Managing Symptoms Vs Treating Illness

Ever hear doctors claim labels for severe mental illnesses--like schizophrenia, bipolar disorder, etc.-- are "wastebasket diagnoses"? Have you ever stopped to think why some say this and what that means about our treatment of patients with these diagnoses?

Listening to some Continuing Medical Education (CME) about mental illness can be quite thought-provoking… revealing the huge gap between research and practice, and between medical and “mental.”

In this psychiatric medical discussion about schizoaffective versus schizophrenia[1] they boldly used the term "wastebasket diagnosis" for the DSM diagnosis of schizoaffective when talking about its diagnosis and treatment. But let's take this conclusion about this one diagnosis (and treatment) a step further.

ICD-10 vs DSM-V

At what point should a diagnosis be medical—in the ICD—as opposed to mental—in the DSM?

Psychiatrists are working on the next version of the hefty psychiatric "bible" of diagnoses (DSM-V) to replace the current DSM-IV. In newspapers around the country, an article is circulating about it. Here is a link to one copy of the article, in the New York Times: Psychiatrists Revise the Book of Human Troubles

The debates are passionate, because many “mental” disorders are “medical,” “biological,” “physical.”

Hard-to-Find but Commonly Needed Hypoallergenic Supplements

Many of our children with pediatric-onset symptoms of depression, schizophrenia, schizoaffective, bipolar, OCD, ADHD and autistic-spectrum have biological problems requiring nutritional supplements. But these same children often have food sensitivities to some ingredients commonly found in these supplements.

My younger daughter cannot consume gluten/wheat, dairy (casein), eggs, or soy.  She is also allergic to propylene glycol. Finding some supplements without these ingredients are difficult. We found that even if gluten or soy is not listed as an ingredient, it does not mean there is no gluten or soy in that product!

Plastics & The Brain

It is now common knowledge that ingredients in many plastics (especially when heated) may affect the growth and development of our children's brains. They can even lead to inflammation, increasing risk of diabetes and heart disease.[1] Research is showing these chemicals (Bisphenol A (BPA), phthalates and flame retardants (PBDEs)) can affect mood, cognition, and our endocrine system.[2,3,4]

From our own personal experience, some children are simply more sensitive to some effects than others. Our own daughter was found to be quite sensitive to the endocrine system disrupting effects, and was sent to an endocrinologist about it-- SIXTEEN years ago!

Sleep: A Critical Yet Under-addressed Component of Health

Sleep is critical for human life.

Grossly disrupted or disturbed sleep is often an early indicator that something is going wrong. Many neurological and endocrinological problems have disturbed sleep as a symptom.

Disturbed sleep can cause physical distress as well as mood and psychological issues(*). And physical distress, as well as psychological and emotional issues, can also cause disturbed sleep.

Teasing out what is causing what and, more importantly, addressing the issues that need to be addressed, can be a daunting task.

Nutrition, genes, and brain dysfunctions: Folate

Sometimes eating a healthy diet is not enough. In their search to answer why supplementing with folate helps some people with the brain symptoms of schizophrenia, NARSAD-funded research scientists are studying some people with schizophrenia who may have genetic defects that lower the amount of folate (vitamin B9) available in their bodies for their cells to use. This was found to be true in my daughter's case, as well (see book).

New Doctor Visit: The Medical History

How much should be in a medical history? What details are relevant? What aren’t? Should it be done by age? Or by symptom? There are many ways to create a medical history. Here are some ideas.

The Doctor Went Dumpster-Diving (Medical Records Delivery)

Ever take your child to a new specialist with a sense of happy anticipation that this time will be different—this time the doctor will listen and help—only to be left confused at the end, wondering how everything went so horribly wrong, so fast? Ever wonder how to minimize the chance the same thing will happen with the next specialist you see?

My daughter’s GP keeps meticulous records, keeping not only all the information sent from all the other doctors, but he consolidates lab results into what he calls a “Laboratory Flow Sheet.” It has all the lab test names and normal ranges down the left side, and dates along the top. All abnormal results are printed in red. If your own child’s pediatrician does not do this, I suggest that you create your own spreadsheet. Keep track of all the lab results yourself.

Inflammation of Body and Brain

Many studies have linked inflammation, excessive oxidative stress, and autoimmune disorders with psychiatric and many other medical illnesses. Altered levels of inflammatory markers such as cytokines and immune cells keep cropping up in the literature.

There is increasing evidence that many illnesses categorized diagnostically in the DSM-IV and ICD-10 under “Mental and Behavioral Disorders” are actually systemic (body-wide) disorders. They are physical illnesses affecting the brain—i.e. biological disorders. This systemic effect is well-documented in autism.

Important Links, Books, & Resources to Help Our Children

Perhaps your child is already diagnosed with a non-psychological condition affecting his or her brain (such as clinical depression, pediatric-onset bipolar, autistic-spectrum, hormonal issues, migraines, psychosis-nos, lyme disease, narcolepsy, Kleine-Levin syndrome, thyroid issues, or childhood-onset schizophrenia).

Or, you may still be in the early stages of thinking, “Something is distressing my child. The screaming, horrific nightmares, spacing out, acting like perhaps he/she is hearing voices, not sleeping or sleeping too much, and tantrums indicate that something is wrong.”). In either case, in addition to treating the more salient symptoms of the condition, we need resources to help the child’s underlying biology.

The Stress Connection: Meeting Hormonal, Nutritional, and Metabolic Needs

Many chronic illnesses are affected by stress (see Stress, Immune Response, and Illness). There have been many links between psychiatric symptoms, stress, mitochondrial function, and the endocrine system. A common thread connecting them all is nutrition.

The United States' government organization, NIMH, is currently running studies using nutritional substances to augment treatment of some neurobiological brain disorders such as autism, bipolar and schizophrenia.

Stress and Our Children. How Much is Too Much?

Responding to an acute stressor can boost our immune system. But the impact to our immune system, and the inflammatory response, from some stressors can be quite damaging.