Blog Archives

NEURO-INFLAMMATION AND OLMSTEAD

2/25/2021

WHAT WE GET:

Overwhelming the Health Care System with Covid cases is a BAD THING.
One of the reasons we get that is Covid-19 is a more dangerous BUT FAMILIAR looking VIRUS.

WHAT WE DON'T GET:

We don't get that OVERWHELMING the Systems serving People with Cognitive Disability is a BAD THING
One of the reasons we don't get that is we think a lot of those people are just BAD PEOPLE.
AND the CARE & TREATMENT of people with COGNITIVE DISABILITY at the HIGH END of the CONTINUUM of CARE is extremely expensive in 2021.

Recent Advances and Changing Paradigms

Conjecture

The dominant paradigm was that "Mental Illness" was a BRAIN DISEASE.
Now, many researchers might say "Mental Illness" isn't a classic disease.
Rather "Mental Illness" is a product of NEURO-INFLAMMATION on the brain that can produce a wide range of "symptoms."
Further, a lot of people with SERIOUS MENTAL ILLNESS (SMI) --- had significant MATERNAL IMMUNE ACTIVATION.
It's a complicated EQUATION but many people wouldn't have SMI BUT FOR Maternal Immune Activation.
For many people "Mental Illness" is really a DEVELOPMENTAL DISORDER that can get worse with additional inflammation.
Further, I would submit the "OVEREXCITABLE" Minds and Bodies of people with NEURO-DEVELOPMENTAL INFLAMMATION are often FEEDING this INFLAMMATION on a regular basis.
This is pretty OVER-SIMPLIFIED TAKE but the new focus on NEURO-DEVELOPMENTAL INFLAMMATION, INFLAMMATION in general and the Gut MIcrobiome are starting to bring "MENTAL ILLNESS" down to earth.

So What Does This Have to do with Olmstead?

States are way behind in what they should be doing for people with Cognitive Disabilities
The needs of people with cognitive disabilities after DECADES of REFUSAL to come to terms with the SCALE of the PROBLEM are ENORMOUS.
Getting away from the UNCONSCIOUS BIAS "BAD PEOPLE" Paradigm of Cognitive Disability to the "NEURO-INFLAMMATION" Paradigm would be a big step up.
Further, having access to STATE OF THE ART CARE would certainly be important to staying out of the mental institute or more likely the jail or prison.

EXECUTIVE FUNCTIONING & NEURO-DIVERSITY

2/18/2021

Conjecture

What's BEST for Executive Functioning?
I would submit that is a matter of perspective and generally is answered by the MAJORITY.
Further Executive Functioning is generally NOT AS INTERESTING to people as a lot of other types of Diversity.
BUT Executive Functioning Diversity is very much a part of HUMAN DIVERSITY and it's often associated with what we think of as "HUMAN":
- the arts
- science
- reason
I would submit the reason for that is at least sometimes people are trying to manage what sure looks like Emotional Dysregulation.
Further, I would submit some people are trying to INTEGRATE AN ENORMOUS AMOUNT OF INFORMATION -- that is sometimes much greater than their more organized counterparts.
Additionally, I would submit that the reason why some people look more "CREATIVE" is that they really are more BIOLOGICALLY SENSITIVE TO THE ENVIRONMENT and have access to more INFORMATION>
- It doesn't make them BETTER than anybody, BUT
- It sure as heck doesn't make them worse.

Neil Young
Sugar Mountain

What's the Point?

At some point, we all have to leave Sugar Mountain. That can be a difficult and even dangerous journey for anyone, especially for those who are NOT NEURO-TYPICAL and don't fit very easily into this society.

We need a SOCIETY --- that has an ABUNDANCE of Important Roles for people who are Neuro-Diverse.

WHAT CAN MAKE PEOPLE WORSE?

Most people don't come with INSTRUCTIONS that they have Executive Functioning Differences.
Further, it is an often Excruciating Process of DISCOVERY for the person and those around them --- often over the course of a lifetime.
Additionally, focusing on Executive Functioning Issues is a relatively NEW THING --- AN EXTREMELY IMPORTANT NEW THING.
People with Executive Functioning Differences often have higher than average NEURO-DEVELOPMENTAL INFLAMMATION.
They tend to be more SENSITIVE & REACTIVE
Work-Arounds are STRIPPING AWAY the Task Components people are STRUGGLING WITH, and maybe adding Task Components that people are good at.
This isn't to say that OCCUPATIONAL THERAPY might not be helpful, BUT we're really talking about NEURO-DEVELOPMENTAL DIFFERENCES.
That makes it easier to understand the importance of DEVELOPING STRENGTHS and COMPENSATING FOR WEAKNESSES --- which we ALL have --- some of us just aren't in the MAJORITY.

Where are we at?

2/17/2021

Ideas we're researching in an attempt to CLARIFY:

Neuroinflammation and its relation to Mental Illness, Suicide and Anti-Social Behavior
Work Arounds for Executive Functioning issues
The Mixed Bags of Neuroinflammation
- Below Average Intelligence
- Above Average Intelligence
- High Sensitivity / High Reactivity
- Executive Functioning Issues
What might a Public Health Approach to Anti-Social Personality Disorder look like?

We're doing this research because it has significant legal & policy implications.

From our perspective, thousands of citizens are homeless or involved with the Criminal Justice System because we haven't made it a priority to incorporate THE RESEARCH THAT's OUT THERE and work out the CONTRADICTIONS in our Criminal Justice and Health Care Systems.

ARE CO SHERIFFS LEADING THE WAY ON RESIDENTIAL SERVICES?

2/16/2021

   In 2021, some of the most VOCAL advocates for RESIDENTIAL SERVICES in Colorado are Colorado SHERIFFS.
They do care about people with cognitive disabilities AND they really care that this expense has been cost-shifted to them.
Further, there are a lot of problems that come with trying to house people with cognitive disabilities --- and one of the solutions has been Solitary Confinement, Administrative Segregation, a/k/a --- Restrictive Housing.
Both our 2020 & 2021 Colorado Cognitive Disability Report -- referenced this issue with resources about getting rid of or greatly restricting AdSeg.
The 2020 report was incorporated by reference in our 2021 report.

In the meantime, Mental Health Colorado has done an excellent job of getting this off the ground and working with legislators on a proposed bill.

The bill adds to the list of duties of the Sheriff's Office --- Discharge Planning.
I'm basically fine with that if we are going to provide resources to do that. AND even if the State doesn't provide resources, is it better than nothing --- maybe it is.

Legislators feel that they want to consider everyone's concerns --- and at the end of the day --- they want something they can pass.

This falls into a very long line of:

Navigators
Administrative Offices
Cost Shifting

in lieu of tackling the BIG SHORTAGE in many things, most notably RESIDENTIAL SERVICES.

It does seem that there is a BROAD RECOGNITION and CONVERGENCE in thinking on the need to bring RESIDENTIAL SERVICES to SCALE.

We said this before --- doing that Planning during COVID or COVID ECONOMIC RECOVERY is actually a GOOD THING:

Expectations are LOW, and
We can get a HANDLE on our RESIDENTIAL SERVICES needs, and
Start Planning to REASONABLY meet that need.

Any future Behavioral Health Services Administration should be tasked with doing just that, and including the needs in Criminal Justice.

A VALENTINE'S DAY OF MIXED BAGS AND INNATE & ADAPTIVE IMMUNITY

2/15/2021

NEUROINFLAMMATION, INTELLIGENCE, PSYCHIATRIC ILLNESSES
& DELICATE EQUILIBRIUMS

Conjecture

We're living in a country and largely a world that has low-grade systemic inflammation.
When we think about what it is to be Human we often think about the inherent CONTRADICTIONS -- that seem to be tripping us up whether we are coming are going.
We would submit "intelligence" or rather the inflammation that is its necessary component is a DOUBLE-EDGED SWORD and too much inflammation can and does lead to PSYCHIATRIC ILLNESS.
Further it appears that:
- Innate Immune Cells are Regulators of Brain Development & Behavioral Function (2018)
- Cognitive and Social Abilities Rely on Fine-Tuned Equilibrium of Innate & Adaptive Immune Responses (2019)

This is a new way of looking at human behavior.

We need to start the work THIS YEAR, to integrate these new understandings regarding neuro-developmental inflammation to our approaches to:

Homelessness
Criminal Justice
Mental Health Practice, and
Forensic Mental Health Practice

Further, we need the Biden Administration to provide comprehensive and effective:

Translational Research & Medicine, and
Translational Criminal Justice

General intelligence is associated with subclinical inflammation in Nepalese children

The Impact of Systemic Inflammation on Neurodevelopment

Abstract

Inflammatory mediators affect the brain during development. Neurodevelopmental disorders such as autism spectrum disorders, cognitive impairment, cerebral palsy, epilepsy, and schizophrenia have been linked to early life inflammation.

Recent advances have shown the effects of systemic inflammation on children’s neurodevelopment.

We discuss the potential mechanisms by which inflammatory molecules can exert their effects on the developing brain and consider the roles of MHC class I molecules, the HPA axis, glial cells, and monoamine metabolism.

Methods to prevent the effects of cytokine imbalance may lead to the development of new therapeutics for neuropsychiatric disorders.

Future research should focus on identifying at-risk individuals and early effective interventions to prevent long-term neurodevelopmental disabilities.

HOW DID OUR MENTAL HEALTH PROFESSION GET SO FAR BEHIND THE RESEARCH?

2/13/2021

In 2021, a lot of researchers would identify neuro-developmental inflammation as a big player in the development of "Mental Illness."
Many, most clinicians wouldn't be able to do that.
That change in CONCEPTUALIZATION has a lot of ramifications, and certainly bolsters the call for a PUBLIC HEALTH approach to HOMELESSNESS and INCARCERATION.
By the early 2000s and even before, some researchers were starting to focus on the IMMUNE SYSTEM as a major player in "mental illness."
In 2013, the National Institute of Mental Health
- Referenced research that psychiatric categories seemed to be BLURRED due to common Genetic and Epigenetic Factors affecting the Immune System
  - See Disorders Share Risk Gene Pathways for Immune, Epigenetic Regulation ---
    Genome-wide findings add to evidence blurring traditional psychiatric categories
- Then NIMH Director Thomas Insel declared the DSM 5 lacked scientific validity (NIMH later backed up from that -- but the more blunt, truthful statement had already been made)
- But this created a huge practical problem --- how do you even talk about "mental illness." NIMH advised one should use the DSM 5 only as a "DICTIONARY."
  - Not surprisingly, that really hasn't worked, BUT
  - One is still left with the practical problem and the lament of the American Psychiatric Association (APA) --- Hey, if you want us to consider something contact us -- otherwise, we don't have anything else other than the DSM 5.
    - Somehow the COVID effort for all its problems --- is light years ahead of Mental Health Translational Research.
- By 2015, Jonathan Kipnis and his team at the University of Virginia School of Medicine had made a major discovery: LYMPHATIC VESSELS in the BRAIN where none were thought to exist.
  - The lymphatic system is a part of the IMMUNE SYSTEM
  - The case for a major role of the IMMUNE SYSTEM in mental health / mental illness --- just got exponentially stronger.
- The research since then has been coming fast and furious to CORROBORATE this IMMUNO-PSYCHIATRY APPROACH ----
  - BUT this isn't making its way to Clinicians in any kind of timely manner.
  - In 20 years, will clinicians be on top of the research between 2000- 2021 -- they probably will be. But they are NOT on top of it NOW.
    - By and large this isn't the result of some type of considered OBJECTION or even a CAUTIONARY NOTE to move slowly and deliberately.
    - Generally, this is just a result of IGNORANCE.
    - Further, it's an IGNORANCE the APA may be willing to remedy if they are provided the TRANSLATIONAL RESEARCH SUPPORT to do it.

The Epidemic of Misdiagnosis in the Gifted Community

"Giftedness" seems to be a mixed bag of biological features, characterized by:
- Asynchronous Development, and
- Emotional Intensity (which can look a lot like Emotional Dysregulation)
- Executive Functioning is sometimes below what would be expected, and other abilities are higher than the norm.
There are "gifted" people today who are homeless or in jails or prisons because they did not get the support or accommodations they needed.
- This affects 'gifted" people across the board.
- It certainly affects "gifted" people of color more.

Conceptualization Matters in the Criminal Justice System

We're not in favor of Sowell's punitive approach --- BUT right now the only reason why more mental health professionals would not be deemed "INCOMPETENT" --- the Standard of Care is so LOW.

See Former NIMH Director Insel's 2014 Blog: Atonement:

"[N]ot enough of our care has been standardized to a high level of quality, as expected in the rest of medicine."

Now that is not their fault --- BUT we need policymakers who can make it a PRIORITY to ramp up TRANSLATIONAL MENTAL HEALTH RESEARCH & MEDICINE.

In fairness, Mental Health Conceptualization and Treatment had stagnated for decades, even if modest improvements were made.

BUT that is NOT true today in the RESEARCH where significant new conceptualizations and understandings have been discovered.

--- BUT that STAGNATION is still true for CLINICAL MENTAL HEALTH PRACTICE and FORENSIC MENTAL HEALTH PRACTICE.

NEUROINFLAMMATION & COGNITION ACROSS PSYCHIATRIC CONDITIONS

Click Here

Univ. of Pennsylvania Proposal that Anti-Social Personality Disorder should be considered a Developmental Disorder

What "mental illness," "personality disorders," and "giftedness" seem to have in common is HIGH SENSITIVITY or REACTIVITY to the ENVIRONMENT.
That seems to be the result of NEURO-INFLAMMATION.
Even if one questions whether Anti-Social Personality Disorder is a DEVELOPMENTAL DISORDER ----
- The question is who bears the BURDEN of UNCERTAINTY?
- We would submit it shouldn't be the individual.

The Shaky Foundations of Psychiatric Diagnostics

COVID VACCINATION PRIORITIES AND "SCHIZOPHRENIA"

2/12/2021

"Homeless" or for that matter "Incarcerated" more often than not means that the person's cognitive disability has reached such a stage that the person can't house themselves or live safely in the community.

So when Gov. Polis says he doesn't want to make homeless people a vaccination priority --- "just because they happen to be homeless" ---- OMG.

We realize this is hard, and seniors should be a priority --- BUT acting like homeless people are perfectly healthy people and living in perfectly healthy environments --- they just happen to be homeless is ridiculous.

There are a number of news stories on this phenomena with "Schizophrenia" and Covid.

This is the only video we found which is UNTV News & Rescue out of the Philippines.

The study was out of New York University.

NEURO-INFLAMMATION-------- MIXED BAGS AND "FINELY TUNED EQUILIBRIUMS"

2/10/2021

This is Conjecture

Neuro-inflammation is one of those things that we don't want too little of but we don't want too much either.
The brain-gut-immune axis and the endocrine system ---- all those extremely complicated systems are INTEGRATED.
A lot of people with "mental illness" --- seem to be starting out with some type of "neuro-developmental" difference or disability.
- Part of that difference is a sometimes greater sensitivity to the ENVIRONMENT.
- That environment is an emotional environment but its also a physical environment.
- Part of that difference often is related to MATERNAL IMMUNE ACTIVATION.
When we think about some emotional injury, a physical injury, or allergies --- we're making BIG DISTINCTIONS --- but it's not clear our bodies are making those distinctions --- at least in some respects.
- All those things and more could lead to neuro-inflammation --- on top of the neuro-inflammation somebody may have been born with.
- Further, that person with a neuro-developmental difference or disability may already be more sensitive to their environment.
So when we think about "MENTAL ILLNESS" being related to neuro-inflammation and other general mechanisms of the body ---- it's NOT that surprising that traditional categories of "mental illness" are looking very BLURRED in the 21st Century.

Wiley Online Library

Three Big Take Aways

Cognitive and Social Abilities Rely on Fine-Tuned Equilibrium of Innate & Adaptive Immune Responses (2019)
Innate Immune Cells are Regulators of Brain Development & Behavioral Function (2018)
The Vagus Nerve serves as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. (2018)

Click Here

"The Earth is not flat" -------------NEURO-DEVELOPMENTAL DIFFERENCES / DISABILITIES, "MENTAL ILLNESS," WORK AROUNDS & CRITICAL THINKING

2/9/2021

Star Institute is located in Centennial, Colorado

A pilot study by the STAR Institute found that the 35% of the children in one large sample (n=550) from a gifted and talented center exhibited symptoms of SPD (Sensory Processing Disorder).

This is significantly more than the 5% that pilot studies have found in the general population.

ADHD, Autism, Bipolar Disorder, Depression and Schizophrenia share common genes according to the National Institute of Mental Health.

According to the University of Michigan, bipolar disorder is developmental.

The cells of people with bipolar disorder are developmentally different than the cells of those people without bipolar disorder.

Terra Incognita

The "Mental Illness" Map has been pretty far off the mark even if professionals did the best they could.

Some of our new scientific understandings of the last 10 years are creating a very different map in which neuro-developmental difference / disability is playing a prominent role.

Further, a lot of the MYSTERY surrounding some of this is starting to go away and a lot of it does seem to be related to neuro-inflammation.

We would submit that conversion therapy comes in a lot of forms.

When we are talking about executive functioning neuro-developmental differences / disabilities---- a frontal societal attack to change them or just refusal to accommodate can often make them "worse."

WORK AROUNDS and ACCOMMODATIONS are a lot like RECYCLING---- if it is relatively easy and understandable people will do it, if not they won't.

We must as a society and individuals use our CRITICAL THINKING SKILLS to RAMP UP our ability to do these WORK AROUNDS and ACCOMMODATIONS until there are better treatments.

A lot of people are struggling in this society because they don't have the executive functioning that is the price of admission to participate.

IN-GROUPS & OUT-GROUPS & BIOLOGICAL UNIVERSALS

2/6/2021

To me, the SCIENCE and BIOLOGY surrounding In-Groups and Out-Groups are probably the most important discoveries in our lifetimes.

Getting us all in the same IN GROUP without sacrificing individuality and safety have been big goals certainly of the US and most modern democracies.

It's turned out to be a little harder than we have thought.

Further, a lot of things have turned out differently than what we thought when it comes to "mental illness."

It's a lot about the IMMUNE SYSTEM and SOCIAL BEHAVIOR.

Certainly in rich countries and increasingly in the developing world ---- we have populations with widespread low grade inflammation.

"Inflammation" might be a UNIVERSAL BIOMARKER that we could target to reduce.

FURTHER, Reducing Inflammation might be a COMMON GOAL among others --- to get us all back in roughly the same In-Group and Healthier at the same time.

I think what we are going to find is that there are a lot of causes of "INFLAMMATION" --

some people were born with the inflammatory effects of Maternal Immune Activation,
- This appears to be a big factor in a lot of mental illness and developmental difference / disability

some people have experienced trauma or intergenerational trauma
- Intergenerational Trauma is a human phenomenon not limited to any particular category
- Blake Shelton's "God's Country" is a powerful rendition of the trauma of the Dust Bowl and the 1930s for many white (& black) Americans that reverberates through their descendants.

some people are struggling to maintain a healthy diet and exercise, and/or

pollution or other environmental toxins

etc.

[I think one of the reasons it has taken us so long to get a handle on MENTAL ILLNESS is the "IMMUNE SYSTEM" is doing so much more than we thought.

On the one hand, the IMMUNE SYSTEM as MASTER REGULATOR could be EFFICIENT ---- but like a lot of EFFICIENT things -- it's masking enormous complexity.

The same is true for In-Groups and Out-Groups.

We post this video again & again --- That's because it has a ton of ramifications.

The Brain with David Eagleman
In-Groups & Out-Groups

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Val's Blog

NEURO-INFLAMMATION AND OLMSTEAD

EXECUTIVE FUNCTIONING & NEURO-DIVERSITY

Where are we at?

ARE CO SHERIFFS LEADING THE WAY ON RESIDENTIAL SERVICES?

A VALENTINE'S DAY OF MIXED BAGS AND INNATE & ADAPTIVE IMMUNITY

NEUROINFLAMMATION, INTELLIGENCE, PSYCHIATRIC ILLNESSES
& DELICATE EQUILIBRIUMS

HOW DID OUR MENTAL HEALTH PROFESSION GET SO FAR BEHIND THE RESEARCH?

COVID VACCINATION PRIORITIES AND "SCHIZOPHRENIA"

NEURO-INFLAMMATION-------- MIXED BAGS AND "FINELY TUNED EQUILIBRIUMS"

"The Earth is not flat" -------------NEURO-DEVELOPMENTAL DIFFERENCES / DISABILITIES, "MENTAL ILLNESS," WORK AROUNDS & CRITICAL THINKING

IN-GROUPS & OUT-GROUPS & BIOLOGICAL UNIVERSALS

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NEUROINFLAMMATION, INTELLIGENCE, PSYCHIATRIC ILLNESSES & DELICATE EQUILIBRIUMS

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NEUROINFLAMMATION, INTELLIGENCE, PSYCHIATRIC ILLNESSES
& DELICATE EQUILIBRIUMS