Lamotrigine? and memory
Memory doesn’t always serve us faithfully. It fails in ways that reveal the complexity and fragility of the mind, turning from reliable guide to a trickster, reshaping reality into something that never quite was. Memory’s failures emerge through gaps, distortions, and reconfigurations, not as mere lapses but as fundamental alterations in how we recall and reconstruct the past.
Emotions have a profound effect on how we perceive and interpret the world, often distorting our experiences and reshaping reality. This distortion can occur through several mechanisms, transforming our thoughts, memories, and sensory perceptions.
Bias distorts perception by altering the way we interpret information, often unconsciously, leading us to see the world through a subjective lens. These distortions shape how we perceive reality, impacting our decisions, judgments, and interactions with others. Bias operates in subtle and complex ways, and here’s how it distorts various aspects of perception:
At the core of bias distortion is confirmation bias, the tendency to seek out and prioritize information that confirms our pre-existing beliefs, while dismissing or ignoring contradictory evidence. This bias acts as a filter through which we view the world, reinforcing what we already think and feel, rather than allowing new, conflicting information to reshape our understanding. For example, if someone strongly believes in a particular political ideology, they are more likely to focus on news or data that supports their viewpoint, interpreting neutral events in a way that aligns with their belief system. This selective attention creates a skewed version of reality, where opposing facts are minimized or discredited, solidifying personal convictions regardless of broader evidence.
Another powerful form of bias is availability bias, where we rely on immediate examples that come to mind when making judgments or decisions. This bias leads us to overestimate the likelihood of events based on how easily we can recall them. For instance, after hearing about a plane crash on the news, a person might suddenly believe that air travel is much more dangerous than it statistically is, simply because the vividness of the event makes it seem more frequent. The emotional impact of easily remembered events distorts our perception of reality, leading us to believe that rare occurrences are more common than they are.
Anchoring bias is another distortion where people rely heavily on the first piece of information they receive—whether it’s accurate or not—when making subsequent judgments. This bias can distort decision-making in negotiations, pricing, or problem-solving. For example, if a person is told that a product originally costs $500, but they are now offered a price of $300, they might perceive it as a great deal, even if the product is only worth $200. The initial anchor, in this case, distorts their perception of value.
Stereotyping represents a bias that distorts how we perceive people and social groups. When we rely on generalized beliefs about a group—whether racial, gender-based, or related to occupation—we distort our perception of individuals from that group. Stereotypes simplify complex realities into digestible categories, but in doing so, they strip away nuance and individual differences. This bias can lead to unfair assumptions or judgments that don’t reflect reality, as we interpret people’s behaviors and traits through the narrow lens of preconceived ideas.
Hindsight bias distorts our perception of past events, leading us to believe that outcomes were more predictable than they actually were. This bias gives us the false sense that we "knew it all along," when in reality, events were far more uncertain. For instance, after a sports game, fans often claim they knew which team would win, despite any prior uncertainty. This distortion affects learning, as it reduces our ability to accurately assess what we did and didn’t know before an event, limiting our understanding of risk and probability.
Optimism bias is a distortion where individuals believe they are less likely to experience negative events compared to others. This bias can skew perception in a way that makes people underestimate risks, whether it’s related to health, financial decisions, or personal safety. For example, a person might acknowledge the risks of smoking but convince themselves that they personally won’t suffer from its harmful effects. This bias distorts reality by painting a rosier picture than facts or statistics would suggest.
In everyday life, biases warp our perception of reality, leading to judgments that are not rooted in objective truth. Whether it’s confirmation bias strengthening pre-existing beliefs, availability bias exaggerating the frequency of dramatic events, or optimism bias downplaying personal risk, each form of bias alters the lens through which we view the world. These biases work quietly, often without conscious awareness, reinforcing a version of reality that fits more comfortably with our expectations, fears, and desires.
At its core, emotions act as filters that colour perception. When we are experiencing strong emotions—fear, anger, happiness, or sadness—these emotional states prioritize certain stimuli while muting others. A person in a state of fear, for example, may interpret ambiguous stimuli as threatening, their mind scanning for danger in every shadow, every sound. This is because fear triggers heightened awareness, amplifying sensory inputs related to potential threats while suppressing more neutral information. This hyper-vigilance is an evolutionary response designed to help us survive, but it distorts perception by exaggerating risks and minimizing the mundane.
Happiness and sadness work similarly, though in different directions. In a positive emotional state, people tend to overlook negative details, focusing instead on the aspects of a situation that reinforce their mood. This phenomenon, often called the "rosy retrospection effect," explains why people remember past experiences as more positive than they might have felt at the time. On the other hand, sadness sharpens the opposite focus, drawing attention to negative details and diminishing the importance of positive ones. This selective attention skews reality, making a balanced view of situations difficult when strong emotions are involved.
Emotions also distort time perception. When we are excited or fearful, time may seem to slow down, as our brains process more sensory information per second. This happens because the amygdala, the brain's emotional processing center, kicks into overdrive during heightened emotional states, making every moment feel more intense and prolonged. Conversely, in neutral or pleasant states, time tends to pass more quickly because we process sensory information more leisurely.
Memory is another domain where emotions distort perception. Emotional memories are encoded more deeply and vividly than neutral ones, a process driven by the amygdala’s interactions with the hippocampus, the part of the brain responsible for memory formation. However, these emotionally charged memories are not necessarily accurate. They tend to emphasize the emotional elements of the experience while distorting or omitting other details. For example, a traumatic event may be remembered in extreme clarity for certain aspects—like sights or sounds associated with the trauma—while other parts of the event fade or warp. Over time, as the memory is recalled, it can be reshaped by current emotional states, becoming exaggerated or altered based on how the person feels when they remember it.
Anger distorts perception by narrowing focus. In an angry state, the mind becomes fixated on the perceived source of the anger, often leading to an overestimation of the other party’s fault or intent. This tunnel vision limits the ability to see nuance or understand the situation from a broader perspective. Anger simplifies complex situations, reducing them to black-and-white narratives where the angry person is wronged and the other party is at fault, regardless of any mitigating circumstances.
Emotions like anxiety work similarly, especially by distorting risk assessment. In an anxious state, a person might perceive a relatively benign situation as catastrophic, interpreting minor problems as insurmountable challenges. This is partly due to the brain’s focus on worst-case scenarios during anxiety, which crowds out more balanced or rational thoughts.
Social interactions are also subject to emotional distortion. When we're emotionally charged, we often project our feelings onto others, assuming they share or reflect our emotions. If you're feeling insecure, you might interpret neutral expressions from others as judgmental or critical. Conversely, if you're feeling confident, you might interpret those same expressions as admiration or respect. This projection causes a kind of emotional contagion where our inner states shape how we believe others are feeling or thinking.
Emotions are powerful forces that shape and reshape our perceptions, often leading us to see the world in ways that reflect our internal states rather than objective reality. These distortions are not inherently negative; in fact, they are essential to our survival, helping us react quickly to threats, bond with others, and navigate the complexity of human life. However, when emotions become overwhelming or unbalanced, they can lead to significant distortions that cloud judgment and obscure the true nature of our experiences.
One way memory falters is through forgetting. This is perhaps the most straightforward failure, where the mind simply cannot retrieve the information it once stored. Forgetting can happen because the memory was never encoded properly, or because it has decayed over time, a phenomenon known as transience. But memory isn't just lost like water evaporating from a pool. Sometimes it fades selectively, where details that once seemed clear become hazy, creating gaps in our recollections. These gaps can leave behind only fragments, or worse, allow inference to fill in the blanks, blending truth and fiction without our knowing.
Then there’s misattribution, a subtle but profound failure where the mind recalls details but attributes them to the wrong source. It’s as if memory, trying to piece together a coherent narrative, grabs elements from various experiences and places them in the wrong context. You may recall a conversation vividly, but it may have occurred with someone else, or in a different place, twisting your understanding of when or how it really happened.
Another more devious failure is suggestibility. This happens when outside influences—leading questions, suggestions from others, or even media—seep into memory, altering or entirely fabricating details. A person might be convinced they remember something simply because it was suggested to them, and their mind, seeking coherence, weaves it into the fabric of their memory. Elizabeth Loftus, a pioneer in memory research, demonstrated how easily people can be led to remember events that never occurred, especially under conditions of stress or persuasion. In these cases, the memory isn’t just inaccurate; it’s entirely false.
Bias is another way memory fails. The way we feel in the present colors how we remember the past. If you’re feeling down, you might recall previous events as more negative than they actually were. Or, if you’ve changed your opinion about something, your memory reshapes past events to fit your new worldview. It’s a continuous rewriting of history, not by intent but by the unconscious workings of your brain, making memory less a static archive and more a narrative constantly updated to fit the present.
Perhaps the most haunting failure is persistence, where memory refuses to fade even when it should. Traumatic memories can stick, replaying endlessly, refusing to soften with time. This isn’t just a failure to forget but an intrusion of the past into the present, as if the boundary between memory and reality has dissolved, leading to conditions like PTSD. The brain can’t suppress these memories, and they emerge unbidden, vivid and distressing, as though the event is happening all over again.
Even in recall, the mind can play tricks. Reconstructive memory means that every time you remember something, you’re not pulling it from a fixed storehouse but reconstructing it from fragments. This reconstruction is prone to errors, influenced by your current state of mind, external stimuli, and even other memories. The more often a memory is recalled, the more it is edited, reshaped each time until it becomes a mix of what actually happened and how you've reinterpreted it over time.
Memory fails not simply by erasing, but by transforming, fabricating, and bending. It’s this fragility—its susceptibility to emotion, suggestion, and decay—that reveals just how much of what we believe we remember is a creation as much as it is a retrieval. And in these failures, we see the line between reality and perception blur, not just in the moment but long after, as memory rewrites the past to fit the present, and in doing so, reshapes who we are.
Lamotrigine’s journey through the body isn’t just the mechanistic drifting of a molecule in blood. It’s a deliberate, intricate ballet—a molecular odyssey shaped by the body’s chemistry, as precise as it is unconscious. You swallow the pill, and its coating dissolves like the first layer of a disguise. From the gut lining, the lamotrigine molecule slips into the bloodstream, flowing through your body’s rivers, but with intention. It knows, somehow, where to go. Its oily structure, fat-loving, makes it a key that fits the locks guarding the brain—the infamous blood-brain barrier, which stops many invaders cold. But not lamotrigine. It slides past those defenses as though invited in.
Now inside the brain, it begins its real work. Think of the neurons as gates, voltage-sensitive sodium channels as the sentinels of the brain’s electrical empire. Lamotrigine, like an expert diplomat, binds to these channels when they are in their inactive state, quieting the overexcited neurons responsible for the electrical storms we know as seizures or the mood fluctuations that plague the mind in bipolar disorder. It’s selective, knowing which battles to fight, where to intervene, leaving the normal rhythms untouched, unbothered, while focusing its energy where the chaos threatens.
But this isn’t just suppression. Lamotrigine targets the over-release of glutamate—imagine it as a fire-starter, an overzealous flame in the brain’s circuits. The drug doesn't smother the fire completely but lowers its intensity, reducing the brain’s overexcited state without dulling its ability to function normally. It’s a delicate balance, like adjusting the flame on a gas stove. You need the fire, but not so much that it burns everything down.
What’s fascinating is how lamotrigine interacts with the body on a broader level. It’s not just focused on one receptor. There’s a symphony of minor engagements with other neurotransmitters—serotonin, dopamine, GABA. These interactions may not headline the show, but they hum in the background, stabilizing the complex harmony of brain chemistry. It’s not a one-note performance. It’s a balancing act, a masterclass in biochemical subtlety.
When the job is done, lamotrigine doesn’t linger. It passes through the liver, where enzymes—glucuronidation—metabolize it into inactive forms, like a veteran warrior hanging up its sword. The body, ever efficient, excretes it, mostly through the urine, ensuring that what once fought the brain’s battles now leaves with dignity, waste in form, but not in purpose.
And here’s the beauty: lamotrigine doesn’t have a GPS. There’s no magic guiding it to the brain. Instead, it’s the brain’s high blood flow and its need for specific chemical interactions that draw the drug in. The body’s natural architecture, its equilibrium, shapes where the drug goes and how it works. The brain, a conductor in its own right, calls the drug to the sodium channels that need calming, the neurons that need regulating. It’s a system designed by evolution, but executed with precision.
This journey isn’t just lamotrigine’s. It’s the same pathway perception takes when filtered through the brain’s structures. Just as lamotrigine navigates the body’s bloodstreams, our sensory experiences are funneled through biological and cognitive filters. We don’t see reality as it is; we see it as it’s presented to us—through the biases of our senses, the limitations of our tools, the contours of our brain’s architecture. In much the same way that lamotrigine doesn’t affect every part of the body equally, our perception narrows the vastness of reality into manageable, digestible pieces. It’s a system of filtering, selecting, and focusing—whether it’s a drug calming an electrical storm in the brain or a mind interpreting the chaos of sensory input.
So, when you consider lamotrigine’s path through the body, think of it not as a mere chemical, but as a metaphor for how we perceive. It doesn’t wander; it focuses. It doesn’t fix everything; it hones in where it’s needed, shaping and reshaping the environment, one interaction at a time. Just as we perceive the world through lenses—biological, cultural, cognitive—lamotrigine moves through the body, precise and selective, responding to the calls of the overactive neurons. Perception, then, is both a mirror and a map, guiding us through the vast unknown, just as this molecule finds its way to the overworked neurons that need calming. Each step in the journey is shaped by structures, whether in the body or in the mind, and it’s within those structures that both perception and lamotrigine work their most intricate magic.
Perception, both in the scientific sense and the broader human experience, is shaped by an intricate web of factors, ranging from biological and neurological processes to social and cultural influences.
At its most fundamental level, biological mechanisms govern how we perceive the world. Sensory systems—vision, hearing, touch, taste, and smell—serve as gateways to the external environment. But these gateways are limited. For example, our eyes can only perceive a small fraction of the electromagnetic spectrum (visible light), and our ears detect sound only within a specific range of frequencies. These physiological limits immediately shape perception by filtering out large portions of reality, narrowing down what we are capable of sensing in the first place.
Once sensory data is received, the brain processes it through cognitive frameworks. These frameworks are shaped by prior knowledge, experience, and expectation. Cognitive scientists have explored how top-down processing allows our brains to use prior knowledge to interpret incoming sensory information. This means we don’t perceive the world passively, but rather, actively construct an understanding of it based on what we already know or expect to see. This helps explain phenomena like optical illusions or why people often see what they are looking for, rather than what is actually there.
Cultural and linguistic factors play another critical role in shaping perception. Philosopher Ludwig Wittgenstein famously argued that "the limits of my language are the limits of my world," suggesting that the words we have at our disposal influence what we can conceptualize and understand. Different languages emphasize different aspects of reality. For instance, languages that have multiple words for different shades of blue (such as Russian) can lead speakers of that language to perceive colors differently than those with fewer terms for the color. This demonstrates that language doesn’t just express our perception; it shapes it by influencing what we pay attention to and how we categorize the world around us.
On a broader level, cultural influences impact how we perceive everything from time to social relationships. Cultures vary in their focus on individualism versus collectivism, for instance, and these values influence how people perceive their roles within their communities. Similarly, concepts like time are perceived differently across cultures—some cultures see time as linear and progressive, while others experience it as cyclical.
Then there’s the technological factor—the tools we use to extend our sensory capabilities. Scientific instruments, like telescopes and microscopes, extend our perception beyond natural sensory limits, yet they also introduce new layers of abstraction. When we look through a microscope, for example, we are not directly seeing a microorganism; we are seeing an image created by the instrument, subject to the limitations and biases of that technology.
Psychological and emotional states shape perception. Emotions can act as filters, altering how we interpret the world around us. When we are anxious, we may perceive neutral faces as threatening, or when in a positive mood, we may overlook negative stimuli. Perception, in this sense, is a dynamic interplay between the external world and our internal states, constantly influenced by context, memory, and expectation.
Even more fascinating is how lamotrigine’s mission doesn’t stop at calming electrical storms. This pill acts across a broader spectrum. Although its primary dance partner is the sodium channel, lamotrigine has been seen to weakly interact with a series of other receptors—serotonin, dopamine, and GABA among them. These interactions, though less intense, create a symphony of balance in the brain. It’s not just muting the fire of excitatory signals; it’s gently adjusting the harmonics of various brain functions.
So how does it know where to go? The body doesn’t hand it a GPS. It’s the drug’s molecular affinity for fat-soluble environments, the properties that make it permeable through biological membranes like those in the brain. The body’s chemistry is all about equilibrium, and lamotrigine’s design allows it to swim through that environment like a molecule custom-fitted to the gaps that neurons leave in their overactive states.
Once it’s done its job, lamotrigine doesn’t just stick around waiting for the next event. It’s metabolized in the liver through glucuronidation, becoming an inactive form that can be excreted safely, mostly through the urine. The body recycles the waste but keeps the neurons steady in the process.
The way lamotrigine finds its way to its destination is much like perception in science. Just as our sensory and cognitive frameworks filter the world down to digestible fragments, lamotrigine finds its narrow but essential pathway through the body’s complex environment. It sees the sodium channels like a scientist sees through a microscope—focused, limited but intent on a clear purpose. Its journey mirrors how instruments in science focus on one aspect of reality, enhancing our perception while also constraining it.
In a broader sense, this is the nature of all interactions between science and perception: the drug finds its way through the body much like how we perceive the world—through biological, chemical, and cognitive filters that narrow down a vast universe of possibilities into something manageable, yet powerful.
When you take a pill like lamotrigine, it follows a complex and highly orchestrated journey through your body before it reaches its target locations, primarily in the brain. Here’s an in-depth look at how lamotrigine (and similar drugs) finds its “right spots” in the body, involving several phases from absorption to distribution and targeting:
After ingestion, lamotrigine is absorbed from the gastrointestinal tract. It exhibits almost complete bioavailability (about 98%), meaning nearly all of the drug reaches your bloodstream. The absorption rate can vary depending on whether it’s taken with food or other medications, but typically, its peak concentration in the blood (Cmax) is reached between 1.4 to 4.8 hours after ingestion【13†source】【10†source】
The drug enters the bloodstream without being significantly metabolized by the liver during this phase, which is a phenomenon known as low first-pass metabolism. This high bioavailability allows it to maintain sufficient concentrations in circulation to effectively reach its target sites.
Once lamotrigine enters the bloodstream, it is distributed throughout the body. Drugs are carried by the blood to tissues and organs, but this distribution depends on several factors,
Blood Flow: Organs with higher blood flow (like the brain, liver, and kidneys) tend to receive the drug more rapidly.
Tissue Permeability: Lamotrigine is lipophilic (fat-soluble), which allows it to cross the blood-brain barrier, a highly selective membrane that protects the brain from many substances circulating in the bloodstream. The blood-brain barrier consists of tight junctions between endothelial cells in the brain’s capillaries, making it difficult for many drugs to penetrate the brain. However, lamotrigine's molecular properties enable it to do so【9†source】【13†source】
Lamotrigine’s ultimate goal is to bind to voltage-gated sodium channels located on neurons. These channels play a crucial role in the propagation of electrical signals in the brain. By selectively binding to these sodium channels, particularly when they are in an inactive state, lamotrigine blocks excessive excitatory signals that contribute to seizures and mood instability【13†source】
The drug preferentially targets sodium channels in their inactive state, which is typically more prevalent in hyperactive neurons (such as those involved in epilepsy or mood swings). This means lamotrigine doesn’t affect normal neuronal activity as much, thus reducing unwanted side effects like excessive sedation【10†source】【12†source】
After reaching the brain, lamotrigine inhibits the release of glutamate, an excitatory neurotransmitter. It does this by stabilizing neuronal membranes, particularly in the presynaptic neurons where glutamate is released. By reducing the excessive release of this neurotransmitter, lamotrigine dampens neuronal overactivity, which is key in controlling seizures and stabilizing mood【12†source】【13†source】
Lamotrigine also has weaker interactions with other receptors, such as serotonin and dopamine receptors, though these are less significant to its primary mechanism of action.
Perception is no passive event, no mere reception of the world as it is—it’s the endless weaving of memory into every sensation, a dynamic interplay between the present and the past. Think of it as a lens, sharpened and clouded by the weight of everything you’ve experienced. Every time you see, hear, or touch something, the brain doesn't just respond to the raw data streaming in from your senses. Instead, it summons memories, shaping, distorting, and framing the experience. It’s not a stretch to say that we’re never truly seeing things as they are; we’re seeing them as we've seen them before.
Take a simple object—say, a chair. For someone who grew up around art, it’s not just a piece of furniture; it’s a reflection of style, function, and history. For someone else, that same chair could carry the weight of memory, a reminder of childhood, comfort, or even discomfort. These mental imprints change how we perceive the physical object in front of us. Our memory is like an echo, rippling through the present and turning every perception into a reflection of what came before.
It’s more than just recognition. Memory actively primes the brain. When you walk into a room, your brain anticipates what you might encounter based on past experiences. That’s why a creak in the floorboard might mean danger if you’ve experienced something terrifying in a similar space before, while for someone else, it’s just an old house groaning in its bones. Memory isn’t a dormant archive; it’s a live feed that constantly feeds into your perception, setting the stage before the players even arrive.
Memory’s fingerprints are clearest when emotions are involved. Think about how a certain smell can instantly transport you to another time, another place. That’s not just nostalgia playing tricks on you; it’s your brain pulling from the deep well of emotional memory, changing the flavor of what you’re experiencing in the moment. Emotions become filters, altering the very texture of perception. An anxious mind may turn every neutral face into a threat, every shadow into something sinister. But joy? Joy floods perception with light, glossing over what might otherwise seem bleak, transforming the mundane into something golden.
There’s a reason for this. The brain, in its ceaseless effort to survive, depends on efficiency, so it turns to memory to anticipate and understand the world. It’s the brain saying, "I’ve seen this before, I know what’s coming." This is where things like cognitive biases—confirmation bias, the availability heuristic—take root. These are the mind's shortcuts, rules of thumb rooted in memory, that help you navigate an overwhelmingly complex world. The more memorable an experience, the more it defines future perceptions. Just like a scientist bound by the limits of their instruments, memory binds us within the limits of our past.
But it’s not infallible. Memory, like perception itself, is prone to error. False memories—the brain’s own rewrites—can change how you see and understand the present. If you misremember someone wronging you, that skewed memory colors every future interaction, warping the perception of that person’s every word, every gesture. Perception becomes a mirror, reflecting not the present reality, but the remembered past, sometimes accurately, sometimes twisted by time and emotion.
In this way, memory does more than just contribute to perception; it co-authors it, drawing lines and filling in spaces, giving shape and meaning to the otherwise chaotic sensory input. We don’t perceive the world as it is—we perceive it as we remember it, as we expect it to be, a dance between past and present that constantly reshapes what we see, feel, and believe. It’s as if memory is the painter, and perception the canvas, but the masterpiece that results is never quite as objective or fixed as we’d like to believe. It’s a mosaic, fragmented and beautiful, reflecting both the limits and possibilities of our mind.
Lamotrigine is mainly metabolized in the liver through glucuronidation, where it binds to glucuronic acid to form inactive metabolites (mainly lamotrigine-2-N-glucuronide). These metabolites are then excreted through urine, with a small portion excreted through feces. The drug’s half-life (the time it takes for half of the drug to be eliminated from the body) varies depending on whether other drugs are taken in combination (such as valproate, which can double lamotrigine’s half-life)【13†source】
- Lipid Solubility: Lamotrigine’s lipophilic nature helps it cross the blood-brain barrier more easily than water-soluble drugs.
- Low Protein Binding: Lamotrigine has relatively low plasma protein binding (55%), meaning a larger fraction of the drug remains free to cross cellular membranes and reach its target tissues【13†source】
- Selective Binding to Sodium Channels: Its mechanism of action is highly specific to sodium channels in neurons, especially those that are overactive, ensuring it primarily affects neurons that are contributing to seizures or mood fluctuations without significantly affecting normal brain function【9†source】【12†source】
Lamotrigine “finds” its target locations due to its biochemical properties, including its ability to cross the blood-brain barrier, its selective affinity for inactive sodium channels in neurons, and its high bioavailability. These factors help ensure that the drug is delivered to the brain and modulates the activity of neurons involved in epileptic seizures or mood disorders. The drug’s metabolism in the liver and excretion through the kidneys also prevent it from accumulating excessively in the body, maintaining a balance that minimizes side effects while preserving efficacy【10†source】【13†source】【12†source】
This highly orchestrated journey involves several physiological barriers, but lamotrigine’s design allows it to reach the right spots—particularly overactive neurons in the CNS.
Lamotrigine’s journey through the body isn’t just a matter of chemical reaction, it’s a story of how modern medicine interacts with the biological frameworks that have evolved over millennia. The pill itself, upon entering the body, dissolves and is rapidly absorbed through the lining of the gastrointestinal tract. From there, it enters the bloodstream, but this isn’t a matter of it ‘choosing’ where to go. It’s the sheer genius of biological systems that help it reach the places where it is most needed.
Once in the bloodstream, lamotrigine is distributed based on blood flow. The brain, due to its high energy needs and complex circuitry, requires a significant amount of oxygen and nutrients delivered by the blood, and this is where the medication finds its primary target. But the brain doesn’t let just any molecule in—there’s a gatekeeper here, a highly selective barrier known as the blood-brain barrier. This barrier is designed to protect the brain from harmful substances, but lamotrigine, with its lipid-soluble structure, slips through, crossing this barrier that keeps so many others out.
Inside the brain, lamotrigine’s task is to calm the electrical storms that rage in neurons when someone is having a seizure or experiencing the fluctuations of mood disorders like bipolar disorder. It does this by selectively binding to voltage-gated sodium channels, which are like the gates that control electrical signals in the brain. When these gates open too much or too often, the neurons fire excessively, creating a storm of electrical activity that manifests as a seizure or mood disturbance. Lamotrigine stabilizes these gates, selectively interacting with those that are overactive—think of it as a kind of electrical conductor, guiding the chaotic signals into a more harmonious rhythm.
Its effect doesn’t stop there. Beyond just calming the electrical activity, lamotrigine also limits the release of glutamate, an excitatory neurotransmitter that, when released in excess, fuels the overactivity of neurons. Glutamate is a bit like gasoline on a fire; too much of it leads to the seizures or the rapid cycling of mood that people with bipolar disorder experience. By controlling the release of this neurotransmitter, lamotrigine ensures the brain can function more normally, but not so much that it stifles normal activity.
This dance of biochemical interactions is refined by the body's systems, which metabolize the drug primarily through the liver, transforming it into inactive metabolites before it is excreted through urine. The liver’s enzymes, specifically those involved in glucuronidation, act like cleanup crews, breaking down the drug after it has done its job. This process ensures that lamotrigine doesn’t linger too long, building up and causing unnecessary side effects.
But how does lamotrigine ‘know’ to target only the brain and not every organ equally? The truth is, it doesn’t exactly target the brain. Rather, the brain's unique environment—its high blood flow, its specific chemical make-up, and the presence of those voltage-gated sodium channels that are so critical to the drug's function—makes it the most effective location for lamotrigine to work. In other parts of the body, the drug doesn’t have the same opportunities to bind and act, so its primary effects remain concentrated where they are most needed.
This process highlights how perception—whether sensory or molecular—works both as a gateway and a limitation. Just as our sensory perception narrows reality into manageable data, the molecular pathways of a drug like lamotrigine sculpt its action to fit the needs of the body, but always within the confines of its biochemical design. And just like the limitations of our tools and languages in science, the drug's interactions are shaped and limited by the environments they encounter.
So, in a sense, lamotrigine’s journey is not unlike our own journey in understanding the world. It moves through various stages, each step defined by the structures it encounters and the specific environments that allow it to thrive. But always, whether it’s neurons firing or proteins folding, the drug’s pathway is defined by limits, boundaries, and specific interactions that enable it to do its work—just as our perception of the world is shaped and narrowed by the tools we use to explore it.
Memory reaches backward, pulls the threads of past experience, and weaves them into the fabric of present perception. Every glance, every sound, every touch—none of it is pure; it is all painted with the hues of what we’ve lived before. When we encounter something as seemingly simple as a familiar face, our perception isn’t just a raw intake of sensory data. No, it is colored by recollections, the emotions tied to previous interactions, the biases we’ve stored away. Memory stands as a silent architect, building the scaffolding of our immediate experience before the data even arrives.
Picture how memory primes us. You walk down a street and smell something—fresh bread. You’re immediately transported to a morning long gone, perhaps a kitchen, a different place entirely, yet that memory latches on to the present, bending how you feel, how you take in the world. Memory gives you not just the scent but the warmth, the echo of a place where bread was more than just food. It primes your perception, inviting in more than what’s immediately there. Without memory, the world would arrive in us unfiltered, chaotic, and impossibly new each time.
It is the same with language. Wittgenstein spoke of the limits of language as the limits of our world, and memory reinforces that notion. Each word we hear, each symbol we read, brings with it layers of meaning accrued over years. The memory of how words have hurt or healed us, the specific tone of a loved one's voice, all of it seeps into the moment of hearing again. Words are not just sounds; they are the ghosts of every time they've been spoken, all rushing into the present. Memory, through language, shapes the contours of how we understand even the simplest sentence.
But it goes deeper. Memory and perception engage in a dance of expectation. When you walk into a room, you expect certain things based on what you’ve seen before, and when reality aligns with that expectation, the world feels stable. But when memory misfires or tricks you, when a place or a person does not match what you thought you knew, your perception shifts abruptly. It's not reality that’s changed, but your memory-infused understanding of it. False memories, those illusions of the mind, can hijack perception, making us see things that never were, convincing us that what we now encounter fits into a story we once imagined.
And let’s not forget how emotions—anchored deeply in memory—act as filters. Have you ever noticed how a bad day can twist everything you see into a shade darker than it actually is? That’s memory again, blending past disappointments with present experience, casting a long shadow over the now. The brain doesn’t bother processing the world anew every moment. It leans heavily on memory, on the emotional tags we attach to everything we’ve felt before, shaping our present experience into something that matches our past.
All perception, therefore, is a palimpsest—layers of past experience written over and over upon the present moment. The signals may come from the outside world, but what we perceive is profoundly shaped by the memories that linger inside us. Each moment becomes not just an experience but an amalgam of what has come before, bent and refracted through the lens of memory. Reality, as we perceive it, is an echo of our past, always more than just the raw data of the senses. It is the mind, retrieving the familiar, bending the new to fit the known, and reshaping the now into something that always seems, somehow, to carry a whisper of the then.
Emotions have a profound ability to distort our perception of reality, shaping how we interpret the world, our memories, and even our decision-making processes. This distortion occurs because emotions influence not only what we pay attention to, but how we process and evaluate that information. Here’s how emotions can alter and warp perception:
First, emotions affect attention. When you’re in a heightened emotional state—whether it's fear, anger, joy, or sadness—your brain prioritizes certain stimuli over others. For instance, fear narrows attention to potential threats. If you’re walking down a dark street and feeling anxious, your mind is likely to focus intensely on every shadow or unfamiliar noise, interpreting them as threats, even if they aren’t. Joy, on the other hand, tends to make people focus on positive stimuli, overlooking potential risks or negative details in their surroundings. In both cases, the emotional state dictates what the mind deems important, filtering out the rest.
This attentional bias leads to cognitive distortion. Emotions influence how we interpret the information we do notice. For example, in a state of anger, someone might interpret a neutral comment as an insult, while the same comment might seem benign when they are calm. Similarly, a person in love might see ambiguous actions as more meaningful or positive than they truly are, magnifying their partner's virtues and downplaying any flaws. Emotions color our cognitive lens, causing us to reinterpret events through the emotional state of the moment.
Memory, too, is susceptible to emotional distortion. When recalling a past event, your current emotional state can reshape the memory, a phenomenon known as mood-congruent memory. If you’re feeling sad, you might more easily recall other sad experiences, while happier memories fade into the background. This reinforces the current mood, making it harder to break out of a negative emotional state. Over time, persistent emotions can even alter the content of memories, so that events may be recalled as more positive or negative than they were at the time.
Emotional amplification also occurs. Strong emotions make certain experiences feel more intense or significant than they might objectively be. For example, when someone is embarrassed, a minor social misstep might feel like a catastrophic failure. Similarly, when in love, small gestures can feel grand, magnifying their emotional impact beyond the objective reality of the act. This emotional amplification can distort not just the perception of the present but the remembered significance of events.
Moreover, emotions affect decision-making. Emotional states often lead to impulsive decisions or clouded judgment. Fear, for example, can cause someone to overestimate risks and avoid actions that might actually be beneficial. Conversely, overconfidence driven by excitement or happiness can lead to underestimating risks and making reckless choices. This is because emotions often override rational analysis, pushing the brain to prioritize immediate emotional comfort over long-term logic.
Emotions can distort interpersonal perception. The way we perceive others is highly influenced by our emotional state. Anger can make us see others as hostile or unfriendly, while feelings of affection or admiration can make us overlook negative behaviors or interpret them in a more positive light. This is why the same behavior from someone can be seen in completely different ways depending on your emotional state—what seems like a joke one day might feel like an insult the next, all because of how emotions filter our perception.
Emotions warp our perception by guiding attention, coloring interpretation, reshaping memories, amplifying experiences, and influencing decisions. While emotions provide valuable information about our environment, they can also mislead us, distorting reality in ways that reflect our internal state rather than the external world. This emotional lens can be both enriching, making life feel more vibrant, and distorting, causing us to misjudge situations, people, and even ourselves.
Trauma persists because it imprints itself deeply into the brain’s emotional and survival circuits, creating memories that are not easily processed or integrated into normal cognitive frameworks. Unlike ordinary experiences, traumatic events activate the brain's stress response systems—particularly the amygdala, hippocampus, and prefrontal cortex—which govern emotions, memory, and decision-making. The way these regions respond during a traumatic event lays the foundation for why trauma lingers.
First, the amygdala, the brain’s emotional processing center, becomes hyperactive during traumatic experiences. It amplifies the sense of threat and fear, encoding memories with intense emotional weight. This heightened activation helps ensure survival by making the brain extremely vigilant in the face of danger. However, after the event, this same hyperactivity makes it difficult to forget or diminish the emotional intensity of those memories. The amygdala continues to react as if the threat is still present, even long after the trauma has passed. This is why trauma can feel as though it’s happening again in the present, leading to persistent flashbacks or emotional responses to triggers【9†source】【12†source】
The hippocampus, which is responsible for processing and organizing memories in time and context, is often impaired during trauma. Under extreme stress, the hippocampus fails to properly encode the traumatic event as a past experience, causing the memory to remain fragmented and disjointed. Instead of being integrated into the brain’s narrative of past events, these memories resurface as isolated, sensory-laden flashbacks—more like vivid, present experiences than distant recollections. This fragmentation prevents the trauma from being fully processed, leading to the repetitive re-experiencing of those distressing moments【9†source】
The prefrontal cortex, which helps regulate emotions and supports rational thinking, can be weakened during trauma. Stress hormones like cortisol flood the brain during traumatic events, dampening the function of the prefrontal cortex. This creates a gap in the brain’s ability to assess danger logically and temper the emotional overreaction of the amygdala. As a result, trauma survivors often struggle to use rational thought to calm their heightened emotional responses. This diminished regulatory ability allows trauma to persist by keeping the emotional memory of the event raw and unresolved【9†source】【11†source】
Additionally, chronic activation of the stress response keeps the body in a state of hyperarousal, even in the absence of immediate danger. The nervous system can become stuck in "fight or flight" mode, unable to return to baseline. This constant state of alertness contributes to the persistence of trauma by reinforcing the sense that a threat is always present, making relaxation and emotional recovery difficult【11†source】
Trauma also persists because the brain encodes it with strong sensory and emotional associations. Certain sights, sounds, smells, or feelings can trigger intense emotional responses that bring the trauma back to the surface. These triggers act as cues that reawaken the trauma, leading to the sensation of reliving the event. This re-experiencing is a hallmark of conditions like post-traumatic stress disorder (PTSD), where the brain continually fails to store the traumatic memory in the past【12†source】
Trauma can persist due to a lack of proper integration into the larger narrative of the person’s life. When trauma is not fully processed, it remains isolated in the mind, resurfacing in fragmented ways and resisting assimilation into the flow of normal, day-to-day experiences. Therapy approaches like cognitive-behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR) aim to help trauma survivors process and integrate these memories by connecting them to the present and contextualizing them as part of the past【10†source】【11†source】
In summary, trauma persists because it is encoded into the brain’s emotional, sensory, and stress circuits in a way that resists normal memory processing. This leads to intense emotional reactions, intrusive memories, and ongoing hypervigilance, keeping the trauma alive in the present.