially if they already were in the borderline condition.

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 Ecstasy and Clinical Depression

While danger of short-term mild depressive episodes has somewhat limited effect on mental wellbeing, the long-term consequences might be far more dangerous, and even disastrous.

Based on the study 2003 results in Britain, experts warned that the changes to the brain brought about by the drug leave a legacy of long-term mental health problems, including memory loss and lack of concentration. Psychologists have found that even those who gave up taking the drug several years ago scored higher on a depression rating than people who had never taken it.

A 2005 Cambridge University study discovered that people with a certain genetic make-up showed greater signs of depression after using the drug. The Cambridge team looked at the gene which controls serotonin transporters in the brain. Everybody has two copies of each gene, and there are two possible versions which people can carry, so they can either be classed as ll, ls or ss. They found that 60% of people who had the ss version were assessed as having at least mild depression after taking ecstasy, while non-drug users with the ss type displayed no such problems.

Similar results were received in 2006 during the three-year study conducted at the PET Center at Arhus Hospital in Denmark, showed the recreational drug caused depression in laboratory pigs. The scientists injected pigs with varying doses of Ecstasy to study the effect the drug has on the pigs' brains. The study has significant importance for humans as well, as pigs' brains are quite similar to human brains in many perspectives.

Controversial Studies

Recently, the Ecstasy positive and negative therapeutic effects came in light of the general community due to several researches, producing controversial results of weather ecstasy may cause the long-term brain damage or not.

There is no evidence that ecstasy causes brain damage, according to one of the largest studies into the effects of the drug. Too many previous studies made over-arching conclusions from insufficient data, say the scientists responsible for the research, and the drug's dangers have been greatly exaggerated. It was concluded that ecstasy has not been linked to damage to the central nervous system and no long-term changes to emotional states and behavior have been triggered by consumption of the drug.

The study was carried out by a team led by Professor John Halpern of Harvard Medical School and published in the journal Addiction February 2011. Many experts who have argued that the drug is relatively safe welcomed the new paper. "I always assumed that, when properly designed studies were carried out, we would find ecstasy does not cause brain damage," said Professor David Nutt, who was fired as chair of the Advisory Council on the Misuse of Drugs by Alan Johnson, then home secretary, for publicly stating alcohol and tobacco were more harmful than ecstasy.

Ronald Cowan, M.D., Ph.D., associate professor of Psychiatry in his report in the May 2011 issue of Neuropsychopharmacology opposes this viewpoint, insisting that recreational Ecstasy use is indeed associated with a chronic change in brain function. Cowan and his colleagues examined brain activation during visual stimulation, using functional magnetic resonance imaging (fMRI), in subjects who had previously used Ecstasy (but not in the two weeks prior to imaging) and in subjects who had not previously used Ecstasy. They found increased brain activation in three brain areas associated with visual processing in Ecstasy users with the highest lifetime exposure to the drug. The findings were consistent with the investigators' predictions based on results from animal models: that Ecstasy use is associated with a loss of serotonin signaling, which leads to hyper-excitability (increased activation) in the brain. The hyper-excitability suggests a loss in brain efficiency, Cowan said, "meaning that it takes more brain area to process information or perform a task." The investigators found that this shift in brain excitability did not return to normal in subjects who had not used Ecstasy in more than a year.

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Summary

While I am not expert on the topic, based on the various resources, available on the Web, I can conclude that both proponents and opponents of Ecstasy have their valid points, but research results are still inconclusive to choose side. There are multiple studies and clinical ongoing trials, trying to bring the positive effects of the drug to the safe medicine (for PTSD, depression, and cancer treatment) in Europe, Israel, and USA, but there is still a long way to go, and the resulting drugs might be substantially modified by the scientists from the state as you may take it now.

For those, who use ecstasy as recreational drug on regular basis, I have one question to ask: Are you ready to jeopardize your health for short-term positive emotional effect, if there is a chance that it may cause your mental destabilization on long run? Think about that, before you take next pill.

In any case, there are safer alternatives, as marijuana, for example...  


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