What’s the cause?

Recently on these two podcasts, Found My Fitness and The Drive, medical professionals discuss their new understanding of Alzheimer’s. My simplified summary of these podcasts is that we are now seeing that there are several subtypes of Alzheimer’s. These subtypes are actually unique diseases that all have similar effects, yet a unique cause. The scientific community seems to be aware of the following subtypes: the first is characterized by systemic inflammation, the second type shows reduction in support for synaptogenesis, and the third type characterized by environmental toxin exposure from molds or heavy metals. They even named another type 1.5, as it seems to be a mix of the first and second types. When medical providers thought it was only one disease, then the cures that were being applied were probably unlikely to apply to all types of the disease, as they had different causes. If someone’s Alzheimer’s is related to mold exposure from their homes, then reducing systemic inflammation via dietary intervention may have little impact. I’m wondering if we will see similar discoveries in mental health.

I think it’s likely that we will discover multiple subtypes of depression, anxiety, and other mental health concerns. I think it’s likely there will be overlaps between the subtypes, such as the type 1.5 for Alzheimer’s. When I review studies on the treatment of depression (broccoli sprouts to support neuroimmune system, curcumin, transcranial magnetic stimulation) so many of treatments provide improvement for a portion of the people in the study, yet not one treatment provides benefit for all the people. Is it possible that the reason for this partial effectiveness is that there are many subtypes of depression?

What could be the causes of some of the subtypes of depression? My guesses are:

  • Distressing Beliefs
  • Childhood Trauma
  • Behavioral Patterns
  • Rigid Neuropathways/Default Network
  • Overactivity of Immune System/Inflammation
  • Poor Nutrition
  • Poor Gut Health
  • Sedentary Lifestyle
  • Poor Sleep
  • Social Stress

When counselors are lucky, we see clients that are only suffering from depression that is connected to beliefs, emotions, stress, and traumas. We have the tool set to support clients in these cases. What happens when the client is suffering from multiple subtypes or a subtype that is outside of our professional lane? What if we started with interventions with the highest benefit and least risk, and find ways to keep these affordable for our clients? Could we partner with professionals in other fields and find ways to offer group consultations to keep costs low? A childhood obesity clinic offered parents group informative sessions by a nutritionist on dietary advice for their children. All the parents had a similar concern and they all needed similar support from the nutritionist, and the group information sessions made them more affordable.

As mental health counselors, can we build a network of providers that can affordably support our clients? Maybe a nutritionist, you partner with, offers a monthly class on nutritional recommendations for depression and you offer a class on distress tolerance skills or something else that would be supportive to her clients. These classes can have a fee and be a referral source. We could each have a network of many other providers from different fields.

When we have clients that aren’t responding to our tools, maybe it’s not because they are resistant, maybe it’s because their depression has a different cause.

Comfort vs. Discomfort

Where does your preference lie on the spectrum of comfort to discomfort? And in what areas?

For me, I like workouts, personal challenges, and temperatures (bot and cold exposure) more in the uncomfortable side of the spectrum. My clothes, food, and technology, I prefer in the comfortable side.

Where could it benefit you to move an area to a different area of the spectrum? In example, today I’m traveling, so choosing to fast instead of indulging in the many offerings of food like substances at the airport. Yet. I’m tuning into ways to bring more comfort to my body today, by rubbing my neck and ears, while enjoying the sunrise over Mount Rainier.

What practice of moving more towards comfort or discomfort would you like to try today? Can you engage in this practice 5 times today?

005 Questions to ask when reviewing medication efficacy

Personal History

  • Witnessed people experiencing difficulty on and trying to get off of medications
  • Concerns about the efficacy and legitimacy of studies and some pharmaceuticals

 

When looking at studies

  • What’s a placebo? Nocebo – negetive expectation on treatment.
    • Placebos more effective in treating issues related to dopamine.
    • The larger, more colorful, or intense the placebo, the more effective.
  • Is there a control group?
  • Is the control group on an active placebo?
  • What’s the difference between the control group and the treatment group?
  • Have the studies looked at what happens when one tries to get off the medications? What happens when one tries to get off the placebo?
  • How long is the medication shown to provide benefit compared to the control group? Example Benezos may have a 2 week window of providing more benefit then what the control group receives.
  • What population is the study on? Do you match the population?
  • What’s the recurrence rate of the symptoms on the drug verses no treatment?

 

For the professional prescribing you the medication:

  • What’s their expectation for how long you will be on this medication?
  • What’s their plan on getting you off of this medication?
  • What are the risks on being on this medication, what are the risks when getting off this medication, and what are the long term risks of this medication?
  • What are other maybe more natural ways of treating this issue?
  • What’s the company that owns this medication policy on making public their studies, does it include loose language like “all studies will be considered for publication”? This could mean the company is hiding studies that illustrate ineffectiveness or harm.

 

Things to consider if you’re already on medications:

  • If you’ve tried to quit or reduce your dose and you feel worse, these may be signs of detox and not a sign that the drug is working and you need to stay on it.

 

Resources