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The ECONOMICS & ETHICS of: A MENTAL HEALTH PROFESSION in the MIDDLE of a MAJOR PARADIGM SHIFT

8/6/2023

and A SHADOW HEALTHCARE SYSTEM in CRIMINAL JUSTICE

Conjecture

There are so many PAINFUL CHALLENGES about living in a WORLD OF INFINITE POSSIBILITY and
- Finite Resources
- Limited Time and
- Energy

We are almost always of necessity leaving work for FUTURE GENERATIONS.

One of the most important things we can do is grapple with the ETHICAL ISSUES raised by PARADIGM SHIFTS in OUR OWN TIME.
- AND how we can do this BETTER.

To me ---- A BIG PIECE OF THE PUZZLE IN DEALING with COGNITIVE DIFFERENCE/DISABILITY and RESOURCE INEQUALITY is thinking through a PRO LIFE APPROACH through the LIFE SPAN.

I often pick on Elon Musk because he is an "OUT" NEURO-DIVERSE PERSON, he is one of the RICHEST PEOPLE in the the WORLD --- and he is kind of a NUT CASE and in "some ways" is very SMART.

I also often "pick on" the Mental Health Profession and the Legal Profession ---
- and I do think those Professions have serious problems --- and so do most professions.

So one of the ISSUES is trying to ACCURATELY DESCRIBE where we are at in our understanding of "Neuro-Developmental and Psychiatric Disorders."
- Seemingly we know or some people (some researchers, lay people, etc) know that the current PSYCHIATRIC DIAGNOSTIC MANUAL is SERIOUSLY FLAWED and/or "INVALID" according to the National Institute of Mental Health in 2013.
- What are the Ramifications of that?

Neuro-Developmental & Psychiatric Disorders are more and more viewed as on a "CONTINUUM."
- What are the Ramifications of that?

Neuro-Developmental & Psychiatric Disorders are still viewed as "Brain Issues" but in addition to the Central Nervous System, we're also talking about DYSREGULATIONS of the IMMUNE SYSTEM, ENDOCRINE SYSTEM, the MICROBIOME, and the METABOLISM.
- What are the Ramifications of that?

Further, this is not as SIMPLE as:
- Challenging Genes = Neuro-Developmental and Psychiatric Disorders
- At the very least this is often:
  - Challenging Genes + Maternal Immune Activation (during pregnancy)
  - And the impact of GREATER "DEVELOPMENTAL" and AFTER ACQUIRED INFLAMMATION OVER THE LIFE SPAN
- Both Maternal Immune Activation and Inflammation Acquired after Birth can come from MANY SOURCES.
- What are the RAMIFICATIONS of this COMPLEXITY?

So when it comes to ECONOMICS ---

We need to fund TRANSLATIONAL RESEARCH, MEDICINE
We need to DE-PERSONALIZE as in DE-CRIMINALIZE DYSREGULATIONS of the Body --
- while at the same time recognizing the need for PRECISION MEDICINE and these DYSREGULATIONS can be HIGHLY IDIOSYNCRATIC.
Get HONEST about IMPERFECT TREATMENTS, and
Bring people into the PROBLEM-SOLVING PROCESS from all sides.

Neurodevelopmental disorders—the history and future of a diagnostic concept  (2020)

Abstract

This article describes the history of the diagnostic class of neurodevelopmental disorders (NDDs) up to DSM-5.

We further analyze how the development of genetics will transform the classification and diagnosis of NDDs. In DSM-5, NDDs include intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD).

Physicians in German-, French- and English-speaking countries (eg, Weikard, Georget, Esquirol, Down, Asperger, and Kanner) contributed to the phenomenological definitions of these disorders throughout the 18th and 20th centuries.

These diagnostic categories show considerable comorbidity and phenotypic overlap. NDDs are one of the chapters of psychiatric nosology most likely to benefit from the approach advocated by the National Institute of Mental Health’s Research Domain Criteria project.

Genetic research supports the hypothesis that ID, ASD, ADHD, schizophrenia, and bipolar disorder lie on a neurodevelopmental continuum.

The identification of recurrently observed copy number variants and disruptive gene variants in ASD (eg, CDH8, 16p11.2, SCN2A) led to the adoption of the genotype-first approach to characterize individuals at the etiological level. 

***Physical Health Issues, the Immune System, the Endocrine System & Mental Health Index

Shared Genes & Psychiatric Disorders

Maternal Immune Activation

Schizophrenia, the Immune System, the Endocrine System & the Microbiome

Psychiatric Disorders:

Maternal Immune Activation
Developmental Aspects
Common Genes
Epigenetics
Executive Functioning Difference/Deficits

Maternal Immune Activation, Neuro-Diversity, Auto-Immunity and Immune Issues

6/18/2023

[Originally posted on the Homepage on Mother's Day ---

There will be EQUAL-OPPORTUNITY for Dads on Father's Day]

Conjecture

The THING about INFLAMMATION is that it is CODING FOR SO MANY THINGS.

So if someone were to say this is about . . .

Infections, or
Trauma, or
Auto-Immunity
Alcohol or Drug Consumption
Smoking during pregnancy
Toxins in the Environment

THEY WOULD ALL BE RIGHT.

Although --- Some Researchers may be able to tell the difference ---

Pregnancy as a Time of Increased Vulnerability to Trauma, Persistent Changes in Immune Function.

Adversity in early life and pregnancy are immunologically distinct from total life adversity: macrophage-associated phenotypes in women exposed to interpersonal violence

But how that shakes out at individual times and places and for individuals --- in individual times and places in history is very complicated.

Further, it is about the INDIVIDUAL, but there are SOCIETAL ASPECTS as well as GENERATIONAL ASPECTS.

For example, if your grandmother smoked during pregancy --- You could be more at risk for "ADHD."
- See Smoking During Pregnancy and the Risk of ADHD in the Third Generation

We're often talking about SHARED GENES -- which genes get turned on and off ---- and significantly EPIGENETICS.

There's been a rise in "AUTO-IMMUNITY" since the Black Death --- because those immune systems are the ones that survived.

See The Black Death Shaped the Evolution of Immunity Genes

Medical Science keeps expanding the role of the IMMUNE SYSTEM and I think that may continue ---

See from the University of Virginia School of Medicine --- The Immune System Controls Social Behavior (in Mice)

Low Status Can Damage the Immune System --- BBC News reporting on a study at Duke University

Currently, we recognize AUTO-IMMUNITY more in WOMEN than MEN.

Thyroid Issues are very common among women and they are "The Tallest Tree in the Forest of Poly-Auto-Immunity."

Further, more and more women and medical professionals are raising the issue that there is more going on than the current Thyroid Test measures.

Finally, Maternal Immune Activation is associated with:

ADHD
Autism
Bipolar Disorder
Depression
Schizophrenia

Modulation of human endogenous retroviruses and cytokines expression in peripheral blood mononuclear cells from autistic children and their parents (2022)

Conclusion: Herein we show that autistic children and their mothers share an intrinsic responsiveness to in vitro microenvironmental changes in expressing HERVs and pro-inflammatory cytokines.

Remarkably, the antiretroviral drug Efavirenz restores the expression of specific HERV families to values similar to those of the controls, also reducing the expression of proinflammatory cytokines but keeping the regulatory ones high.

Our findings open new perspectives to study the role of HERVs in the biological mechanisms underlying Autism.

Hyper-Connected Brains & Associational Thinking ---Strengths and Weaknesses

5/5/2023

Conjecture

I think one of the things that people with Hyper-Connected Brains often have are:

MORE ASSOCIATIONS than the AVERAGE PERSON.
MORE INTENSE EMOTIONS
There is something to be said for going with your GUT --- BUT that's pretty fraught and maybe more complicated than we thought ---it depends on whose living down there.
Often a lot of Reasoning and Rationality to try to deal with all this.
Which can give the perception and in some senses the reality of SLOWER PROCESSING but I would say the person is also PROCESSING MORE.

Leadership development

Learn How to Think Different(ly)

Reams of relevant research (including our own) proves Jobs right. Innovators excel at connecting the unconnected. They engage in associational thinking.

At Apple (or at any innovative company), they take a little bit of this, sprinkle in a little bit of that and that and that to churn out market-busting ideas such as iTunes, and the iPod, iPhone, and iPad (along with a few market disasters like the G4 Cube computer).

Val's Take: One of the reasons ART is so powerful --- ARS LONGA, VITA BREVIS

It's not only the ASSOCIATIONS of One or a FEW Artists
- It can HARNESS the ASSOCIATIONS of Many People Across Many Generations and
- It's BUILDING on the ASSOCIATIONS of the ARTIST ---often using particular SENSORY EXPERIENCE and COMBINATIONS
- It Can open up a CONVERSATION

I think for people with Hyper-Connected Brains we tend to have A LOT OF ASSOCIATIONS and INTENSE EMOTIONS we're trying to manage and ultimately to REASON THROUGH.

Elon Musk along with others thought Jobs was a jerk.

Many think Musk is a jerk.

I think A NATURAL ABILITY IN ASSOCIATIONAL THINKING is one of many reasons why Entrepreneurship often attracts Neuro-Diverse People.

BUT there often are Executive Functioning Challenges --- Jobs and other Entrepreneurs, Artists, etc. can be MAJOR JERKS and we don't want to EMPOWER that.

I think this is more complicated than LECTURING WHOEVER --- "DON'T BE A JERK."

Further, some illegal drug operations and even some questionable activities of BIG PHARMA are major ENTREPRENEURIAL ENTERPRISES --- but we don't want people using their TALENTS for HARMFUL PURPOSES and acting in ways that are "ANTI-SOCIAL."

Generally, Substance Use & the Immune System and as related to Neuro-Developmental & Psychiatric Disorders

4/2/2023

My view is that Neuro-Developmental Differences/Disorders are often coming with Developmental Systemic Inflammation through Maternal Immune Activation.

When we talk about Substance Use and the Immune System or Health Aspects ---
Historically, that has been the HEALTH IMPACTS of ADDICTION
Prosecutors have often said --- WELL, DON'T START.

It is becoming more clear that some people with Neuro-Developmental Differences & Disorders (that are BLURRED) are coming "PRIMED FOR ADDICTION"
We've kinda known this for awhile BUT the evidence is growing as well as the Ethical Dilemmas for Prosecutors.

Drug Courts have been one response.
I would submit we need to go further back in the CHAIN and recognize not only the Substance Problem but also the Neuro-Developmental Difference/Disorder.
- Further, I would submit that the Neuro-Developmental Difference/Disorder is often PRIMARY and the Substance Use and/or Psychiatric Disorder are SECONDARY.

Neuron-Glia-Immune Triad and Cortico-Limbic System in Pathology of Pain. (2021)

Glial cells in the peripheral nervous system, astrocytes in the brain, dorsal root ganglia, and immune cells all contribute to the development, maintenance, and resolution of pain. ...Immune responses may also exacerbate pain perception by modulating t …

The Convergent Neuroscience of Affective Pain and Substance Use Disorder. (2021)

"With these tools, future research strategies targeting severe SUD (Substance Use Disorder) should focus on the common neurobiology between negative reinforcement and affective elements of pain, possibly by reducing excessive stress hormone and neurotransmitter activity within shared circuitry."

The role of gut-immune-brain signaling in substance use disorders. (2021)

Substance use disorders (SUDs) are debilitating neuropsychiatric conditions that exact enormous costs in terms of loss of life and individual suffering. ...Accumulating evidence suggests an important role for gut-immune-brain communication in the patho …

Contributions of neuroimmune and gut-brain signaling to vulnerability of developing substance use disorders. (2021)

Here we will review the rapidly growing body of literature that examines the importance of interactions between the peripheral immune system, the gut microbiome, and the central nervous system (CNS) in mediating the transition to pathological drug use. While …

The immune system and autism spectrum disorder: association and therapeutic challenges. (2021)

This study provides a review of the autoimmune involvement in the pathogenesis of ASD. The\r\nmicrobiome, the representative of the innate immune system in the central nervous system (CNS), plays a critical role in triggering inflammation. ...Moreover, the hi …

Val's Take: We tend to view ADHD as more associated with Substance Use Disorders --- but ADHD and Autism are BLURRED.

Further, what is "LEGAL" or "ILLEGAL" in this society is often much more a matter of POLITICS than it is SCIENCE.

Alcohol is very damaging and we've struggled to turn it into a HEALTH FOOD (especially wine) --- but the RESEARCH keeps coming back that even small amounts generally aren't good for us.

ADHD and Substance Use Disorders in Young People: Considerations for Evaluation, Diagnosis, and Pharmacotherapy. (2022)

Co-occurring ADHD and substance use disorder (SUD) is a common clinical presentation associated with significant impairment requiring careful evaluation, diagnosis, and treatment. Treatment with medication, along with cognitive behavioral therapy, is g …

Glial mechanisms underlying substance use disorders. (2019)

Addiction is a devastating disorder that produces persistent maladaptive changes to the central nervous system, including glial cells. Although there is an extensive body of literature examining the neuronal mechanisms of substance use disorders, effec …

Glial Cells: Types and Functions - Verywell Health (2022)

Oct 25, 2022 · Microglia are tiny glial cells ("micro" means small). They act as the brain's own

Drug addiction: a curable mental disorder? (2018)

Drug addiction is a chronic, relapsing brain disorder. Multiple neural networks in the brain including the reward system (e.g., the mesocorticolimbic system), the anti-reward/stress system (e.g., the extended amygdala), and the central immune system …

Grace & Mercy For A Society that is Facing a Much BIGGER Problem than It Realizes

3/31/2023

SOME HOPE

When it comes to some of our most difficult health problems --- Medical Researchers do seem to be on the cusp of if not a THEORY of EVERYTHING --- A THEORY of MANY SOURCES of DISEASE and DYSREGULATION.
INFLAMMATION has been a big buzz word for a few years ---
- I think that can lead to a kind of misguided religious zealotry if we don't understand that for many people much of this INFLAMMATION is DEVELOPMENTAL.

Further, INFLAMMATION is a kind of UNIVERSAL LANGUAGE that is also being acquired during the lifetime.
- Mental Health Problems are often involving MULTIPLE DYSREGULATIONS of the BODY
  - For some people there may be some relationship between even a MINI STROKE and PSYCHOSIS.

" 'Mini-strokes' lead to PTSD and other psychiatric disorders Transient ischemic attacks are commonly referred to as “mini-strokes,” but this does not make them any less serious than major strokes."

www.medicalnewstoday.com/articles/283383
'Mini-strokes' lead to PTSD and other psychiatric disorder

www.texaschildrens.org
Pediatric Stroke Clinic - Stroke in Newborns and Kids
Our Expert Neurology Team Treats Common and Rare Conditions with Compassion. Learn More. Experience the Comprehensive Evaluation and Treatment of Strokes at Texas Children's.

www.self.com/story/what-is-a-mini-stroke
Causes, Symptoms, and Signs of a Mini Stroke | SELF

"There are a few reasons why young people might have mini strokes, and they’re pretty similar to why people have regular strokes. Stroke risk factors include smoking, high blood pressure, diabetes, poor diet, physical inactivity, obesity, high cholesterol, and a history of artery or heart disease, per the American Stroke Association."

Maternal immune activation and neuroinflammation in human neurodevelopmental disorders (2021)

Immune Cells in the BBB (Blood Brain Barrier) Disruption After Acute Ischemic Stroke: Targets for Immune Therapy? (2021)

Comorbidity between neurological illness and psychiatric

...Psychiatric disorders are common in many neurological disorders, including epilepsy, migraine, Alzheimer's disease, Parkinson's disease, essential tremor, and stroke.

These comorbidities increase disease burden and may complicate the treatment of the combined disorders.

PBS NewsHour

"Pennsylvania Sen. John Fetterman announced Thursday that he is in the hospital after voluntarily seeking treatment for clinical depression. Millions of Americans struggle with depression but few politicians ever share their stories publicly.

"Geoff Bennett discussed this with Jason Kander. He stepped away from a mayoral campaign in 2018 after acknowledging struggles with depression and PTSD."

Estimates are that 50% of US Population has experienced some type of Mental Health Problem --- and Some Estimate Higher.

Heartbreaking Footage Shows Man’s Death in Hands of CO Springs Mental Health Team

Feb 15, 2023

Neurodevelopmental disorders-the history and future of a diagnostic concept (2020)

Abstractin English, Spanish, French

This article describes the history of the diagnostic class of neurodevelopmental disorders (NDDs) up to DSM-5.

We further analyze how the development of genetics will transform the classification and diagnosis of NDDs. In DSM-5, NDDs include intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD).

Physicians in German-, French- and English-speaking countries (eg, Weikard, Georget, Esquirol, Down, Asperger, and Kanner) contributed to the phenomenological definitions of these disorders throughout the 18th and 20th centuries.

These diagnostic categories show considerable comorbidity and phenotypic overlap.

NDDs are one of the chapters of psychiatric nosology most likely to benefit from the approach advocated by the National Institute of Mental Health's Research Domain Criteria project.

Genetic research supports the hypothesis that ID, ASD, ADHD, schizophrenia, and bipolar disorder lie on a neurodevelopmental continuum.

The identification of recurrently observed copy number variants and disruptive gene variants in ASD (eg, CDH8, 16p11.2, SCN2A) led to the adoption of the genotype-first approach to characterize individuals at the etiological level. .

Maternal-Fetal Inflammation in the Placenta and the Developmental Origins of Health and Disease (2020)

3/22/2023

Affiliations

1 Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
2 Department of Nutritional Sciences, College of Health and Human Development, Penn State University, University Park, PA, United States.
3 Section of Allergy and Immunology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital and Northwestern University, Chicago, IL, United States.

Abstract

Events in fetal life impact long-term health outcomes. The placenta is the first organ to form and is the site of juxtaposition between the maternal and fetal circulations.

Most diseases of pregnancy are caused by, impact, or are reflected in the placenta.

The purpose of this review is to describe the main inflammatory processes in the placenta, discuss their immunology, and relate their short- and long-term disease associations.

Acute placental inflammation (API), including maternal and fetal inflammatory responses corresponds to the clinical diagnosis of chorioamnionitis and is associated with respiratory and neurodevelopmental diseases.

The chronic placental inflammatory pathologies (CPI), include chronic villitis of unknown etiology, chronic deciduitis, chronic chorionitis, eosinophilic T-cell vasculitis, and chronic histiocytic intervillositis.

These diseases are less-well studied, but have complex immunology and show mechanistic impacts on the fetal immune system.

Overall, much work remains to be done in describing the long-term impacts of placental inflammation on offspring health.

Maternal immune activation in mice disrupts proteostasis in the fetal brain (2021)

[Proteostasis:

"A typical mammalian cell contains up to 20,000 types of protein, which must be continually regulated and maintained.

"The homeostasis of these proteins, also referred to as 'proteostasis', is a complex pathway that functions to maintain all of the proteins within and around a cell."
----News Medical Life Sciences]

ISR = Integrated Stress Response]

Affiliations

1 Department of Neurobiology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
2 Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
3 Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
4 Department of Neurobiology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
5 Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
6 The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA.
7 Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.
8 Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.
9 Degenerative Disease Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA.
10 Department of Neurobiology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
11 Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA. [email protected].
12 Evergrande Center for Immunologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA.

Abstract

Maternal infection and inflammation during pregnancy are associated with neurodevelopmental disorders in offspring, but little is understood about the molecular mechanisms underlying this epidemiologic phenomenon.

Here, we leveraged single-cell RNA sequencing to profile transcriptional changes in the mouse fetal brain in response to maternal immune activation (MIA) and identified perturbations in cellular pathways associated with mRNA translation, ribosome biogenesis and stress signaling.

We found that MIA activates the integrated stress response (ISR) in male, but not female, MIA offspring in an interleukin-17a-dependent manner, which reduced global mRNA translation and altered nascent proteome synthesis.

Moreover, blockade of ISR activation prevented the behavioral abnormalities as well as increased cortical neural activity in MIA male offspring.

Our data suggest that sex-specific activation of the ISR leads to maternal inflammation-associated neurodevelopmental disorders.

Developmental inflammation

2/28/2023

Val's Take
We're starting to see Mental Health Outpatient Treatment at Schools and more recognition of the need for a CONTINUUM OF CARE from SECURE PLACEMENTS to PUBLIC EDUCATION --

When it comes to the many health consequences of HIGH LEVELS of DEVELOPMENTAL INFLAMMATION

Metabolic Dysregulation
- People are having to work a lot HARDER than they have in the past to maintain a healthy weight.
  - that is a TIME COST and a FINANCIAL COST.
  - in some cases, there is a need for very sophisticated medical intervention

Endocrine Dysregulation
- Ramped Up Stress Responses that require conscious effort to manage ---
  - that is a TIME COST and a FINANCIAL COST.
  - in some cases, there is a need for very sophisticated medical intervention.

Dysregulation of the Microbiome
- literally TRILLIONS OF FACTORS
- improved diet will likely help
  - this can be a TIME COST and a FINANCIAL COST
- some cases, there may be the need for sophisticated medical intervention

Dysregulation of the Immune System

Autoimmune Problems
Many more functions than previously appreciated ---
- Recently recognized --- Social Interactions are a DELICATE BALANCE of the INNATE & ADAPTIVE IMMUNE SYSTEMS.
Recently recognized --- the immune system has DIRECT PIPELINES TO THE BRAIN.

Dysregulation of the Central Nervous System

Dysregulation of the Cardio-Vascular System

All of these systems are INTER-RELATED and their Functioning is INTEGRATED.

Our Understandings Need to be INTEGRATED, TOO.

The DYSREGULATIONS are highly IDIOSYNCRATIC and are DRIVING the need for PRECISION MEDICINE and INDIVIDUAL TAILORING of LIFESTYLES.

Inflammation & the Developing Brain

New insights into the detection, pathophysiology and treatment of inflammation-induced injury in the immature brain

The immature brain is especially vulnerable to inflammatory factors, before, during and after birth. This publication presents new insights into the detection, pathophysiology and treatment of inflammation-induced injury in the developing brain from both clinical and basic science perspectives.

Cellular mechanisms that lead to perinatal brain injury are presented, with specific emphasis on inflammation, brain development and potential treatment strategies. In particular, studies report on inflammatory pathways involved in perinatal brain injury, including caspases, STAT3, toll-like receptors and oxidative stress. Some data demonstrate how different inflammatory cell types may contribute to the injury, such as microglia and mast cells, and how peripheral organs can influence the cerebral inflammatory response.

Further, new developments in neuroprotective therapies using human amnion epithelial cells to reduce inflammation-induced brain damage in the fetus are described.

This publication is recommended to both clinicians and basic scientists who are interested in the developing nervous system, its vulnerability to inflammation and the short- and long-term consequences for neurologic development.

The ETHICS & ECONOMICS of Our Current Knowledge Games in Health Care & Mental Health

2/14/2023

Mental Health Care and Health Care in general in the US are already ECONOMICALLY UNSUSTAINABLE --

Further, I would say a BIG DRIVER of our Health Care and Mental Health Crisis are people who are coming with DEVELOPMENTAL SYSTEMIC INFLAMMATION and
- are more VULNERABLE to CHRONIC DISEASE and MENTAL HEALTH ISSUES

Further, it does seem like the SHORT TERM FUTURE is NEURO-DIVERSE ---
- When I say that I am really referring to people with more Developmental Inflammation that we are considering ATYPICAL ---
  - May be more common than we think
  - Coming in more VARIETIES than we think
  - & Appears to be increasing.

Despite that, I think we are in a MUCH BETTER POSITION to understand ROOT CAUSES
- even if we don't completely understand them.
- and even if we need "SUPER COMPUTERS" that we have built and are building to understand our own COMPLEXITY.

"Personal Responsibility" -- ArtStation

Ironically, our PERSONAL RESPONSIBILITY WARRIORS are a big part of the problem --- this is really ramped up in:

EDUCATION
MEDICINE
RELIGION, and
LAW
- which I would humbly submit all often attract NEURO-DIVERSE people

A lot of our PERSONAL RESPONSIBILITY focus has been on:

EXECUTIVE FUNCTIONING, and
- planning
- short term memory
- decision-making
- emotional regulation
METABOLIC ISSUES
- obesity being top of the list
- but fatigue and/or atypical fluctuating energy supplies a big stealth issue

These ISSUES have turned out to be much more individually and idiosyncratically driven than we've typically appreciated.

The KNOWLEDGE we need is not in its RAWEST FORM --- a lot of it is on PubMed (not all of it)

BUT the TASK of SYNTHESIZING all this information is HUGE.

IN THE INTERIM --- we can't keep pretending we know everything --- even if we know a lot.

Val's Take: We're not going to get to a CULTURE OF LIFE without LOVE --- I think that is something Pope John Paul II understood --- I don't think it is something we understand in many of our debates.

"Mental Health" And "The Rest of MedicinE" ----Putting some of the Pieces together

1/23/2023

Conjecture

One of the things that some researchers have noticed about Mental Health Treatment ----

It hasn't tended to matter as much what THERAPY as much as whether the THERAPIST was "KIND" and "NICE"
Now there are a lot of ways you could look at that --- you could say --- hey, these people just need somebody to be nice to them ---
And I'm sure there are exceptions --- but by and large MENTAL HEALTH THERAPISTS are "KIND" and "NICE."
- Former Director of the National Institute of Mental Health Thomas Insel recognized that when he said Mental Health Professionals try to help people "CHANGE" through "COMPASSION."
- At the same time he was trying to DIPLOMATICALLY deliver the MESSAGE that Mental Health professionals hadn't achieved the same level of professionalism as expected in the rest of medicine.
Further --- many of the issues facing "MENTAL HEALTH PATIENTS" are NOT SHORT TERM ---
- and the question is HOW IS SOMEONE GOING TO "COPE" OVER THE LONG-TERM.
I don't think the answers we've come up with over the MANY MILLENIA (prayer, meditation, art, music, etc.) and more RECENT ANSWERS are necessarily WRONG ----
- MEDICATION: One of the things that even limited GENETIC TESTING is showing --- that MEDICATION might work well for one person but not another ---
  - even if those people have relatively similar SYMPTOM CLUSTERS.
- COGNITIVE BEHAVIOR THERAPY --- can be helpful --- can be HARMFUL when the TRUE NATURE of the issue is NOT UNDERSTOOD by the PRACTITIONER.
  - So it's going to be hard for the PRACTITIONER to EDUCATE the PATIENT if the PRACTITIONER'S UNDERSTANDING isn't on SOLID GROUND.

One of the things that we're having to address is the INDIVIDUAL who is not neatly fitting into our CATEGORIES --- whether our DIAGNOSTIC CATEGORIES or TREATMENT MODALITIES
- So a lot of people are being MISSED until there is a CRISIS

Further --- despite the fact that it is terribly INTELLECTUALLY INCONVENIENT for our Society and its SYSTEMS --- it appears that PSYCHIATRIC DISORDERS are often additional manifestations at least in part of MATERNAL IMMUNE ACTIVATION and SHARED GENES.
- Further --- it appears not just to be a DYSREGULATION of the BRAIN or the CENTRAL NERVOUS SYSTEM ---
- But multiple systems of the body --- the IMMUNE SYSTEM, ENDOCRINE SYSTEM, the METABOLISM, the MICROBIOME -- etc.?

Additionally --- while TRAUMA is important --- it's TRAUMA often working on "HIGHLY REACTIVE CELLS" that is an additional part of the EQUATION.

Finally, I don't think the "REST OF MEDICINE" can be COMPETENT or as PROFESSIONAL as we might assume if "MENTAL HEALTH" is not fully INTEGRATED into the REST OF MEDICINE.

Image Credit: Shutterstock

3 Big Take Aways from the Research

Maternal Immune Activation

People with Mental Illness Die Earlier than the Rest of the Population

***Physical Health Issues, the Immune System & Mental Health

University of Michigan
"The Study of Bipolar Disorder is the Study of Humanity" (2017)

1:38: begins discussing research at the University of Michigan regarding the CELLS of people with "BIPOLAR DISORDER."

NIMH (National Institute of Mental Health
5 Disorders Share Some of the Same Genes (2013)

David and Goliath
Osmar Schindler (1888)

600 Research Institutions Take on the DSM & the American Psychiatric Assn.

Analysis of shared heritability in common disorders of the brain (2018)

Shared Genes & Psychiatric Disorders

University of Virginia School of Medicine

Shocking New Role Found for the Immune System: Controlling Social Interactions (2016)

From the YouTube Summary:

• Researchers determine that the immune system affects – and even controls – social behavior.

• Blocking a single type of immune molecule made mouse brains go hyperactive and caused abnormal behavior; restoring it fixed both.

• Discovery could have enormous implications for neurological conditions such as autism and schizophrenia.

• “It’s crazy, but maybe we are just multicellular battlefields for two ancient forces: pathogens and the immune system. Part of our personality may actually be dictated by the immune system.”

In a startling discovery that raises fundamental questions about human behavior, researchers at the University of Virginia School of Medicine have determined that the immune system directly affects – and even controls – creatures’ social behavior, such as their desire to interact with others.

"So could immune system problems contribute to an inability to have normal social interactions? The answer appears to be yes, and that finding could have great implications for neurological diseases such as autism-spectrum disorders and schizophrenia.

“The brain and the adaptive immune system were thought to be isolated from each other, and any immune activity in the brain was perceived as sign of a pathology. And now, not only are we showing that they are closely interacting, but some of our behavior traits might have evolved because of our immune response to pathogens,” explained Jonathan Kipnis, PhD, chairman of UVA’s Department of Neuroscience.

“It’s crazy, but maybe we are just multicellular battlefields for two ancient forces: pathogens and the immune system. Part of our personality may actually be dictated by the immune system.”

Long-Term Use of Tylenol During Pregnancy May Raise Risk of Autism, ADHD

1/15/2023

Val's Take

This is sort of another chink in the armor of the MEDICAL COMMUNITY and also RESEARCH COMMUNITY ----

I'm not so concerned that THEY'RE NOT PERFECT ---
- I'm concerned about our EXPERT CLASS --- the ROLE they want to play in the SOCIETY and we want them to play
  - when the FOUNDATIONS of the EXPERTISE are often NOT AS SOLID as we all might hope.
I'm really wanting to get to the ISSUE not of INDIVIDUAL PRACTITIONERS PROVIDING SUB-STANDARD CARE --- but of a STANDARD of CARE that is SUSPECT.

So one of the reasons why the law focuses on STANDARD OF CARE ----
- is to have a BENCHMARK that is KNOWN or SHOULD BE KNOWN to the PRACTITIONER ---
- & the idea is that makes it FAIR to hold the PRACTITIONER --- ACCOUNTABLE --- for the STANDARD OF CARE.

Holding people "ACCOUNTABLE" ---
- Generally, the Criminal Law for Poor People and crimes of specific intent and
- The Civil Law for many Corporations, Professionals and others where the issue is often negligence and/or fraud.

Holding people "ACCOUNTABLE" is a lot different than SOLVING PROBLEMS.
- I've seen a lot of SCAPEGOATING in both the CRIMINAL & CIVIL LAW SYSTEMS ---
  - and it is DESTRUCTIVE.

The move to PROBLEM-SOLVING COURTS and COLLABORATIVE JUSTICE is an attempt to address some of these issues.

Long-Term Use of Tylenol During Pregnancy May Raise Risk of Autism, ADHD

Researchers say pregnant women who use acetaminophen products for four weeks or more can increase their unborn child’s risk of autism and ADHD.

Cont. from Column 1

There's a lot of HIERARCHY in the Medical Disciplines -- and Mental Health has traditionally not been at the top of it.When someone like myself RAILS AGAINST the DSM and THE MENTAL HEALTH PROFESSION NOT BEING ON TOP OF THE RESEARCH Where would the BANDWIDTH even come to address those issues?The National Institute of Mental Health?

NIMH has some fantastic LONG TERM PROJECTS such as the RDoC (the Research Domain Criteria Program)
BUT MEANWHILE . . .

US CRIMINAL JUSTICE is struggling and we're often relying on PSYCHOLOGICAL EXPERTS who aren't really getting the SUPPORT they need to be RELIABLE EXPERTS.

Psychiatry & The Criminal Justice System: Simplicity on the Near Side of Complexity

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