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Epigenetics and Neuro-Developmental, Psychiatric Disorders & Auto-Immune Disorders

2/23/2022

So when we think about what are CAUSING NEURO-DEVELOPMENTAL, PSYCHIATRIC & AUTO-IMMUNE DISORDERS, the primary RESEARCH UNDERSTANDING which hasn't quite made it to CLINICIANS are:

Genetics --- BUT many genes are SHARED across "disorders."
Epigenetics
Environment

Further, many people with PSYCHIATRIC DISORDERS also have some form of AUTO-IMMUNE DISEASE with Thyroid Disorders being the "Tallest Tree in the Forest of POLY AUTO-IMMUNITY."

Further, many AUTO-IMMUNE diseases bring with them PSYCHIATRIC SYMPTOMS.

When we think about this from a PUBLIC HEALTH perspective, it's often EPIGENETICS and ENVIRONMENT that are powering our explosion of NEURO-DEVELOPMENTAL, PSYCHIATRIC and AUTO-IMMUNE DISEASES.

Further, we do seem to be becoming MORE SENSITIVE to OUR ENVIRONMENTS ----

More allergies, more food sensitivities --- that are in greater numbers than even a generation ago.
BUT we also seem to be more "EMOTIONALLY SENSITIVE" in more ways that are NOT just about getting better COPING SKILLS ---
- although everybody's doing what they can & probably should--- this "seems" more complicated than that.
- Further, while SOCIAL MEDIA may be part of the problem --- it's not clear its SUFFICIENT to explain everything -- especially when we start taking into account the EPIGENETICS of these disorders.

Epigenetic Mechanisms in Psychiatric Disorders --- Major Depression, Psychosis, Addiction (2021)

University of Maryland

Scientists Discover That Mating Can Cause Epigenetic Changes That Last for 300 Generations (2021)

We can't make the horrific errors that the 20th Century made with Eugenics & Genocide BUT we can't keep failing to appreciate the MAGNITUDE of the PUBLIC HEALTH CRISIS that widespread:

Neuro-Developmental Disorders
Psychiatric Disorders, and
Auto-Immune Diseases represent

This is A LOT MORE than 1 person getting his, her, their Sh** Together.

University of British Columbia at Vancouver

Disruptions of genes that are involved in epigenetic functions are known to be causative for several mental retardation/intellectual disability (MR/ID) syndromes.

Recent work has highlighted genes with epigenetic functions as being implicated in autism spectrum disorders (ASDs) and schizophrenia (SCZ).

Epigenetic Impacts on Neurodevelopment: Pathophysiological ...

Emory University School of Medicine in Atlanta, Georgia

Epigenetic Regulations in Neuropsychiatric Disorders - Frontiers https://www.frontiersin.org › articles

by JN Kuehner · 2019 · — In the mammalian CNS, epigenetic dysregulation is associated with neuropsychiatric diseases such as major depressive disorder (MDD), ...
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Abstract · ‎Regulatory RNA · ‎Major Depressive Disorder · ‎Autism Spectrum Disorders

Altered immune phenotype and DNA methylation in panic disorder (2020)

Chapter 25 - Epigenetics of Autoimmune Diseases (2020)

Although strong genetic bases have been found by genome-wide association studies, no unique genetic mechanism underlying immune tolerance breakdown was identified in autoimmune diseases.

The largely incomplete concordance rates of autoimmune diseases in monozygotic twins strongly support other complementary mechanisms involved in gene regulation ultimately causing overt autoimmunity, and it is becoming increasingly evident that epigenetic deregulation contributes to the emergence and/or the progression of disorders that include lupus, rheumatoid arthritis, systemic sclerosis, Sjögren’s syndrome, vasculitis, diabetes, and multiple sclerosis.

WHY IS THIS IMPORTANT?:

Auto-Immune Diseases, very much like Neuro-Developmental Disorders or Psychiatric Disorders were both:
- believed to be at one time "psycho-somatic" --- ALL IN YOUR HEAD
- they are not totally genetic
MS often has psychiatric symptoms as well and it is being more and more related to the Epstein-Barr Virus.
Neuro-Developmental Disorders and Psychiatric Disorders are more and more related to MATERNAL IMMUNE ACTIVATION.

Inflammation: The Modern Equivalent of Learning to Control FIRE

2/9/2022

Inflammation is so confusing --- its like a BABY crying --- that baby maybe crying for the usual reasons:
- hungry
- tired
- needs a diaper change, BUT
- it could be something else

To me, inflammation is like that baby crying ---- maybe there are different types of cries and different types of inflammation --- but it's this kind of UNIVERSAL SIGNAL that something is needing to be addressed.

In some ways, that CRYING BABY is more IMMEDIATE and EASIER to UNDERSTAND.

INFLAMMATION can not only build up over a period of years in a SINGLE LIFETIME --- it can build up over GENERATIONS.

One of the things that has made it HARD to UNDERSTAND is that we have IDEAS that there is a STRICT SEPARATION between our SOCIAL ENVIRONMENTS, PHYSICAL ENVIRONMENTS and our BIOLOGY
- So we've SEPARATED THINGS OUT to UNDERSTAND them.
- We haven't really understood the MAGNITUDE of INFLAMMATION because to do that we would have to INTEGRATE an ENORMOUS AMOUNT of KNOWLEDGE from areas and expertise we consider DISTINCT and SEPARATE.

So when we talk about PSYCHIATRIC DISORDERS that involve the BRAIN, but other SYSTEMS of the BODY as well, including the IMMUNE SYSTEM --- there are a lot of things that can damage the BRAIN's IMMUNE SYSTEM:
- Maternal Immune Activation
- Trauma
- Intergenerational Trauma
- Infections
- Toxins
- Not getting enough oxygen
- COVID
- Genes that go to the Immune System and Epigenetics
- etc.

Human beings aren't necessarily just contending with 1 of those things -- but multiple factors that are playing out in INDIVIDUAL and IDIOSYNCRATIC ways.

We've started the PROCESS of UNDERSTANDING the role of DEVELOPMENTAL INFLAMMATION in many people with PSYCHIATRIC DISORDERS and the role of EPIGENETICS.

So this is MORE COMPLICATED than we're treating it in our HEALTHCARE PROFESSION and in our PUBLIC POLICY.

"First Do NO Harm" --- is easy to say --- but it has proven hard to put into practice when multiple systems of the body are DYSREGULATED --- we're kinda just figuring that out ---- and we're at the beginning stages of IDENTIFYING BIOMARKERS.

The Society is looking to the MEDICAL PROFESSION and the HEALTHCARE PROFESSION to help NAVIGATE what can be a challenging ETHICAL & MORAL LANDSCAPE.

You wouldn't be the first person or first group of people to feel compelled to take a step back and say: Maybe our current judgments aren't completely accurate or fair.

Touched with Fire --- Manic Depressive Illness and the Artistic Temperament (1996) by Kay Redfield Jamison

Hair Analysis, Psychological Analysis, the Criminal Law & the Ethical & Moral Imperative to Pull Back

The Importance of Addressing Executive Functioning ---- from ADMINISTRATIVE SUPPPORT to Assertive Community Treatment

2/2/2022

For a long time, Mental Health along with everyone just considered challenges in Executive Functioning as problems with LACK of RESPONSIBILITY.

Where do I personally get the best appointment reminders ---my upscale Suburban Dentists' office.
- I get reminded 2 weeks before the appointment.
- 1 week before the appointment
- And the day before
- In the manner --- I prefer
  - The "WHAT I PREFER" part is important
  - It is also challenging for any medical or health care provider
  - Some automated systems do provide for choice in manner of communication:
    - E-mail
    - Telephone
    - Text
    - Some people may need an actual in-person contact --- that Suburban Upscale Dentists' Office is providing a lot of personal contact just as a good business practice for the BOTTOM LINE.
That doesn't just happen --- it's a COST
At this point in my mental health journey, what ADMINISTRATIVE SUPPORT the psychiatrist has is MORE IMPORTANT to me --- than who the psychiatrist is.
I know this was a BIG ISSUE in Colorado Medicaid a few years ago and may have been at least partly resolved.
In Private Mental Health --- the Solos are sometimes trying to perform their own Administrative Support at the same time they are charging out of network.
- I know I felt ripped off --- and I probably wasn't the only one.

Group practices and Corporate Mental Health generally have more in the way of Administrative Support --- but it is still often falling short of what one can get in other areas of the Society.

Beyond that --- it is a telling indication that the profession doesn't really understand that they should be LEADING on matters of accommodating Executive Functioning Differences and Deficits.

A COMMON PRESCRIPTION: Let's try to turn this person into a NEURO-TYPICAL often doesn't work and it can EXACERBATE things. WHY IS THAT?

Those EXECUTIVE FUNCTIONING DIFFERENCES are at least in part often DEVELOPMENTAL.
The BRAINS of People with Neuro-Developmental Disorders do become HYPER-CONNECTED as a way to try to COPE with various DIFFERENCES and DYSREGULATIONS.
By the time one gets to the MENTAL HEALTH PROFESSIONAL --- that's needing to be CALMED DOWN.

For some people with neurodevelopmental and psychiatric disorders, the Executive Functioning Support they need goes beyond APPOINTMENT REMINDERS which are really going to MEMORY and some other challenges related to DOPAMINE DYSREGULATION and other issues.

Part of EXECUTIVE FUNCTIONING is EMOTIONAL REGULATION.

This is also an issue where it is NOT FEASIBLE for the Psychiatrist or Counselor to try to bear the ENTIRE LOAD of that.

PEER SUPPORT can be an EQUIVALENT of ESSENTIAL ADMINISTRATIVE SUPPORT when it comes to providing EMOTIONAL SUPPORT.

This does get to why serving people with Executive Functioning Differences can be so CHALLENGING --- we don't want to burn anybody out and we don't want to BANKRUPT our SYSTEMS either.

That's why having a SOCIETY that is EXECUTIVE FUNCTIONING INFORMED is important.

In many cases, if we're providing A LITTLE BIT to MEDIUM SUPPORT --- IN MULTIPLE AREAS --- we can avoid the need for that total breakdown of functioning that is so costly PERSONALLY and FINANCIALLY FOR INDIVIDUALS, FAMILIES and THE SOCIETY --- to say "Hey, something isn't working here."

Further, we can't put this on just one segment of the society --- or they can breakdown too --- and that is part of what has happened with Mental Health.

On the FLIP SIDE ---- we not only have to engage others ---- we have to develop, reward and employ those UNEXPECTED STRENGTHS that often come with NEURO-DIVERSITY.

One of the reasons ASSERTIVE COMMUNITY TREATMENT is the gold standard of Intensive Mental Health Care:

It's addressing those MULTIPLE NEEDS that EXECUTIVE FUNCTIONING Differences and Challenges can present.

I love this video. It is from Canada and it's on Housing and Assertive Community Treatment.

One of the points the psychiatrist makes is --- You don't just get people better by seeing a PSYCHIATRIST --- you need this whole system of support.

I would submit the reason you need that whole system of support is to address DIFFERENCES and DEFICITS in EXECUTIVE FUNCTIONING.

If we are combining TRAUMA-INFORMED CARE with EXECUTIVE FUNCTIONING INFORMED CARE ---- we probably could do this more COST EFFECTIVELY.

Translational Medicine Friday

Epigenetics and Neuro-Developmental, Psychiatric Disorders & Auto-Immune Disorders

Inflammation: The Modern Equivalent of Learning to Control FIRE

The Importance of Addressing Executive Functioning ---- from ADMINISTRATIVE SUPPPORT to Assertive Community Treatment

Translational Medicine Friday

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