Wednesday, July 29, 2009

Mental Illness

When someone's brain is not working properly others describe them as "mentally ill." Mental health and mental illness are poorly chosen terms that obscure the medical and social issues that arise whenever human dysfunction is examined. The hospital in my community has a separate building described on a sign as “Mental Health and Addiction Services.” I suspect that the staff and the patients that use this building do not understand what “mental health” means. I am certain that the juxtaposition of the words “health” and “addiction” is a mistake.

Kurt Vonnegut described the cause of mental illness as “bad chemicals.” Humans are unrealistic about what substances they can safely ingest, inhale and inject into their bodies. Humans are most unrealistic about how easily and how profoundly small amounts of external chemicals can affect their mind. They believe that they are tougher than they are. Modern psychiatric theory imagines bad chemicals or good chemicals in the wrong amounts manufactured by mistake inside the brain of each victim. Physicians often view the brain as a black box with no chemical input except the drugs they prescribe. A neurobiologist will recognize that numerous chemicals arrive from the outside to interact with brain chemistry. Bad chemicals in the food supply can disturb brain function in entire populations with endemic brain dysfunction as the result.

The World Health Organization claimed that one-fourth of the world’s population is affected at any time by depression, other mental disorders or substance abuse problems. According to the WHO report: "Women are more often affected then men. The higher prevalence of mood disorders in women may include the frustration of relying on the role of housewife for identity and self-esteem; lack of personal income; and for those who do work lower pay and more labor-intensive jobs than men." In addition, violence against women has been recognized as a growing problem. Some studies show that as many as half of all women living on planet earth have been physically abused at some time in their lives. Their abusers are mostly men and most of those men are boy friends, spouses, family members or close “friends.”

Kessel et al suggested that half of all Americans will have a mental illness during their lifetime, with symptoms beginning in the teen years for many. They favored diagnoses such as mood disorders, anxiety, impulse control and substance disorders. Rather than using fuzzy terms such as “anxiety, mood disorders or depression,” we can recognize “mental illness” as a variety of interacting maladaptations caused by bad genes, bad chemicals, bad food, infections, malnutrition, poverty, oppression and abuse.

Mental disturbances are the first symptoms of bad environments that substitute disease-causing conditions for healthy conditions.

Mental illness is often self-inflicted by overeating the wrong foods, drinking alcohol to excess, using and abusing drugs obtained from both legal and illegal sources.

Social Chaos

Common effects of erratic brain function are conflict and chaos. Two people living together with erratic brain function increase chaos by more than a factor of two. More people interacting erratically increase chaos exponentially until family structures, community structures, and national structures become dysfunctional.

Bad chemicals entering human brains from polluted air and water, wrong foods, alcoholic beverages, legal and illegal drugs is a recipe for a society's dysphoric disintegration. We might better appreciate the folly of "fighting a drug war" when we realize that most chemical demons live at home. Unfortunately, in terms of substances that can impair brain function, “drug sellers" include every corner store, fast food outlet, pop vendor, pharmacy and supermarket. Local bars and liquor outlets generate a continuous stream of social and health problems at an enormous cost to society.

We must be smart enough to see the connections among food materials which influence brain function: alcoholic beverages, nicotine in tobacco, teas, coffee, chocolate, spices, food additives, sugar excess, wheat, milk, eggs, prescription drugs and street drugs. We should be very concerned about the prescription drug problem with drug addiction and dependency that is supported by all our institutions. Unfortunately, the practice of medicine has become a drug-pushing affair. An addicted society will better tolerate the social pathology and diseases caused by tobacco smoke, alcoholic beverages, air pollution, bad food, sedatives, antidepressants, tranquilizers, and sleeping pills but displaces its dysphoric energy in a "drug war" against cocaine, heroin and a few other "drugs of abuse".

Humans are seldom consistent in setting goals and priorities so that societal confusion about the use and abuse of food chemicals and drugs is more or less predictable. Smart policy makers will, however, understand that most citizens are under the influence of one mid-altering drug or another. The daily use and abuse of several brain chemicals produces mentally disabled people who are neither reasonable nor correct in their thinking and conduct. When physicians intervene and prescribe more chemicals, they add to the chaotic mix, not realizing there is there is little hope of benefit. To my way of thinking, this “drug psychotherapy” has become a perverse enterprise with no happy endings in sight.

Read the Human Brain in Health and Disease by Stephen Gislason MD

Tuesday, July 21, 2009

Pandemic Viral Illnesses Occur Every Year.

A Perspective

What interests me and other science philosophers is how nonsense routinely overwhelms reliable knowledge. Humans appear to have an endless capacity and need to generate nonsense. Nonsense is generated, in part, as nominal fog that obscures a simple truth - we do not know what will happen next. "Experts" are just as limited as the most ignorant and opinionated nonsense generator. You could, without any hesitation, award television news media with the Oscar for the best nonsense generators of the year. Their nonsense spreads worldwide with speed and penetration that would make any virulent virus envious.

There are a host of current examples of noumenal fog generators under titles such as Health Care, Economy, National Security, Terrorism and most recently, Pandemic. Whenever these key words appear, have a look, you will not be disappointed -- the ratio of nonsense to sense will be at least 9 to 1.

I have chosen today to do a brief review of the Swine Flu Scare of 2009 - a great pile of nonsense that seem to have overwhelmed even the most cautious of scientists. This is not to argue that H1A1 viruses are innocuous, but to develop a perspective on the relative threats of viruses in general and to reveal that the evidence for swine flu as a special threat is lacking.

In the Northern hemisphere, viral epidemics cause up to 80% of all respiratory illnesses. The most common infections are caused by six viral groups: rhinovirus (RVs), respiratory syncytial virus, influenza virus, parainfluenza virus, corona virus, and adenovirus. In one study of 285 children admitted to hospital with lung infection, viruses were identified in 125 - respiratory syncytial virus (107), influenza (9) and parainfluenza type 3 (9). Clinical and radiologic diagnoses included bronchiolitis (127), interstitial pneumonia (47) and lobar pneumonia (91).

Rhinoviruses often referred to as “cold viruses” cause the majority of respiratory illnesses. Other viruses contribute to waves of colds, coughs, bronchitis, asthma and pneumonia that pass through every human population in epidemic patterns. Colds are rhinovirus infections that are usually mild and self-limiting but are more serious in premature babies and children with chronic diseases or immunosuppression. The average child can expect to have four to eight rhinovirus infections per year, and adults have three to five infections.

Respiratory Syncytial Virus is spread by coughing and sneezing; by close contact with sick patients or by hand contamination. Infection develops in care -givers who touch their eyes or nose with contaminated fingers.

Adenoviruses While Influenza viruses are well-known and epidemics of more virulent influenza strains are feared, other less known viruses, especially adenoviruses, tend to be common and can produce severe illnesses. For example, adenoviruses are the second most prevalent cause of acute lower respiratory infection of viral origin in children under four years of age in Buenos Aires, Argentina. Pneumonia was observed in 71% and bronchiolitis in 29% of children admitted to hospital with adenovirus infection. Wheezing occurred in 58% of the children. Four children died (a fatality rate of 16.7%). Adenoviruses have emerged as important pathogens in immunocompromised patients, in whom disseminated disease occurs frequently and is associated with a high mortality rate. For over 25 years, the US military controlled adenoviral respiratory infections through immunization of its members. A group of Navy physicians reported a “large epidemic of respiratory illness due to adenovirus in healthy young adults” after adenovirus vaccine supplies were depleted.

The US military medical services are perhaps best equipped to diagnose and treat adenovirus infection which cause outbreaks of disease among military recruits. A National Surveillance for Emerging Adenovirus Infections system includes military and civilian laboratories at 15 sites in the USA. Fifty-one adenovirus serotypes have been identified. In 2007 the emergence of a virulent Ad14 variant spread through the United States with some deaths. Ad14 infection was described initially in 1955 and was responsible for an epidemic acute respiratory disease in military recruits in Europe in 1969. In 2001-2002, Ad14 was associated with approximately 8% of respiratory adenoviral infections in the pediatric ward of a Taiwan hospital, with approximately 40% of Ad14 cases in children aged 4-8 years manifesting as lower airway disease. During the years, 2004-2007, the US surveillance system detected 17 isolates of Ad14 from seven sites. During March-June 2007, a total of 140 additional cases of confirmed Ad14 respiratory illness were identified in Oregon, Washington, and Texas. Fifty-three (38%) of these patients were hospitalized, including 24 (17%) who were admitted to intensive care units (ICUs); nine (5%) patients died

Influenza viruses cause epidemic respiratory illness every winter in most countries on the planet. New virus strains spread globally and cause prolonged illness and some deaths. The routine death toll in the US and Canada every year has been estimated to be 32,000 people.
Since the exact cause of fatal pneumonia is seldom correctly diagnosed, the fatality rate for influenza ( and other viral infections) is not really known. Other viruses also cause illnesses that spread globally with substantial morbidity, cost and some deaths. Influenza often begins with cold symptoms and progresses to involve the lungs. Most patients develop a chronic cough that can last for weeks. Pneumonia can develop and is a common cause of death.

Much publicity has been given to the possibility of an especially virulent strain emerging that will increase the death toll from thousands per year in the US and Canada to millions. Some virologists were concerned that influenza virus epidemics in birds would produce a newly virulent human virus. The World Health Organization warned that the world was not prepared for the next pandemic ( true). As of January 2006, the strain of avian influenza, A (H5N1), has been identified in only 148 human, 79 of them fatal, from direct contact with infected birds. The strain was first detected in Hong Kong in 1997 and has spread through Southeast Asia and then in Russia and Turkey. So far, bird flu has not become a major threat to human survival.

In 2009 a H1N1 variant ("swine flu") emerged and caused another media frenzy; the WHO declared a "pandemic" and despite reports of a relatively mild illness with a low mortality rate, news anchors began to refer to a "deadly virus" (false). The positive aspect of the scare tactics was increased international cooperation in monitoring the spread of the virus and increased funding of vaccine development.

Some of the fear was generated by comparison with the 1917 flu pandemic caused by another H1A1 virus. The truth is that speculations adn predictions based on very limited knowledge of that pandemic are likely to be wrong. While you can argue that every year, influenza and many other types of viruses create pandemics and every year more virulent strains could emerge, there is no reliable knowledge that allows experts to predict what will happen next.

Airborne causes of illness are discussed in the 2009 book,
Air and Breathing by Stephen Gislason MD