The UltraMind Solution (57 page)

Dr. Herbert’s TRANSCEND (Treatment, Research, and Neuroscience Evaluation of Neurodevelopmental Disorders) research program at Harvard is breaking radical new ground in looking at the brain as part of the whole body system. Stay tuned, because I believe their work will change not only our perception of autism but of
all
disease and the nature of research itself by changing what questions we ask, how we ask them, and how we search for answers.

Now is the moment in medical science that parallels the shift in thinking that occurred when Christopher Columbus said the world was round or Galileo proposed that the earth was not the center of the universe but revolved around the sun.

The implications across the entire spectrum of suffering and illness are profound.

Is Depression a Systemic Inflammatory Disease?

How can exercise and fish oil often be a more effective treatment for depression than antidepressants? Could it be because they are both potent anti-inflammatories? Could it be that depression is a low-grade inflammatory disease of the brain?
⁶
Let’s look at the evidence.
⁷

1.
Proinflammatory cytokines IL-1, IL-6, and TNF a (molecular messengers that set off the inflammatory response) and bacterial toxins (produced in our gut for reasons we will explore in chapter 9) produce symptoms of depression and anxiety.

2.
Cytokines overactivate the HPA (hypothalamic-pituitary-adrenal) axis (the stress response), just as we find in depressed patients.

3.
Cytokines increase the function of an enzyme (IDO) that breaks down tryptophan, leading to less serotonin in the brain.
⁸

4.
The immune system is overactive in severe depression, producing brain inflammation.

5.
Using immune therapy like interferon (a cytokine) for diseases like hepatitis C or multiple sclerosis triggers depression.

6.
Depression is more common in inflammatory diseases like autoimmune disease and heart disease.

As compelling as these pieces of information are, they are not the only indications that depression is caused by an inflamed brain.

Researchers from the Free University of Berlin discovered a new virus called Bornavirus found in the limbic system (or emotional center) of the brain in 30 percent of the population. One in six people who carry the virus have depression
and
can be cured by treatment with short-term anti-viral medication. Think about it: a virus can cause depression and treating the virus can
cure,
not just reduce the symptoms of, depression. Even the best antidepressant drugs don’t cure depression.
⁹

And there is more evidence that inflammation can cause depression. A new technique called vagal nerve stimulation is very helpful in depression.
¹⁰
The vagus nerve is your calming, relaxation nerve. When you take a deep breath, meditate, or do yoga, the nerve is activated and it releases acetylcholine, which reduces the production of inflammatory cytokines.

There may be many reasons deep breathing and relaxation work, but certainly one of them is the fact that inflammation is reduced.

We also know that omega-3 fats help depression and produce remission.
¹¹
They work through lowering inflammation, and also through their effects on cell membranes and communication.

Similarly, we know that exercise is an anti-inflammatory and works better than Prozac in treating depression.
¹²

Another example comes out of Harvard. A group of researchers there discovered an increased number of “white matter lesions” or little white spots in the brain that are seen in autoimmune diseases like multiple sclerosis in depressed patients. This correlated with low levels of folate, which caused high levels of homocysteine, a molecule that causes inflammation in the brain.
¹³
So being vitamin-deficient produces toxic molecules that inflame the brain and cause depression.

Of course, we must ask, “What came first, the chicken or the egg? Does depression cause inflammation or inflammation cause depression?”

The answer is yes. It is a vicious cycle. Inflammation leads to depression, which leads to more inflammation.

The message is that to adequately treat depression we must look for, find,
and eliminate the causes of inflammation and then help the body create balance in the immune system, turning off this vicious cycle.

All of the things that create inflammation not only cause depression but also anxiety, obsessive-compulsive disorder (OCD), and bipolar disease. Of course, we must remember that these are just names of collections of symptoms we give people. The causes may be very different from person to person. But within the seven keys we can find the causes, and we must treat all of them for people to heal.

Looked at as a whole, the pieces of the scientific puzzle make sense. In a separate but connected example, there is a form of OCD that is well documented in children called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). This condition causes children to suffer from the strange obsessions and compulsions “called” OCD—anything from repeatedly washing hands, or opening and closing doors, to counting objects, to involuntary movements. It is triggered by an infection with streptococcus.
¹⁴
The streptococcal bacteria release toxins that produce inflammation in the brain. Treat the bacteria with antibiotics, inflammation in the brain is reduced, and the OCD goes away.

Why aren’t we looking at models like this one as a way to treat other “brain disorders”? Why do we insist on viewing them as “psychiatric problems” instead of systemic imbalances?

Surprising discoveries like the ones above break open new territory for treating mood disorders, particularly depression. Treating infections, eliminating allergies, learning to deeply relax, exercising, and taking vitamins and fish oil all can reduce inflammation and fix depression.

But we must remember that it is not either/or, it is
and
. Illness (whether it is mental or physical) is not usually one thing. It is often everything—just to different degrees in different people. Hundreds of my patients with mood disorders improve simply by addressing the inflammation. It is an “accidental” side effect of treating their other problems.

The lesson? Treat the fire, not the smoke.

Just like I did for Elizabeth.

Elizabeth was a twenty-one-year-old woman who suffered, as many of my patients do, from a long list of problems.

At the top of the list were mood problems that had plagued her since childhood. She had been diagnosed with anxiety, depression, and even borderline personality disorder because of her wild mood swings.

At work, people avoided her, never knowing what to expect, and she was always fighting with her parents.

She was high strung, irritable, and also had trouble concentrating. Sugar cravings drove her to the fridge every day after work—pudding, pizza, and junk food were staples and latenight snacking was hard to control.

She had been on Zoloft since she was thirteen. Now, an adult and five-foot-one-inch tall, her weight ballooned up to 170 pounds. Not only was she tired (though she was sleeping ten hours a night) but she also had allergies, postnasal drip, sinus congestion, fluid in her ears, and snored.

Her delayed or IgG food-allergy tests showed she was highly sensitive to eggs, wheat, rye, dairy, and yeast. She also had low levels of omega-3 fats.

I put Elizabeth on an elimination diet—giving her a break from foods that triggered her immune system. I added a few vitamins, including vitamin D and B
_6,
and
omega-3 fats.

Two months later she came back. She had lost twenty-three pounds and her cravings were gone. But it was the mood change she experienced that was truly astounding. Her mood changed for the first time in her life. She no longer had wild mood swings or irritability.

Her energy level dramatically improved as well. She needed only seven to eight hours of sleep to feel fully and vitally awake.

After five months she had lost thirty-three pounds without trying, felt deeply happy for the first time in her life, and was thriving at work and in her family. All her other symptoms—sinus problems, postnasal drip, and premenstrual syndrome—were gone as well.

Alzheimer’s: The Brain on Fire

When we look at an autopsy of an Alzheimer’s brain we see a brain on fire. Considering that the fastest-growing segment of the population is people eighty and older (and more than half of them will get Alzheimer’s), we must focus on finding the cause. The good news is that we are closer than ever to understanding what goes wrong.

The inflammation story is repeated over and over in all disease, and dramatically so in aging and the brain. This is why sugar, trans fats, saturated fat, stress, infections, lack of exercise, autoimmune disease, obesity, diabetes, vitamin deficiencies, celiac disease (from eating wheat and gluten), and colitis, which are inflammatory digestive diseases, all increase the risk of dementia and neurodegenerative diseases like Alzheimer’s.
¹⁵
They all promote inflammation. It is also why anti-inflammatory drugs like Advil may reduce the risk of dementia. But don’t take them to reduce your risk. Over 100,000 people per year end up in the hospital and 16,000 people die every year from intestinal bleeding caused by these medications.

Everyone is searching for the one thing that causes diseases like Alzheimer’s. But there is no one thing. Complex interactions between multiple factors from your lifestyle and environment interacting with your genes create problems. We have to address all the factors to succeed in helping the brain become healthy and recover.

Like in autism and depression, many cases of dementia and Alzheimer’s can be slowed and even reversed if all the causes are dealt with. The brain has extraordinary powers of healing and recovery if we provide the right conditions. But the answer is not taking aspirin or Advil! We must deal with the underlying causes of disease—causes like inflammation.

That is what I did for Christine, and her recovery from early-stage dementia was remarkable.

Until her seventies, Christine was mentally sharp, and while still highly intelligent, she noticed increasing trouble with her memory. By the time I saw her at eighty-one her memory was failing. Her ability to live on her own was being questioned by her children, who took her to see a neurologist and psychologist. After extensive neuropsychiatric and memory testing she was told she had early dementia. No treatment was recommended.

Her daughter brought her to see me and we found a high level of inflammation (C-reactive protein), along with a number of other factors that all contributed to this inflammation—low vitamin D; undiagnosed autoimmune thyroid disease; low levels of B
_6,
folate, and B
₁₂
; and a high level of mercury and lead.

Any one of these factors may not have been enough to cause problems, but added together in the body of an eighty-one-year-old woman, they caused her brain and body to start shutting down.

Over a period of six months we aggressively treated her with a fresh, whole foods, anti-inflammatory diet, gave her omega-3 fat supplements, and replaced all the vitamins she was missing—vitamins D, B
_6,
folate, and B
_12.

We treated her thyroid and helped her gently reduce the level of mercury and lead in her body.

After this treatment Christine had her three-hour battery of neuropsychiatric and memory tests repeated, and they all
improved
.

Normally dementia is progressive and—according to conventional wisdom— cannot be reversed. But after cooling inflammation, improving nutrition, and helping her detoxify, Christine regained a lost part of herself.

In cases like these, the inflammation itself is caused by something. So let’s have a look at what the major causes of inflammation are.