Given my conviction that the vast majority of psychiatric conditions are caused by inflammation of the brain, most of the recommendations that I make to patients in my practice of holistic psychiatry are designed to support the immune system which decreases inflammation. Depression, anxiety, attentional difficulties, brain fog, and other cognitive changes are all mediated by inflammation.
My healing strategy is multi-modal and holistic. The centerpiece is always an auto-immune type diet like the Paleo Auto-Immune Protocol or the Wahl’s Protocol, as well as often encouraging intermittent fasting. Learning to cook is a priority. In addition, it is essential to identify and treat common causes of systemic inflammation such as environmentally acquired illnesses like mold toxicity and mast cell activation syndrome. It can be helpful to identify deficiencies and excesses of vitamins, minerals, and biogenic amines like histamine, and to prescribe targeted nutrient therapy protocols to rebalance biochemistry. I typically recommend Low Dose Naltrexone to support and modulate the immune system. Therapies to heal the effects of trauma, like Dynamic Neural Retraining System which rewires the limbic system, and Accelerated Resolution System, an eye movement therapy, can be very helpful for many. We always discuss circadian rhythms and sleep, the potential benefit of practices like meditation, yoga and tai chi, the vital importance of incorporating daily movement into one’s day, as well as the necessity of avoiding synthetic hormones, toxic conventional personal care, and household cleaning products. It is crucial to take seriously the biological effects of electromagnetic frequencies emitted by cell phones and other electronic devices. Most patients are unaware that these devices can increase systemic inflammation. We discuss the importance of getting sunlight and communing with nature, developing a sense of belonging to a community, the uplifting effect of service and cultivating nourishing personal relationships. Often an anti-inflammatory treatment includes old fashioned talk therapy and discussion of how to implement a spiritual practice.
A holistic approach requires a great deal of commitment. motivation and hard work on the part of the patient, as it is challenging to adhere to dietary changes, to say no consistently to favorite foods, to exercise regularly, to take many supplements, to put your phone on airplane mode when you are carrying it on your person, to turn off the router at night, etc. It is very different than taking medications, as it involves a whole change of lifestyle and orientation.
One of my very favorite podcasts is Phoenix Helix, which is about healing auto-immune disease. The host, Eileen Laird, is an excellent interviewer and invites wonderful guests. I always recommend this podcast to my patients, as the first four episodes give great advice about how to implement the Paleo Auto-Immune Protocol (AIP) and feature inspiring healing stories. The recipe section contains a treasure trove of AIP friendly recipes.
The newly published book featured at the beginning of this post, The Angel and the Assassin, by science journalist and award-winning author Donna Jackson Nakazawa, is about the connection between the immune system and brain health. Donna Jackson Nakazawa was a recent guest on the Phoenix Helix podcast in a fabulous episode entitled “Autoimmunity and the Brain.”
The episode begins by making the important point that patients with auto-immune illnesses are often told that their depression, anxiety and cognitive changes are a perfectly natural response to the stress and suffering that are part and parcel of living with chronic illness. What is not recognized is that autoimmune illness causes inflammation not only in the body but in the brain as well, and it is the inflammation that is causing symptoms. The protagonist of her book is the microglia cell, an immune cell in the brain, whose role in brain health has only recently begun to be appreciated and understood. Microglia can both support a healthy immune response or become overactive, causing damage to synaptic connections and emitting neurotoxins, which causes brain inflammation. Overactive microglia are seen in many different conditions including anxiety, mood disorders, Alzheimer’s and Parkinson’s disease, to name a few.
We are living through a time of tremendous intensity, uncertainty, grief and change on our planet. The collapse of the biosphere and the ever-increasing toxicity of the environment is creating chronic stress and existential angst, which manifests in our bodies and brains as inflammation. An inflamed person often feels depressed, self-critical, unworthy, anxious, preoccupied, separate and alone. In order to meet these times with resilience, strength, and courage, and to foster well-being, clarity, and hopefulness in the face of such confusion and darkness, it is essential to implement holistic practices that decrease inflammation.
In terms of the larger meaning of all of this suffering and loss, it helps me to keep in mind the quote from the 12-century Persian poet Rumi, ” You have to keep breaking your heart until it opens.” May this heartbreak serve to catalyze the paradigm shift that is needed in order to create what sacred activist Charles Eisenstein called ” The More Beautiful World that our Hearts Know is Possible.”
Here is a link to the audio file of the Phoenix Helix podcast: “Auto-Immunity and the Brain.”