Monday, December 22, 2014

Depression

The term "depression" is descriptive and vague. I believe the whole concept of depression is flawed and needs to be revised. "Depression” does not point to one discrete disorder but to a variety of unpleasant experiences common to all humans. When the term “depression” is used without qualification, it is usually misleading. Since antidepressant drugs have become a big business, the promotion of "depression" as an illness, treatable with drugs has become a scandalous enterprise with little or no merit.

Although the term “depression” was an invention of psychiatry the use of the term is pervasive in medicine, the media and in folk psychology. Writers, TV journalist and MD’s alike have been talking about “clinical depression” as if the word “clinical” increased the credibility of this dubious term. The best use of the term “depression’ is to point to someone who is unusually sad, critical and angry; a person who does not enjoy life and withdraws from work, play and close relationships with other humans.

Suppression and Oppression

All humans are involved in competition and negotiation with other humans. If you are losing a competitive struggle, you feel, sad and angry, sometimes with a terrible sense of loss; you want to withdraw, hide, cry and sometimes you want to die. If you habitually lose competitions or have an effective oppressor close by, you feel dysphoric often or always. We call this social inhibition, oppression or suppression rather than depression.

The symptoms are features of a withdrawal-inhibition-supplication response that occurs normally in social mammals to reduce the consequences of power struggles for dominance in a social hierarchy. Subordinate individuals in any primate group are more or less “depressed.” They have to withdraw when challenged by superior animals, supplicate and inhibit their self-serving, aggressive inclinations. All humans experience episodes of withdrawal with inhibition and supplication if someone threatens or is mean or if privileges, property or prestige are lost. Whole groups of humans experience collective depression when the group is threatened or diminished in some way. Suicide is equated with depression, but self-inflicted death is a deep and troubling human behavior that cannot be explained away as an illness. Self-inflicted death may follow loss of prestige and property and is associated either with giving up hope of desired rewards, or anger at the inequities and injustices of the “system”.

A reasonable person will acknowledge that life is difficult and suffering is inevitable. Everything we value is impermanent. Every feature of each of us is in flux and we change continuously. We age. We become ill. We suffer injury and loss. No human knows what comes next so that uncertainty is a constant companion. Modern life in cities is not normal for humans who emerged from living in small groups in natural environments and whose basic tendencies want to continue in that style of living, but cannot.

Psychiatrist, Clements observes that normal feelings and the inevitable sadness of life are often denied and turned into a disease that can be treated with expensive chemicals. She stated: “Sorrow is not recognized as part of the human condition and reactive sadness is viewed as a medical illness, a pathology rather than a normal and very human response… I confess I cry for humanity, and another person's tears tend to generate tears in my eyes too. If sorrow can be avoided, well and good. But the reality is sorrow is an integral part of the complicated system of the cosmos, and of human existence.
Depression, a vague label, what is the correct diagnosis ? Depression as a medical diagnosis is equated with “mood disorder’ and as a problem located inside one individual. Much of the content that is included under the term “depression” has little or nothing to do with mood and involves changes in body function, cognitive dysfunction and changes in specific behaviors. The main textbook features of “depression” are withdrawal from and loss the loss of interest in job, family, social activities and personal hobbies. "Depressed thinking" is said to be pessimistic, critical of others and oneself and tends toward guilty ruminations and suicidal thoughts.

Research into the neurobiology of “depression’ has produced a bewildering display of abnormalities, not because depression is a real illness with a lot of abnormal findings, but because people gathered together under this diagnosis are a heterogeneous group with many contributing disorders. Some are just sad, lonely people with poor diets, poor living conditions, family conflict, no fun and no exercise.

It should be obvious that some people are happier than others and some people live under a cloud of doom.  The reader needs to recall our basic understanding of genetics. The idea is that all human characteristics are distributed and, no matter what human feature you are considering, you will find some individuals with more and some with less. When you accumulate sufficient data and do the appropriate statistics, you will have an idea about the distribution of the feature and an indirect understanding of the genetic and environmental determinants of that feature. When researchers reported that variations in a gene they were studying more or less correlated with the tendency to become depressed, the media ran cover page stories linking the gene to “stress” to depression and promising new tests and treatments.

Helen Person in her review of the study stated: “The gene, which encodes a protein called 5-HTT, reveals its influence when people experience divorce, debt, unemployment or other occasions of "threat, loss, humiliation or defeat. People carrying two short forms of the 5-HTT gene had a 43% chance of becoming clinically depressed after four or more stressful events experienced between the ages of 21 and 26. This compares with 17% of those with two long ones…  The new results also raise the prospect of genetic tests to predict those who are vulnerable to depression. But this remains unlikely, partly because there is no clear preventative therapy for those at risk.  Such a test would also be unreliable. Of the two-thirds of the general population with one or two short stress-sensitive genes, only a fraction becomes depressed. Many other genes and experiences, such as physical illness, are involved. These must be identified before an accurate risk assessment can be made.”

Depression Solution

Many of the symptoms included under the title of “depression” are typical of common food-related diseases including diabetes, atherosclerosis, malnutrition, hormonal dysfunction and delayed pattern food allergy. All these problems require diet revision. We suggest that a prudent person suffering depression and body symptoms would be wise to pursue vigorous, thorough diet revision at the earliest opportunity. Because some brain dysfunction compromises judgment learning and motivation, family members, friends and professional advisors often have to provide the right direction and support.

From the Human Brain by Stephen Gislason MD

Gluten and the Brain, Protein Diseases

Celiac disease is the best studied form of delayed pattern food allergy caused by eating wheat and other cereal grains. A surprising range of disease is triggered by the proteins in these foods, collectively referred to as gluten. Celiac disease may present as a vague illness, even a mental illness.

Patients often complain of dysphoria with fatigue, difficulty in concentration, loss of recent memory, irritability, loss of pleasure and interests, often with sleep disturbances. Sleep and dreaming are influenced by food problems. Most people eat their major meal in the evening and snack at night. This food is digested and absorbed during the night and symptoms often emerge as you sleep. Some allergenic effects tend to peak at night - asthma, migraine, body pains, and itching are often at their worst. Sleep disturbances include difficulty falling asleep, frequent waking and nightmares.

Luostarinen et al suggested: It is well known that coeliac disease may be associated with various neurological manifestations. We have had a high index of suspicion of coeliac disease during recent years in our neurological clinic. As a result 10 (7%) out of 144 of our new coeliac patients were detected because of neurological symptoms. The most common neurological manifestations were neuropathy, memory impairment and cerebellar ataxia. In these patient groups screening for coeliac disease with serological antibody tests helps to find patients who may suffer from this disease.

Wills suggested A number of neurological syndromes have been described in association with coeliac disease. These include disorders of the central nervous system encompassing epilepsy, myoclonus, ataxia, internuclear opthalmoplegia, multifocal leukoencephalopathy and dementia. Most of these associated conditions show a poor response to gluten restriction. Peripheral neuropathies, of axonal and demyelinating types, have also been reported and may respond to elimination of gluten from the diet. The mechanism underlying these processes remains obscure but may be immunological or related to trace vitamin deficiencies. Controversially, it has also been claimed that occult coeliac disease accounts for a substantial proportion of patients with neurological dysfunction of unknown cause. Some authorities recommend that cryptogenic ataxias and neuropathies should be routinely screened for the presence of gluten-sensitivity but this remains contentious and has not been universally accepted.

Gluten and Cerebellar Ataxia

One example of specific brain injury from eating gluten is cerebellar ataxia. The cerebellum looks after the coordination and smoothing of movements so that problems here show up as movement disorders. Gluten sensitivity, with or without classical celiac disease symptoms and intestinal pathology, is a treatable cause of cerebellar ataxia.

Bushara et al reported: We investigated the prevalence of abnormally high serum immunoglobulin A (IgA) and IgG anti-gliadin antibody titers and typical human lymphocyte antigen (HLA) genotypes in 50 patients presenting with cerebellar ataxia who were tested for molecularly characterized hereditary ataxias. A high prevalence of gluten sensitivity was found in patients with sporadic (7/26; 27%) and autosomal dominant (9/24; 37%) ataxias, including patients with known ataxia. Patients with hereditary ataxia (including asymptomatic patients with known ataxia genotype) should be considered for screening for gluten sensitivity and gluten-free diet trials.

Hadjivassiliouet al reported that patients with gluten ataxia have antibodies against Purkinje cells. Antigliadin antibodies cross-react with epitopes on Purkinje cells. Burk et al reported the symptoms of gluten ataxia: The clinical syndrome was dominated by progressive cerebellar ataxia with ataxia of stance and gait (100%), dysarthria (100%) and limb ataxia (97%). Oculomotor abnormalities were gaze-evoked nystagmus (66.7%), spontaneous nystagmus (33.3%), saccade slowing (25%) and upward gaze palsy (16.7%). Extracerebellar features also included deep sensory loss (58.3%), bladder dysfunction (33.3%) and reduced ankle reflexes (33.3%).

From The Human Brain by Stephen Gislason MD

Wednesday, December 10, 2014

Feeding Infants and Children

Children are exposed to major health problems from their food supply. In affluent countries, the children's food supply tends to be the most processed and chemically contrived of any age group. Food manufacturers and vendors advertise their synthetic, processed foods directly to youngsters, and generally succeed in marketing their products. Boxed, canned, and bottled foods, fast foods, snack foods, candies, chocolate bars,  burgers, pizzas, and pop all form the food vocabulary of our adolescents and many of our younger children.
Some problems, such as food-borne infection, insufficient food and malnutrition, are painfully obvious in third world countries but also occur closer to home because of poverty, ignorance, and neglect. Other food problems are less obvious and may not be recognized; these include major, pervasive biological disturbances from inappropriate food choices, food excesses, nutrient deficiencies, food allergy, and chemical toxicity from food additives and contaminants. Children of poor families with limited food choices are more obviously at risk of malnutrition but children of more affluent families may also suffer malnutrition in the form of wrong food choices, caloric excess, nutrient disproportion and even vitamin mineral deficiencies when packaged and processed food replaces real food.

Problems with Common  Food Rules

For years, official food rules suggest that children eat from the four food groups: milk, eggs, meat, and whole grain cereals as staple foods. Boxed cereal and milk is a common breakfast. The cereal has been nutritionally fortified, and so has the milk; nutrient intake may be satisfactory by nutrient accounting, but what about the impact of the food on the child as a whole?

The Unique Child

In theory, all children should be treated equally, but all children are not created equally. Nourishing food has to interact with each person’s unique metabolism and reactivity. Many things can go wrong. Abnormal food-body interactions change the rules of nutrition. A cheese sandwich may be nourishing to one child and a toxic mix for another. A chocolate bar with peanuts may please one child and send another to the hospital in an ambulance. Daily milk or bread ingestion may be suitable for one child and cause chronic disease in another.
The premise of the Alpha Nutrition Program is that each child will have a best fit of safe, nourishing foods and nutrient supplements that permit a long and healthy life. Your best fit diet is likely to be different from other people’s best fit. Even close relatives will be different.

Two parents with three children should have five different diets to suit the individual needs of each unique individual. The idea of a “normal diet” suitable for the whole family is flawed.  A better idea is that a small selection of best foods may serve the needs of the whole family, but beyond this “core diet” individual differences will become all important in the determination of who does well, who does poorly, and who develops a disease.

Biologists understand that the distribution of observable characteristic follow the distribution of genes in an in any given population. A "normal distribution" of any measured characteristic is a bell-shaped curve, with most scores in the middle range and a few at each end, or "tail," of the distribution.
The main idea is that all human characteristics are distributed and, no matter what human feature you are considering, you will find some individuals with more and some with less. When you accumulate sufficient data and do the appropriate statistics, you will have an idea about the distribution of the feature and an indirect understanding of the genetic and environmental determinants of that feature.

Food Allergy is Common

During the first year of life, the infant diet is the most powerful determinant of the growth and development of the child and food allergies are the most common health problem. Many studies show that breast feeding is best and that the feeding of solid foods is best delayed  4 to 6 months to reduce the risk of food allergy. Food allergy in infancy is expressed as crying, colic, vomiting, diarrhea, rashes, eczema and cold-like respiratory congestion. Some infants with food allergies become seriously ill and fail to thrive unless their allergy is recognized and corrected. Infants who develop a food allergy in their first year may "outgrow" the first effects but tend to grow into children with more pervasive health, behavior and learning problems unless their diet is properly managed.

We have found that milk and wheat allergy are common in children of all ages, Food allergy causes physical symptoms and also contributes to learning and behavioral problems. A peanut butter and jam sandwich and a carton of milk is a common school lunch, followed by the most common afternoon symptoms - flushing, congestion, fatigue, irritability and the inability to concentrate. 
There are many ways for food problems to interfere with a child's normal functioning and to promote disease. We  assume that several problems interact in a complex manner to produce the symptoms and dysfunction that we seek to remedy. It is always necessary, therefore, to correct nutritional problems by complete diet revision

 Using the Alpha Nutrition Program

See Feeding Children by Stephen Gislason MD