Tag Archives: Depression

The Child & Youth Mental Health Epidemic

Healing Complex SystemsMaybe we all have a reason to be here.

If I have a mission for my time on earth, it’s about healing.

Supporting the healing capacity of complex systems~.

That’s what I’m attempting with this blog. It’s what I try to do in my personal life. And it’s the primary emphasis of my career.

In my work, I coordinate a Collective Impact initiative called the Child & Youth Health Network.

A principal concern of all our partners in that initiative, across sectors & cultures, is the current mental health epidemic among children and youth.

We are hearing from our school district partners that our schools are overwhelmed, starting in Kindergarten.

Anxiety and depression rates are increasing. As are diagnoses of ADHD, autism and behavioral disorders.

Our kids are suffering.

We know from our government and non-profit organizations, as well as from youth and parents, that mental health services are insufficient and outdated. And the waitlists for those services are ridiculously long.

Youth who struggle with metal health issues have told us that the current mental health system is like Mordor. As in: “Even if you can get in, you’re still screwed”.

Even if you can get in...

Some data on youth mental health from my corner of the planet:

  • Among Southern Vancouver Island youth who attended secondary schools in 2013, 8% of males and 15% of females seriously thought about killing themselves in the past year (that’s over 1 in 10). And 4% of males and 7% of females reported attempting suicide in the past year.
  • In 2013, 8% of males and 22% of females who attended secondary schools on Southern Vancouver Island also reported cutting or intentionally injuring themselves in the past year.
  • Rates of problematic mental health for youth who are not engaged in secondary school are even higher, as often it is mental health issues, compounded with other risk factors, that result in disengagement from the education system. For example, 68% of homeless and street-involved youth in British Columbia (62% of males & 72% of females) reported having at least one specific mental health condition in 2015.

As I have Collective Impact conversations with diverse cross-sectoral partners who genuinely want to figure out how to reverse this alarming trend, I have to decide (over and over again) how much I am going to share about what I understand about the origin of this epidemic.

About the origin of illness.

Because saying that the Canada Food Guide is part of the problem is still considered a fringe perspective. Not supported by evidence.

The paradigm is changing, but it hasn’t shifted sufficiently yet to enable us to consider some of the primary contributing factors to this serious population-level health problem. Doctors are still dismissive of the role of diet in health.

So instead, we all get together and talk earnestly about better arrangements for the deck chairs on the Titanic. As the saying goes.

Even though we are coming together because we all acknowledge that such a serious health problem is going to require that we work together in innovative ways and try new approaches.

The Healing CapacityI know the system isn’t ready until it’s ready.

I know that because I have devoted my life to system-level work.

Supporting the healing capacity of complex systems.

It’s my thing~.

I know that I can influence systems by nurturing the conditions that will lead to a tipping point, but no one can force a system to do anything it isn’t ready to do. Or, more accurately, the resources required to try to instigate that kind of change make those efforts extremely wasteful and low leverage.

The Complex Origins of Mental Health Issues

I know, from experience, that mental health issues have complex origins.

I have worked with children, youth and families who live with conditions of complex risk for over 20 years. And I struggled with depression and anxiety for over 30 years, from the time I was 10 until a few years ago.

I still need to stick very close to my optimization protocol to be emotionally and spiritually well.

I know that my own mental health is impacted by a combination of:

  1. My personal history of connection and trauma (& the way my brain is wired as a result);
  2. My biological health;
  3. My spiritual health; &
  4. Epigenetic factors: the impacts of my experiences and my environment on the way my genes express themselves.

As is yours.

Through my own n=1 experiments I am working to address these four factors.

In my experience, it is the elements of the Microbiome Protocol that have had the most profound impact on my mental health, specifically through an intentional return to ancestral patterns of living, combined with continual monitoring of my well-being through biohacking methodologies.

I can’t say that out loud in my work.

Very often.

But I feel tremendous urgency.

Because I know that our young people are suffering. Really suffering. Right now.

And the impacts of the origin of the mental health epidemic become harder to reverse as time goes on.

beach youthWhen these children and youth become adults, how many of them will continue to struggle with their mental health?

How many will develop autoimmune conditions?

Because it seems that the origin of these illnesses, in many cases, is the same.

I believe the health of our young people is a pretty good indicator of the health of our society.

How much of this epidemic is preventable?

And when can we talk about it?

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The Origin of Illness (the Microbiome~)

My understanding of the microbiome is evolving.

New research is surfacing almost every day. Some of it I don’t fully comprehend.

Most recently, I’ve been reading David Perlmutter’s Brain Maker, which simplifies things enormously.

Here’s a step-by-step (with diagrams~) of my current understanding of the origin of illness. As ever, I welcome your thoughts.

The Origin of Illness

Both health and illness begin in the microbiome.

Here’s the basic idea:

Microbiome 1

My initial understanding involved a 3-step process:

  1. Inflammatory food upsets the balance of the bacteria in the gut, resulting in intestinal permeability.
  2. This allows foreign particles to leak into the body, causing systemic inflammation.
  3. Inflammation causes disease.

The connection between diet and gut health is the foundation of the nutritional elements of the Autoimmune Protocol as outlined in The Paleo Approach by Sarah Ballantyne, (as well as all other evidence-based healing protocols like the The Wahls Protocol and The Bulletproof Diet).

But not only autoimmune conditions are caused by an unhealthy imbalance in the microbiome: it seems that most illnesses are.

The notion that most chronic health conditions are at least partly caused by inflammation is, in itself, a radical departure from the previous, mechanistic understanding of health. But this story gets way more interesting:

Microbiome 2

Inflammation isn’t the only cause of health problems.

We also need to consider genes & environment. Which leads us to…

Epigenetics

Epigenetics is the study of the interaction between genes & environment. It’s partly this interplay that determines whether or not a genetic predisposition to a particular disease gets activated in response to systemic inflammation.

And helps explain why one person might get Psoriasis while another one gets Multiple Sclerosis.

Here’s a cute overview on Epigenetics:

The Origin of Gut Dysbiosis

Gut dysbiosis is an unhealthy imbalance in the microbiome and as mentioned, it is this imbalance that is a primary culprit in illness.

What causes an imbalance?

In addition to an unhealthy diet, chemicals (like chlorine); environmental factors (like excessive hygiene); side effects from drugs (including antibiotics); Caesarean birth and formula or bottle feeding all contribute to dysbiosis.

Before we are born, we have a minimal microbiome. We begin to acquire a robust one at birth. A vaginal birth followed by breastfeeding is the best possible way to get a healthy and protective microbiome started.

Interestingly, Dr Natasha Campbell-McBride suggests that a newborn receives microbiota from both the mother and the father (or the mother’s other sexual partners) during vaginal delivery. Which gives a whole new meaning to the term ‘dirty sex’~!

Stress

Stress is a really big deal.

Not only does ongoing stress contribute to gut dysbiosis through elevated cortisol levels, but gut dysbiosis causes stress.

And because chronically elevated cortisol levels contribute directly to intestinal permeability and inflammation, stress creates a nasty reinforcing loop of disease-provoking conditions in the body.

What causes stress?

Modern life.

We just weren’t designed for living this way.

Microbiome 3

 Toxins in the Brain

We used to think that the blood-brain barrier protected the brain from toxins. According to David Perlmutter in Brain Maker, that isn’t so.

Intestinal permeability allows toxins into the body and some of these travel up to the brain.

This is one explanation for the mental health epidemic we are now experiencing, including widespread depression and anxiety.

Remarkably, toxins can stress the brain into perceiving threat, which automatically triggers a neurological takeover by the limbic system.

The limbic system does a great job of protecting us from old-school hazards like predators, but is incapable of higher reasoning or anything approaching enlightenment, and simply can’t navigate the complexity of modern life.

So these toxins not only provoke depression and anxiety, but can render us incapable of making good decisions.

The Collateral Damage of Chronic Health Conditions

Compounding the problem, people who end up with chronic health conditions end up dealing with a host of other factors that contribute to stress, including pain, financial impacts and negative effects on relationships, which add add to the stress fest that help create their illness in the first place.

Microbiome 4

Mental Health

Obviously, the presence of toxins in the brain isn’t the only cause of mental health issues. The whole point of creating a convoluted spaghetti diagram like this one is that the origin of illness is complex.

In addition to epigenetics (genes & environment), trauma & brain architecture are significant factors to consider when thinking about our mental health.

I haven’t seen any reference to the connection between microbiome research and neurological development research in the literature, but it’s highly relevant.

(Still with me? We’re almost done~!)

Toxic Stress & Brain Architecture

Neurological research over the past 20 years has demonstrated that toxic stress in childhood changes the architecture of the brain.

The Harvard Centre on the Developing Child is a wonderful repository for this research.

The basic idea is that all children experience stress, but prolonged stress without the support of a caring adult is toxic to early brain development and permanently impairs executive functioning.

The ability to handle stress, fascinatingly, is wired into the same part of the brain as executive function skills, so that reduced executive function capacity also results in reduced ability to handle stress throughout the lifespan.

Executive function skills are also exactly what become impaired in an adult who experiences brain fog as a symptom of systemic inflammation.

Trauma & Nervous System Dysregulation

Finally, trauma, whether it occurs during childhood or adulthood, can result in nervous system dysregulation, which also impairs the body’s ability to manage stress.

So there it is.

My current (& no doubt flawed & incomplete) understanding of the origin of illness.

Next up: what we can do about it~!

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Depression as a Food Reaction

Matthew & Petra

Recently I tried reintroducing Macadamia Nuts into my Autoimmune Protocol (AIP) and I learned something about my mental health.

Organic raw dehydrated Macadamias were a go: I noticed no untoward effects.

But the supermarket non-organic kind in a tin were not. My stomach felt mildly inflamed, my energy plummeted and most interestingly, I felt quite depressed for several hours.

I could easily have ignored the stomach thing, but the depression was untenable.

I’d been upbeat & happy, then suddenly, about an hour after cracking the mac nut tin, all the joy and potential bled out of the world. I was no longer able to do my day. All I could do was steep in gloom, deep under the covers, with the woe of the world crashing down on me.

The first time it happened, the experience was so real and consuming it took awhile before I realized I was having a food reaction. That put things in perspective, and I made myself go outside for a walk, where I could begin analyzing my reaction rather than just getting lost in it.

Testing, Testing…

Over the next few weeks I tested my reaction several times, using an ABAB time series:

  • Organic raw dehydrated Macadamias: fine!;
  • Non-organic supermarket Macadamias in a tin: feeling of mild inflammation in my digestive system, low energy and depression;
  • Recovery time;
  • Repeat~.

The more un-organic mac nuts I had, the worse the reactions was.

Depression as a Food Reaction

Depression is a primary food reaction Matthew experiences when he tries to reintroduce foods, only his effects last longer (24-48 hours compared to my 4-6) and are more severe.

Even now that we know that this is a reaction he is likely to have, we still get bowled over by his feelings of absolute futility.

ABABWhen he’s in it, the reaction is so strong and deep, he loses the ability to remember that the reaction is caused by food.

That is a dangerous time.

The last time it happened, his feelings led him to question whether he even wanted to be here anymore.

It reminds me of the scene in Harry Potter & the Half-Blood Prince, when Professor Dumbledore consumes the Drink of Despair, a potion that causes him to re-live all his worst memories and fears. Matthew gets like that.

His despair results in very negative (short-term) attitudes about the severity of the restrictions he lives with on a low-FODMAP version of the AIP and a sense of hopelessness about the slow progress he is making, among other things.

This often results in a impulsive decision to reintroduce a bunch of other non-compliant comfort foods, because nothing matters anyway.

This unintended cascading reintroduction of non-AIP foods occurred for Matthew a year ago, after 3 months on the AIP, though we didn’t fully understand the phenomenon at the time. Once he recovered his ability to think clearly and got back on track, it took months to recover the progress he had made before that first derailed reintroduction experiment.

During an attempt at reintroduction, we now know that I have to be present and available to remind Matthew that he is having a food reaction, and that it is not a good time to make the decision to abandon his 15-month commitment to the AIP.

When he’s deep in despair, he’s not appreciative of my ministrations. But after, when he is able to look back and comprehend what just happened, he is.

So, We’re Careful With Reintroductions

We don’t do a lot of reintroduction experiments.

So far, Matthew has successfully reintroduced coffee and organic full-fat yogurt. They don’t cause a depression reaction, but he is only 70% confident that he actually tolerates them, so he’s still experimenting (ABAB~).

Macadamias~

Macadamias~

Chocolate & Mac Nuts? Not good. No matter how organic.

These observations have led me to reflect on the potential relationship between food and mental health issues in the general population.

People who are on a strict, clean dietary protocol are able to directly track the effects of reintroduced foods, but those who are consuming potentially problematic foods (or food additives or chemicals) all the time aren’t able to tease out the impacts of particular triggers on their well-being, including on their mental health.

Food & Mental Health

It is now widely accepted that gut health=mental health.

I experienced an alleviation of my decades-long battle with depression and anxiety after 6 months of paleo eating. Since then, I’ve surmised that perhaps gut health=psyche health, too.

What if certain foods (or fungicides, pesticides, or other chemicals) are also directly contributing to mental health problems? How would people know?

Only by adhering to a strict, clean dietary protocol for a significant period of time and then reintroducing foods (or additives or chemicals) to test their reactions.

Use of antidepressants are increasing all the time. More than 10% of Americans are now using them in an attempt to manage their depression. This number increases to 23% for women in their 40s & 50s (also the age group with the highest prevalence of autoimmune).

More research into the phenomenon of depression as a food (or chemical) reaction is warranted.

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A Paleo New Year

April seems to be my paleo new year.BeforeandAfter

Two years ago in April I went Paleo and lost 75 lbs in 5 months.

Soon after that I realized all 9 of my health issues had disappeared.

At the time I thought I’d ‘made it’. After all, I’d achieved even more than I’d set out to do.

I didn’t realize I was still only in the foothills of health and I’d taken just the first baby steps in my paleo experiments.

What I’ve experienced since then, as my food has become increasingly pure and my gut has continued to heal, is previously unimagined levels of well-being.

As someone who struggled with depression and anxiety every day in my pre-paleo life, I’m still astounded by the feeling of psychological well-being. And the impact psychological health has had on all aspects of my life, including my career.

Levelling Up

During my first paleo year I only ate fish & poultry, which was obviously sufficient for weight loss & initial healing. As a recovering vegetarian, I wasn’t prepared to eat mammals at first, but it became apparent that I needed to reduce my reliance on fowl as a protein source.

So last April, I had my first bite of steak.

And this April, after 3½ months on the Autoimmune Protocol, I went ketogenic on the Wahls Paleo Plus.

As April seems to be my Paleo new year, I’m going to make a resolution.

This year I’m going to level up to organ meat.

I’ve been recalcitrant on the offal front. I actually don’t even want to change (that’s sort of the definition of recalcitrant). But I know it’s the next step.

And one year from now I will no doubt wonder why I stayed offal-obstinate for so long.

Maybe it was because I started with lamb kidney.

Started and ended with lamb kidney.

I know it’s politically incorrect to say so, because in paleo-land we’re all just supposed to start salivating & shouting hallelujah the moment we see a pile of fresh organs in the butcher’s display case, but lamb kidney tastes like urine and the taste stays in your mouth for a long time, even if you brush your teeth (& your tongue) repeatedly.

I’m an offal wimp.

I just had to get that off my chest.

According to the Paleo PI, kidney is intermediate offal. Tongue & heart is the place to start.

I actually think chicken liver might be the way to edge in for me.

In any case, I’m celebrating my new year with offal.

Celebrate with me!

 

 

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Yog-Sothoth: the small dependent mammal

I’m not big on small dependent mammals.

Nevertheless, three years ago we adopted two rescue kitties from the SPCA. My #3 kid and I went to the kitty shelter every weekend for a month waiting to meet our perfect cats. We saw lots of pretty young cats come & go, and lots of old cats that will probably stay in the shelter for the rest of their lives. We seriously considered adopting one of these oldsters. And we really thought about the fellow who had been so severely abused that he’d had a front and a back leg amputated when he arrived. But he got adopted by a rich old lady who promptly went out to buy him $500 in kitty toys, so we figured he was going to do better with her than with us.

My stepson joined us (my #4 bonus kid!) on the big day and as soon as he walked into the kitty room, a black cat climbed out from under the bank of cages and looked lovingly into his face. They gazed at each other like two very old friends.

So that was obvious.

And then I saw Allie peering out at me from behind the piece of paper that was taped to the front of her cage. She’d been there every time we had, and for a couple of months before that. She had a paper barrier between her and the world because she got so distressed whenever people came near. Allie was another cat who had been severely abused. Pure white, with crik in her short tail where it had been broken. And she was looking at me.

I opened her cage door and she sniffed my hand.

Of course, I’d told the kids they could each pick a cat, but I wanted to recant. I had to have her. Luckily, my #3 kid was just as impressed, and Allie came home with us.

I did try very hard to get Matthew and the kids to agree to change her name to Yog-Sothoth, but we couldn’t get consensus on that. Allie was the name they’d given her at the SPCA, and Allie it stayed, though I do sometimes call her Alligator for short. We all agreed that Sebastian was a perfect name for a handsome black gentleman with such frightfully tattered ears.

Allie spent most of the first six months crammed in the tiniest crevices she could find. But over time her crevices became less tiny. Then sometimes she’d let a paw stray out while she slept. If you pulled on it, she’d suck it back in, like a snail recoiling to its shell. Then she started hanging out when just the family was home. And then she started skulking in corners when visitors were over. Sniffing them, even. Giving their pant legs a little lean, but disappearing before she could be touched.

Allie’s a comparatively well-adjusted cat now, but she still bolts if you move quickly. If you close the door to the room she is in, she leaps up from a dead sleep and wants out now. I’m pretty sure she will always be like that, even though she knows that she is safe with us. Her early trauma is stuck in her body. Her flight response is on a hair trigger.

Turns out Sebastian is quite a vocal cat. He’s a meowler. He’s hungry? Meowl! Wants’ out? Meowl! Wants love? Meowl! Not sure what he wants but he thinks maybe you should do something about it? Meowl!

I have talked to kitty experts who have said that this can happen to abandoned cats. Seb was discarded and as a result he meowls, irritatingly.

Sebastien meowls and Alligator startles.

And the only solution is love, patience & compassion.

Image

Love, patience & compassion~

What does this have to do with being paleo?

I think that a lot of us are stuck in meowling and startling; fighting & flighting; and are in the habit of trying to regulate our disordered nervous systems with simple carbohydrates.

Unresolved trauma results in a disregulated nervous system, for mammals of all kinds. In humans it can lead to addiction in an attempt to numb the discomfort and get the nervous system back in balance. Not everyone becomes a meth-head or an alcoholic. A lot of us become starch & sugar addicts, because it’s legal & cheap & socially acceptable & our fix is available at every corner store. In fact, I think we might be a whole society of SAD starch & sugar addicts.

And it is really, profoundly, and utterly hard to quell this addiction.

That’s the reason I’m writing this blog. To address the complexity of making the change to paleo. It’s not as simple as sanctifying your pantry and downloading some recipes. It’s healing work. But unlike Alligator and Seb, we can make choices.

If you still need your tiny crevice, or your sugars and starches, to be safe: choose them.

Know that healing is a process. Work on creating a safer environment so you can put first a paw, and then your whole self, into the change you want to be.

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Health 9; Problems 0;

Image
Health issues that have resolved since being paleo: 9
Health issues that remain: 0

I know some people are dealing with much more serious health stuff, but I felt like my body was disintegrating. And I was only 41. How was I going to make it to 50?

My 9 pre-paleo health issues:

  1. Chronic neck pain that no amount of chiro, massage or acupuncture could assuage;
  2. Carpal tunnel that required a wrist brace with steel supports so I could sleep;
  3. Plantar fasciitis that necessitated orthotic arch supports for my shoes, making it difficult to walk any distances. I even had to stop wearing flip flops, which was actually (I know this sounds overwrought) heart-breaking;
  4. Obesity;
  5. Depression;
  6. Anxiety. And it’s good buddy Ativan;
  7. Periods so heavy we could have made a slasher movie;
  8. One wiry black hair that grew out my chin. I joked that it was my beard (but only to Matthew, because I was actually quite self-conscious about it);
  9. Insomnia. I took increasingly large doses of ‘sleep vitamins’ every night for years;

Wow. Writing that list I’ve just been struck by how much less work my daily life is now that I’m no longer managing a dilapidated body. And how much money I’m not spending on supplements, drugs and therapies. And people critique paleo for being time consuming and expensive!

Actually, being unhealthy is time-consuming and expensive.

My health changes didn’t happen immediately, but they’re old news now and I’m not yet 43, so in retrospect it was pretty rapid.

After a while I realized that I’d been peering at my chin for weeks, tweezers in hand, ready to pluck my lone black chin hair, but it just wasn’t growing back.

Over time I noticed my neck, wrist and foot pain was gone. So I got rid of my wrist brace and orthotic shoe inserts. I wore flip flops all summer this year and I’m still wearing them (sometimes) in November, here on Vancouver Island. I’m euphoric about that.

Some issues healed gradually and others transformed overnight. After 7 months of paleo life I was at work one morning when I noticed an odd feeling. And it wasn’t the familiar pre-paleo mid-morning feeling: I need coffee and a muffin stat! so I don’t perish right here on my keyboard. It was an absence of fuzziness or a lack of greyness, sort of like I’d misplaced an itchy sweater I had become accustomed to wearing. It was an unsettling sensation until I realized that what I was experiencing was well-being. For the first time since I was ten (31 long years) I didn’t feel depressed.

That’s when I understood that pre-paleo my depression had become so much a part of me that it didn’t even register unless it got severe enough that I had to hide in my bed. If I could force myself out of bed and keeping rolling the gigantic boulder that was my life uphill, no matter how slowly or ineffectively, then my awareness of my depression faded. That was my normal. Over the next few weeks I rummaged around in the cupboards of my psyche looking for my misplaced depression but I couldn’t find it anywhere. I think it’s just gone.

And I haven’t taken anything to help me sleep since July.

And my Ativan has fallen into disuse at the back of my underwear drawer.

But it does take time. 30 days isn’t enough. The more complex and severe your health problems, the more time they might take to heal or abate.

I’m not suggesting paleo is a cure-all. Many of my health issues resolved because I lost weight. But I lost that weight, and have maintained my new weight, by being paleo. It’s a stormy Saturday morning in November and I’m about to go out for a 10k run in the rain and there is nothing I would rather do. That’s an indicator of wellness I just never experienced before.

So I’m feeling pretty fantastic. Better all the time, actually. 17 months into this paleo experiment I’m feeling finer than I ever have before.

Suprahuman.

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