It's Not Mental

Whole Health Healing

2012-01-20T12:10:00.000-05:00

I was only slightly surprised that some speakers at integrative medical conferences, and some writers of whole-body healing, had their start in the chiropractic profession. After all, their skills are often viewed as “alternative” (especially by orthopedic surgeons, in my experience. Admittedly, to me, I was very glad to have such an “alternative” to the back surgery my orthopedist insisted was absolutely necessary!).

People who manipulate the body, whether by an Osteopath (DO—similar to an MD) or a Chiropractor, are immersed in the body’s own ability to heal itself.

Readers of my book and blog know very well that my family uses Integrative medicine for both managing chronic ailments, and natural techniques (such as diet changes, sleep hygiene, exercise, and supplements) for healing. We helped the “mind” by helping the body.

Coming from the chiropractic profession, we have a guest writer who would like to share his view on the use of natural remedies: Dr. Tom Potisk—author of the book “Whole Health Healing” and owner of the website of the same name: Whole Health Healing.

Natural Remedies Come from Whole Health Healing

By Tom Potisk, DC

Natural remedies are increasingly being sought by people with a variety of chronic illnesses like psoriasis, lupus, asthma, hypertension and diabetes.

Sadly, most people confuse the source of the remedy, expecting there to be a natural magic like potion or tablet that will solve their problem. This “outside-in” approach is the typical conventional medicine attempt.

True natural remedies come from an ‘inside – out“ approach; meaning that we are each gifted with our own inner doctor that can heal us provided the doctor gets what it needs to do it’s job. The remedy is more of a release. It’s not a cure all for every malady, but an approach worth perusing in most non-emergency and non-crisis situations.

“The witch doctor succeeds for the same reason all the rest of us doctors succeed. Each patient carries his own doctor within him. The patients come to us not knowing that truth. We are at our best when we give the doctor that resides within each patient the chance to go to work.” – Dr Albert Schweitzer

More specifically I call this holistic approach whole health healing. Our anatomy and physiology is complex. It makes a lot of sense to sometimes back away from trying to figure out its seemingly endless intricacies and instead focus on giving it proper fuel, rest, and alignment – restoring whole health.

For over 25 years I worked tirelessly as a holistic family doctor. What energized me was watching patients improve and being in near constant awe of the human bodies self healing ability. It’s truly a gift from God; sadly often overlooked or at least unappreciated.

I recommend anybody with any chronic illness, be it a physical malady or a mental one, to consider taking a whole health healing approach for relief or resolution of their problem. If you are currently under conventional medical care, ask about attempting at least a trial period of this alternative. Don’t expect approval; but do demand cooperation.

- Dr. Tom Potisk is an award winning holistic family doctor and bestselling author of “Whole Health Healing: The Budget Friendly Natural Wellness Bible for All Ages.”

www.wholehealthhealing.com

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Property of www.ItsNotMental.com
Last Updated: 20 January 2012

Healing Young Brains - Take Home Points from a 2011 Medical Conference

2011-12-30T15:11:00.001-05:00

What better way to end the year, than to look back at the awesome 3-day medical conference I recently attended, titled “Healing Young Brains.” It was hosted by the nonprofit Midway Foundation for Integrative Medicine headed by James Roach, MD. I was pleased to see doctors from all over the country, but unfortunately not many psychiatrists (there were some, though!) I was also approached by two people who had actually read my book. That was a pleasant surprise!

I cannot give a synopsis of the conference, as each presenter gave over an hour of densely-packed information, each of which was itself just a "synopsis" of the material! But each person comes away from such an even with their own set of salient points that stuck in their minds. Here are the top twenty points from the conference that stuck with me. Here-and-there, I've included some books and, in some cases, just some helpful links.

Start with the gut. Heal the gut. The younger the better. At birth is best. Then keep it healthy. It is not just because the mothers have used antibiotics, but the babies do, too. Because of these gut problems we get increasing number of food and environmental sensitivities. (Klaire Labs has a probiotic safe for infants.)
THERE IS NO SUCH THING AS INFORMED CONSENT.... as long as doctors do not inform the patient of alternatives (i.e. using an integratED, IntegratIVE, Functional approach – which is what I advocate in my book).
An Integrative approach is not really “alternative” since it uses state-of-the-art testing and treatment.(See: Looking Beyond the Symptoms – An Integrative Approach)
Food and environmental allergies can affect any, and multiple, organs and body systems. In one individual we may see hives. In another we get mood changes and aggression. In another it may be artherosclerosis and osteoarthritis. If a baby screams or child (not cries) for hours, suspect food allergies/sensitivities. The IgE skin scratch test is insufficient for this. You really need to do a food elimination diet (if breast feeding, it is the mother who must do this). Our jails and juvenile justice system are probably full of individuals with food and chemical sensitivities.

Here are some symptoms (aside from the obvious stuffy noses and dark circles under the eyes) to look out for in the very young that I found particularly interesting:
- En-Utero: Excessive Hiccupping, Excessive Kicking
- Infancy: Screaming (not crying) for hours, Frowning, Excessive drooling, Head banging, "wiggly" Extreme diaper rash
- Toddlers: Clucking throat sound, Leg aches, Easy gag reflex.
- Children: Screeching, ticcing, acting bizarrely and intermittently silly or aggressive, making animal sounds such as whinnying like a horse, or barking like a dog.
From the beloved physician, Dr. Doris Rapp MD, author of “Is This Your Child?” “Our Toxic World”, and a few others (see books below): To stop (ease) a reactivity happening to food give baking soda (1/4 tsp in a glass of water). This alkalinity helps. And by the way, keeping the body alkaline with diet may help prevent/stall the spread of cancer. Another antidote is a greatly diluted drop (of the “right” dilution) of the item that the child just reacted to. This can be done with a baby and the mother's breast milk. This method does not help with gluten sensitivity.
If one individual in a family is found to have a problem with a food, it is likely others do too, but possibly affecting different body parts/systems (see #4)
Some individuals with a problem with gluten need to get off ALL GRAINS... and dairy. In fact, that is sometimes recommended as a first line treatment for many individuals. GET OFF ALL GRAINS and DAIRY.A Paleo Diets does not mean heavy in meat, but rather, good organic nutrition for the brain for the brain and body. It feeds mitochondria. Think lots of fresh organic green leafy and cruciferous, sulfur-rich vegetables, and berries, with a lesser amount of seafood and grass-fed meats. What does not appear in a paleo-type diet is processed foods and grains.
Prevention: Since each generation is affected epigenetically en-utero by the mothers (who were themselves affected epigenetically by their mothers while they were en-utero), the next generation may be sicker even than this generation of children are. To truly help the children we must change medical practices and help the young future mothers -- even before they get pregnant. They need medical, emotional, nutritional, WHOLE-istic care. And while pregnant, they need to be truly nurtured. We need to change the way we do childbirth. Have childbirth be more natural in a relaxed, calm, subdued, sensual, nurturing environment. And let the umbilical cord stop pulsing before cutting it.
It is wrong to look at nutrients individually. Giving one vitamin can affect the usage of another, and that one affects another which affects another.In some cases, serum testing of nutrients is not very accurate. Lymphocyte testing is better (I don't think he mentioned the name Spectracell Labs, but I know they do such testing.) See NOTES at bottom. The MD who gave that talk, Dr. Alan Gaby, wrote a 900-plus page medical book on nutrition. 22 chapters of that book has information on "psychiatric" effects. He mentioned EMPowerPlus in a positive light saying there have been 12 research studies on it. To find these research studies look for the keyword "micronutrients." (Here is a link to research articles that have been published on it.)
Negative (ie showing no benefit) food and nutritional studies are often flawed as they eliminate only one food or class of foods at a time, or add in only one nutrient at a time (nutrients are synergistic). Sometimes they use a biologically active placebo (such as using olive oil capsule as a “placebo”), and also, a lab setting is not always indicative of how a person is responding in the stress and bustle of the real world.
Sugar actually can trigger “ADHD” symptom in some children. 76% of children diagnosed with ADHD, in one study, had an abnormal glucose tolerance test. They may have “reactive hypoglycemia.” Abnormal insulin metabolism itself (hyperinsulinemia) can trigger neuropsychiatric symptoms). Iron deficiency can also have neuropsychiatric effects.
The FDA is picking and choosing studies. In fact, even when a CEO of a pharmaceutical company (I forget which) wrote about the dangers found from one of their drugs, the FDA chose to ignore it. Many negative (damaging to a product) studies never get published so they aren't even on the public government database. However, due to the Freedom of Information Act, if you know what to ask for, you can get these other studies. Much of the wonderful research about nutrition does not get published. Newspapers ignore great studies, publish flawed studies (sometimes ignoring 9 good ones to publish the results of one negative, flawed one) and will sometimes even publish headlines directly conflicting with conclusions of studies.
Sensory Integration Processing problems need to be addressed as early in life as possible. The window closes at about age 9. After that, it can be helped, but not as much and not as easily.
Some people really are sensitive to EMFs (Electro magnetic frequency). Some schools are hot spots for EMF and it isn't just your child reacting. Turn off routers at night. At least have the bedrooms as EMF-free as possible.
Herbals. They do not act directly on the symptoms. They help body systems, downregulating or upregulating... they help the body do what it does. The herbals themselves don't don't heal the body. They help the body heal itself.
Here's interesting tid-bit about omega 3s and which ratio of EPA:DHA is best. DHA grows brain. Babies need it. Some doctors advocate for giving supplements with JUST the DHA! But what about the EPA for mood stability? That is fine, but may also be wrong for some people, because some people need the GLA added to the mix. Look for EPA:DHA:GLA ratio of 4:3:2 (I have now added such a product, "Beyond Essential Fats" by Natura to my list on "Fish Oil": $$ and Favorite Brands of Omega-3 Supplements and also to my list of Hard-to-Find but Commonly Needed Hypoallergenic Supplements.
Eat some protein at every meal.
With a possible few exceptions, we should eat at least some meat, at least some times, and this advice goes even if we are vegetarian... eat some meat - it doesn't have to be red meat.
Eggs are an excellent source of needed protein and fats, but they should come from what I call “happy hens.”
A few presenters did talk about techniques not backed by extensive scientific research and those techniques were referred to, (affectionately?) as “woo woo.”

NOTES:
I know I said the top 20, but I just need to mention a few random tidbits to give a flavor of the complexity of the human body - no wonder psychiatrists prefer to hand out antipsychotics!

Zn (Zinc): Large doses of folic acid early in pregnancy can then cause zinc deficiency resulting in neurological issues in the infant. When taking zinc, we need copper. Growth hormone receptors are upregulated by zinc.
Fe (iron): What can look like "anemia" (low iron) may actually be a deficiency in B6 and zinc. Raising ferritin levels (when low) can increase mood and improve sleep. An inflammatory process in the body can raise serum ferritin (iron) level. That does NOT mean the person has too much Fe!
Mg (Magnesium): Needed for phosphorylation of B6 & B1. When taking Mg, we also need thiamine.
DHA: Too much EPA may interfere with DHA. DHA is the most important. But taking DHA can lead to poor vitamin E status. If we look at vitamin E, we also need to look at selenium, and from selenium, to vitamin C.... we need balance.
Dopamine and Dopamine receptors: require multiple nutrients such as zinc, iron, B6, and vitamin C.
Metformin (commonly used by people on psych meds due to the meds causing weight gain and type 2 diabetes) can cause a deficiency in B12.
Inositol: Can be effective for Bipolar, panic attacks, and OCD, not so much for psychosis.Dr. Scott Shannon recommends DBT for all patients (CHILDREN!) with bipolar symptoms.
Depression: Light therapy is not just for SAD (Seasonal affective disorder) but for anyone with an affective disorder. Check vitamin D status! St. John's Wort is sometimes used in a 900mg dose for children as young as 8 for MAJOR depression (not just mild).
Bacopa affects the cholinergic system, having a calming effect on the brain. It can help ADHD, along with American Ginseng extract.

Property of www.ItsNotMental.com
Last Updated: 30 December 2011

Dialectical Behavior Therapy (DBT) for the Strength to Recover

2011-12-11T18:43:00.001-05:00

Practice with Dialectical Behavior Therapy (DBT) helped my older daughter cope with her bipolar symptoms. Just as with her younger sister, her symptoms were not due to psychological problems, but to be successful and move forward with her life, and to be able to do what she needed to do to get better in spite of the symptoms, she had to essentially be stronger and more mentally healthy than a person without bipolar disorder.

Although DBT is best done with both individual and group therapy with a therapist who specializes in the technique, my daughter used self-directed workbooks (included at the bottom) and assistance from her individual psychotherapist. Prior to starting the DBT, she had already been using the technique of Cognitive Behavior Therapy (CBT) to deal with the manifestation of anxiety.

We have a guest poster writing about DBT, Lindsey Webster. Ms. Webster has been a rehabilitation counselor for 15 years and owns the site Masters in Counseling. The site serves as a great resource for new students looking to find all the information they need about obtaining a Masters degree in Counseling. She has a Master's degree in Social Work.

The Benefits of Dialectical Behavior Therapy for Those with Anxiety Disorders

by Lindsey Webster, MSW

In recent years, more research has been done to verify the benefits of combining dialectical behavior therapy (DBT) with cognitive behavior therapy (CBT) for those with anxiety disorders. There is a large amount of evidence to support the theory that using both CBT and DBT to treat anxiety disorders is a better approach than just using CBT alone.

Dialectical behavior therapy (DBT) was originally developed to treat people with borderline personality disorder. This type of therapy uses the concepts of acceptance and mindfulness to help give the patient a better understanding of their disorder in the present moment. The concept of mindfulness (or awareness) was taken from Buddhist meditative practices that have been used for thousands of years. .

Marsha Linehan, the psychology researcher who developed the dialectical behavior system of therapy, noted in her research that the chronically suicidal patients she studied required unconditional acceptance, because they had been raised in an environment which offered little acceptance. For this reason, therapists who use DBT want the patient to view them as an ally in all things. When the patient tells the therapist about their feelings and behaviors, the therapist accepts those feelings and behaviors while, at the same time, showing the patient a better way to view and handle the situations that create those unsettling emotions and actions. .

The goal of being mindful in DBT is aided by the patient noting and recording all issues that arise during the week in a diary. These issues are discussed during their next counseling session. Debilitating behaviors are listed in order of severity, with self-injurious and suicidal behaviors first, behaviors interfering with treatment second and quality of life issues third. A patient should work at improving the most austere behaviors first before improving less serious behaviors. .

There is also a group therapy component to DBT. The group meets to learn and discuss skills that are organized into four modules: core mindfulness skills, emotion regulation skills, interpersonal effectiveness skills and distress tolerance skills.

When combined with cognitive behavior therapy (the most common type of therapy used for the treatment of anxiety disorders), dialectical behavior therapy acts as additional support and teaches the patient to always be aware of their emotions and actions and to accept and tolerate stress. .

Both CBT and DBT provide patients who suffer from anxiety disorders an opportunity to talk about their disorder in an accepting environment. It is important to note that some studies have shown that talking about your anxiety (and trying to find reasons why and how you can overcome it) can be just as effective, if not more effective, as taking an anti-anxiety medication. For this reason, it is almost necessary that those who suffer from an anxiety disorder combine some form of cognitive behavior and/or dialectical behavior therapy with medicinal treatments. Using both counseling and medicine will ensure the best chance of improvement for the patient.

Lindsey Webster has been a rehabilitation counselor for 15 years and also owns the site Masters in Counseling. She likes to write about different topics related to counseling and careers.

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Last Updated: 28 December 2011

Looking Beyond the Symptoms – An Integrative Approach

2011-11-28T11:28:00.001-05:00

The book, It's Not Mental: finding innovative support and medical treatment for a child diagnosed with a severe mental illness takes the reader on our journey from puzzlement over our gentle younger daughter’s bizarre mood and schizophrenic symptoms, to despair, through grief and anger, and into a future better than we had hoped. Along the way, we were helped by family, doctors, nurses, therapists, and friends. Once we had her “fixed,” readers of this website know we could then address the older daughter’s “bipolar disorder” in a more integrated fashion—one which looked beyond the symptoms themselves.

One of the innovative, integrative medical doctors who helped my younger daughter heal is Dr. James Roach (Dr. Jim, as some of his patients affectionately call him). He was recently featured in our local newspaper: Midway physician takes an integrative approach to help his patients. (This link may not stay around long).

Readers may recall the point in our story (in college) when the younger daughter's last psychiatric symptoms were gone, and she no longer needed psychiatric medications. It was then that I turned in puzzlement to Dr. Roach and sputtered out a BUT... "...but then where is the mental illness?" If she no longer needed antipsychotics, then where was her psychotic illness? His response was a simple, "Where indeed?"

He wrote thusly about “It's Not Mental”:

“Wolfson’s persevering drive to unravel her daughter’s debilitating ‘mental illness’ ultimately reveals its diverse, resolvable biomedical origin—an important truth for psychiatry. This is a vital book for parents and medical professionals alike!”

Integrative therapy is not “alternative medicine” although for some individuals, some treatments we call alternative may help (see note at bottom).

Modern psychiatry only gives lip service to their mantra about giving “individualized care,” and insurance often will not cover the 3-pronged treatment approach advocated - biological, social, and psychological. The only "biological" paid for is throwing random brain-chemical medications at symptoms, and the spiritual, and emotional care is woefully lacking. We already know the social net is lacking and many loved-ones are incarcerated instead of receiving the wrap-around medical and social care someone with dementia might receive. If there is any doubt about that, just read this heart-wrenching account from this one loving parent: Insanity - the Definition of Kentucky's Mental Health Laws at Work

Integrative medicine, as practiced by the best physicians, truly delivers. Dr. Roach hit the proverbial nail on the head for why my daughters suffered needlessly for so long with ‘mental’ illnesses that had “resolvable biomedical origins” when he stated about the medical professions (this supposedly includes “psychiatry”):

“Maybe we specialize too much. You need a general in charge of everything who can look at the whole body.”

He uses the word “integrative” to describe the style of medicine that melds high technology with extensive counseling and testing. The tests and treatments are often more precise and detailed than those found in some specialty clinics, and a good integrative doctor (any good doctor, in my opinion) has ample time to spend with each patient.

"There are answers. You just have to look for them. It takes time. But why don’t you at least look and see?”

“Why don’t you at least look and see?”

That is the question voiced in the epilogue of my book, and what I fervently advocate for-- for doctors who see patients with psychiatric symptoms to look beyond those symptoms to what truly ails them.

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Direct link to List of Important Resources.

Note: We call some treatments "alternative" such as use of herbals (which merely enhance the body's own defenses and healing powers), and nutritionals such as micronutrient supplements, even without knowing in advance the patient needs the extra nutrients. But since even these treatments are backed by numerous research and in some cases 1000+ years of practice (it is very difficult to have non-pharmaceutical research funded and fairly evaluated and reported on in a world dominated by the muscles of a trillion dollar pharmaceutical industry) perhaps they should not be considered "alternative." Additionally, these "alternative" treatments, including meditation, hypnotherapy, and biofeedback, and dietary changes are usually used in conjunction with other changes. Perhaps people call it "alternative" purely because insurance companies do not pay for this, and therefore, many psychiatrists do not suggest it. Indeed, many psychiatrists do not even know about any treatments other than those taught to them by the pharmaceutical companies themselves.

Property of www.ItsNotMental.com
Last Updated: 28 November 2011

Recovered - No Longer on Psychiatric Medications

2011-11-13T10:04:00.001-05:00

In No Longer Bipolar / No longer Schizophrenic - Recovered, In Remission, or Misdiagnosed ??? we discussed how to wrap our minds around the fact that many individuals, withalternative, complementary, functional, and/or biomedical therapies nolonger have severe, persistent, and supposedly life-long symptoms of Bipolar,Schizophrenia, Schizoaffective, Major Depressive Disorder and Anxiety--and theyare NOT on psychiatric medications.

"Recovered" is not a part of the usual paradigm of those involved in severe mental illness. Only "in recovery" is.

So what exactly IS "recovered"? And what is a real-life example of this?

I like this definition from Recovery From Schizophrenia and Other Psychotic Disorders:

Question: What does it mean to recover?
Answer: Full recovery means having regained a meaningful life, no longer having a mental health disability, and no longer being in need of any sort ofmental health treatment.This definition of “full recovery” should be contrasted with the definitions used by some who suggest that recovery should be thought of as learning how to have a better life, while continuing to be mentally ill and needing treatment such as [psychiatric] medications.

So, here is a simple case of how it works in real life.
You hopefully have already read the more complicated real-life case of my younger daughter in It's Not Mental (the book) (discussed later in this entry).

My older daughter had intractable, teen-onset treatment-resistant, ultradian cycling Bipolar Disorder for 13 years. She had been in and out of psychiatric hospitals. She is now fully recovered (see: Bipolar and Off Meds - Part1 and Bipolar and Off Meds - Part2.)

She had hypothyroidism, but was on a minimal amount of thyroid hormone – her endocrinologist refused to raise her level above the bottom-most number of “normal” because, after all – it IS “normal.”It didn’t matter that she still had symptoms of hypothyroidism and even psychiatric textbooks suggest trying a higher level (some people respond to slightly above “normal” range). There are various reasons a person’s available thyroid hormone may not work, such as low vitamin D, progesterone, omega-3s, antithyroidantibodies, ineffective thyroid transport mechanism etc. (see here for more: Brain Health: The Thyroid Connection).

A new GP entered the picture. Changing her thyroid medication to the prescription dessicated form (Armour Thyroid, which contains T1, T2,T3, T4) and raising the level to borderline hypERthyroid immediately helped mood, reducing depression and lethargy, and increased cognitive function. However, from her psychiatrist's point of view, this was irrelevant to her "bipolar" diagnosis. Since herpsychiatric symptoms had existed in spite of low but “normal” thyroid level, her psychiatrist only said, “I don’t understand.” This then, was still not considered a “medical cause” for her psychiatric symptoms even though the medical intervention lessened the symptoms.

She got on a micronutrient supplement (EMPowerPlus by Truehope) which worked better than the antipsychotic she had been on. The antipsychotic hadjust caused Tardive Dyskinesia (she was also on her base mood stabilizer-- an antiseizure medication). With the addition of the supplement, she no longer needed as much mood stabilizer and started overdosing on it. However her psychiatrist insisted that her onset of classic overdose symptoms could not possibly be due to overdosing on the mood stabilizer and absolutely did not want to try lowering the dose. She eventually insisted he help her safely lower it. He did, and the overdosed symptoms immediately subsided.

Still, there was more she needed.

A biomedical test for her body reacting to casein, gluten, yeast and soy [see Brain Health: The Gluten (Dis)Connection and Brain Health: Cut Out The Casein(Doped with Dairy) proved positive. The bovine casein indeed turned out to be a direct cause of her bipolar symptoms.

She changed her diet, healed her gut (see Gut, Brain, Bacteria, and Behavior), went through the terrible withdrawal symptoms from slowly getting off the psychiatric medication. She had to come off the medications since she no longer needed them, and she was overdosing on them as her body healed.

To remove all... ALL... symptoms.. the last of her intermittent brain fog, occasional negativity, hypoglycemia, etc. she had to get off all grains (other grains have small amounts of gluten) and be careful to eat some protein with every meal.

She was left with NO… ZERO… bipolar symptoms.

She has never lookedback, no longer considers herself to have bipolar disorder, and no longer has what we thought of as “bipolar personality.”

But there is no medical diagnostic code for a problem withcasein affecting brain function… although there is that ICD code for anunspecified encephalopathy (see ICD-10 vs DSM-V).

Still, the “mainstream” medical system does not recognizecasein as possibly affecting the brains of some individuals even thoughextensive research showing food-related causes (mostly gluten and dairy) datesback over 30 years with new research frequently being published in the medicaland scientific literature. And Dr. Doris Rapp, MD--Specialist in Environmental Medicine wrote a book decades ago about allergies and chemical causing symptoms exactly the same as we label "Bipolar", "ADHD", "OCD", "perseveration", "OCD", "ODD" and simply, bad. (See books below.)

I suppose this is because a pharmaceutical company does nothave a pill to treat it. Afterall, deficiency in methylated folate (vitamin B9) was not recognized until a pharmaceuticalcompany came out with a pill – Deplin – which is just methylated folate (vitamin B9). Ofcourse though, it is still for “Depression” and “Bipolar Disorder” which ishuge business. And, since it is for a “psychiatric” illness, doctors donot even need to test the patient for a methylation problem, a genetic variant(MTHFR/MTRR), or for a deficiency.

And by the way, by not testing, they may also miss amethylated B12 deficiency (a pharmaceutical company does not own a patent on a pill yet like they do with methylated B9). This and other problems can be easily picked up with nutrienttesting from labs such as Sepctracell, especially combined with others fromother innovative laboratories (Metametrix, Genova Diagnostics, Great PlainsLabs, etc.).

So, with no psychiatric medication, no bipolar symptoms, buton higher dose of thyroid medication plus a dietary change, what is that daughter’sbipolar?

A misdiagnosis? If so, what is herdiagnosis since we do not have one for (autoimmune reaction to) caseinaffecting the brain?
In remission as long as she stays onthe diet change?
It can’t be called “in remission”because “remission” is the current absence of illness/disease or symptomswithout currently being treated for it.
Cured?
Who cares? – They are all labelsanyway.

And what about the younger daughter? Assuming you read the book: "It's not Mental" – remember what the psychiatrist said? If she still didn’t have thesymptoms of schizoaffective in five years he willconsider her to “just not have schizoaffective.” But, “No, it was not amisdiagnosis.”

Then wheredid the schizoaffective go? And if it was "schizoaffective" – not a misdiagnosis:

Why aren’t all psychiatrists looking for the CAUSE of the symptoms? Or at least using an integrative, biomedical treatment approach to get the treatment closer to the core of the symptoms?

Why aren’tthe “regular” physicians treating this way?

Why will insurance not pay for these incredible testsand Integrative, inexpensive, health-promoting treatments?

Is it really because pharmaceutical companies likekeeping us sick and on multiple medications for life? (This is highly lucrative for them$ They are not "evil"$ It is also not a "conspiracy" since it is done blatantly--we just choose to ignore it as a society$ They are just businesses$)
Is it because doctorscannot just hand out a prescription pill for the stock DSM diagnosis which is easily done based on symptoms rather than digging deeper?
Is it because the psychiatrists are quite constrained by financial considerations - a 15 minute "medication management" consult and what insurance will pay for?

I do not have the answers, because whatever answer I give,there will be others saying “No, no, no…”

I hope this gives you food for thought, and I would behappy to know your opinions.

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Last Updated: 13 November 2011

No Longer Bipolar / No longer Schizophrenic - Recovered, In Remission, or Misdiagnosed ???

2011-10-13T16:27:00.015-04:00

Do people who have recovered from these “lifelong” illnesses of schizophrenia, schizoaffective and bipolar disorder still have these illnesses? Are they now in “remission” while no longer being symptomatic (albeit possibly with effective non-psychiatric biomedical care appropriate to their specific cause of symptoms?) Or, did they have misdiagnoses to begin with? (Read here for real life stories of remission/recovery from schizoaffective and bipolar -- no longer needing psychiatric medications.)

These questions are complex and highly debated. After all, these illnesses are supposed to be for life. People with severe “mental” illnesses are never expected to “recover,” just to continually struggle with maintaining, or returning to, a state called “in recovery” while on psychotropic medication.

But as readers of my book or this website know, both my daughters have recovered from their severe psychiatric illnesses (schizoaffective and bipolar). (Here is the post about when my older daughter "recovered from bipolar disorder")

Although my book touches on the topic of "recovery" vs "recovered" vs "misdiagnosis," I felt I should expand on this topic here since it is so misunderstood and controversial.

We know that some women have temporary and/or partial "remission" of symptoms during pregnancy (that should tell the doctors something!). However, we are talking here about the long-term type of "remission" or "recovery" which no longer requires psychiatric intervention for the (formerly) diagnosed condition.

The DSM (“Diagnostic and Statistical Manual of Mental Disorders”) states that when a person is diagnosed with bipolar, schizophrenia, or schizoaffective, the symptoms should not be due to another medical condition.

However, if they go to a psychiatrist, even if due to a medical condition (whether recognized by most mainstream doctors -- such as Lupus, sleep disorder, or hypothyroidism -- or mostly ignored by many mainstream medical doctors -- such as a reaction to gluten or casein), they will still be diagnosed with a psychiatric illness because psychiatrists use DSM diagnostic codes to bill insurance. The DSM has codes for mood and psychotic disorders due to medication reactions and medical illnesses. But “Bipolar,” “Schizoaffective,” “Schizophrenia,” “Mood Disorder-nos,” and “Psychotic Disorder-nos” are supposed to be reserved for the cases when the psychiatrist does not know the medical cause.

A medical doctor can avoid psychiatric labeling simply by using an ICD (medical) code for a medical illness. If unsure of the medical cause, “encephalopathy” (Any disease in which the functioning of the brain is affected by some agent or condition), can be used. Or, a diagnosis can be made (depending on symptoms) based on the area of the brain affected, such as “hypothalamic dysfunction.” (For more on this, see: ICD-10 vs DSM-V.)

There seems to be no controversy if the patient with “schizophrenia” or “bipolar” is later found to have Wilson’s disease or a brain or adrenal tumor that had caused their psychiatric symptoms. Everyone seems to be in agreement the schizophrenia/bipolar was, in those cases, MISdiagnoses.

A controversy, with the following views, arises if the biomedical treatment that eliminates the symptoms is treating a cause that is not documented by an ICD (medical) code (such as by eliminating gluten and dairy, raising thyroid levels, and/or taking nutritional supplements):

If the treatment is not recognized as the true remedy of the symptoms, then the illness is merely considered to be “in remission” but oddly, without medications. However, there is the view that all people with a “mental illness” should be on medication (even if they no longer have symptoms because "once you have a mental illness", they say, "you always have a mental illness").
If a psychiatric illness can ONLY be treated with psychiatric medications, but biomedical treatment works, then it wasn’t really a psychiatric illness.
If we accept that these “mental” illnesses CAN be treated with biomedical approaches, it would have to be accepted that autoimmune reactions, food sensitivites, hormonal imbalances, need for micronutrient supplementation, sleep disorders, etc. can be medical causes of major psychiatric illnesses. However, since the symptoms can still return if the treatment stops, the person really does have bipolar disorder, schizophrenia, or schizoaffective disorder. In this case, the person is considered to still be in treatment. (However, accepting a medical cause should negate the psychiatric diagnosis to begin with).

This is long enough for now. Next, I’ll give a real-life scenario of how this works and continue the discussion. (Read here for real life stories of remission/recovery from schizoaffective and bipolar -- no longer needing psychiatric medications.)

Comments, as always, are welcome.

Note, that there are people who seem to have healed from these disorders, and talk about it in terms of spiritual journeys to wellness. Some call it using a "life model" approach rather than a "medical model." That is best saved for other bloggers. Here is one such interesting location for such discussions: Recovery from "schizophrenia" and other "psychotic disorders"

Besides our book, please let me know about other books about people who had been diagnosed with bipolar, schizoaffective, or schizophrenia who are no longer symptomatic. I’ve included some below, along with books by physicians helping with recovery.

And for the non-medical, psycho-emotional theme: Here is one book (memoir) by Lia Govers, who recovered from emotionally-driven delusions, also labeled as schizophrenia.

All these different illnesses. . . all being called "bipolar" and "schizophrenia." No wonder we can't seem to come to any agreement on cause, let alone treatment.

Related Articles:

Property of: www.ItsNotMental.com
Last Updated: 02 December 2011

Brain Health: "Crazy" From Casein?? (Doped with Dairy)

2011-08-05T15:00:00.026-04:00

Evidence (see references below) shows cow dairy really can cause symptoms of "mental illness."

We’ve talked about Brain Health and the Gluten (Dis)Connection ( here ) and the connection found between gluten and some cases of schizophrenia ( here ). At the time, I mentioned my daughters also had to come off of DAIRY. They did test positive for IgA and IgG (immune) reactivity against the cow dairy protein (bovine casein). Such reactions may be involved in severe psychiatric disorders such as bipolar.[1]

Inflammation and other immune processes are increasingly linked to psychiatric diseases. . . Anti-casein IgG associations with bipolar I diagnoses, psychotic symptom history, and mania severity scores suggest that casein-related immune activation may relate to the psychosis and mania components of this mood disorder.

But there is another way a person can be affected by casein even without the IgA or IgG allergic-type reactions.

I tested positive to casein as well (IgG), although my own symptoms were confusing chronic hives and gut issues. I’d lived with it, along with issues with gluten, for so long I had not even realized I was also lactose intolerant!

Before I get back to the casein issue, let me explain the difference between lactose and casein.

Lactose is the milk sugar. Many people, after childhood, lose the enzyme, lactase, required to digest milk. Lactose is very different from casein, which is the milk protein. A dairy product which says “whey” or even “lactose-free” will contain casein—the protein. In fact, products that one might not think have dairy but have a “lactose” (dairy sugar) filler, such as many medicines, are contaminated with casein (dairy protein) and dairy peptides. Our family learned this the hard way, then verified it with several pharmacists.

We already know how addicted to milk and cheese some of our children who test positive to a dairy sensitivity/allergy seem. Why?

And... Why do some people have such a dairy issue even when they test negative to the IgG or IgA allergy testing for dairy?

And why do so many doctors talking about gluten and gut permeability often mention dairy in the same sentence?

First, there is another word we need to know – Peptide. Proteins are composed of peptides. Some peptides can be similar enough to other peptides that our body may respond to them in similar ways, such as when they bind to receptor sites on our cells. This is the case when a peptide from milk makes its way intact into our brain and binds to “opiod receptors.” Peptides during the digestion process are normally broken down to their basic components—amino acids (proteins are composed of various proportions of about 20 common amino acids).

The peptide in question in called β-casomorphin-7 (β-CM7) or beta-casomorphin. This milk peptide has been found to be taken up by the brain in people diagnosed with “mental” illnesses (i.e. DSM diagnoses) such as “autism” and “schizophrenia”[1][2][4] and even postpartum psychosis.[3] (See here for “Autism is Not A Mental Illness”.)

As we already have seen, gluten in some individuals, can contribute to intestinal inflammation and thus to gut permeability. One problem with this is then the gluten proteins can pass as peptides into the blood stream. One theory is that the gliadorphin (also known as gluteomorphin) molecule from gluten can affect brain function. It is similar to the casomorphin peptide, which is why some doctors will mention gluten and dairy in the same breath.

These peptides from gluten (grains such as wheat, rye, barley) and bovine (cow) dairy (casein) then act as neuropeptides (ie. Proteins that affect brain function). Here is a VIDEO lecture featuring noted psychiatrist James Greenblatt, MD about casomorphins, gliadorphins, and their implication in OCD, tics, schizophrenia, bipolar disorder, and eating disorders:
VIDEO: Neuroactive Peptides and Psychiatric Disorders (Click here).

And on an aside note, I knew my milk-loving child had problems with milk, but I thought it was just making her allergies worse—making her more congested and mucousy. And indeed, the same protein has been shown to make us release histamines (the stuff we take antihistamines for).[5]

beta-Casomorphine-7, a naturally occurring product of cow's milk with opiate-like activity, was studied for possible direct histamine liberation activities in humans. . . . Oral pretreatment with the H1 antagonist terfenadine [an antihistamine] significantly inhibited the skin responses to beta-casomorphine-7.

This is one of the ironies of my older daughter’s 13-year (mis)diagnosis of “bipolar disorder” (see “Bipolar and Off Her (psychiatric) Meds PART 1” and “PART 2” )—she now takes an antihistamine (Benadryl) as her “emergency med” rather than a psychiatric medication such as quetiapine or lorazepam. But mostly, she takes the preventative measure of staying away from gluten, dairy, and in her case, soy.

Since research is suggesting that some individuals may be reacting to gliadorphins and casomorphins regardless of the results from IgA and IgG testing for allergies/sensitivities to gluten or dairy, what is a person to do?

The simplest thing, in my opinion, is simply STOP gluten and dairy completely for a few months and see if that has any effect on symptoms, at the same time as taking steps to heal any potential problems with the gut (here).

But, there is a test available to see whether these milk and gluten peptides have actually slipped through intact and are therefore potentially wreaking havoc in the brain.

Click Here for the Gluten-Casein Peptide Test Brochure from Great Plains Laboratory.

And here is the direct link to the where the (urine) test for these gliadorphins and casomorphins can be ordered by either the patient or their physician: HERE

One of my daughters found that although cow (bovine) casein turned out to cause the exact symptoms that had been diagnosed as ultra-ultra rapid “bipolar disorder” according to the DSM, goat dairy did not. She had stayed off ALL dairy and healed her gut before attempting the goat cheese about a year later but then decided to not have even the goat dairy for reasons of her own particular general health.

Related Books and DVDs:

Click HERE for more related books on Nutrition in Amazon Store.

Other Related Links:

Allergies, Asthma, and “Mental” Illness
Inflammation, Schizophrenia, and Bipolar Disorder
Gluten Sensitivity and the Impact on the Brain (off-site article)
The Gluten File (off-site link)
Food Sensitivity Journal (off-site link with recipes)
Living Without (off-site Magazine website with recipes for people with various food allergies)
Brain Health: Nutrition and Epigenetics

REFERENCES

[1] Immune activation by casein dietary antigens in bipolar disorder.. Severance EG, Dupont D, Dickerson FB, Stallings CR, Origoni AE, Krivogorsky B, Yang S, Haasnoot W, Yolken RH. Bipolar Disorder. Bipolar Disord. 2010 Dec;12(8):834-42.

[2] A Peptide Found in Schizophrenia and Autism Causes Behavioral Changes in Rats Zhongjie Sun, J. Robert Cade Autism March 1, 1999 3: 85-95

[3] CSF and plasma beta-casomorphin-like opioid peptides in postpartum psychosis LH Lindstrom, F Nyberg, L Terenius, K Bauer, G Besev, LM Gunne, S Lyrenas, G Willdeck-Lund and B Lindberg Am J Psychiatry 1984; 141:1059-1066

[4] β-Casomorphin Induces Fos-Like Immunoreactivity in Discrete Brain Regions Relevant to Schizophrenia and Autism
Zhongjie Sun, J. Robert Cade, Melvin J. Fregly, R. Malcolm Privette Autism, March 1999; vol. 3, 1: pp. 67-83.

[5] A naturally occurring opioid peptide from cow's milk, beta-casomorphine-7, is a direct histamine releaser in man. Kurek M, Przybilla B, Hermann K, Ring J. Int Arch Allergy Immunol. 1992;97(2):115-20 also see:
Pseudoallergic skin reactions to opiate sequences of bovine casein in healthy children. Kurek M, Czerwionka-Szaflarska M, Doroszewska G. Rocz Akad Med Bialymst. 1995;40(3):480-5.]

Property of www.ItsNotMental.com
Last Updated: 12 August 2011

Recipient in 3 Book Award Categories! – Indie Book Awards

2011-06-25T11:51:00.009-04:00

It’s Not Mental by Jeanie Wolfson is one of three finalist winners in THREE different categories of the 2011 Next Generation Indie Book Awards.

These 3 categories are:

Best Cover Design – Non-Fiction
Education / Academic
Biography

“It’s Not Mental” is published by tiny Cerebella Publishing and distributed by Ingram Books, so any book store can order this book. It can also be easily obtained from on-line retailers such as Amazon Books and from Barnes and Noble

Readers of “It’s Not Mental” know how much books and reading were an integral part of Keri’s young life. I put together an Amazon list HERE (this is an Amazon.com outlet, or “Store”) of many of the books she loved to read as a young child, some of which were mentioned in the story. Most of these are sweet non-violent stories for young children since that is what she preferred. They would be great for summer reading, reading for winter break, and birthday gifts. As an adult, I have to admit, I enjoyed them as well.

List of 2011 Next Generation Indie Book Winners and Finalists: HERE

Related Posts (some of these are off-site links):

Property of: www.ItsNotMental.com
Last Updated: 25 June 2011

When Hearing Things Is Not Schizophrenia

2011-05-24T10:14:00.010-04:00

I received an E-mail (below) from a mother, Arna Mathiesen in Norway, who went that extra mile for her son who was hearing things, withdrawn, panicky, and dizzy for no apparent reason. She sent me a link to an article about him.

“When he was still in a room, he would be staring and not answering.” He was having panic attacks. The doctors initially could not find anything wrong with him and repeatedly suggested that his issues were mental.

Hmmm…. Let’s see, hearing things that no one else hears…Staring out into nothingness. Disengaged from life around him...Claiming symptoms the doctors couldn't believe in because they saw no medical cause. Schizophrenia perhaps? Severe Depression with psychosis? Bipolar Disorder? Schizoaffective?

Some people wonder why I accepted my daughters had diagnoses of “mental illness” and just needed medication “for depression,” “for bipolar,” and “for schizoaffective.” They cannot believe I was that “stupid,” or “naïve.” I readily acknowledge my ignorance. I do not think I am much different than most other people. I have a science background. I was entrenched in the belief that the medical doctors (and psychiatrists) would help, that the diagnoses were correct—after all, their symptoms absolutely DID meet the criteria for their psychiatric diagnoses—and I, too, had hubris—I did not wish to appear ignorant, believing that any of that “alternative whako stuff” had any validity. Mainstream medical doctors and pharmaceutical companies would have been proud of me.

The point is that when doctors do not find physical problems associated with the invisible complaints of the patient, those symptoms automatically meet the criteria for “mental.”

Here is the E-mail (printed with permission):

I am the mother of Wolfie, a boy who suddenly got very ill half a year ago.

We were in and out of hospitals about 6 times, several days each time.

Every day in the hospital I was asked if it had occurred to me that Wolfie had a mental problem.

Finally Wolfie was diagnosed and had a craniotomy in the US 2 months ago.

The diagnosis was Superior Semicircular Canal Dehiscence (SSCD). Less than 10 children in the world are diagnosed with this illness. Wolfie had more severe symptoms than any known SSCD-patient. If his symptoms had not been so severe he might never have been diagnosed correctly.

SSCD (or SCDS) was first described in the medical literature 12 years ago and still very few doctors know about it, but now some doctors think it is not unlikely that the mental hospitals are full of misdiagnosed SSCD patients.

The fantastic thing though is that SSCD is curable. We came back home 2 weeks after the surgery and Wolfie has been in school and perfectly without SSCD symptoms ever since (he has just a bit weak muscles after not being able to raise his head from the pillow due to vertigo and panic attacks for 4 months.

Why am I telling you this Jeanie?

The whole experience has just been so overwhelming and I feel the need to tell anybody who can help me get out the information so that others can be able to learn from Wolfie’s story and save their children from being locked inside a horrible medical condition nobody can figure out.

Here is the link to Wolfie’s story:

Search for a cure: Norway family finds relief for son’s condition in Baton Rouge (March 22, 2011) The Advocate

Note that at the mother’s insistence, the doctors in Norway searched until they had a medical diagnosis for Wolfie, even after their first battery of medical testing came up with nothing. Their centralized government health care system pays for diagnostics and treatments, so although the small country did not have the facility there to correct Wolfie’s problem, as they do in such cases, they send the patient wherever such treatment is available – even if it is half-way across the world.

Also note that not all people with this condition have such severe symptoms. Not all are so dizzy they cannot stand. That is why the doctors surmised that patients with SSCD can be misdiagnosed and treated erroneously with psychiatric medications, as is customary when a medical cause for sensory, behavioral, and affective symptoms are not yet known.

The treating doctor commented:

One unusual condition is called “autophony,” whereby a patient may hear all sorts of noises, Gianoli said. Body sounds like heartbeats, chewing, creaking joints and a person’s own voice will seem unusually loud in the affected ear. “Some patients even report that they hear their eyes move,” Gianoli said. . . “Sometimes a patient can get very position sensitive,” Gianoli said. Others may develop panic attacks.

As readers of my book, "It's Not Mental" know, my husband and I were repeatedly told by the medical professionals that the bizarre physical symptoms our child was complaining of were "mental." My husband and I did not dismiss the idea that they indeed were "mental." At the same time, we did not completely dismiss the idea that, as our child stated, they were "real." Such readers will also recall it was one of our daughter's largest gratitudes during those stressful years—that at least we did not disbelieve her.

Thank you, Arna Mathiesen, for sharing this interesting story in an effort to help others.

Further Reading:

Property of: www.ItsNotMental.com
Last Updated: 24 May 2011

Allergies, Asthma, and “Mental” Illness

2011-05-04T21:31:00.009-04:00

When most people hear the word “allergies” they think of sneezing, drippy noses, red eyes, and maybe some wheezing and congestion. Some people may think of hives or maybe even an anaphylactic reaction to food or insect bite allergies. Some may also visualize allergic people feeling fatigued, and having slowed, fuzzy thinking. They feel sick and lethargic, and indeed may even get more frequent infections.

But most people do not connect “seasonal allergies” and even “asthma” to more severe brain symptoms such as Major Depressive Disorder, and children’s “raging” and prolonged tantrums. Yet that connection exists. Remember the scene in my book about Keri’s summer of allergies segueing into to deep dark depths of depression? After decades of observant parents noticing that connection, mainstream media is finally reporting on the research validating those observations.

One newspaper, in their carefully mainstream, conservative science news section, ran an article [1] about allergies being linked to a higher risk of depression, anxiety, and possibly even an increase in suicide, explaining a cause-effect scenario involving allergic inflammation affecting a brain neurotransmitter (thereby affecting mood).

Unfortunately, I saw other outlets reporting on the same research perpetuating the misconception that “psychiatric” (medical) is the same as “emotional” or “psychological” with misleading headlines (and text) about allergies causing “emotional problems” or being “psychologically harmful”[2] implying that having allergies causes so much emotional distress that the person’s personality becomes… what?… distorted in some way, and if only they had stronger character the inflammatory process causing brain function changes would not happen? No wonder the general public is confused and stigma persists about the illnesses that affect brain function, those that we term “mental illness.” The pattern of blaming the victim persists, in part, due to such reporting.

What does the actual research say about both allergies and asthma and the higher risk of “mental” illness? As we’ve previously discussed, allergic reactions release inflammatory cytokines.[1,2] The inflammation is said to precede symptoms as severe as bipolar disorder.[3] Now, scientists are saying the cytokines might reduce levels of the hormone/neurotransmitter serotonin, which helps maintain feelings of well-being.[1,2]

To complicate matters, some common allergy and asthma medications including those with corticosteroids and/or salmeterol can cause anxiety, mood swings, insomnia, hallucinations,[1,3,4] and paranoia[5].

The next big questions are 1- Is there other scientific medical research about the connection between asthma/allergies and “mental” illness, and 2- Why are there more cases of allergies and asthma?

In answer to #1 – Yes. Remember in my book I talked about the hypothalamic-pituitary axis? From an article in 2008 titled: “A Review of Candidate Pathways Underlying the Association Between Asthma and Major Depressive Disorder:”[6]

Results: MDD [Major Depressive Disorder] occurs in almost half of patients with asthma assessed in tertiary care centers. Dysregulation of the hypothalamic pituitary adrenal axis may predispose people to both MDD and asthma, and similar alterations in the immune, autonomic nervous, and other key systems are apparent and may contribute to this increased risk of co-occurrence.

Conclusions: High rates of MDD in asthma may result from the stress of chronic illness, the medications used to treat it, or a combination of the two. The high level of co-occurrence may also reflect dysregulation of certain stress-sensitive biological processes that contribute to the pathophysiology of both conditions.

Which leads to question #2 - why are more children ill with asthma and allergies? Theories abound, with many leading back to the gut/probiotic/brain connection. These theories include the increased prevalence in babies being delivered via C-section (referenced in my book), as well with the increased use of antibiotics[7].

In a study of antibiotic use in infants:[8]

Babies given antibiotics before the age of six months are up to 70 per cent more likely to develop asthma later in childhood . . .

In a report on their findings, the Yale researchers blamed the drugs for upsetting the balance of protective microbes in a baby's gut, which help to ward off illness in the early stages of life.

'Very early microbial exposure, particularly in the intestinal tract, seems necessary for a mature and balanced immune system in childhood.

'Antibiotic use, especially broad spectrum antibiotics, may alter microbial flora in the gut, thereby causing imbalances in the immune system and a poor allergic response.'

Doing a further search on the allergy-asthma connection we find links to acetaminophen use in infants (increasing risk of both asthma and eczema)[9], stress during pregnancy[10], and even the excessive consumption of fast-food hamburgers (more than 3 per week)[11].

Which in my mind just leads full circle to the fact that environmental stressors on the organism, whether due to toxins (constantly increasing in our world), absence of normal gut biota, emotional traumas, poor nutrition, poor sleep, poor health, etc… leads to inflammation and immune malfunction, mitochondrial dysfunction, more poor sleep, more poor health, more stress, etc.

Remember what different doctors both said about my daughter’s illness – that it was systemic—body-wide—not just “in her head?” One factor affects multiple parts affecting the whole of the person, even though modern medicine is set up to just look at pieces of us.

Our job is to break the cycle. Heal the whole.

This post is long enough. I haven’t even touched on “brain allergies” which are so commonly associated with reactions to foods and chemicals.

Here is interesting reading on that topic: BRAIN ALLERGIES.
Be sure to see the books and video below!

This video news story about a boy with autism really resonated with me with talk about the boy’s illness affecting the WHOLE BODY, causing pain and affecting mitochondria and the gut … or should we say when something affects the gut and the mitochondria, and causes pain, the WHOLE BODY is affected.

Autism Now: Meet Nick, Robert MacNeil's Grandson, PBS NewsHour, PBS Video
Related article: Autism Is Not a “Mental Illness”

If you read nothing else, at least get some ideas from my book, and read this books by Dr. Doris Rapp, MD - pediatrician, allergist, and board-certified specialist in environmental medicine, and watch this video!!

WATCH this child get "bipolar" and perseverate with just a drop of pollen!

Here is Dr. Doris Rapp's website: http://www.drrapp.com/

If you have read my book, you'll know - our lives would have been at least partially better if we had read her book twenty years ago!

Related Books:

References

[1] "Studies link allergies to higher depression risk" Lexington Herald-Leader 12 April, 2011.

[2] New York Times Are Allergies and Depression Related?

[3] Inflammation of Body and Brain

[4] See listed side effects for Advair, pseudoephedrine and Benadryl.

[5] "It’s Not Mental" (the book) by Jeanie Wolfson

[6] A Review of Candidate Pathways Underlying the Association Between Asthma and Major Depressive Disorder Psychosomatic Medicine February/March 2009 vol. 71 no. 2 187-195

[7] Babies given antibiotics before six-months have a higher asthma risk

[8] Gut, Brain, Bacteria and Behavior

[9] Acetaminophen may raise asthma risk in kids
Study covered pain reliever's use among children in 31 countries

[10] Pregnancy Stress Ups Kids' Asthma Risk Study Shows Stress on Moms May Affect Child's Immune Response

[11] Hamburgers Linked to Asthma Risk in Kids Study Shows Higher Risk for Asthma in Kids Who Eat 3 or More Burgers a Week

Property of: www.ItsNotMental.com
Last Updated: 4 November 2011

Gut, Brain, Bacteria, and Behavior

2011-03-24T14:56:00.013-04:00

Can the way we use antibiotics — without focusing on keeping up the normal biota in our gut that antibiotics wipe out — be contributing to the rise in both “mental” illnesses as well as inflammatory and metabolic disorders such as allergies and diabetes?

Scientists are saying “YES.”

They are re-confirming what many doctors and researchers in the field of Integrative medicine have been saying for years — that gut health is intimately connected with the function of our brain.[1]

The gut-brain connection is being implicated in brain disorders ranging from anxiety to schizophrenia (as it was in my own children).

One recent study[2] showed that having normal gut bacteria during early life may result in resistance to not just intestinal problems, but to systemic autoimmunity and allergic responses. Why? The authors say the bacteria

"promote anti-inflammatory immune responses by expanding and activating regulatory T-cells. The finding has important implications for understanding how gut-resident bacteria affect both intestinal and systemic immune responses."

What are T-cells and how does this tie in with mental illness? T-cells are the white blood cells that search and destroy foreign bodies that threaten the host. A healthy gut equals a healthy person.

But even more directly relating to the brain, is another study. In a communiqué from McMaster University via EurekAlert! [3], we find:

A lot of chatter goes on inside each one of us and not all of it happens between our ears.

Researchers at McMaster University discovered that the "cross-talk" between bacteria in our gut and our brain plays an important role in the development of psychiatric illness, intestinal diseases and probably other health problems as well including obesity.

"The wave of the future is full of opportunity as we think about how microbiota or bacteria influence the brain and how the bi-directional communication of the body and the brain influence metabolic disorders, such as obesity and diabetes," says Jane Foster, associate professor in the Department of Psychiatry and Behavioural Neurosciences of the Michael G. DeGroote School of Medicine.

In a study using germ-free mice, Foster and colleagues found the functioning of genes (see epigenetics) linked to learning and memory are altered in the absence of germs. In particular, they found the genes functioning differently in one of the key brain regions for learning and memory -- the hippocampus.

"The take-home message is that gut bacteria influences anxiety-like behavior through alterations in the way the brain is wired," said Foster.

This study took place in the Brain-Body Institute, a joint research initiative of McMaster University and St. Joseph's Healthcare in Hamilton. The institute was created to advance understanding of the relationship between the brain, nervous system and bodily disorders.

"We have a hypothesis in my lab that the state of your immune system and your gut bacteria -- which are in constant communication -- influences your personality," Foster said.

She said psychiatrists, in particular, are interested in her research because of the problems of side effects with current drug therapy.

"The idea behind this research is to see if it's possible to develop new therapies which could target the body, free of complications related to getting into the brain," Foster said. "We need novel targets that take a different approach than what is currently on the market for psychiatric illness. Those targets could be the immune system, your gut function…we could even use the body to screen patients to say what drugs might work better in their brain."

Gut health was definitely an intensely important factor in my children’s recovery from “mental” illness.

Many people address the gut issue on multiple fronts:

Digestion from chewing to elimination, possibly using digestive enzymes.
Probiotics (normal biota of the gut can be affected even from birth such as in the case of Caesarian Sections, but also later from antibiotics, poor diet, and illness).
Prebiotics nutrients (such as arabinogalactan) and fiber to assist in the gut bacteria taking hold and flourishing).
Attacking Candida overgrowth that typically occurs in the absence of normal gut bacteria (often done via a low sugar, low refined-carb diet (such as a person with diabetes or metabolic syndrome should eat) plus over-the-counter anticandidal agents, and occasionally prescription antifungal agents).
Healthy diet – well-rounded with lots of whole foods and fiber.
Eliminating foods which the person may be allergic or sensitive to. Food sensitivity testing can be done in different ways, such as:
- IgA testing (see www.enterolab.com)
- IgG blood testing (see here for an easy at-home kit, from the Life Extension foundation, which you mail in).
- There is even a urine test for gliadin (gluten – wheat, rye, barley) and casein (dairy): GPL Gluten-Casein (gliadorphin / casomorphin) Peptide Test
Note that foods (such as gluten and cow casein) as well as an assortment of food and environmental sensitivities can also directly cause brain symptoms, and may not be just affecting gut health. (See here, here, here and here).

Related Reading:

A Few Related Books and DVDs (see site for more):

Important Related Off-site Links:

References:

[1] K. M. Neufeld, N. Kang, J. Bienenstock, J. A. Foster. Reduced anxiety-like behavior and central neurochemical change in germ-free mice. Neurogastroenterology & Motility, 2011; 23 (3): 255 DOI: 10.1111/j.1365-2982.2010.01620.x
[2] Induction of colonic regulatory T cells by indigenous Clostridium species.
[3] 'Knowing It In Your Gut' Is Real, Researchers Find

Property of www.ItsNotMental.com
Last Updated: 25 October 2011

Getting Better – Part 1 - Overview (Bipolar and Off Her Meds Part 2)

2011-02-19T15:08:00.012-05:00

Over a year ago, I wrote of an unexpected event in our lives, “Bipolar and Off Her Meds (and doing well),” about my older daughter. I promised to eventually provide more information. Fortunately, my children are far from unique in their experience of recovery from the epidemic of mental illness.

It is, perhaps, ironic, that my older daughter’s former psychiatrist wanted information from her—research he could hand out to patients—on how she got better. The research is not new. It has been available for over thirty years.

Thirteen years of psychiatric medications and multiple hospitalizations had never stabilized her. Yet she now has no symptoms – and isn’t even on psychiatric-type medications. I will add a caveat to the "no symptoms" statement. She does have the emotional fallout to deal with from the life experiences she had while unstable. And she, like her sister, can get various temporary symptoms (such as brain-fog, mood swings, etc) from foods eaten, as you will see as this series progresses.

The psychiatrist has had other cases over the years like hers—ones he could not stabilize. He works in a psychiatric hospital, and the same situation exists there today. My older daughter had ultradian cycling (ultra ultra-rapid cycling) bipolar disorder that is notoriously difficult to treat, and usually has a poor outcome.

I say it is ironic, because one thing that helped her so much was simply increasing her thyroid hormone levels, a tactic which has been in psychiatric textbooks, I am told, for many decades. The other irony is he himself had been the one to first give me research papers, many years ago in my younger daughter’s case, about the possible connection between autism and the gut, even though my daughter's diagnosis was NOT "autism" but rather, had meltdowns and symptoms of depression, mood swings and hallucinations. Readers of the book It's Not Mental, would be well aware of that part of our story.

My older daughter had teen-onset bipolar disorder. Today, she is bipolar disorder symptom-free on just:

Dessicated thyroid hormone (prescription) with her fT3 & fT4 levels optimized for her needs,
Diet change for Gluten, cow-dairy, and soy intolerance plus low refined carbs & sugar intake to control metabolic syndrome,
Help for sleep – Melatonin, tryptophan, and both a small dose of Ambien and sometimes Benadryl to counter painful effects of a permanent side-effect left from antipsychotic use (a tardive dyskinesia called tardive akathisia, and painful muscle tightness. The Ambien allows her to fall asleep in spite of this).

But getting to this point was not easy, and I am not even talking about the horrific, brutal withdrawal symptoms from coming off the psychotropic medications. She had to get to a place mentally and emotionally where she was willing to do whatever it took to get better even if that meant the scary prospect of changing her diet -- giving up foods she seemed addicted to. After that, there were still steps needed to help her heal.

After seeing her little sister get better, she switched to a more caring GP (the same one treating her sister who has recovered from a combination of schizophrenia and bipolar) and also attacked her illness on multiple fronts:

Micronutrients (EMPowerplus by Truehope)
Thyroid hormone (prescription dessicated thyroid hormone raising T3/T4 levels to UPPER range)
Understanding of overdose symptoms/side-effects, and true illness symptoms vs withdrawal symptoms
Help for withdrawal symptoms
Diet changes
Gut health (anti-candida, pro-biotics)
Sleep

That may sound complicated but it was actually much simpler and straight-forward than her sister’s case. After reading what it took for her little sister to get better, you will recognize we implemented those lessons learned, and this one was a piece-of-cake in comparison.

In other entries, I will delve more deeply into each, although readers of the book about her younger sister , probably already have a pretty good idea about each part.

Related Reading:

Good educational Videos about Gluten Sensitivity/Celiac, and cross-reactive foods from Health Now Medical's Channel (See book "The Gluten Effect")

Having trouble figuring out where to start, let alone a specialist to start with? Click here for list of resources: Helpful resources -- websites, articles, books, organizations, products (I do not sell these products.)

Related Books

Property of www.ItsNotMental.com
Last Updated: 09 December 2011

We Have Sick Children

2011-02-08T11:14:00.012-05:00

The latest statistics in the U.S.A. show that one in FOUR children are now on long-term prescription medications for chronic illnesses.

This does not include acute care medicines such as antibiotics for a sinus infection. It doesn’t even include over-the-counter (OTC) medications such as allergy medications, cough medicines, and analgesics. It means medications such as for asthma, diabetes, autoimmune disease, high cholesterol, and “mental” illnesses.

This is great news for the pharmaceutical companies and their shareholders.

It isn’t such good news for the American public. But it is so much faster for a physician to put children on long-term medications for what seems to be a pervasive problem in the very fabric of our society, than to tackle the underlying social, personal, medical, environmental, and familial issues head-on.

Both my children were 2 of those one-in-four children on chronic prescription medications. And, they were two of the one-in-five children with psychiatric diagnoses.[1] The psychiatric medications helped dampen some symptoms, but damaged them in the long run. But worse -- they did not get at what was causing their symptoms. The medications do not heal them.

What I feel is even more horrific for us, but certainly wonderful for the pharmaceutical industry, is that even when it turns out the person does not need the psychiatric medications such as antipsychotics and mood stabilizers, and even though they are deemed "non-addictive," our experience (and that of many others) is that getting off them can have withdrawal symptoms that rival those people describe getting off Heroin.

According to Maggie Kozel, M.D,’s article in the Huffington Post,[2]

A recent study by the AAP predicts that treatment of mental illness and mood disorders will soon make up 30-40 percent of a pediatrician's office practice.[3].

To put this trend in perspective, an earlier study that appeared in the journal Pediatrics revealed that 8 percent of pediatricians felt they had adequate training in prescribing antidepressants, 16 percent felt comfortable prescribing them, but 72 percent actually did.

A woman I encountered on one discussion board was complaining that her sister did not understand her children’s bipolar illness. The sister kept harping at her about her children’s poor diet. She commented with sarcastic bitterness something to the effect: “Yeah, Right. Like change the way the kids eat and they won’t have bipolar disorder anymore.”

I slunk away, not daring to comment. I could have been that same woman a few years earlier. Not that my children ate poorly. And I do not think that woman’s sister is correct. After all, my younger daughter got ill with “mental” illness in spite of not eating junk food. Pre-natal and too many other environmental factors come into play.

In fact, our babies are even being born with toxins already in them, and many are then exposed to many more avoidable ones during early growth years. The CDC says 95% of us have endocrine-disrupting toxins (BPA from plastics) in our body.[5] Newborn infants have an average of 287 toxins in their umbilical cords![6]

But I had no idea back then how much food reactions, and toxins — including toxins from things such as plastics coming in contact with the food — gut health, and the need for food supplements (Vitamin D, K, B vitamins, melatonin, tryptophan, EMPowerPlus and more) would feature so prominently in the mystery of both my daughters' severe, unrelenting “mental” illnesses of anxiety, depression, ultradian cycling bipolar disorder and schizophrenia spectrum (schizoaffective) disorders.

Yep. I was the skeptical woman who completely trusted the medical industry rather than, like the woman on the board with her sister, giving any credence to my father sending me information and food supplements. I am ashamed to say it – but I completely understand that woman. I blew off my dad, with all his hours spent reading the research literature, and even his lovingly packaged supplements.

Ah well. Live and learn. I am just glad my kids forgive me for my former arrogance and ignorance. After all, I was from a science background. I shared the same hubris as apparently much of the medical professionals we encountered do.@ I did not understand "Integrative Medicine," confusing it with "Alternative Medicine." And, I did not give credence to the thousand-plus year history of medical science the pharmaceutical industry has brainwashed us to call "Alternative" and to deride. AND, the term "Functional Medicine" had not yet even been coined.

@ Note: We now surround ourselves with medical professionals who are incredible - so present company are not included in the list of past arrogant medical professionals.

If you read nothing else, at least get some ideas from my book, and read these books by Dr. Doris Rapp, MD - pediatrician, allergist, and board-certified specialist in environmental medicine, and watch this video!!

Here is her website: http://www.drrapp.com/

If you have read my book, you'll know - our lives would have been different if we had read her book twenty years ago!

Resources:
[1] NIH Educational Guide to Mental Health

[2] Little Pharma: The Medication of U.S. Children by Maggie Kozel, MD. -- The Huffington Post

[3] AAP department of Community and Specialty Pediatrics. "Resources Help Primary Care Clinicians Address Mental Health Concerns." AAP News 31 (7) 34

[4] Jerry L. Rushton, et al. "Pediatrician and Family Physician Prescription of Selective Serotonin Reuptake Inhibitors." Pediatrics 105 (6): e82

[5] National Report on Human Exposure to Environmental Chemicals

[6] Body Burden — The Pollution in Newborns: A benchmark investigation of industrial chemicals, pollutants and pesticides in umbilical cord blood Environmental Working Group, July 14, 2005

Related Books:

Click HERE to see a more complete list of suggested books.

Related Blogs, Sites, and Posts:

Additional Reading:

Property of www.ItsNotMental.com
Last Updated: 7 October 2011

Childhood-onset Schizoaffective - A Medical Doctor's Perspective of the Case

2011-01-15T13:13:00.005-05:00

We are fortunate to have the following perspective about my daughter's case (and the book) from her General Practitioner, Dr. David Marwil, M.D.

Please note that Dr. Marwil is a traditional doctor (not specializing in "alternative medicine" nor "complementary" or "naturopathic," etc.) He is a regular GP who goes the extra mile for his patients.

Jeanie Wolfson and her daughter Keri walked into my office several years ago, frustrated and discouraged. For many years, Keri had been experiencing profound fatigue, sleepiness, headaches, body pains, and hallucinations.

She had seen a long list of doctors, including endocrinologists, neurologists, and psychiatrists, and she was on an even longer list of medications. No diagnosis had ever been given that adequately explained her symptoms.

Jeanie was engaged in her daughter’s health care. When she wasn’t working at her full-time job, she occasionally spent time on the Internet looking for causes of Keri’s symptoms, where she encountered esoteric disorders never before heard of by Keri’s physicians.

Compiling a new history from the very beginning, I realized that poor sleep, excessive sleep, and REM-like (dream-like) hallucinations had plagued Keri from a very young age. Knowing the importance of sleep, I sent Keri for a sleep study, which surprisingly had never before been suggested.

Armed with the idea that sleep problems could be contributing to her daughter’s collection of problems, Jeanie ultimately came across the name of a cutting-edge endocrinologist in Nevada, who, after speaking with her, thought he might be able to help her daughter. Jeanie and Keri made the trip, and after exhaustive testing, the doctor found numerous anomalies in Keri’s blood, bone, and intestinal absorption. He came up with a theory about what could possibly be causing all her problems, and he began treatment in an attempt to help alleviate them. He also included me in the loop. As results of tests were compiled, I was able to review them to continue Keri’s care as her primary physician.

Keri seemed to feel a little better after starting medical treatment. She was by no means well, but some of her symptoms improved, such as low bone-density, pain, and frequent infections. Upon review of her test results, I noticed that her thyroid level was a little low. I didn’t think her level was low enough to cause even subtle symptoms, and yet she had florid symptoms of low thyroid, such as fatigue, sleepiness, depression, dry skin, brittle hair, lack of menstruation, body aches, and feeling cold. When we started her on thyroid hormone treatment, her low-thyroid symptoms dramatically improved. She was no longer as sleepy. She began to menstruate, her skin and hair improved, and her mood brightened. She could go to school, pay attention in class, and do her homework. I was amazed that something so subtle could cause such profound symptoms.

Keri exhibited other symptoms, including hallucinations and insomnia, which did not fit a diagnosis of low thyroid. Neither did these symptoms seem connected to other hormones on which Keri was low, including cortisol and progesterone. Yet these symptoms also partially improved with the introduction of additional hormones. Obviously, there was more to the puzzle.

I learned from research articles Jeanie brought in that certain vitamin and mineral deficiencies can affect the function of some of the brain’s chemical receptors. She found supplements that contained large amounts of these nutrients. Interestingly, Keri’s symptoms improved after starting these supplements and worsened when they were withheld. I developed a new respect for the role of nutrients and herbs in promoting health. I no longer looked at them as “alternative” medicine, but rather as “integrative” medicine.

My experience with Keri and Jeanie helped me to rethink how I practice medicine. I have always tried to take the approach I learned during training, which is to collect a list of symptoms from the patient, come up with a working diagnosis, then go back and elicit other symptoms to fit the diagnosis. If the patient’s symptoms did not fit my preferred diagnosis, I would dismiss them as confounding and irrelevant. Now I take the approach of collecting the symptoms, fitting them into diagnostic categories, and holding in reserve the unexplained symptoms. As in a crossword puzzle, if you don’t know the answer to a particular clue, you can go on to the next one. Once more boxes are filled in, you may eventually find the answer.

Our patients are giving us the clues, and every one of them is important. As physicians, we must keep our minds open and vigilant. There is much we don’t know. The paradigm has always been to follow prescribed diagnostic protocols and evidence-based treatment. Insurance companies have picked up on this paradigm and thus limit their coverage only to those particular protocols and treatments. The problem is, much of what we do is not evidence-based, so we must rely on critical thinking and intuition, that which we refer to as the art of medicine.

Jeanie’s dogged pursuit of a solution to Keri’s problem, coupled with our serendipitous discovery of abnormal blood tests, gave Keri back her life. God bless Jeanie for the sacrifice she made for her daughter, and God bless Keri for the suffering she endured. Now the time for suffering is over, but the time for a more comprehensive approach to patient care is just beginning.

Written by David Marwil, M.D.

Related Entries:

Suggested Books:

Property of www.ItsNotMental.com/Jeanie Wolfson
Last Updated: 11 February 2011 (Links added)

Brain Health: Thyroid Hormones

2011-01-09T16:33:00.007-05:00

There is good reason the book, It's not mental, talks so much about thyroid hormones, dedicating an appendix to that topic. Not only were those hormone levels intertwined with both my daughters’ cases of ultradian cycling “bipolar” and “schizoaffective” (schizophrenia with a mood disorder), but the topic has been in psychiatric textbooks, and involved in the research on these brain symptoms, for going on half a century.

Many doctors only measure TSH – Thyroid stimulating hormone - from the pituitary. If the level lies within a broad range of statistical “normalcy” for the population, they say “the thyroid is fine” without ever measuring the levels of actual thyroid hormone (from the thyroid gland). Not only can this be misleading, even when measuring actual thyroid hormone levels, what is optimal for one person may be in the upper range of “normal,” whereas another may do well with levels in the bottom range. For some, bottom range of “normal” may still lead to pathology – symptoms – due to additional factors such as genetics, antibodies, ability to convert one form of thyroid hormone (T4) to the form cells require (T3), levels of nutrients and other hormones, and ability to transport the hormone across the blood-brain barrier.

So much has been written about this topic that I will not reference an article here for each statement above (see my book for references). Instead I will send you to some major informational sources (see BELOW) about hypothyroidism (low thyroid hormone levels) and hyperthyroidism (high thyroid levels) in relation to the brain (i.e. “mental” illness).

Here is Hypothyroidism: Is It Contributing to Your Child's Symptoms? from a CABF (Child and Adolescent Bipolar Foundation) newsletter quoting the medical doctor who contributed information on the topic in “It's not mental.” Or for those who are more scientific-minded, go straight to these wonderful articles referenced from Current Psychiatry Online (login required), but hopefully you can go straight to these cached versions:
Identifying hypothyroidism’s psychiatric presentations
Identifying hyperthyroidism’s psychiatric presentations

In a nutshell for hypothyroidism (low thyroid level):

➢ Patients diagnosed with mental illnesses, especially those with a mood component, are more likely to have the biochemical involvement of a thyroid hormone imbalance than the general population.

➢ Patients with thyroid disturbance and psychiatric symptoms are most often diagnosed with one of the following:

atypical depression (which may present as dysthymia)
bipolar spectrum syndrome (including manic-depression, mixed mania, bipolar depression, rapid-cycling bipolar disorder, cyclothymia, and premenstrual syndromes)
borderline personality disorder
psychotic disorder (typically, paranoid psychosis)

➢ Psychiatric symptoms of hypothyroidism can include:

psychosis
depression
mood instability
mania
anxiety
hypersomnia
apathy
lack of energy
impaired memory
psychomotor slowing
attentional problems

➢ Timing of blood draws for testing matters and should include so much more than TSH, such as

free triiodothyronine (T3)
free levothyroxine (T4)
total T3
total T4
antithyroid antibodies
serum cholesterol
prolactin
and even nutrients such as omega-3 fatty acids and Vitamin D.

(A list of tests for possible problems with thyroid functioning or hormone utilization suggested by Dr. Thomas Geracioti is included in the book and a longer list of possible tests are included in an appendix.)

Interestingly, when a regular family GP finally switched my older daughter’s prescription T4 thyroid hormone to a prescription natural dessicated type, and increased her thyroid hormone levels to the upper range (they had been on the bottom-most number), we got the first glimmer of real hope for her in over a decade.

Although we had a psychiatric textbook writer inform us this technique (increasing thyroid hormone level) has been in psychiatric textbooks for decades, and even though she had symptoms of low thyroid such as the dry cracking skin, mood problems and more, her psychiatrist’s response, was “But, I don’t understand! Why increase it when it was normal?”

Fine. He is not an endocrinologist, but the endocrinologists don’t seem to be informed about psychiatric care (see Psychiatrist vs Endocrinologist: Who is Responsible?)

Note that my older daughter had hypothyroidism before this, and was already on hormone, but the endocrinologist had brought her level up to the rock-bottom number of “normal” and rather than re-test and readjust, even though she still had symptoms – had just left it there, feeling her job was done.

Dr. John Lowe explains that thyroid hormone resistance began being investigated in the 1950s, yet many endocrinologists still have never heard of it, or believe it’s a rare condition.

“The difference between hypothyroidism where there is a deficiency of thyroid hormone, and thyroid hormone resistance, is that the same amount of thyroid hormone—within the laboratories’ reference range—that would maintain normal metabolism in cells don’t do so adequately.

Those people [with thyroid hormone resistance] need a much higher dosage of hormones—a dosage that would cause most endocrinologists to scream, “You’re going to die of heart attack if you don’t get off that,”

Now that my older daughter is doing so well (see Bipolar and Off Her Meds), the psychiatrist asked her for articles on these medical treatments that have worked to stabilize her when he never could. After all, there are so many more like her with intractable ultra-ultra-rapid cycling bipolar (ultradian cycling bipolar). Well, I have just shared some of the articles with everyone. But this information is supposed to be right in the psychiatric textbooks – unless it has been removed in the newer textbooks, so influenced by a massive pharmaceutical industry which is making billions of dollars on people using psychiatric medications for life.

Related Books:

Additional Reading:

Property of www.ItsNotMental.com
Last Updated: 27 February 2011

Brain Health: Vitamin D

2010-12-31T15:42:00.011-05:00

Just in time for the winter months is a reminder about sunlight, blue light, sleep, and that all-important hormone, vitamin D.

We’ve talked at length about the importance of sleep hygiene—the sleep-wake cycle, diet and exercise—but also of critical importance is the “sunshine vitamin,” the hormone we call “Vitamin D.” Readers of the BOOK- "It's not Mental" know how all this tied in to my daughter's full recovery from bipolar/schizoaffective disorder.

Historically, the FDA made a grave error in its vitamin D recommendation level due to a misunderstanding in the scientific community about what vitamin D does. Their recommendation was just high enough to prevent immediate damage (rickets) and immediate death but, at the time, they did not realize that this did not prevent slower long-term damage (“mental” illness, autoimmune diseases, lower immune function, obesity) and earlier deaths (cancer, heart attacks).

One of the most influential scientists responsible for the old FDA recommendation, Dr. Robert P. Heaney, M.D.) speaks out on the error he and his colleagues made (see video below).

Note that Dr. Heaney says in his talk that which vitamin D taken and which is measured in the blood matters – vitamin D3, not D2 is what the body requires, and it is the serum total 25(OH)D status that matters. Also, the “recommended” levels is actually the MINIMUM level – something to keep in mind when we read about “recommended” levels of a nutrient. (that video is embedded last, below)

Here is a very short CBS News video from 2008 stating that the new FDA recommendation for children is DOUBLE that of their previous recommendation. Doctors Now Say to Double Vitamin D Note that from personal experience we found not to just go by taking supplements of Vitamin D3 since not everyone can absorb and utilize it the same; Testing of a person's Vitamin D level is necessary. For instance, one person may have optimal levels on 2000 units per day while someone else may need more than 10,000 units per day. So have your doctor check your levels and not just go by the amount you ingest.

Although the minimal blood level for vitamin D is 32, our experience has been that many doctors say between 50-70 is optimal, so they want us to supplement at least up to that blood level of 50.

Next, some people have a vitamin D Cell receptor polymorphism necessitating the intake of more vitamin D3 just to have an adequate amount in their cells. Again, we found this out the hard way, when one family member could not seem to get her vitamin D level up and there was bone involvement. At least once, you may want to either get genetically tested for this, or consider the SpectraCell Laboratories Micronutrient analysis which will determine the level inside your cells.

Next is a wonderfully easy-to understand 10 minute video exploring the history, current knowledge, and what to do about getting the proper dose and proper form (i.e. D3 rather than D2):

I highly recommend this lecture, below, (What is a Vitamin D Deficiency? ) for those intrepid souls wanting to watch the entertaining, fascinating, eye-opening full-length (45 minute) explanation of the importance of higher levels of vitamin D levels and what a vitamin D deficiency actually is and how the wrong recommendation occurred straight from the scientist responsible – Dr. Robert P. Heaney, M.D.

Note that he stresses that all these “recommended” amounts, are actually the MINIMUM amounts possible to prevent really bad things from happening to us! He says that since we dropped the word “minimum” the general public now thinks the FDA recommendations are optimal when they are not. They are still MINIMAL.
What is a Vitamin D Deficiency?

For those who would prefer reading, here is a Scientific American article about vitamin D and brain function:
Does Vitamin D Improve Brain Function? New studies show low vitamin D levels may impair cognitive function

And lastly:

Related Entries:

Related Books:

Property of www.ItsNotMental.com
Last Updated: 15 December 2011

It‘s Not Mental — The Book Description — Availability

2010-12-05T12:35:00.020-05:00

Otherwise mentally healthy children can experience sleep problems, symptoms of depression, bipolar mood swings, and/or psychosis.

The award-winning book, "It's Not Mental - Finding Innovative Support and Medical Treatment for a Child Diagnosed with a Severe Mental Illness" is currently available on Amazon, Barnes and Noble and other on-line booksellers, and, in Lexington and Midway, Kentucky, at:

Morris Bookshop,
Good Foods Co-op,
Joseph-Beth Booksellers, and
Midway Center for Integrative Medicine.

Being distributed through Ingram Books, any book store can order a copy of the book for you.

If you live in Lexington, KY, please shop local!

***********************

Book Description

Can a child diagnosed with a mental illness—a brain disorder—in reality have a physical illness—a disorder affecting the brain? “It’s Not Mental” is the compelling yet educational story of Keri, a highly gifted, learning-disabled child diagnosed with mental illness. It is also the story of her parents’ persistence in finding help for their daughter, help that ultimately led to a future filled with promise.

Beginning in infancy, Keri began to experience a range of increasingly debilitating symptoms. Sleep dysfunction, body pains, attentional difficulties, tics, obsessions, mood swings, and hallucinations, gradually diminished her quality of life. Before reaching her teens, she’d been diagnosed with schizoaffective disorder and several co-occurring conditions, while underlying issues were ignored.

At their wits’ end, Keri’s parents struggled to find comprehensive medical care for their daughter’s widening range of symptoms. What they found instead were doctors too busy to listen or too rigid to look beyond a “mental” diagnosis. Without an integrated approach to her care, Keri, like many children in similar circumstances, became subject to a merry-go-round of psychiatric medications.

But the author would not give up. She continued to investigate brain malfunctions, psychiatric diagnoses, hormones, diet, sleep, and immune function, all the while navigating the torturous paths of our health care system. Much of what she learned is outlined here in gripping narrative based on real-life experience. In easy-to-understand prose and with clear explanations of medical jargon, she covers topics such as:

* Helping a child deal with hallucinations while they’re happening
* Using a psychiatric service dog to give a child greater independence
* Obtaining special accommodations at school
* Communicating effectively with doctors
* Identifying and obtaining necessary medical tests
* Dealing with medication side effects

Otherwise mentally healthy children can experience sleep problems and/or symptoms of depression, bipolar mood swings, and/or psychosis.

It’s Not Mental encourages us to think outside the box. It is only by tearing down the barriers of stigma and abandoning our traditional band-aid approach to psychiatric treatment that we can embrace more effective emotional, educational, and medical support for these children and their underlying condition(s).

These are some symptoms discussed because all these pertained to this one child!

Training and using a psychiatric service dog (medical service dog)
Obsessive-compulsive Disorder (OCD)
Major Depressive Disorder
Anxiety Disorder
Kleine-Levin syndrome
Tourette syndrome
Post-Traumatic Stress disorder
Mood disorder
Bipolar disorder
Psychotic disorder
Schizoaffective disorder
Fibromyalgia
Chronic-Fatigue syndrome
Narcolepsy
Hypothalamic dysfunction
Convergence insufficiency
Intestinal malabsorption
Mitochondrial dysfunction
Nutritional insufficiencies
Idiopathic Hypersomnia

Related Reading:

Property of http://www.itsnotmental.com/
Last Updated: 01 January 2012

How to SWALLOW PILLS - Video

2010-12-02T09:53:00.002-05:00

The issue of how to teach children to swallow pills gets brought up so often! In my family we started by giving the children tiny hard candies to swallow with a sip of water.

That was fine, but this training video from Dr. Bonnie Kaplan in Canada is awesome! It is for both the child AND parents to watch.
ALL children should learn how to swallow pills, hopefully before the necessity arises.

Here is the main page with the training video on it:
Better than a spoonful of sugar - how to swallow pills

or go straight to the training video:The New Method of Swallowing
Notice that TWO WEEKS of daily practice is necessary.

Original Article on the Research:
Click here to read the published results of Dr. Kaplan and her research team in the Journal of Paediatrics and Child Health.

Important Articles

Books:

and Preparing for doctor visits:

Medication History
Medical History
Record Delivery ("The Doctor Went Dumpster-Diving")
Asking the Right Doctor the Right Question
Psychiatrist vs Endocrinologist: Who is Responsible?
Learn to Swallow Pills

Property of http://www.itsnotmental.com/
Last Updated: 28 November 2011

Holiday Gift Ideas for Special Families

2010-11-21T16:23:00.001-05:00

Many of us have children with special needs who already have enough “stuff” or we really need to concentrate our resources on things that can help them with various issues. My children are now grown, but over the years I’ve accumulated some nifty ideas and thought this was a good time to share some of them. Some ideas are for the children. Some are for the children to give to others. Some are for the parents.

I love the idea of a child opening a gift which shows they have just sponsored a child in another country, or an animal at a nearby zoo they can go visit. Then there are activity ideas (like "tickets" saying they will be going to the zoo) rather than toys they won't use. But there are lots of useful things mentioned below. Some expensive, some inexpensive. At the bottom are some things really needed by us parents when we are overwhelmed!

The best idea for your holiday shopping is to think of the "therapeutic needs" of your child and find "tools" to fit the need.

Fine motor or visual-spatial challenges:
- arts and crafts with small items to manipulate
- Manipulative games such as Perfection, Operation, Jenga, etc. (These were recommended to us by an OT evaluating my younger daughter).
- puzzles (there are some easy 3-D stick-together wood puzzles. My kids loved the dinosaur ones).
- Easy magic tricks (self working) build self-esteem as they astound friends and relatives

Need for exercise?
- interactive Wii and Kinect games
- bicycle (check out the gyrowheel),
- rollerblade,
- exercise mat,
- exercise equipment
- small exercise trampoline
- punching/kicking bag (see Wavemaster) - remember the gloves!

Academic type special challenges?
- Leapfrog and equivalent items
- Puzzle books with connect the dots, or hidden pictures
- Interactive books

Sensory issues?
- bean bag chair,
- calming things to look at (sparkle wand, kaleidoscope, bubbles, sand
- Tactile play (squishy balls, play foam, sand station to draw in
- “fidget toys” can be found in toy stores, dollar stores (go to www.therapyshoppe.com and look at fine motor and fidget toys for ideas)
- Therapy balls to roll around on
- Trampoline
- swings / glider chair / hammock
- Self supporting small tent, provides private calm space to retreat to with a flashlight and book.
- heavy comforter for the bed (which can also be used to help calm because of the weight),
- CD or MP3 player (which can be used to listen to favorite music to help calm),

Challenge to go to sleep?
My daughter loved music. She liked relaxing before falling asleep by listening to classical music.
- Recorded (audio) books.
- CDs or downloads with nature sounds or calm music or guided relaxations
- Aromatherapy pillow bags.
- Microwavable warm bags (I made some filled with rice)
- Colored light pattern changing thingy
- Look at www.unwind.com for ideas.

Challenge to wake up?
- Unique alarm clock (such as for the deaf)
- Dawn simulator
- Look at www.Sunbox.com
- Amber sunglasses for evening use before sleep (see Sleep: Timing of Melatonin, Light, Dark, and Use of Other Aids )

Long car rides lead to issues?
- Travel games
- Sing-along children’s songs
- Recorded books
- Books
- MP3 player and head phones
- Hand-held games

Depression?
- “Happy Lights” (as we called them) – Full spectrum lights for well-used areas of the house.
- 10,000 lux light boxes (SunSquare + SAD Light Therapy Light Box 10,000 Lux) See The Sunbox Company for more products
- High density negative ion generators (see http://www.negativeiongenerators.com/)
- “1,400 Things for Kids to Be Happy About” (book with categories of lists of wonderful things to trigger ideas, and lots of spaces to personalize a child's own favorites)
- Journal or art supplies
- Bubble bath
- Bottles of natural flavoring to make hot milk-type drinks or even icy drinks from fresh-fallen snow.
- stick-on wall decor for a quick bedroom redecoration

Older child with lapses in responsibility?
- Pay overdue library fines
- Pay off finance charges

Other:
- Art supplies,
- donate money in their name to charitable organizations such as NAMI
- "gift certificate" for one-on-one special activities with a parent (such as go out for breakfast, bowling, go to a movie, play, or concert, "paint your own ceramics" place, bake cookies, go on a hike, do a craft, or play mini-golf.
- subscription to a monthly magazine.
- Jackets, clothes, gloves, pajamas, night socks, huge bath towels just for them, cool bed sheets with matching comforter or curtains, sunglasses.

The greatest gift children can give others? They can give their time to others.
- babysitting,
- lawn mowing,
- snow shoveling,
- cookie baking,
- housecleaning
- caring for pets.

The Gift of Time:
And don't be ashamed to answer truthfully to family and friends wanting to know what you most want as a gift. Usually that answer is TIME! Respite care? Housecleaning? Help organizing and filing medical insurance claims or taxes? Grocery shopping while you treat yourself to a needed haircut? An outing with friends, without the kids! Let them know what would be most useful!

BOOKS!
Lastly, here are some BOOK ideas for for a sensitive girl child: CLICK HERE FOR CHILD'S BOOKS
and a link to BOOKS I suggest you give the parents!!! CLICK HERE FOR PARENT'S BOOKS

Property of: It's Not Mental
Last Updated: 27 November 2011

Repeated Depression

2010-11-06T12:44:00.006-04:00

A recent study written up in the Archives of General Psychiatry found that although almost all teens treated for Major Depressive Disorder recovered in the short term, half suffered a relapse within 5 years. This held true even if the teens had received a combination of antidepressant and cognitive behavior therapy (CBT). This combination has been considered to be the “gold standard” for depression treatment, with the hope that the CBT would help prevent relapses.

I am a strong proponent of therapy (especially CBT and DBT for older children, teens and adults). But obviously, even when treated with antidepressants and therapy to change thinking and behaviors, in half of these cases there is/are some underlying problem(s) which have yet to be addressed.

I always say it was not from lack of mental HEALTH that my kids got mental ILLNESS.

Thank goodness for the therapy, though, because the depression and subsequent life disruption would have been much harder to bear without that extra therapy, support, and skills learned.

The study didn't talk about it, but I wonder if the cognitive behavior therapy at least helped the people who relapsed cope the next time around, recognize what was happening, and get support sooner.

Here is a quickie video about just one of MANY possible contributors to "Depression":

References:

Original Study: Recovery and Recurrence Following Treatment for Adolescent Major Depression John Curry, Ph.D., professor of psychiatry and behavioral sciences, Duke University, Durham, N.C.; Keith A. Young, Ph.D., vice chair for research, department of psychiatry and behavioral science, Texas A&M Health Science Center College of Medicine, and core leader for neuroimaging and genetics, Center of Excellence for Research on Returning War Veterans, Temple, Texas; Nov. 1, 2010, Archives of General Psychiatry
Article: http://www.drugs.com/news/teens-treated-depression-relapse-study-27576.html

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Last Updated: 7 October 2011

Bipolar, Cancer, Stroke. What's One Connection?

2010-09-03T19:23:00.014-04:00

Epigentics, influenced by food, toxins, environment and even our grandparents' lives may connect seemingly unrelated medical illnesses such as bipolar, schizophrenia, cancer, stroke and heart disease.

There is good news in this!

Conceivably, the extensive amount of money poured into cancer research and prevention may pay off for these other illnesses as well. [1]

Diverse problems, ranging from cancer to cardiovascular disease and neurological disorders, can all be caused at least in part by altered "histone modifications," and their effects on the reading of DNA in cells, says Rod Dashwood, a professor of environmental and molecular toxicology at the Linus Pauling Institute at Oregon State University.

Histone deacetylase (HDAC) enzyme can "switch off" tumor suppressor genes which is bad news, but "HDAC inhibitors" have already been identified in common foods such as cruciferous vegetables (like broccoli), and vegetables containing organosulfur compounds like garlic and onions. Naturally occurring organoselenium compounds in the diet has been recently added to the list of dietary compounds which positively affects the HDAC inhibition mechanism.

Even the act of eating fibrous vegetables can help since butyrate, a compound produced in the intestine when dietary fiber is fermented, is an HDAC inhibitor.

Dashwood says:

"Some therapeutic drugs already used for cancer treatment in the clinical setting probably work, at least in part, because they are acting as HDAC inhibitors. And what's most intriguing is that HDAC inhibition may affect many degenerative health issues, not just cancer. Heart disease, stroke, bipolar disorder, and even aging may all have links to HDAC/histone alterations.

In the future, a single HDAC inhibitor conceptually could have benefits for more than one degenerative disease problem."

Read more on Brain Health: Nutrition and Epigenetics

Now, just my opinion, but don't go ditching your current regimen for good foods expecting some miraculous cure! There are so many different types of underlying factors that go into illness. For instance, I doubt any amount of foods or medications can somehow correct the schizophrenia in people whose symptoms caused by severe straight genetic (DNA) or mitochondrial (mDNA) problems affecting brain function.[2,3] Of course, those cases are not all cases.

What this DOES show, is there is a lot of credence in the saying that we are what we eat. In fact, we are also what our parents and grandparents ate. And better yet, there is still hope we can improve our current state.

References:

[1] Original Article Source was prepared by Heart Disease Weekly editors from staff and other reports. Copyright 2010, Heart Disease Weekly via http://www.NewsRx.com.The full copy of the article can be found at many Internet sites. Here is one:
http://www.sciencedaily.com/releases/2010/04/100428081836.htm
Original Source: Federation of American Societies for Experimental Biology

[2] Strong synaptic transmission impact by copy number variations in schizophrenia

[3] Mitochondrial Dysfunction & Psychiatric Symptoms

Outside link:
Adjuvant Cancer Protocols from the Life Extension Foundation:

Books of Interest

Healing the Gerson Way: Defeating Cancer and Other Chronic Diseases - Beata Bishop, Joanne Shwed, and MD, Ph.D. Abram Hoffer Charlotte Gerson (Author)
Knockout: Interviews with Doctors Who Are Curing Cancer--And How to Prevent Getting It in the First Place - Suzanne Somers (Has interviews with cancer doctors)
Herbal Medicine, Healing and Cancer - Donald Yance
Nutrition and Physical Degeneration - Weston A. Price
Crazy Sexy Diet: Eat Your Veggies, Ignite Your Spark, and Live Like You Mean It! - Kris Carr
Crazy Sexy Cancer Tips - Kris Carr
Crazy Sexy Cancer Survivor: More Rebellion and Fire for Your Healing Journey - Kris Carr
The UltraMind Solution: The Simple Way to Defeat Depression, Overcome Anxiety, and Sharpen Your Mind - Mark Hyman
Knockout: Interviews with Doctors Who Are Curing Cancer--And How to Prevent Getting It in the First Place - Suzanne Somers
The China Study: The Most Comprehensive Study of Nutrition Ever Conducted And the Startling Implications for Diet, Weight Loss, And Long-term Health
The Paleo Diet: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat

And last but not least - Kris Carr Video - Crazy Sexy Cancer Tips

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Copyright: September 2010
Last Updated: 16 April 2011

Inflammation, Schizophrenia, and Bipolar Disorder

2010-07-09T12:08:00.004-04:00

Inflammation can be contributing to symptoms manifesting as schizophrenia-spectrum disorders, as a Dutch study adding ASPIRIN to these patients' drug regimen showed.[1]

Much research has been done about the link between inflammation and brain symptoms that get diagnosed as “mental illness.” We discussed back in 2008 about the study showing inflammation in body and brain preceded the brain symptoms that got diagnosed as mental illness.[2,3]

Now, this Dutch study adding 1000 mg/day aspirin (acetylsalicylic acid vs. placebo) to regular medication had a significant effect on positive symptoms (hallucinations, voices, etc.) in patients with “schizophrenia spectrum” disorders: http://pn.psychiatryonline.org/content/45/13/16.2.full

They found the aspirin did not significantly affect (improve) cognitive function.

They concluded that aspirin does indeed reduce the symptoms of schizophrenia spectrum disorders, and that this reduction is more pronounced in those with more altered immune function.

At this point, I want to say that inflammation is indeed intertwined in my both my daughters' cases. Many other parents have noticed that allergies worsen some of our children's behaviors/symptoms, and many books have been written on this topic by physicians. Both my kids turned out to have food sensitivities and allergies, and ultimately their endocrine system was affected. They would be considered to have had “altered immune function.”

There is increasing evidence that psychiatrists need to act more like regular MDs, but in the U.S., there seems to be a vast divide, and psychiatrists here do not think, run tests, examine patients, and treat like other medical doctors.

In the end, after 13 years under psychiatric care, regular medical care is what helped both my daughters more than the psychiatric care.

I have a comment/suggestion about the scientists' finding, “aspirin did not significantly affect cognitive function” along with the last line of their conclusion: “Inflammation may constitute a potential new target for antipsychotic drug development.”

Rather than throw a modified antipsychotic at the patients, try to answer:

WHAT is causing the inflammation??!!

I know that after my daughters healed their bodies — medically — and stayed away from certain foods causing their inflammation, improved sleep, etc., their immune function improved and guess what…. Not only did their symptoms of “schizophrenia spectrum disorder” disappear, their cognition improved as well.

And that finding, aspirin alone cannot duplicate.

Perhaps, though, our “heath care system” just wants another pill they can administer to try to cover up symptoms rather than tailoring treatment to individuals and testing for their actual, individual, causes.

REFERENCES:

[1] Wijnand Laan, PhD; Diederick E. Grobbee, MD, PhD; Jean-Paul Selten, MD, PhD; Cobi J. Heijnen, PhD; René S. Kahn, MD, PhD; and Huibert Burger, MD, PhD Adjuvant Aspirin Therapy Reduces Symptoms of Schizophrenia Spectrum Disorders: Results From a Randomized, Double-Blind, Placebo-Controlled Trial J Clin Psychiatry 2010;71(5):520–527

[2] Roos, et. al. A Discriminating Messenger RNA Signature for Bipolar Disorder Formed by an Aberrant Expression of Inflammatory Genes in Monocytes Arch Gen Psychiatry. 2008;65(4):395-407.

[3] Saey, T.H. Body and Brain: Possible link between inflammation and bipolar disorder Science News April 12, 2008

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Last Updated: 05 May 2011 (added links, books)

Bipolar and Off Her Meds

2010-02-05T09:31:00.027-05:00

Words that usually strike fear into a parent’s heart are that their adult child with a diagnosed mental illness is off their meds.

My older daughter suffered 13 years of unrelenting, unstable bipolar disorder in spite of hospitalizations, psychiatrists, therapy, and strict adherence to medications.

She is finally STABLE, but NOT while on any of the past psychiatric medications.

She is finally stable, AND off her meds. (Part 2 here - Getting Better and Part 3 - Recovered: No Longer on Psychiatric Medications or, start with the book that started it all -- It's Not Mental)

Huh!!???

It was the winter solstice when I reminded my husband to really appreciate the moment. After all, we'd had years of darkness with the younger daughter's childhood-onset schizophrenia/bipolar (schizoaffective) and the older daughter's teen-onset bipolar disorder. “Mental” type illnesses run rampant in the extended family –from anxiety disorders and depression to frank schizophrenia. The book is mainly about the younger daughter. This is about the older one. (After helping the younger daughter's more complicated case (see book), we at least knew "tricks of the trade" to help the older one).

Both my daughters had come over with their significant others to look at all the holiday cards and gifts from family and friends that had been sent to our home. The two girls were huddled together reading the cards and family letters, laughing and talking. The younger fellows were looking at a laptop that had been plopped on the table and were talking about various software apps. The successful college semester was over and our daughters were really enjoying this downtime. I was getting a simple dinner together to place on the table.

And that's when I turned to my husband and said, “It doesn't get any better than this.”

My older daughter's onset of bipolar disorder had initially presented as depression. Given an antidepressant, the psychiatrist missed that she was slowly cycling between hypomania and depression. It was the typical slow cycling at first, but being left on an antidepressant even while hypomanic exacerbated the illness until she was cycling faster and faster, culminating in ultra-ultra rapid cycling (ultradian cycling) with mixed states. This is the hardest type of bipolar to control.

At twenty, she was hospitalized and put on lithium while being in a clinical trial for a novel atypical neuroleptic (antipsychotic). She suffered some severe side-effects and her medications had to be switched, but at least the extended hospitalization and close monitoring gave her time to learn about her bipolar illness, how to take care of herself, and gave her time to process what had happened to her.

Next came the typical years and years of hospitalizations, lost life and lost opportunities, as medication after medication and combinations of medications were tried, without achieving stability or a return of her previous cognitive functioning. She at least had insight and persisted with cognitive behavior therapy (CBT), learning to deal more effectively with her symptoms and side-effects of medications.

A decade later, the psychiatrist was running out of medication options, and my daughter had suffered the dreaded but hopefully-not-permanent side-effect Tardive Dyskinesia (TD) from the last antipsychotic trial. Note that she never had psychosis. The antipsychotics were given on top of other mood stabilizers to try to control the ultra-rapid mood cycling.

With nothing left to lose, she looked at how well her little sister was doing, and wanted to go that route. Her little sister had been diagnosed with what was supposed to have been an even worse psychiatric diagnosis with a poorer prognosis than hers--schizoaffective disorder-- yet was doing better, as far as psychiatric and cognitive symptoms go. In fact, her little sister no longer had any of her previous "schizophrenia" symptoms.

The older daughter had not been ready to follow in her sister’s footsteps before because some of what her little sister had to do was change her diet. She was scared that she might need to as well.

But she was ready now. Ready to change doctors, get biomedical testing, get treatments for medical issues if any were found, take supplements, and even, if found to have a problem with gluten and dairy as her little sister did, give up her beloved breads, cheeses, and milk.

Her case was found to not be as complex as her little sister’s, but she still had to address some of the same major issues: Sleep, hormones, gut, diet and nutrition.

In another post, I will go into more detail about how each of those issues were addressed in HER case.

For now, I want to say that getting off her now-unneeded medications was an arduous ordeal due to horrible withdrawal symptoms. The withdrawal of the medications was done very slowly and carefully.

The goal had NOT been to get off her mood stabilizer, and for a long time, she TRIED to STAY ON it! But she was getting symptoms of being overdosed. She slept eleven hours a day and was still fatigued. Additionally, she was clumsy – bumping into things, and dropping things. And more dangerously, she often fell over while standing or walking. One of the times she just suddenly fell over, she injured both her feet and was in a cast for 4 weeks. She asked her psychiatrist if she could be having a side-effect of her mood stabilizer, Lamictal, and he said NO—that her hypersomnia (excessive sleeping) and fatigue was not a reason to lower it. So for a long time, she didn’t lower it. But what the psychiatrist had told her was not correct.

Confusingly, each time she lowered the Lamictal, she got psychiatric symptoms. At first she mistook this for needing the Lamictal and would raise it back up, only to again be plagued by the overdose (side-effect) symptoms.

Learning from the horrible withdrawal her younger sister had gone through lowering some of her medications, she toughed out each tiny decrease in her own mood stabilizer dosage, and within a few days the psychiatric withdrawal symptoms subsided.

She’d feel better for a while.

But each time as her body healed more, and additional biological/medical interventions were initiated, she would start sleeping excessively again and falling over. Soon she recognized these as overdose symptoms, and would again lower her Lamictal dosage.

Then came the day when she was completely off all her psychotropic medications, and over the withdrawal symptoms.

And she was completely—solidly—unbelievably—STABLE! She could even handle stress better and had less anxiety issues now OFF the meds!

For a person with ultradian cycling bipolar who’d been affected every day of her life for over a decade, being stable for days, let alone a couple months, was beyond remarkable.

Without the medications, she has realized many benefits of not having side-effects. She can think more clearly. She appreciates having a better sense of balance. She has lost weight and has the energy to be more active and healthy. She has more time in the day to get things done, go to college, volunteer at a free clinic, and hang out with friends.

And the goal in all this was not even to come off meds. She just wanted stability since the meds alone were not doing the trick.

But once these other issues were addressed, she didn’t NEED the bipolar medications.

It just left us all ecstatic, dumbfounded, and saying, “HUH????”

She then asked the $64,000 question—“So does this mean I don’t have bipolar disorder??”

Interesting question. We had never doubted for one moment in those 13 years that what she had was bipolar. She seemed to have not just the bipolar mood swings but what people refer to as "bipolar thinking" and "bipolar personality." She made poor choices.

Now I reflect back on that, realizing ... DUH - of course she made poor choices--many of which adversely affected the course of her illness.... but DUH... her BRAIN was affected! The choices didn't CAUSE her illness. The illness caused the poor choices!! The fact that she managed to get out of the quagmire of her own thinking to take the steps necessary to get well is a testament to her maturity and.... something.... something really special that I cannot put into words.

As far as I know, according to DSM-IV diagnostic criteria, the answer would be “YES, you still DO have bipolar.” But that then brings up another question. SHOULD an obviously non-psychological problem--a set of physical problems affecting brain function--BE a diagnosis in the DSM at all?? Obviously her "mental" illness is MEDICAL. Others tell me if she is completely fine and not on psychiatric medication, the answer is NO. But needing psychiatric medications to control bipolar is not listed in the DSM as a diagnostic criteria. And look at all the other children and adults with "ADHD", "bipolar" and "schizophrenia" now doing fine, off meds, simply using a multi-nutritional suppplement (Truehope's EMPowerplus). If we find something medical/nutritional to help them does that really mean they do not have the psychiatric diagnosis?

All I know, is she cannot relate to her former(?) diagnosis anymore since she no longer has any symptoms. She has her brain back - better than before.

It is obvious her "mental" illness is being treated better now—completely and effectively— and with no side-effects, by addressing personal medical, functional, metabolic, physiological needs rather than trying to directly affect brain chemistry with the psychotropic prescription medications with no real understanding of what was causing the affected brain chemistry, nor, obviously, having the right chemical cocktail in the form of a medicine to correctly alter that brain chemistry.

And if you wonder if there was any way we could have gotten her better sooner, knowing what we now know. You may be surprised at my answer. "Perhaps not." But that discussion will have to wait for another day.

For now, you can read more about her recovery here:
Getting Better - Part 1 - Overview

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Last Updated: 9 October 2011

Treat the Whole

2009-11-07T17:45:00.006-05:00

By now, most people have probably read about the proposed change to the psychiatric DSM (Diagnostic and Statistical Manual) whereby the diagnostic labels for Asperger’s syndrome and pervasive developmental disorder not otherwise specified (PDD-nos) will be eliminated, and enfolded into the broad diagnostic label of autism spectrum disorder. Here is an article about it in the New York Times: A Powerful Identity, a Vanishing Diagnosis.

But the pros and cons of that proposal is not what my writing is about today. I am more interested in the MEDICAL-oriented updates to be included in the new DSM-V, which is due to be published in 2012, replacing the current DSM-IV.

The authors are catching on to something the parents have been screaming for years – just because there is a label for the set of symptoms in that manual, does not mean it is not medical, and as much of the medical as possible needs to be treated.

Apparently, a broad change in the DSM-V is the recognition that patients with disorders affecting the brain – referred to as psychiatric disorders – often have a kaleidoscope of health problems affecting mind and body. If the new DSM-V starts getting taught in the schools, it will be encouraging doctors to evaluate and treat the WHOLE patient. Hmmm… Let’s see… the book will be published in 3 years. Then it will take another 8 years for the new psychiatrists to be trained and in practice… hey!! Just eleven more years until we have newly emerging doctors of psychiatry who are trained to be real DOCTORS and treat psychiatric patients as people who may not have an emotional or personality problem, but a slew of complex medical issues, each of which need to be addressed.

The New York Times article says the change for autism spectrum disorder will likely include in the array of health issues commonly accompanying the disorder: seizures, gastrointestinal problems, anxiety, attention disorders, and sensory differences like extreme sensitivity to noise.

The only questions I have about this is then… will the psychiatrists be trained to address the endocrinological, autoimmune, allergy-related, gastrointestinal, dietary, and neurological problems that comprise the illnesses in this “psychiatric” manual? Why have them in a psychiatric manual at all? Why not just have them listed as medical issues for which is needed a collaborative team approach addressing the WHOLE patient – a dietician, integrative medical specialist, gastroenterologist, allergist, neurologist, endocrinologist, and therapists as needed for speech, sensory, behavior and processing issues.

And if, then, we treat our children as they should be treated – with this team of medical specialists –which one will be the “conductor” of the medical symphony? Will the psychiatrist take on that role? Currently, my children’s psychiatrist certainly did not. We found a GP who was willing to put in the time and effort to do so – to communicate and sometimes even teleconference with all the other doctors on our cobbled-together team. He is the central repository of updated medical records, summarizing as necessary so we could have information from him to take to the other doctors (many doctors accept the same data coming from another physician better than us typing it up ourselves). However, the GP worked the psychiatrist right out of a job. We suddenly realized – hey – the GP really was doing what was necessary. There was no role left for the psychiatrist on the team, and so he was phased out entirely.

It is an entire shift in how we view and treat these children that is needed. And they don’t have eleven more years for society and the newly trained psychiatrists to BEGIN thinking about a better way to treat the WHOLE of the child, rather than a narrow PIECE of the child.

Our only option now is to insist on the proper care, NOW. Be relentless. Gather together a team of doctors who will help. Use word of mouth. Use every resource available. Keep learning. Keep up the fight.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

On a completely different tangent, I leave you with a thought to ponder about the proposed changes – This part. . .
The proposed changes to the autism category are part of a bigger overhaul that will largely replace the old “you have it or you don’t” model of mental illness with a more modern view — that psychiatric disorders should be seen as a continuum, with many degrees of severity.
. . .
Isn’t all human behavior, human health, human personality, all a part of a continuum? In the past, a disorder was not considered a disorder unless it adversely affected function or the quality of either the person’s life or the lives of those around him/her. With the new definitions, might not all of us fall on virtually every continuum diagnostic category, since all that is abnormal derives from the normal. It is the degree of distance from the center which labeled it as a disorder. I for one, would like to keep that distance.

Will the child who prefers order and cleanliness, who in the past might grow up to be a brilliant meticulous, “OCD-ish” surgeon, now be labeled on the continuum of OCD (obsessive Compulsive Disorder) and put into therapy to better conform with the messiness and chaos considered closer to “normal”?

Perhaps including the medical issues is a step in the right direction; perhaps the continuum diagnoses constitute a step down a slippery slope.

And adding murk to the whole DSM, is, even as I type, more organic – pathogenic (microbial, viral, retroviral, etc), medical, nutritional, metabolic, neurological, genetic, epigenetic, inflammatory, toxic, endocrinological – causes are being discovered implicated in the development of many of these illnesses of non-“mental” (i.e. non-psychological) mental disorders. (See related reading and additional references below.) At least we removed some symptom sets (such as toticollis, chronic fatigue and fibromyalgia) from under the umbrella of “mental disorders.” Perhaps we should do the same with a few others.

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Last Updated: 7 November 2009

Brain Health: Nutrition and Epigenetics

2009-09-23T17:39:00.011-04:00

Nutritional and other environmental factors, such as too much or too little food, toxins, smoking, trauma, viral infections, and other stress-inducing factors—both before and after birth—can affect the functioning of genes due to changes in the proteins regulating those genes. These changes can even be inherited much as genes are inherited, incredibly complicating the study of genetic involvement in illness.

This month, we are fortunate to have a paper describing the subject written by a nutritional science student studying dietetics.

References are at the end.

Environmental Epigenetics
by

Keri Cross, A.S., A.A.

The term epigenetics refers to heritable traits that do not involve changes to the underlying deoxyribonucleic acid (DNA) sequence. The prefix epi- in ‘epigenetics’ means "on top of" or "in addition to", so ‘epigenetic’ traits exist on top of or in addition to the traditional molecular basis for inheritance. Post-synthetic modifications of either the DNA or proteins closely connected with the workings of DNA are key factors in the epigenetic process. The term ‘epigenome’, stemming from ‘genome’, refers to the epigenetic state of a cell.

Most of the epigenome is established during embryonic and fetal development. However, some epigenetic changes do take place in later development. Some Hox developmental genes are methylated after birth, as is at least one gene controlling adult behavior. External influences on proteins involved in the epigenetic processes can be seen with long-term diseases like cancer.

DNA methylation is a chemical modification of DNA which involves the addition of a methyl group to a nucleotide sequence. Because this modification can be inherited and then later removed without making a change to the original DNA sequence, methylation is considered part of the epigenetic code and a highly important epigenetic mechanism. Methylation is also an essential element of normal development. Under typical circumstances, DNA methylation is made use of as a means of genome control, sequestering the DNA and making it less available for transcription.

In adult tissues, DNA methylation typically occurs in a CpG dinucleotide context (cytosine and guanine nucleotides linked together by a phosphate). CpG islands are areas of the DNA with high concentrations of unmethylated CpG sites. Most CpG islands are associated with genes. In the rare cases when CpG islands do become methylated, extended, sometimes permanent shutdown of the associated gene occurs.

DNA methylation may affect the transcription of genes in two ways. First, the actual methylation of the DNA may hamper the binding of transcriptional proteins to the gene. Secondly, methylated DNA can be bound by methyl-CpG- binding domain proteins. These proteins then recruit other chromatin remodeling proteins that can modify histones, forming compact, inactive chromatin, called ‘silent chromatin’.

Chromatin is the structure of proteins (histones) and DNA, wound tightly into the cell nucleus. Certain substances such as acetyl groups, enzymes, and some forms of ribonucleic acid (RNA) can modify chromatin structure to create changes in gene expression. One such effect of chromatin modification is called imprinting. Imprinting is when one of the two alleles from a standard gene pair is silenced through an epigenetic process. The expression of imprinted genes is species, tissue and developmental stage dependent and may play an important role in the speciation of mammals. In mice and humans, approximately 80 imprinted genes have been identified.

Imprinted genes function as though they have a single set of chromosomes, expressing either the maternally or paternally inherited allele, based on where they were inherited from. Because of this genetic ‘memory’, mutations of these genes can have severe health related consequences, the results being diseases such as cancer and certain pediatric developmental disorders. Prader–Willi syndrome and Angelman syndrome are congenital imprinting disorders. Both are caused by errors to the same part of chromosome 15. Errors inherited from the father result in Prader–Willi syndrome, those inherited from the mother result in Angelman syndrome. Links have been made with Autism to the same region on chromosome 15.

Metastable epialleles are alternate forms of genes that undergo epigenetic modifications related to maternal nutrition and environmental exposure during very early development. The fetus is quite vulnerable to environmentally-induced epigenetic changes early on in development. It has been found that simple dietary changes can protect against the negative effects of environmental toxins on the fetal epigenome. Epigenetic effects are not solely prenatal events, but occur over the full course of a human life span. Postnatal exposure to nutritional, chemical and physical elements in the environment can alter the epigenome.

There is evidence linking a wide variety of illnesses, behaviors, and other health problems with epigenetic alterations, including almost all types of cancer, cognitive dysfunction, respiratory, cardiovascular, reproductive, autoimmune, and neurobehavioral illnesses. Postnatal epigenetic states are susceptible to being modified by environmental factors as well. Known or suspected contributors to the epigenetic development of abnormal phenotypes includes heavy metals, pesticides, diesel exhaust, tobacco smoke, polycyclic aromatic hydrocarbons, hormones, radioactivity, viruses, bacteria, and basic nutrients (or rather, the lack thereof).

During aging, an epigenetic drift occurs throughout the body systems. The hypermethylation of rDNA repeats with age, and can lead to a decrease in transcription of many genes. Genetically and environmentally triggered epigenetic alterations occur day after day, while age, diet, and disease related deteriorations interact with other processes. As these accumulate, the occurrence of age-related disease increases.

In the past, it was generally assumed that starting the development of an embryo, its genetic slate was “wiped clean”, a concept relating well to the totipotency of the zygote. Transgenerational epigenetic effects come about because of incompletely erased epigenetic marks, caused by the experiences and exposures of previous generations. In various places across the genome, epigenetic changes seem to resist being wiped away more than the rest. These “incomplete erasures” result in patterns of inheritance from one generation to the next.

A survey was done of more than 5000 fathers who had children in the early 1990’s. All these men were or had been smokers. Of these men, 166 started smoking before they were 11, during a prepubescent time when the body is especially sensitive to environmental stress. The data was checked for the influence of factors such as socio-economic status, and whether the fathers had continued smoking until their child was conceived. The men who started smoking before puberty had sons who, at age nine, were much fatter than the average. No correlating effect was seen for daughters.

Research looking at historical records in Sweden, traced families back three generations and assessed their dietary habits based off harvest records. People whose grandparents experienced slight famine around the ages of 9 to 12 years old seemed to live longer. The grandchildren of people who had plenty of food around that age tended to be at higher risk for diabetes and cardiovascular disease. Also, the diet of grandfathers was only found to be linked to the lifespan of grandsons, and the grandmothers only affected their granddaughters. The nutrition of the grandmother during pregnancy not only influences the mother’s nutrition during the gestation period, but also affects the grandchild’s birth weight.

Effects from exposure to chemical toxins may carry on four generations or more. Pregnant rats were exposed to the fungicide (and endocrine disrupter) Vinclozolin. The male young had increased sperm cell apoptosis, decreased sperm number and decreased sperm motility. These alterations were passed on to male offspring for 4 generations through the male line, despite no further treatment with Vinclozolin.

The epigenetic process includes a mechanism by which dietary components can influence genes’ ability to produce enzymes and other proteins that may control major metabolic processes in the body. This same mechanism is also a main component in the process of cell differentiation during embryonic development. Lipids and lipoprotein components interact directly with chromatin structure to influence gene expression. So the intake of specific dietary fatty acids during establishment of epigenetic mechanisms could cause permanent changes in gene expression. Epigenetic changes that occur during early life may be capable of influencing susceptibility to chronic diseases in adulthood.

Different people may respond very differently to certain dietary variations. There is a lot of room for gene-diet interaction because of the high amounts of enzymes, transport proteins, receptors and transcription factors involved in the absorption and metabolism of dietary fat. People of a specific genotype called apo E4 usually have higher low-density lipoprotein (LDL) levels, are at higher risk for cardiovascular disease, and respond better to a low-fat diet. While moderate alcohol consumption can have protective effects in cardiovascular disease, this protection is greatest in people with slower alcohol metabolism, stemming from a variant form of the alcohol dehydrogenase enzyme. Methyltetrahydrofolate reductase (MTHFR) is an enzyme involved in folic acid and homocysteine metabolism. A common polymorphism that occurs is the replacement of the cytosine by thymine at a specific based pair. If both cytosines are replaced by thymine in a person’s MTHFR gene, their homocysteine levels more than double when on a low-folate diet, which raises their risk for cardiovascular disease.

Folate, methionine, zinc and vitamin B12 affect the activity of enzymes that supply methyl groups for different cellular methylation processes. Varying levels of these micronutrients can influence the rate of disease manifestation, as is seen in certain cancers. Reduced folate levels are connected to neural tube defects when occurring during gestation, along with genomic instability and hypomethylation. Methyl-deficiency in the diet has also been shown to induce liver cancer.

The major polyphenol from green tea, Epigallocatechin gallate (better known simply as ‘EGCG’) is a target of invitro methylation and an inhibitor of nuclear DNA methytransferase activity, along with reducing the growth of cancer cells. When used in the treatment of cancer cell lines, the hypomethylation and transcriptional activity of previously hypermethylated genes occurred. Many other substances, such as baicalein and curcumin, histone deacetylase inhibitors, ibuprofen, lycopene, pomegranate extracts, quercetin, selenium, alpha and gamma-tocopherols, valproic acid, vitamin D, and zinc are known for their effect on epigenetic processes.

The coat color gene agouti gives some mice yellow color fur, as well as a predisposition to obesity, diabetes, and tumor development. When pregnant female brown mice are fed a diet supplemented with methyl groups, a larger percentage of their offspring are born without the effects of the agouti gene in comparison to those fed the standard diet. The methyl groups block proteins that approach the agouti gene, which otherwise would produce more proteins, thus setting the effects of the gene into motion. That methylation status affects both the phenotype of the animal and of its offspring is indication that some epigenetic modifications of the genome are not fully erased during oogenesis, and go on to influence the epigenetic state of the genome and the activity of genes in the next generation

Asthma is viewed as a theoretically preventable environmental disease. Epigenetic regulation could play a substantial part in the gene/environment interactions that can lead to asthma or modify the risk level of it. The transmission of this risk may develop over multiple generations as a result of epigenetic changes after environmental exposure, whether in early development or later in life.

In the realm of neuropsychological illnesses, the term ‘environmental’ encompasses the traditional physical parameters of infectious agents, pollutants and other influencing factors on the physical surroundings; along with drugs, injuries, nutritional deficiencies, and an individual’s psychosocial conditions. Psychosocial and/or physiological stressors can interact with genetic preconditioning, altering brain chemistry and thereby mental health.

On average, if one of a set of identical twins develops schizophrenia, the risk is less than 50% that the other twin will as well. This makes a strong case for the involvement of environmental influences. Similar outcomes are found in depression and bipolar disorder. Studies based on a famine in the Netherlands during World War II, and on the Chinese famine in the mid 1900’s produced evidence that maternal starvation during pregnancy can double the risk of schizophrenia among offspring. Nutritional deficiencies could produce epigenetic mutations in genes required for normal brain development. Folate deprivation could hinder DNA repair or make changes in DNA methylation.

The reelin protein helps regulate processes of neuronal migration and positioning in the developing brain. Later, reelin continues to do work in the adult brain. Reduced expression of reelin and its mRNA levels have been found in the hippocampus, cerebellum, basal ganglia, and cortex, and in the blood levels of schizophrenia sufferers, but in only the cortex of those with bipolar. Hypermethylation is thought to be the cause of the reduction in reelin levels. Studies have displayed evidence that prenatal exposure to a number of microbial infections, including those caused by rubella, toxoplasmosis, and influenza can raise the risk of schizophrenia. Fetuses having had this exposure in utero secrete significantly less reelin once born. The risk appears to be highest after an infection during the second trimester. The reelin pathway has also been considered as a link between Alzheimer’s disease and schizophrenia.

Cancers are not just genetic, but also epigenetic abnormalities. During carcinogenesis, the genome simultaneously undergoes genome wide hypomethylation and regional hypermethylation of CpG islands. Chromosomal instability, activation of oncogenes by demethylation, and the silencing of tumor suppressor genes by hypermethylation are all changes in cancer cells which can be caused from epigenetic changes. Methylation of CpG islands contributes to gene silencing. Methylation of the CpG island at the retinoic acid receptor causes a protein fusion known to induce leukemia in humans. The reelin gene is considered a tumor supporter, but the means by which it functions are varied. Expression has been found to be suppressed in pancreatic cancer, whereas in prostate cancer, reelin expression is excessive.

As we identify more and more epigenetically unstable locations in the human genome, screening for epigenetically susceptible diseases at an early age will be made possible, along with more accurate disease diagnosis. This knowledge will allow for more precise and effective monitoring of an individual’s health. Because epigenetic profiles are potentially reversible, preventions and therapies, such as nutritional supplementation and/or pharmaceutical treatments can be developed to help counteract and even reverse negative epigenetic alterations.

Studies have shown that many disorders, such as obesity, cardiovascular disease, diabetes, hypertension, asthma and schizophrenia, have roots in early nutrition and environmental exposure during gestation. The potential for epigenetic change continues from conception until the time of death. A person’s lifetime not only affects their own epigenome, permanently modifying things like appetite control, metabolic balance, and disease susceptibility, but that of the epigenome for generations to come as well.

Related Articles:

Related Books

References

Buttriss, J. L. "Diet-gene interactions and current EU research: something for everybody!" Nutrition Bulletin 31 (2005): 65-68. Mar. 2006. Academic Search Premier. EBSCOhost. 23 Nov. 2008 http://search.ebscohost.com/login.aspx?direct=true&db=aph&an=23462978&site=ehost-live&scope=site

Charles, Schmidt W. "A Deeper Look into Mental Illness." Environmental Health Perspective 115 (2007): A404-410. Aug. 2007. Academic Search Premier. EBSCOhost. 23 Nov. 2008 http://search.ebscohost.com/login.aspx?direct=true&db=aph&an=26375828&site=ehost-live&scope=site

Cooney, Craig A. "Epigenetics - DNA based mirror of our environment?" Disease Markers 23 (2007): 121-37. Academic Search Premier. EBSCOhost. 23 Nov. 2008 http://search.ebscohost.com/login.aspx?direct=true&db=aph&an=24162570&site=ehost-live&scope=site

Dolinoy, Dana C., and Randy L. Jirtle. "Environmental Epigenetics Has Potential For Preventing And Treating Disease." 6 Feb. 2008. Blackwell Publishing Ltd. 22 Nov. 2008 http://www.sciencedaily.com/releases/2008/01/080131151850.htm

Fatemi, S. Hossein. Reelin Glycoprotein : Structure, Biology and Roles in Health and Disease. New York: Springer, 2008. Google Book Search. 22 Nov. 2008 http://books.google.com/books?id=cg0t08bk9syc&printsec=frontcover&dq=reelin+glycoprotein#ppr13,m1

Gallou-Kabani, Catherine, Alexandre Vigè, Marie-Sylvie Gross, and Claudine Junien. "Nutri-epigenomics: lifelong remodelling of our epigenomes by nutritional and metabolic factors and beyond." Clinical Chemistry & Laboratory Medicine 45 (2007): 321-27. Mar. 2007. Academic Search Premier. EBSCOhost. 23 Nov. 2008 http://search.ebscohost.com/login.aspx?direct=true&db=aph&an=24481803&site=ehost-live&scope=site

Jaenisch, Rudolf, and Adrian Bird. "Epigenetic regulation of gene expression: how the genome integrates intrinsic and environmental signals." Nature Genetics 33 (2003): 245-55. Mar. 2003. Academic Search Premier. EBSCOhost. 23 Nov. 2008 http://search.ebscohost.com/login.aspx?direct=true&db=aph&an=9184608&site=ehost-live&scope=site

Kaati, Gunnar, Lars O. Bygren, Marcus Pembrey, and Michael Sjöström. "Transgenerational response to nutrition, early life circumstances and longevity." European Journal of Human Genetics 15 (2007): 784-90. Academic Search Premier. EBSCOhost. 23 Nov. 2008 http://search.ebscohost.com/login.aspx?direct=true&db=aph&an=25463574&site=ehost-live&scope=site

Miller, and Ho. "Environmental Epigenetics and Asthma: Current Concepts and Call for Studies." American Journal of Respiratory and Critical Care Medicine 117 (2008): 567-73. 10 Jan. 2008. American Thoracic Society. 22 Nov. 2008 http://ajrccm.atsjournals.org/cgi/content/abstract/177/6/567

Waterland, Robert A., and Marie-Therese Rached. Scandanavian Journal of Food and Nutrition 50 (2006): 21-26. Dec. 2006. Academic Search Premier. EBSCOhost. 23 Nov. 2008 http://search.ebscohost.com/login.aspx?direct=true&db=aph&an=23462978&site=ehost-live&scope=site

Weinhold, Bob. "Epigenetics: The Science of Change." Environmental Health Perspectives 114 (2006): A160-167. Mar. 2006. National Institute of Environmental Health Sciences. 22 Nov. 2008 http://www.ehponline.org/members/2006/114-3/focus.html

Whitelaw, Emma. "Epigenetics: Sins of the fathers, and their fathers." European Journal of Human Genetics 14 (2006): 131-32. Feb. 2006. Academic Search Premier. EBSCOhost. 23 Nov. 2008 http://search.ebscohost.com/login.aspx?direct=true&db=aph&an=19473849&site=ehost-live&scope=site

Property of Keri Cross & http://www.itsnotmental.com/
Copyright: 2008 & 2009
Last Updated: 13 May 2011 (added Books)

New Doctor Visit: Medication History

2009-08-27T11:22:00.017-04:00

Sometimes it is just as well to start over with new doctors without going into past history, especially when the past history is based on misdiagnoses. But when we are still in the initial process of searching for answers to complex medical mysteries, knowledge of what has been tried, what worked, and what did not, may add some clarity to a still-murky picture.

It is important to have all the information ready for a new medical consult, and to hand deliver it personally into the doctor’s hands (see The Doctor Went Dumpster-Diving).

In addition to a letter from the referring doctor (if applicable), you need the medical history, pertinent laboratory results (We bring a “lab flow sheet” with years of test results).

Of course, you always need to take a list of current medications and food supplements to all doctor appointments—not just to new visits. But new doctors additionally need to know why the child is taking what he/she is taking.

So, I added a column to the list saying the diagnosis or condition for which the child is taking the medication.

But I soon realized that what I really needed was 3 different things.

* One was the usual brief list of medications and food supplements which every doctor’s office inputs into the computer and puts into the patient folder for quick look-up.

* The next item was a more comprehensive list of the current medications and food supplements, when the child began taking each, and why—what each does for him/her, if anything—and what noticeable side-effects the child has from the medication.

The list of current medications can look something like this:

* But I also realized that an equally important companion to the medical history (see Here- New Doctor Visit: The Medical History ), is a medication history.

This is similar to the “current medications” above, and, indeed contains the current medications, but it lists all the medications tried (past and current) and their outcomes.

Medications that did NOT work or that partially worked can be as important as the medications the child is on now.

I list the ages that the child took the medication/supplement, positive results if any, and negative results and/or reason for discontinuation.

Here is an example of the medication history:

Of course, the medication history can be pages long.

I find it very “telling” how a new doctor reacts to being presented with pages of medical, symptom, and medication histories.

Some are grateful and read it before the next appointment. Some act disdainful and just want the 1 paragraph “history” the nurse wrote up or the page you filled out in the waiting room.

One alarming new trend among some doctors--especially those on HMO's and insurance preferred provider lists-- even limit you to telling only ONE or at the most, TWO symptoms per visit.

I will say, though, the only types of doctors who made headway into solving my kids' medical mysteries were the ones that took their history THEMSELVES, read the information we brought, asked questions, listened, and asked more questions. They cared about past symptoms, and about other family members and their histories as well.

Like I said, the new doctor’s reaction is very telling.

More about this topic can be found in: It's not Mental - The Book

Related Reading:

Having trouble figuring out where to start, let alone a specialist to start with? Click here for list of resources: Helpful resources -- websites, articles, books, organizations, products

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Last Updated: 20 April 2011

Gluten Sensitivity and Symptoms of Schizophrenia

2009-07-06T09:18:00.021-04:00

In Brain Health: The Gluten (Dis)Connection, we wrote about the connection between gluten sensitivity and its ill-effects on the brain function of some individuals.

Research into this area seems to be taking off recently, with several new intriguing articles, the latest of which shows an astonishing percentage of patients diagnosed with schizophrenia having Celiac and gluten sensitivity. (Note that there may be some overlap with sensitivity to casein as well. See information about testing at bottom of article. For more on the topic, see It's Not Mental - the BOOK)

Cascella NG et. al. in the "Prevalence of Celiac Disease and Gluten Sensitivity in the United States Clinical Antipsychotic Trials of Intervention Effectiveness Study Population"[1] say
"Persons with schizophrenia have higher than expected titers of antibodies related to CD [Celiac Disease] and gluten sensitivity."
They state:

Among schizophrenia patients, 23.1% had moderate to high levels of IgA-AGA compared with 3.1% of the comparison group.

Moderate to high levels of tTG antibodies were present in 5.4% of schizophrenia patients vs 0.80% of the comparison group. Adjustments for sex, age, and race had trivial effects on the differences.

Combining this with an earlier study by Scandinavian researchers suggesting partial or complete symptom alleviation in a subset of patients labeled “schizophrenic” can be achieved with the simple solution of withdrawal from gluten, [2] is news that should be rocking psychiatric hospitals and society's understanding of what some of these cases of "mental illness" actually are.

Perhaps there should be as many (if not more) certified dietitians working closely with psychiatric patients as there are psychiatrists. Perhaps, since other nutritional and functional nutritional deficiencies are associated with gluten sensitivity and Celiac (such as tryptophan and B vitamins[3]), medical insurance should be required to pay for the medical use of OTC nutritional supplements when "prescribed" by a physician.

Another recent article speaks of Celiac presenting as severe "Autism".[4] The researchers in that article concluded:

"It is recommended that all children with neurodevelopmental problems be assessed for nutritional deficiency and malabsorption syndromes."

And remember--it wasn't that long ago that society thought of autism as a "mental" illness as well -- like some psychological or emotional aberration due to poor parenting.

For years, one of our children with a schizophrenia diagnosis had abdominal complaints which were chalked up to her "mental illness." Strange intestinal problems the other daughter had were equally ignored as being irrelevant -- and indeed, we really didn't think much of them. Yet in the final analysis, both had gluten sensitivity; one had severe intestinal malabsorption. And for both, going gluten-free had a profoundly beneficial effect on the functioning of their bodies--brain included. They also had sensitivities to other foods. Another factor was thyroid hormones, which should be noted, also affect gut function. Having a TSH in the "normal" range is NOT enough to rule this out, but I'll leave that discussion for another day.

We talk about piecing together or solving "the puzzle" of schizophrenia, yet here we already have a huge piece to investigate--not just for schizophrenia, but for bipolar as well.

A multi-nutritional supplement by Truehope helped both my children -- one diagnosed with bipolar, and the other diagnosed with schizoaffective. When talking to them about how the supplement helped them - but not the supplement alone, I talked with the company personnel about the necessity of healing the gut.

Anti-candida treatments are now discussed on the Truehope website. But another piece to the puzzle for many is the confounding problem of food and chemical sensitivities. Gluten is a major sensitivity for many. But as is often the case, the body becomes increasing sensitized to many different things and it may be worthwhile to be tested for other sensitivities as well, eliminating them for a few years before trying to slowly add them back one by one.

Of course, all this begs another question--why are so many children becoming increasingly sensitive to so many different foods and chemicals in our environment? I'll leave that as an open question for other to mull over in other blogs. But it is not just our imaginations. Gluten sensitivity/Celiac really is becoming more common - with research from the Mayo Clinic in Rochester, Minn., suggesting that the disease is four times more common today than it was in the 1950s, and not just because doctors are more likely to test for it.[5]

General Article:
Gluten Sensitivity and the Impact on the Brain

Other articles and studies specifically about gluten and schizophrenia:
http://jccglutenfree.googlepages.com/schizophrenia

Testing Facilities:
http://www.Enterolab.com
GPL Gluten / Casein peptides Test

Related Reading:

REFERENCES:

[1] Cascella NG, Kryszak D, Bhatti B, Gregory P, Kelly DL, Mc Evoy JP, Fasano A, Eaton WW "Prevalence of Celiac Disease and Gluten Sensitivity in the United States Clinical Antipsychotic Trials of Intervention Effectiveness Study Population" Schizophrenia Bulletin 2009 Jun 3.

[2] Kalaydjian, Eaton, Cascella, Fasano The gluten connection: the association between schizophrenia and celiac disease ACTA PSYCHIATRICA SCANDINAVICA Vol. 113 Issue 2 Feb 2006

[3] Kowlessar OD, Lorraine J, Haeffner, Benson GD. “Abnormal Tryptophan Metabolism in Patients with Adult Celiac Disease, with Evidence for Deficiency of Vitamin B6” Journal of Clinical Investigation Vol. 43, No. 5, 1964

[4] Genuis SJ, Bouchard TP. "Celiac Disease presenting as Autism

[5] Alberto Rubio–Tapia et. al. "Increased Prevalence and Mortality in Undiagnosed Celiac Disease" Gastroenterology Volume 137, Issue 1, Pages 88-93 (July 2009)

Property of http://www.itsnotmental.com/
Last Updated: 2 January 2012

Epigenetics

2009-05-07T15:30:00.009-04:00

Sometimes an illness occurs because of a straightforward gene mutation. But sometimes illnesses occur because of changes in the functioning, or expression, of the genome.

The study of the control of the functioning of genetic material is called epigenetics.

These changes in gene expression are caused by mechanisms other than changes in the underlying DNA sequence. They often involve methylation or demethylation of specific proteins, such as “histones,” which are responsible influencing the expression of genes. The gene may produce more or less protein than normal which, in turn, can affect physical and behavioral traits.

These changes can be passed along with the transfer of the actual genetic material to generations of cells as they multiply, and even be passed on to subsequent generations of people (our children and grandchildren).

Epigenetics is how the same set of DNA can cause some cells to become liver tissue and others to become heart muscle and still others to become brain. The DNA is the same in each organ, but which genes get activated is vastly different in each.

Literally, “EPIGENETICS” describes traits that exist “on top of” or “in addition to” the traditional molecular basis for inheritance.

What this has to do with many illnesses, including those affecting brain function, is that it opens the door to understanding, which in turn leads to a broader range of targets for treatment.

Within epigenetic treatment—the possibility of reversing pathological changes—lies the hope, someday, for cures of some disorders which are now incurable.

We now know a multitude of factors affect epigenomic functioning—starting before the baby is even born, continuing with hormonal “switches” during childbirth, chemical insults while maturing, stresses encountered, nutritional factors, and more.

This is exciting news for people with complex illnesses in which a multitude of genes are involved, but no one specific gene can be to blame. Some genetic variants can place us at hugely increased risk for an illness, but some outside factor – an epigenetic factor – triggers the aberrant function.

Thus identical twins can both be at greater genetic risk for an illness yet only one may develop it. Perhaps the one that does had less nutrition than the other en-utero, less oxygen during birth, was more picky about food, more sensitive to the environment, the mitochondria distribution was different from the other. Whatever it was, the result is their genetic expressions ultimately differed and one may succumb at an early age while the other is unaffected.

Epigenetics may become the master key in the understanding of many major illnesses involving psychosis and mood dysregulation. It is considered to be a "third wave" in psychiatric research with the potential to bridge and unify the first two areas of study—the traditional genetic and environmental studies.

Epigenomic research is leading to better understanding of the regulatory changes in genes and genomes occurring in major complex illnesses such as some involving psychosis. It is unveiling the mysteries behind why the same gene sequence may predispose one individual to schizophrenia yet another to bipolar disorder, yet leave another unaffected. It may shed light on the molecular mechanisms of how hazardous environmental factors interact with the genome.

Results from this area of research may lead to new diagnostics and more effective therapies.

“Developmental Epigenetics” studies epigenetic modifications in children—the epigenetic mechanisms determining which genes in the symphony of life get played and which remain silent at any particular moment—and how these mechanisms interact with the environment to affect their health.

The goal of developmental epigenetics is to help prevent, monitor and treat childhood and adolescent diseases ranging from premature birth to autism, from Tourette syndrome to persistent depression, and from cancer to schizophrenia.

Here is some interesting research and reading pertaining to epigenetics and Illness:

Scientists Suggest Framework For Epigenetics in Common Disease Johns Hopkins Medicine

Epigenetics: Methylation and schizophrenia Monica Hoyos Flight

Epigenetics: A new science peels away another layer of the genetic onion John McManamy

The epigenetics of cancer in children by Frühwald MC, Witt O.

Epigenetics of autism spectrum disorders by N. Carolyn Schanen

New Theory Of Autism Suggests Symptoms Or Disorder May Be Reversible ScienceDaily (Apr. 2, 2009)

Epigenetics: the way we pass on our traits to our children is much more complicated than we originally thought

Epigenetics Catalyst

Tourette Syndrome, Tics, OCD & Depression: The Underlying Biochemistry of Tourette syndrome, Tics and Depression Great Plains Laboratory

Epigenetic risks related to assisted reproductive technologies

Related Reading:

Genetics and Epigenetics:

Property of http://www.itsnotmental.com/
Last Updated: 16 November 2011

Is It ADHD (Attention Deficit Hyperactivity Disorder)?

2009-04-13T10:17:00.015-04:00

It may start out with a teacher suggesting your child be tested for ADHD or that he/she may benefit from stimulant medication. You become anxious and concerned.... or recognize that the teacher is affirming something you already suspected.

Before you rush your child to a psychiatrist with a list of symptoms, take a deep breath, and think this through.

After you take that deep breath, be brutally honest with yourself.

(I’ll assume that your child does not have what used to be termed “minimal brain damage” with a severe lack of impulse control. If so, your child is probably already on medication, and you wouldn’t be looking here for whether or not your child’s more mild symptoms are ADD/ADHD.)

Has your child been brought up on a diet of TV and video games—never having a chance to learn concentration, self-discipline and impulse control? Is there a problem with discipline in the household? Does your family have regular sleep/wake schedules? Does he/she go to bed early enough to get enough sleep? Does the child get plenty of exercise? How about your child’s diet? Sweets, caffeine and many food additives can cause symptoms in vulnerable children that mimic ADHD.

If these problems exist, obviously, lifestyle changes are needed to positively impact your child's mental and physical health. A change is needed in the child’s upbringing and environment (including diet).

~~OR~~

Perhaps your child may be like mine was—displaying symptoms that looked like ADHD—Inattentive Type even though she was eating a reasonably healthy diet, not watching TV or playing video games, had a sleep schedule and plenty of time for active, unstructured outdoor play with friends and was reasonably well-behaved.

Still, she was distracted by everything, and experiencing sensory overload.

After (mis)diagnosis with ADHD she exclaimed that her problem was not with a deficit of attention to the environment—the problem was with noticing too much!

I’d start with the pediatrician who really knows you and your child. Bring along both comments from the teacher, as well as your own. Be sure to compose a medical history, and note any medications your child is currently taking including non-prescription items. Include current sleep schedule, and behaviors. Take time to think through both the documentation you need to collect, and what you want the pediatrician to do.

You may wish to set up an appointment to go over everything without your child present.

One of the worst things we did with our daughter was assuming her attentional difficulties were due to ADHD and allowing her to be put on a stimulant. We did not rule out other things first.

Only in retrospect did we understand that some of what we were seeing was the result of possible seizures, sleep disorder, nutritional deficiencies (due to autoimmune problems in the gut), hormonal problems, metabolic problems, and more. Taken together, something was obviously wrong in the functioning of her body—every cell—affecting the functioning of her brain.

This whole thing is a like puzzle. Don't just look at pieces by themselves. Find all the pieces through all these tests so that you can lay them out and see the whole picture. It is important to do ALL the following testing because multiple problems can (and often do) co-exist.

This is called a biomedical and integrative, or a functional approach to testing and treatment. It tailors treatment to the individual based on the child’s own unique biology rather than to a label for a symptom—“attentional deficit.” Find out WHY that attentional deficit exists.

If any doctor you go to blows off your concerns, do not give up. Consult another and another until you find someone who does take your concerns seriously.

Proper vision testing is critical. You must ensure that the child’s near vision, far vision and binocular vision are checked. This goes beyond what most optometrists/opthalmologists routinely check. If a child’s eyes cannot properly track on a page, this might be the source of a teacher’s complaints that your child lacks “focus.” This can easily be mistaken for “ADD.” You may wish to consult specifically with a pediatric optometrist after examination by a pediatric ophthalmologist.

Hearing tests are quickly done by an audiologist.

Psycho-educational evaluation with a qualified psychologist will determine your child’s IQ, how he/she learns, and if there are any specific tasks, such as in written expression, writing fluency, reading or computation, that are very difficult for your child to accomplish. This specialist may make the determination whether or not ADD is suspected, and whether or not your child has dyslexia or another specific learning disability. The test for dyslexia may be a separate test, so make sure it is included.

Receptive and expressive language testing may be done through a speech pathologist.

Testing with an Occupational Therapist specializing in sensory integration or sensory processing issues is indicated if your child has any one of a number of sensory issues. Some of these include: a problem with how he/she moves in space, awareness of her body, being clumsy or awkward, lack of coordination, being hypersensitive to touch or sound, having problems with the feel of clothes, not liking certain movements such as swinging, or having trouble with fine motor control such as pencil and paper tasks.

Next, there are medical issues to consider.

Testing for nutritional and metabolic problems can be investigated with blood and urine testing which can be ordered by the pediatrician. Levels of a host of nutrients should be tested including vitamin D, B12, folate, calcium, magnesium, Ferritin, glucose, fatty acids, and CoQ10.

A Strep titer should be obtained if your child shows symptoms of OCD or tics.

Sleep disorders must be addressed. Your child should have a sleep study done.

Endocrine problems may exist. A thorough endocrine evaluation consists of dozens of tests which can be accomplished with one blood draw. Don’t settle for a check of “TSH” as being an “endocrinological work-up.” And if your child is already labeled with a psychiatric diagnosis and/or on psychiatric medications, don't settle for your child falling through the cracks as first one doctor then the other says "not my responsibility."

Allergy testing and testing for food sensitivities is important, but not just the skin-prick type the allergist does. In addition to the IgE tests, consider IgG and IgA testing for various foods (such as to gluten, dairy, etc) such as those done via Enterolab, Great Plains Laboratory, Genova Diagnostics, etc.

Neurological testing can investigate whether sleep or seizure disorders are contributing to attentional issues. Migraines, if they exist should be addressed.

Intestinal problems should be addressed: Consider candida overgrowth and treatment, including treatment with probiotics, which help restore intestinal health as well as possibly helping with allergies.

Depending on what is found in the medical tests, you may consider consulting with yet another specialist – an Integrative medical specialist since nutritional and herbal supplements can help with sleep, migraines, endocrine issues and more.

And remember, sometimes the right answer may come from asking the right doctor the right question.

Related Reading:

Property of http://www.itsnotmental.com/
Last Updated: 20 January 2012

Abnormal Sleep as a Cause of Mental Symptoms

2009-03-06T08:36:00.017-05:00

Sleep disorders can be a CAUSE of the brain symptoms being diagnosed as "mental illness."

That seems so logical, except that for years doctors insisted that our children's sleep problems are being caused by the "mental illness." This is true even when we tell them... THE SLEEP ISSUES CAME FIRST. (See book)

In our personal experience, just as some endocrinologists refuse to address endocrine issues in patients on psychotropic medications (see here) some neurologists/sleep specialists refuse to do sleep studies or address sleep issues when the patient has a diagnosis of "mental illness." Their reasoning is "Of course you have sleep issues. That's because you have bipolar [schizoaffective, depression... take your pick]" You sometimes have to go through a list of sleep specialists until you find one who is undaunted by the "mental" diagnosis.

Research has been out there backing up our parental observations (here). Although doctors keep saying the mood and psychotic disorders cause sleep disturbance -- many times it is the opposite way around. SLEEP issues came FIRST. But that research has been widely ignored.

Until now.

An article in a popular magazine (New Scientist) has pulled together the latest peer-reviewed research, and interviewed the researchers, to give the general public a better look into this phenomena and to demonstrate a serious lack of awareness and medical knowledge (see article here).

The article starts off with the profoundly obvious:

TAKE anyone with a psychiatric disorder and the chances are they don't sleep well. The result of their illness, you might think. Now this long-standing assumption is being turned on its head, with the radical suggestion that poor sleep might actually cause some psychiatric illnesses or lead people to behave in ways that doctors mistake for mental problems.

The good news is that sleep treatments could help or even cure some of these patients. Shockingly, it also means that many people, including children, could be taking psychoactive drugs that cannot help them and might even be harmful.

THIS was the case with BOTH my kids! Both the bad news (sleep issues and being given antipsychotics to control mood and psychotic disorder instead of addressing the sleep issues) and the GOOD news - that sleep treatments could help (see Sleep: Timing of Melatonin, Light, Dark, and the Use of Other Sleep/Wake Aids)

MANY other parents say the same thing - SLEEP issues came first.

My younger daughter, especially, had severe issues seemingly from birth. In the end, she came off the last of her Seroquel only by addressing sleep issues with an amino acid, Tryptophan, commonly needed in Celiac/gluten sensitivity cases (which my kids also were found to have - a problem shared with many others with a "mental illness" diagnosis). However, she also takes other meds for narcoleptic symptoms in the daytime, and other supplements at night (see here).

I have often wondered WHY narcolepsy medications (such as Xyrem), and other sleep aids, have not been seriously studied for the treatment of the subset of patients with ADHD, depression, bipolar, schizoaffective, and schizophrenia diagnoses--for whom sleep issues are a major component--and perhaps preceded those diagnoses. (See this interesting article: Narcolepsy Presenting as Schizophrenia).

Hopefully, as other researchers pay attention to these articles, more studies will be conducted, and more attention will be paid to a better medical, functional, and holistic approach to these diagnoses.

But no number of studies will help if psychiatrists and psychologists -- who are usually the first medical specialists our children get referred to--do not get the message that the SLEEP may be the CAUSE -- not the effect.

Sleep-disordered breathing (SDB) is linked to psychiatric symptoms and cognitive impairment even in very young children as this article shows: Snoring Linked to Depression and Anxiety in preschoolers:

Preschool-aged children who snore have more symptoms of depression and anxiety, as well as impairments in attention and language skills.

The snoring children were more likely to have other sleep problems, such as nightmares, talking in their sleep, or difficulties going to bed.

It is disturbing to me that my children's psychiatric and physical conditions continued to worsen while they were prescribed antipsychotic medications, which left them with permanent physical damage from side-effects, partially (maybe wholly if it had been addressed early enough?) because of ignorance about addressing SLEEP issues.

For all I know, in my younger daughter's case, a lot of her hormonal and autoimmune problems came from the stress of disordered sleep.

Can you imagine -- my child who had a problem both staying asleep and staying awake, and who had excessive REM, developed "attentional problems" for which she was given a stimulant, which resulted in her sleeping less, which resulted in her becoming acutely psychotic.

I was then told that of course she did not sleep -- she had a psychotic disorder. The psychosis was an escalation of "her illness." Hmmm... and what exactly was that illness? Well... one that labels her new set of symptoms, of course -- one from the DSM -- a label called "schizoaffective."

The acute prolonged psychosis was over a decade AFTER the onset of observable profound sleep symptoms, and almost a decade BEFORE those sleep symptoms were adequately addressed, and she could eliminate the last of her antipsychotic medication.

What a waste. What a shame. And for the most part, the doctors still aren't listening to what we parents are saying about OUR children.

These books may be of interest:

Also, see the book list on "Sleep: A Critical Yet Under-addressed Component of Health"

Related Articles:

Important Research Articles on this topic:

The adverse consequences of sleep disturbance in pediatric bipolar disorder: implications for intervention." Harvey AG Child Adolesc Psychiatr Clin N Am, 2009 Apr ; 18(2): 321-38, viii.

Narcolepsy in childhood. Nevsimalova S Sleep Med Review 2009 Apr ; 13(2): 169-80

Longitudinal Association of Sleep-Related Breathing Disorder and Depression" Paul E. Peppard, PhD; Mariana Szklo-Coxe, PhD; K. Mae Hla, MD; Terry Young, PhD Archives of Internal Medicine, vol 16 Sep 2006.

Sleep Disturbance in Bipolar Disorder: Therapeutic Implications" David T. Plante, M.D., and John W. Winkelman, M.D., Ph.D. Am J Psychiatry 2008; 165:830-843

Diagnostic and therapeutic challenges in narcolepsy-related psychosis. Kondziella D, Arlien-Soborg P. J Clin Psychiatry. 2006 Nov;67(11):1817-9.

Schizophrenia and narcolepsy: A review with a case report. Kishi Y, Konishi S, Koizumi S, Kudo Y, Kurosawa H, Kathol RG. Psychiatry Clin Neurosci 2004;58(2):117-124.

Narcolepsy Presenting as Schizophrenia. Farid Ramzi Talih, MD Innovations in Clinical Neuroscience 2011 April; 8(4): 30–34.

Mania in a Boy Treated With Modafinil for Narcolepsy Am J Psychiatry 162:813-814, April 2005

The human emotional brain without sleep--a prefrontal amygdala disconnect. Curr Biol. 2007 Oct 23;17(20):R877-8 Yoo SS, Gujar N, Hu P, Jolesz FA, Walker MP.

Circadian Rhythms Factor in Rapid- Cycling Bipolar Disorder
Ellen Leibenluft, M.D. May 1, 1996 Psychiatric Times. Vol. 13 No. 5

Gene Controlling Circadian Rhythms Implicated In Bipolar Disorder ScienceDaily (Mar. 22, 2007)

Circadian patterns of growth hormone and cortisol secretions in narcoleptic patients.
Besset A, Bonardet A, Billiard M, Descomps B, de Paulet AC, Passouant P. Chronobiologia. 1979 Jan-Mar;6(1):19-31

Metabolic and endocrine effects of sleep deprivation. Copinschi G. Essent Psychopharmacol. 2005;6(6):341-7

Impact of sleep and sleep loss on neuroendocrine and metabolic function. Van Cauter E, Holmback U, Knutson K, Leproult R, Miller A, Nedeltcheva A, Pannain S, Penev P, Tasali E, Spiegel K. Horm Res. 2007;67 Suppl 1:2-9. Epub 2007 Feb 15.

Pediatric sleep apnea: Early onset of the 'syndrome'?

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Last Updated: 18 October 2011

Stress, Growth, Life, & Hormones

2009-02-23T08:38:00.014-05:00

As with most families caring for a child with a severe prolonged illness, our family was under tremendous stress when our little girl was very ill. It was not a good kind of stress. It was too severe. Too prolonged.

But in the long run, I do believe it helped us grow as individuals. It made our marriage stronger. It made our family stronger. It helped me to see the wisdom and strength of my extended family, who all extended moral support in spite of physical distance between us. But that was in the long run. I also know that the chronic, prolonged nature of that horrific stress was physically damaging.

There are some articles reminding us how important stress is to us and how stress motivates us. They talk about how just as there is post-traumatic stress disorder, there is post-traumatic growth: Who Says Stress Is Bad For You? and Stress Could Save Your Life

This has resonated with me, and it made me think about the term "post-traumatic" in "Post-Traumatic Stress Disorder" (PTSD). It means ... the trauma has ceased. Only then can the healing and growth occur.

Our child's symptoms traumatized her as they traumatized the whole family. Because of the intensity of what we all went through, that trauma contributed to the shaping of who we are today.

The articles also made me think about how the illnesses my younger daughter got, collectively diagnosed as "schizoaffective," made her so sensitive to the stress, ranging from normal little life things -- good and bad, happy and sad, physical or emotional -- to more severe medical problems affecting body and brain. To us, and to the psychiatrist, at the time, it appeared that she was not "resilient", but it turned out that mentally she was quite resilient. She grew from the trauma, and is now living a productive life, picking up the pieces of shattered dreams and moving on.

At the time, however, it was horrifying and the stress was physically destructive. I experienced situational depression from the trauma. Antidepressants and counseling did not "fix" that, but nutrition did. In my case, the emotional stress must have caused me physical problems. This is not unusual, and we'll talk more about that below.

In my daughter's case, her physical problems caused symptoms which caused stress on her body which caused symptoms which caused stress which caused more symptoms which caused more stress.... and of course, the family was caught in the stress because ... we are a FAMILY.

And now, perhaps, we are different people because of what we went through. We have unique outlooks on life that some families without severe illnesses perhaps don't have. It made us advocates, and, possibly,affected the career paths that our kids have chosen (in social work and in the sciences).

But back to stress and hormones. Hormone imbalance causes stress, and stress causes hormone imbalance.

All kinds of emotional and physical factors cause stress. The body is protected from the damaging results of stress in part by cortisol from our adrenal glands (it is also involved in immune function). They are regulated by the pituitary which is regulated by the part of the brain called the hypothalamus. Thus, this is called the hypothalamic-pituitary-adrenal (HPA) axis.

In many cases of chronic stress, the HPA-axis is up-regulated, with high cortisol, adrenaline, etc. levels which can have adverse effects. In my daughter's particular case, with her type of "mental" illness, her HPA was the opposite -- down-regulated with very low cortisol. Cortisol is involved in both stress-tolerance as well as immune function. It is necessary for life.

Below is an article about research into re-setting the HPA when it is upregulated - with high cortisol. While it might not have been a viable option for my daughter, since her cortisol was already too low, by adjusting and normalizing some of her other hormones, and addressing other physical, metabolic & nutritional needs, her cortisol level is normalizing as well. This, her endocrinologist says, is an indicator of true healing.

Tweaking Hormones Might Ease Chronic Stress

January 27 (HealthDay News) -- U.S. and Canadian scientists say they've devised a potential new method of promoting recovery from chronic stress disorders by utilizing the natural dynamics of the body's "fight or flight" response.

The approach focuses on the hypothalamic, pituitary, adrenal (HPA) axis, one of the body's major control systems. The HPA axis uses hormone feedback regulatory loops to help maintain body homeostasis (balance of systems).

A team led by Amos Ben-Zvi, of the University of Alberta, Edmonton, say that when the HPA axis is pushed far from its natural homeostatic rest point, it may be unable to fully recover. When that happens, HPA axis dysfunction may become permanent, according to background information in the study.

HPA axis dysfunction has been linked to disorders such as chronic fatigue syndrome, depression, post-traumatic stress disorder, and Alzheimer's disease.

The researchers created a short-term intervention designed to help restore normal HPA axis. This method involves temporarily reducing the availability of cortisol, a hormone involved in immune function. Reduced cortisol levels prompt the HPA axis to overcompensate and re-set itself into normal regulation.

This new model, which needs to be tested in clinical tests, was described in an article published Jan. 23 in the journal PLoS Computational Biology.

SOURCE: Public Library of Science, news release, Jan. 22, 2009

Our Story: It's not Mental

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Asking the Right Doctor the Right Question

2009-02-06T07:42:00.012-05:00

There's a lot of medicinal wisdom doctors don't share with their patients. I assumed that was because the doctors are not keeping abreast of current research.

Often, that is true, but there's another reason that some doctors, even if they KNOW about something, won't tell us.

If he/she works in a group, such as at a clinic or hospital, the doctor may be prohibited from divulging any information that is not considered "mainstream." They also must be careful not to outright contradict other doctors.

In this latter case, we might be able to get better answers from doctors just by changing the way we ask the questions. We need to give them a way to give us uncensored advice without violating their job protocols.

A letter to Dr. Mercola from another doctor exemplified a two-fold dilemma. The first is that medicine is not always considered medicine. Some cultures, such as in America, separate out medicinal practices into "complementary, alternative, and mainstream."

The second problem is that doctors can be reprimanded (or fired) by administration for recommending medicine that is not considered "mainstream."

The letter can be read here: An Important Letter About Trust (free registration is required)

In the letter to Dr. Mercola, the doctor writing told the tale of being reprimanded. He said the issue was NOT that what he recommended was not solid advice and efficacious, but simply that it was not "mainstream" in the United States (it was considered "mainstream" in Europe.)

He went on to say that If a patient ASKS about some alternative therapy, he can give honest and well-informed answers.

Another suggestion was to ask something like, "If you had my illness, what would you personally use to treat yourself?" He could answer that as well, because he is talking about himself -- not suggesting that YOU do it.

I had a similar experience myself some years back. I injured my knee and went to an orthopedist who took an MRI and then informed me that I HAD to have an operation "or else such-and-such will happen."

I went to my trusted rheumatologist, Dr. N. who had, years earlier given me great advice such as lose weight, exercise, use food supplements, and get well-fitted running shoes. I asked him if what the orthopedist said was true.

Dr. N. carefully said,"If you don't have the operation, it is possible that such-and-such may happen."

That gave me pause. I rephrased the question. "If I DO have the operation, will such-and-such NOT happen?"

Dr. N. responded, "If you do have the operation, such-and-such can still happen."

Frustrated, I asked, "If it were YOUR knee, would YOU have the operation!??"

"NO." was the firm reply, and he was not hesitant to tell me why HE would not have it.

I did not have the operation. I have not regretted that decision. I am glad I got a second opinion, and asked the question the right way. But just as important (if not more so), I asked the right question to the right doctor.

Related Reading:

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Last Updated: 06 February 2009

Psychiatrist vs Endocrinologist: Who is Responsible?

2009-02-02T11:31:00.017-05:00

Problems within the endocrine system (i.e. with hormone levels) can cause psychiatric problems. Psychiatric medications can cause problems within the endocrine system.[1] So wherein lies the responsibility to test and treat the endocrine problems of children (or adults) with "mental disorders?"

This is not a trivial question, nor an attempt to start an esoteric philosophical debate. The question is being raised out of urgent need, with profound consequences for the well-being of our children.

Often when a child presents with severe psychiatric symptoms, the focus is on quickly alleviating those symptoms with psychotropic medications. Those medications often get added to, changed, more added to... and more symptoms crop up, sometimes as side-effects masquerading as "progression of the illness".

At some point, someone realizes that extensive endocrinological testing needs to be done. Truth be told, even if not to diagnose other ailments, the tests should have been done to at least get baseline values before the psychotropics were ever started.

So who orders the tests? The psychiatrist often does NOT order the tests. After all, they are not endocrinologists. But they ARE M.D.s and since the endocrine system is so often intertwined with psychiatric symptoms, AND the medications affect the endocrine system, should they not order the proper TESTS? Are they not being adequately be trained to address these issues as a MEDICAL doctor should? In the United States (not every country is this way), the psychiatrists are not even supposed to touch the patient -- give an exam, to feel if their thyroid has goiter, check reflexes, look at their skin and fingernails for signs of ill-health, and look for other possible neurological and endocrinologic complications.

Perhaps they have spent too many years focused on just the psychiatric symptoms themselves, immersed in treating with the psychotropics and paying no attention to the rest of the body and the endocrine impact. They CAN order tests, at least, but they defer that to other specialists. The psychiatrist assumes that since the endocrine system is involved, an endocrinologist should monitor what is going on in the endocrine system. An endocrinologist is presumed to be the appropriate specialist to run the appropriate tests.

Let's say the child IS sent to an endocrinologist. The endocrinologist is likely to say that since the child is on psychiatric medication, and the psychiatric medications affect the balance of neurotransmitters such as serotonin, dopamine and norepinephrine as well as hormones such as testosterone, prolactin, ACTH, cortisol, thyroid stimulating hormone, thyroxine (T4), and triiodothyronin (T3) among others including hormones affecting hunger, satiety, and even glucose regulation (even "just" antidepressants have some of these effects), it is therefore the responsibility of the psychiatrist to order endocrine testing as part of monitoring for the side-effects of the given medications.

So the net result, unless the parent is lucky enough to encounter an actual practicing Psychoendocronologist or, better yet, a neuropschoendocrinologist, the child gets left in limbo with insufficient endocrinological testing.

The lucky person gets the thorough endocrine testing prior to the introduction of psychotropics, but here is the catch. Many endocrine problems develop slowly over time and fluctuate. Even getting a partial snapshot of the system at a given time, (like only TSH) -- which is what tends to happen -- can miss what is really going on.

And then once the person is on the psychiatric medications - all bets are off.

IF the parents have enough money to doctor search, travel, or order their own tests, the child may get adequate testing, monitoring, and care. If not... the child, family, and all of society suffers in the long-run economically as tax-payers, as well as emotionally and socially.

So whose responsibility is it?
Ask a psychiatrist and the answer is likely to be "the endocrinologist."
Ask the endocrinologist. The answer is likely to be "the psychiatrist."

That's a problem.

And that was our experience.

But being fore-warned is being fore-armed. KNOWING at least that routine testing is NEEDED while on psychotropic medications such as antidepressant and neuroleptics (antipsychotics) can give us the confidence to INSIST that someone run the tests. If all else fails, find a pediatrician, General Practitioner, Family Doctor, or even an M.D. specializing in Integrative Medicine, to order the tests.

Who knows, it may be the side-effects of the medications themselves contributing to the continuation of symptoms.

Update: It's Not Mental - finding innovative support and medical treatment for a child diagnosed with a severe mental illness
includes information (and an entire appendix) about endocrine testing gathered from Dr. Thomas Geracioti M.D., Dr. Robert Fredericks M.D., Dr. David Marwil M.D. and a few others.

Further Reading:

References:
[1] Side effects blunt antidepressants gains Oklahoma EnidNews.com Feb 2, 2009

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Sleep: Timing of Melatonin, Light, Dark, & Use of Other Aids

2009-01-16T13:49:00.032-05:00

When to take Melatonin, how much, and whether to take the quick-release or the extended-release form can be a confusing issue. And what else can we do to help with sleep problems?

Since sleep is so critical to the health of body and brain, and as seen in our story -- sleep issues can cause mental symptoms -- we have accumulated some "tricks-of-the-trade" covering proper melatonin usage as well as other effective aids.

Here is information gathered from parents and doctors to help clear up some of that confusion about what to take and/or do, and when. But be aware, that there may be even deeper underlying medical issues which, if addressed, may help alleviate some sleep problems (such as healing gut issues, nutritional issues, food and chemical sensitivities, allergies, hormonal issues, etc.- See books: It's Not Mental, Is This Your Child, and Our Toxic World - Don't dismiss books and other information sources aimed at helping children heal just because you are an adult! Those are usually on the leading edge--ahead of their time-- because we will do anything to heal our kids! We adults can learn and implement techniques for ourselves as well!)
As with any suggestions, these are things parents have found helpful for their own children. Consult with your own child's doctor before implementing. At the bottom of this post are links to other websites for more information, including that specifically targeting patients with "bipolar" symptoms.

To get to sleep, some of our children do fine taking 1-3 mg melatonin half-an-hour to an hour before bed, but many need tryptophan as well (see below). And for others, especially with bipolar symptoms, it is much more complicated (to be discussed). See also: Beyond Sleep.

SAMe is necessary for Melatonin. SAMe is melatonin's daytime equivalent. The natural synthesis of melatonin during the night is dependent on the synthesis of SAMe during the day. SAMe is necessary for the biochemical reaction that converts serotonin into melatonin. (Serotonin is the neurotransmitter that drugs like Prozac elevate). SAMe and melatonin are entwined in a circadian rhythm that see-saws back and forth as the sun rises and sets.

Research shows that a rocking, gliding, or swaying motion can quickly lull us into a deep slumber. Until a company comes out with a device to mimic that motion (I am sure they will soon), some are setting up hammocks in the bedroom. Too soon to have feedback on that.

Some children with difficulty remaining asleep take 1-3 mg extended/sustained release melatonin right at bedtime.

Some parents report giving children with both issues a combination of immediate-release and sustained-released melatonin.

Other children do better with melatonin precursors such as L-Tryptophan or 5-hydroxytryptophan (5-HTP). Some additionally use the amino acid brain neurotransmitter Gamma-aminobutyric acid (GABA), along with inositol & niacinamide. GABA is known to induce relaxation and improve restful sleep. One indication for the use of GABA may be tense or achy muscles. Some alternate GABA with, or add, Valerian root. Sometimes they use these in addition to the melatonin.

One of the most obscure but critical facts about melatonin use is in the disorder of circadian rhythm. In this disorder, melatonin is sometimes given 5-6 HOURS before bed!

Here is one case:

The daughter was taking a large quantity (over 6mg) combination of extended-release and regular melatonin, tryptophan, and other supplements were tried, yet she was still having trouble sleeping at night and waking in the morning. Three sleep specialists later, one finally understood the problem was circadian rhythm disorder (a sleep study was NOT required to diagnose this condition). The specialist had her switch the timing and dosage of the melatonin.

Melatonin can be sedating, so a lesser amount was prescribed 5 hours prior to bed.
In addition, light therapy, which was being used, was switched to earlier in the morning, more intensely (closer distance at 10,000 lux), and for her--with a predisposition towards hypomania--a briefer period of time.

It should be noted that others have reported that in addition to the light therapy in the morning, (with some needing the light for extended periods of time, some even for hours on gloomy days) and melatonin either used at bedtime or 5-6 hours before bedtime, DARKNESS at night is equally critical.

For darkness, it has been suggested that if at all possible, the room should be so dark that a person cannot even see his/her own hand. This goes against our parental instinct to provide night lights. It is a judgement call, of course. I certainly would not wish to traumatize a child. I have not heard from a parent trying this, but perhaps a sleep mask over the eyes, if the child would tolerate one, might be useful?

Another suggestion is applying the research stating that dark AMBER or ORANGE sunglasses that blocks the blue portion of the light spectrum (short light wavelengths), worn while awake at night (starting at about 5 or 6pm) can also help re-set the circadian clock, or help prevent it from going awry: See: Blue blocker glasses impede the capacity of bright light to suppress melatonin production and Dark therapy for bipolar disorder using amber lenses for blue light blockade.

Note that you don't want white or blue spectrum lighting on at night. I looked for amber or orange nightlights, and found some bulbs: 5 Watt C7 Orange Ceramic Replacement Bulb and Leviton Mfg.co.,inc. A00-ECONO-LED Nightlight with Amber Led. I'd be happy for anyone to comment on ones you think are good.

Dr. Jim Phelps of PsychEducation.org and the Corvallis Psychiatric Clinic believes dark therapy can be beneficial in treating rapid cycling, and other symptoms of bipolar disorder.

In the article, Keeping bipolar disorder in the dark may just do the trick suggests that since the length of time in darkness-14 hours each night is not do-able, the dark amber sunglasses used in conjunction with the blacked-out room to sleep in, might do the trick.

1000mg L-Tryptophan has been as helpful for my daughter in promoting undisturbed sleep--eliminating horrific nightmares--as 150mg Seroquel/quetiapine (500mg Tryptophan per 75 mg Seroquel was suggested by her M.D. specializing in Integrative medicine as discussed in my book-- It's not Mental).

And many parents love the way some homeopathic remedies, such as Hyland's Calms and Hyland's Calms Forté™, work for helping their children sleep better.

One last suggestion is to change the bed itself. Some children sleep better with a different type of mattress or even no mattress at all, but rather a hammock! Here is an article from NPR about actual research into the gentle swaying of a hammock triggering deep sleep: Why Hammocks Make Sleep Easier, Deeper

In summary, suggestions to consider--depending upon problems-- are:

Small dose melatonin 5-6 hours prior to bed for circadian rhythm disorder
Fast-release melatonin right before bed for help getting to sleep
6 hr. extended-release melatonin for trouble staying asleep
L-Tryptophan
5-hydroxytryptophan (5-HTP)
SAMe in the daytime
Hyland's Calms or Hyland's Calms Forté™
GABA with inositol & niacinamide
Valerian root
NutraSleep™ (by Source Naturals) has GABA, inositol, Valerian root and a few other helpful natural sleep components.
Light therapy early in the morning
- Dawn Simulator before alarm
- Broad Spectrum 10,000 lux "sun" light -- time varies by individual
Dark bedroom for sleep or use eye mask
Dark Amber sunglasses in the evening. Possibly amber or orange nightlights if some light is necessary.
Dark therapy (for 14 hours) at night
Change the mattress if necessary, trying different modalities (such as harder, softer, memory foam or a hammock)

Other suggestions for helping sleep include:

Have a white noise source on at night
Cool room, warm feet
Avoid sugary or refined-grain bedtime snacks which can cause a blood-sugar drop during the night (which can in turn cause disturbed sleep or waking up)
Avoid caffeine
No TV, computer use, or homework within an hour (or 2) of bedtime
Have the child checked for food sensitivities and eliminate those foods
Regular exercise
Strict sleep/wake schedule applied every day. Don't vary it on weekends and vacation days.

In addition, consider having a sleep study done, and using pharmaceutical interventions when necessary. Some children may have sleep disorders requiring the use of pharmaceutical medications such as the daytime use of provigil/modafinl, nuvigil/Armodafinil, Wellbutrin, etc, or nighttime use of medications targeting sleep architecture (such as Xyrem) in the case of severe narcolepsy or related disorders.

Another consideration is that either low or high hormone levels can cause excessive sleep, disturbed sleep, erratic sleep cycles, or diminished sleep.

Amber glasses - blue-light blocker sunglasses product recommended to me by people like YOU: BluBlocker

But here are other ideas for purchasing, including a cheap, effective pair of yellow/amber glasses.

Dawn Simulators and 'Sun' Lights y'all have recommended:

Apollo DayBreak Duo Sunriser (has both dawn and dusk simulation)
Sun Box

Some us love a whole room of "happy lights" in the daytime: TrueSun

Additional Reading:

Well-researched information on Dr Phelp's site about light therapy, dark therapy, light boxes, the importance of blue lights etc.

Bipolar Disorder, Light and Darkness: Treatment Implications
Light Therapy (great information about different types of light boxes, when and how to use them)
Dark Therapy
Blue Light is the Light That Matters: Here's Why

Discussion Forums:

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