Gluten mad!

Tonight as I was browsing Facebook again, I came across an article a person had posted on gluten. The article claimed that gluten is connected to depression, and indeed, nearly every other neurological disorder for good measure.

Gluten is a protein found in certain grains like wheat, barley and rye. Gluten also makes foods taste better and improves their texture, so it’s often added to everything else.

The “gluten is toxic” meme is a very catchy one that’s doing the rounds again. I first heard of the idea that gluten is the cause of nearly every disease when I was in medical school, when every person I knew who’d seen a naturopath was told they had gluten intolerance and were conned into an unappetising and restrictive diet which didn’t make any of them better.

The same meme is now making it’s way back around again now that the low-fat, sugar-free, zucchini broth-type diet fads are waning.

The proposed link between depression, anxiety and gluten is a new twist to the old story. But with depression becoming a preeminent disease in the 21st century, the link doesn’t surprise me.

So what does the evidence say? Is gluten the culprit behind the modern scourge of mental illness?

I certainly don’t think so, at least according to my interpretation of the medical literature. As far back as 2001, researchers studying the mental health of patients with coeliac disease noted that coeliac disease patients had much higher levels of anxiety and depression than healthy matched controls (up to about three to six times greater in one study), and after a year on a gluten free diet, there were no changes to the rates of anxiety and depression (Addolorato et al., 2001).

In more recent times, larger studies have been performed. Hauser, Janke, Klump, Gregor, and Hinz (2010) confirmed higher levels of anxiety in German female coeliac patients who were on a gluten free diet, compared to the normal controlled population. Mazzone et al. (2011) showed that children with coeliac disease on gluten-free diets for about 7 years on average still showed an increased rate of anxiety and depression symptoms and showed higher scores in “harm avoidance” and “somatic complaints” as compared to healthy control subjects.

A larger cross sectional survey was performed in the Netherlands in 2013, on 2265 adults with coeliac disease (van Hees, Van der Does, & Giltay, 2013). That survey showed that a significantly higher proportion of those with coeliac disease, despite being on a strict gluten free diet, reporting a higher rate of anxiety and depression compared to the general population. It also showed (albeit in a smaller subgroup of respondents) that poor adherence with a gluten free diet did not affect the likelihood of depressive symptoms.

To be fair, cross sectional surveys and longitudinal cohorts aren’t necessarily the strongest form of evidence, but it is the best we’ve currently got. There was a recent randomised controlled trial, a stronger form of evidence, looking at the effect the introduction of gluten had on depressive symptoms in people who did not have coeliac disease but reported gluten sensitivity and were controlled on a gluten free diet (Peters, Biesiekierski, Yelland, Muir, & Gibson, 2014). While this showed some worsening of depressive symptoms in those subjects given gluten, the exposure was short, the effect was moderate, and the results should be considered cautiously given the small number of subjects reduced the power of the study.

Given the weight of evidence, I can’t help but be sceptical of books touting the ‘gluten = depression’ theory, books like “Grain Brain”. It’s author, American neurologist Dr David Perlmutter, attests that more than 38 different diseases are caused by gluten, including autism and depression. If you believe the celebrity chiropractor who reviewed Perlmutter’s work (http://www.glutenfreesociety.org/gluten-free-society-blog/gluten-leaky-brain-the-connection-to-depression/), increased intestinal permeability and intestinal dysbiosis (“leaky gut” and bad gut bacteria) combine to increase inflammation in the blood and in the brain, causing depression.

But correlation does not equal causation. Just because brain diseases, inflammation and gut problems tend to occur together does not prove that gut problems cause inflammation and brain problems. Rather, the evidence suggests that it’s the other way around, with all of the processes linked to genetics.

For example, autism is related to a number of genes that both reduce the proteins that help nerve cells grow branches (Won, Mah, & Kim, 2013), and at the same time, switch on a low grade form of inflammation (Onore, Careaga, & Ashwood, 2012). I believe it’s the pre-existing inflammation that adds to the cellular dysfunction of the brain and at the same time, promoting low grade inflammation of a number of organs, including the gut. It’s the pre-existing inflammation that causes the gut to become “leaky”, not the “leaky” gut causing the inflammation.

Because if gluten was the primary cause, then why do people with coeliac disease who do not eat gluten report more depressive and anxious symptoms than control groups who do eat gluten? Why would those with coeliac disease who are eating sporadic gluten be just as depressed as those patients who do not?

If you don’t have coeliac disease, then gluten free diets are just like Amway products. You really don’t need them, and you could probably do much better without them. All you’re really doing is just making someone else obscenely rich.

Not only are you wasting your money, but you might also be harming your health by eating gluten free foods, since most foods that are stripped of gluten are also stripped of most of their other nutrients.

As Nash and Slutzky (2014) summarise, “Every major change in our diet carries with it the possibility of unforeseen risks. Many readers — the general public, as well as medical professionals — accept what they read at first glance. Myths have been part of our medical lore for millennia. Those jumping on the gluten-free/high-fat bandwagon may be disappointed when their symptoms are not mitigated; more critically, they may be at increased risk for other, more dangerous ailments.”

If you really think you feel better off gluten, then talk to your doctor or registered dietician to make sure you remain healthy off it.

References

Addolorato, G., Capristo, E., Ghittoni, G., Valeri, C., Masciana, R., Ancona, C., & Gasbarrini, G. (2001). Anxiety but not depression decreases in coeliac patients after one-year gluten-free diet: a longitudinal study. Scand J Gastroenterol, 36(5), 502-506.

Hauser, W., Janke, K. H., Klump, B., Gregor, M., & Hinz, A. (2010). Anxiety and depression in adult patients with celiac disease on a gluten-free diet. World J Gastroenterol, 16(22), 2780-2787.

Mazzone, L., Reale, L., Spina, M., Guarnera, M., Lionetti, E., Martorana, S., & Mazzone, D. (2011). Compliant gluten-free children with celiac disease: an evaluation of psychological distress. BMC Pediatr, 11, 46. doi: 10.1186/1471-2431-11-46

Nash, D. T., & Slutzky, A. R. (2014). Gluten sensitivity: new epidemic or new myth? Every major change in our diet carries with it the possibility of unforeseen risks. Am J Cardiol, 114(10), 1621-1622. doi: 10.1016/j.amjcard.2014.08.024

Onore, C., Careaga, M., & Ashwood, P. (2012). The role of immune dysfunction in the pathophysiology of autism. Brain Behav Immun, 26(3), 383-392. doi: 10.1016/j.bbi.2011.08.007

Peters, S. L., Biesiekierski, J. R., Yelland, G. W., Muir, J. G., & Gibson, P. R. (2014). Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity – an exploratory clinical study. Aliment Pharmacol Ther, 39(10), 1104-1112. doi: 10.1111/apt.12730

van Hees, N. J., Van der Does, W., & Giltay, E. J. (2013). Coeliac disease, diet adherence and depressive symptoms. J Psychosom Res, 74(2), 155-160. doi: 10.1016/j.jpsychores.2012.11.007

Won, H., Mah, W., & Kim, E. (2013). Autism spectrum disorder causes, mechanisms, and treatments: focus on neuronal synapses. Front Mol Neurosci, 6, 19. doi: 10.3389/fnmol.2013.00019

Dr Caroline Leaf and dualism revisited

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Are we a body with a mind, or a mind with a body?

This may sound like a chicken-and-egg type of conundrum, but it’s a deep philosophical question. The concept of the separation of the mind from the body is known as dualism, and has been debated for centuries because the answer to that question then guides a lot of other philosophies and theories.

Dr Caroline Leaf is a communication pathologist and a self-titled cognitive neuroscientist. She believes that the body and brain are separate from the mind, which significantly influences her teaching. Take, for example, her social media meme-of-the-day today. She posted that, “The brain does not change itself… our MIND changes the brain”. If one assumes that the mind is separate from our brain, then its plausible that the mind influences the brain.

Except that it doesn’t. Our mind is a product of our brain, not a separate entity. Neurological damage from injuries or tumours, electrical stimulation of the brain in the lab, the effect of illicit drugs on the brain like LSD or marijuana, and everyday examples like the changes to our thinking under the influence of caffeine or alcohol, all prove that changes to the structure and function of the brain change thought patterns. It isn’t the other way around. Every brain changes itself too – the brain of an embryo or foetus undergoes massive changes but foetuses don’t have streams of conscious thought. Dr Leaf’s meme is scientifically misguided.

Perhaps what is more worrying is Dr Leaf’s use of scripture to try and justify her view that the mind and the brain are separate. To introduce her meme, Dr Leaf wrote, “Read Luke 16:19-31 to see that the mind is separate from the brain – this is God’s divine design.”

There are a number of scriptures that theologians use to discuss the biblical basis for the separation of the body and soul, but Luke 16:19-31 isn’t one of them. That passage is the parable of Lazarus and the rich man.

It says:

‘There was a rich man who was dressed in purple and fine linen and lived in luxury every day. At his gate was laid a beggar named Lazarus, covered with sores and longing to eat what fell from the rich man’s table. Even the dogs came and licked his sores.
‘The time came when the beggar died and the angels carried him to Abraham’s side. The rich man also died and was buried. In Hades, where he was in torment, he looked up and saw Abraham far away, with Lazarus by his side. So he called to him, “Father Abraham, have pity on me and send Lazarus to dip the tip of his finger in water and cool my tongue, because I am in agony in this fire.”
‘But Abraham replied, “Son, remember that in your lifetime you received your good things, while Lazarus received bad things, but now he is comforted here and you are in agony. And besides all this, between us and you a great chasm has been set in place, so that those who want to go from here to you cannot, nor can anyone cross over from there to us.”
‘He answered, “Then I beg you, father, send Lazarus to my family, for I have five brothers. Let him warn them, so that they will not also come to this place of torment.”
‘Abraham replied, “They have Moses and the Prophets; let them listen to them.”
‘“No, father Abraham,” he said, “but if someone from the dead goes to them, they will repent.”
‘He said to him, “If they do not listen to Moses and the Prophets, they will not be convinced even if someone rises from the dead.”’ (Luke 16:19-31, NIV)

I’m not sure exactly where the convincing proof of the separation of our mind and our body is found in this passage. This is a description of the afterlife, and in this parable, the rich man was very specific about memories (“I have five brothers …”) as well as physical sensations (“I am in agony in this fire”) and even parts of the body (Lazarus’s finger, his tongue). Jesus isn’t telling a story of how the mind is separate to the body, but of a different dimension in which the body and the mind are still together. This passage isn’t proof for the concept of dualism, but against it.

Dualism also has a number of fatal scientific and philosophical flaws, in particular that dualism is conceptually fuzzy, experimentally irrefutable, considers only the adult mind, and violates physics, in particular the law of conservation of energy.

So Dr Leaf bases her teaching on a scientifically and philosophically untenable concept and then attempts to use a scripture which refutes dualism in her attempt to support it. That’s audacious, but then to claim that it’s God’s divine design is, at best, a little brazen.

Dualism may be one of her fundamental philosophies, but I think Dr Leaf should review the basis for it, and possibly reconsider her reliance on it.

For a more in-depth discussion on Dr Leaf and dualism, please see my essay: Dr Caroline Leaf, Dualism, and the Triune Being Hypothesis

The pain and gain of grief

Floral tribute to the Sydney siege victims, at Martin Place, Sydney

Floral tribute to the Sydney siege victims, at Martin Place, Sydney

In many ways, 2014 hasn’t been the best of years, unless you’re a florist.

A dear friend of mine recently went through an unimaginable personal loss, but politely requested that no one send her flowers, because the unintentional metaphor of receiving something beautiful that soon withered and died simply reminded her of what she had lost. Not that I could have given her flowers anyway – it seems like all of Australia’s bouquets have been laid in Martin Place.

The siege in the Lindt Cafe was an assault on Australia’s national psyche as much as it was an attack on a small café in the CBD of Sydney, and marks a highpoint of suffering in the midst of several tragedies back to back. Soon after the tragic events in Martin Place, news came of the murder of eight children from the one family in Cairns. Two weeks before, we were rocked by the sudden death of cricketer, Phil Hughes.

Like many, many others in the last few weeks, I’ve felt that discombobulating mix of sadness, compassion, anxiety, and numbness (and many other feelings) that accompanies loss. I was grieving.

Grief is not fun. There are a wide variety of ways in which people grieve, of course, though grief is rarely described as joyous. Rather than being the five stages of grief that used to be dutifully learned by every medical and psychology student, grief is now considered a mish-mash of nearly every different emotion that a human can experience, for different lengths of time, at different intensities, in different patterns. Like your fingerprint, your emotional pattern of adapting to loss is as individual as you are. I felt helpless at the news from my close friend, shock at the death of Phil Hughes, and anxious when thinking about the Lindt Café. Each tragedy was also accompanied by a deep sadness.

As well as being emotionally draining, the process of grieving can have physical effects as well, associated with high levels of pro-inflammatory cytokine release and the changes that are associated with that (O’Connor, Irwin & Wellisch, 2009). Pro-inflammatory cytokines are also released because of physical stress or infection, so grief would physically feel like you have the flu, which is probably why grieving makes you feel physically awful as well as mentally distraught.

As awful as these feelings are, they are important to our healing and restoration. Grief functions as a way of helping us adjust to life on the other side of our loss. Like our body has to heal and adapt to physical wounds, grief helps us heal and adapt emotionally. Grief is not a disease, but a normal process that everyone experiences at one point or another.

Some authors teach that negative feelings and emotions are toxic, or that the outcome of different stresses in our life is dependent on our personal choices. If there was ever a case-in-point of the benefit of “negative” emotions, and why the outcome of stressful events is not entirely under our control, it’s grief. Grieving is a process which, by definition, is distressing. The storms of painful emotion roll through us, triggered and controlled by our subconscious brain, with our conscious mind along for the ride. As distressing as those emotions can be, they are not ‘negative’ emotions, but the process of healing,

At times of intense sorrow, we can try and ‘help’ those who are grieving by telling them how they should feel, or what they should do, but during times of grief, being too directional is usually not helpful. The blog today is more general in nature because I don’t want to try and push one particular way of grieving over another. There is no right or wrong way to grieve.

My Physical Education teacher often used to say, “No pain, no gain.” Actually, it was more barking through his megaphone, trying to make me run faster in my cross-country race. It may seem an odd match, but the principle applies here too. If you are feeling the sadness and loss over the Lindt Café, Phil Hughes, Robin Williams, or any other personal loss you may have experienced, it’s ok to feel the distress. The pain is hard. The feelings are raw, and they are real. But you will get through them, and they will help you to experience the joy in life again.

I am coming to terms with each of these different tragedies in my own way. Lets pray that 2015 is a much better year.

If you are struggling and don’t know where to go to talk or find assistance, see your GP or psychologist, visit BeyondBlue (http://www.beyondblue.org.au), or the Australian Centre for Grief and Bereavement (http://www.grief.org.au).

If you want to donate to the funds or foundations set up in honour of the Sydney siege victims, please go to http://www.beyondblue.org.au/get-involved/make-a-donation or http://thekatrinadawsonfoundation.org.

References

O’Connor, M.-F., Irwin, M. R., & Wellisch, D. K. (2009). When grief heats up: Proinflammatory cytokines predict regional brain activation. NeuroImage, 47(3), 891–896. doi:10.1016/j.neuroimage.2009.05.049

Don’t stress about stress – Part 4: Stress breaking bad

This is the last blog post in my brief series on stress. Today, we’re going to look at what happens when we do hit stress overload, and a few simple methods that may be able to help you through a tough situation.

One of my favourite shows of all time was Breaking Bad. Breaking Bad told the story of Walter White, a high school chemistry teacher and average family man, who is diagnosed with terminal lung cancer. To support his wife and disabled son after he’s gone, he uses his knowledge of chemistry to launch himself into an underworld career manufacturing crystal meth.

Allostatic overload is the term modern scientists use for stress breaking bad. Stress moves from an agent of growth and change to an agent of disease and death.

In the last few blogs, we discussed that stress is actually more of a positive than a negative. It’s not that stress can’t be bad, because we know from the stress-productivity curve and from the Yerkes-Dodson Law that too much stress overwhelms our capacity to cope with it. The model used to describe the balance of stress on our body is the theory of Allostasis.

Allostasis

All living things maintain a complex dynamic equilibrium – a balancing act of the many different physiological systems that all rely on the other systems working at an optimal range. Imagine trying to stack ten spinning tops on top of each other while trying to keep them spinning. The body does the chemical equivalent of this very difficult combination of balance and dexterity every day. It’s called homeostasis. This balancing act is constantly challenged by internal or external events, termed stressors. Both the amount of stress and amount of time that the stressor is applied is important. When any stressor exceeds a certain threshold (“too strong, or too long”), the adaptive homeostatic systems of the living thing activate responses that compensate.

The theory of allostasis is related to these homeostatic mechanisms, although not just in terms of stress, but broadly to the concept of any change of the optimal range of these homeostatic balancing processes, in response to a change in the environment or life cycle of an organism [1].

McEwen and Wingfield give an example of some bird species, which change their stress response to facilitate their breeding capacity during mating season. They note that the benefit of the increased chance of breeding is important to the bird, but also comes at a cost of increased susceptibility to some diseases because of the weakening of the stress response at the time [1].

When it comes to stress, we adapt in a similar way. A lack of stress, or an excess of a stressor in some way (either too long or too strong) results in adaptation, which is beneficial, but can come at a cost. This is demonstrated by that broadly applicable U-curve, the stress productivity curve.

Chrousos wrote, “The interaction between homeostasis disturbing stressors and stressor activated adaptive responses of the organism can have three potential outcomes. First, the match may be perfect and the organism returns to its basal homeostasis or eustasis; second, the adaptive response may be inappropriate (for example, inadequate, excessive and/or prolonged) and the organism falls into cacostasis; and, third, the match may be perfect and the organism gains from the experience and a new, improved homeostatic capacity is attained, for which I propose the term ‘hyperstasis’.” [2] And as noted by McEwen, “Every system of the body responds to acute challenge with allostasis leading to adaptation.” [3]

More often than not, we adapt to the stressor, either the same as before, or possibly better. It’s only if the response to the stressor is inadequate, excessive and/or prolonged that stress ends up causing us trouble. This is what people normally think of when they think of stress – called allostatic overload – simply stress breaking bad.

Keeping stress in check

To ensure that we keep our stress levels at the optimum to ensure maximum productivity and growth, here are a few simple techniques. Remember, everyone handles stress differently, and so which of these techniques works best for you will be something you’ll have to learn by trying them.

Breathing

The simplest tool is breathing. Sounds a little silly really, since you obviously breathe all of the time! But we usually take shallow breaths, so our lungs are not being used to their full capacity. When we focus on our breathing and deliberately take slow, deep breaths we increase the amount of air going in, and therefore allow more oxygen to enter the blood stream. This better fuels our cells and helps them do their job more efficiently. However, it also sets in motion a physiological mechanism that slows our heart rate.

Our heart pumps blood from our body, through the lungs to get oxygenated. As we take a deep breath, more blood is sucked up into our chest cavity from our veins, because breathing in causes a temporary vacuum in our chest cavity. The extra blood then fills our heart more efficiently. A more efficient heart beat reduces the need for the body to stimulate the heart to pump harder. This promotes more of the parasympathetic “rest-and-digest” nervous system activity, and less of the sympathetic “fight-or-flight” nervous system, via the vagal brake mechanism.

So, to slow your breathing down simply sit in a comfortable position. Take slow, deep breaths, right to the bottom of your lungs and expanding your chest forward through the central “heart” area. Count to five as you breathe in (five seconds, not one to five as quickly as possible) and then count to five as you breathe out. Keep doing this, slowly, deeply and rhythmically, in and out. Pretty simple! This will help to improve the efficiency of your heart and lungs, and reduce your stress levels.

Remember, B.R.E.A.T.H.E. = Breathe Rhythmically Evenly And Through the Heart Everyday.

Meditation

Meditation takes the techniques of breathing one step further, in that meditation involves deliberately switching your brain’s focus to something simple, and in the present. Focussing on nothing – just breathing and turning off your thinking for while – does take some practice. Concentrating on something in the present (not thinking about the past or the future), tends to be easier and requires less practice, although ignoring all the other thoughts that routinely clamour for your attention might be hard when you first try it.

Focusing on the present moment is part of the practice of Mindfulness. Mindfulness meditation has been studied quite extensively over the last few decades, and has been shown to have benefits over a large number of psychological symptoms and disease states [4].

Sometimes it is easier to focus on something visual, that you can see easily in your field of view, or listen to something constant, like the ocean, or a metronome. The easiest thing to do is to again, focus on your breathing. Concentrate on the sound, rhythm and feeling of your breathing, but don’t engage your thoughts, or allow others to creep in. Meditation quietens the mind, which is excellent for reducing stress, and can help to revitalise and refresh your mind.

Guided Imagery

Guided imagery is a step along from meditation. Instead of focussing on something tangible, guided imagery lets you imagine that you are somewhere pleasant, relaxing, or rejuvenating. Some people describe it as a vivid daydream.

Get comfortable, close your eyes and start to breathe slowly and deeply. Once you begin to relax, imagine your favourite scene. It could be at the beach, or in a log cabin in the snow-capped mountains, or swimming in the cool waters in a tropical rain-forest. Whatever you choose, try to imagine the scene in as much detail as possible, and involve all five of your senses if you can, like, for example, the cool water of the waterfall on your bare skin, the sounds of the birds in the trees, the smell of the moss-covered rocks, the canopy of tall trees and vines split by the waterfall and stream allowing the sunlight to spill in to the forest floor. Enjoy the details and the relaxation that this brings. To “come back”, some recommend counting back from ten or twenty, and to tell yourself that when you reach one, you will feel calm and refreshed.

Guided imagery allows you to actively replace the harassing thoughts of your daily routine with pleasant soothing thoughts. There is some early scientific literature suggesting effectiveness, although more research is required [5, 6]. Again, with practice, this can be done anywhere, and can be done quickly if you need a short break to unwind.

Visualisations

Visualisations build on the techniques of guided imagery, but instead of the rain-forest or tropical paradise, you imagine yourself achieving goals, which again could be anything from improving your health, closing that deal, or hitting that perfect drive from the first tee. Again, try and imagine the scene in as much detail as you can, and involve all of your senses.

PMR

Progressive Muscle Relaxation, or PMR for short, is similar to meditation, except that you contract, hold, and then relax your muscle groups in turn. You concentrate on the feel of the tightening and relaxing of the muscles instead of, or as well as, your breathing. Like meditation, it can be done anywhere and involves very little training.

The contraction of the muscle groups, beginning in your feet – working your way up the calves and thighs, tummy, chest, arms and neck, sequentially pumps all of the blood back towards your heart, giving you a boost of blood flow to your lungs. The deep breathing oxygenates this extra blood and hence, gives your brain a burst of oxygen.

Using PMR to meditate helps engage the vagal brake, and there is some evidence that it helps to reduce persistent pain [7, 8].

Exercise

Exercise releases stress and enhances your physical health [9, 10]. It is flexible and easily adaptable – it is usually free and can often be done without any equipment. The downside is that it is not possible everywhere (you can’t go jogging in a plane), but as a daily discipline, it will enhance your physical and emotional wellbeing.

The benefits of exercise are firstly physical. It gets your heart pumping, the blood flowing and your lungs working to their full capacity. It builds physical fitness, which is important to enable the heart and lungs to work efficiently at all times. Exercise has effects on mood, improving depression [11] and anxiety [12].

It can also act as a form of meditation – the solitude of a run or swimming a few laps, concentrating only on the splash of your strokes or the pounding of your feet on the ground – is similar to meditation except that you’re moving (whereas meditation proper involves being still and relaxed). But the outcome is the same, and stress is often reduced by a session of physical exercise.

Music

Music is almost as fundamental to human existance as breathing, and it’s almost as diverse as mankind itself. Listening to ones favourite music can enhance feelings of control and can increase pain tolerance and improve short term anxiety (stress) [13]. The common characteristics of ‘therapeutic’ music was music which had less tonal (pitch) variation, less prominent chord changes, bass lines, or strong melodies [14].

But the key element was personal preference overall, as some of the participants in the study chose music like Metallica. So enjoy music. Make it part of your day. Even Country and Western may be considered therapeutic!

Yoga

Yoga is an ancient practice that has several components including physical postures (asanas), controlled breathing (pranayama), deep relaxation, and meditation.

It’s not for everyone, but it has clearly defined and scientifically validated benefits to your physical and psychological well-being. “It is hypothesized that yoga combines the effects of physical postures, which have been independently associated with mood changes and meditation which increases the levels of Brain-derived neurotrophic factor (BDNF). Other effects that have been noted include increased vagal tone, increased gamma-amino butyric acid (GABA) levels, increase in serum prolactin, downregulation of the hypothalamic-pituitary-adrenal axis and decrease in serum cortisol, and promotion of frontal electroencephalogram (EEG) alpha wave activity which improves relaxation.” [15] So, translated: Yoga is good for stress relief!

Most gyms and community centres will have yoga instructors, so go ahead and make some enquiries.

Massage

I love massage! The first time I had a proper massage was in the small city of Launceston in the tiny Australian state of Tasmania. After just 30 minutes of the therapist kneading my muscles with her fingers of iron, I felt pretty good, but when I sat up, I was actually light-headed for a little while. My heart rate and blood pressure had reduced so much that it took me a while before I could stand up properly!

Deep pressure massage has also been shown to help release the vagal brake enhancing the activity of the parasympathetic (rest-and-digest) part of the autonomic nervous system. There is good evidence of this effect in pre-term infants [16]. The evidence for adults isn’t so strong, although that’s probably because of a lack of quality research [17]. The good studies that have been done show a reduction of cortisol, blood pressure and heart rate after massage, with some studies showing small persistent effects [17].

The data might be thin, but there is enough evidence to make it worth trying at least once.

Probiotics

I add probiotics to this list as a reference for the future. There is good evidence of the anxiolytic effect of having a friendly bacteria garden in your intestines that interacts with your gut and your immune system in positive ways. But there is, at this point, very little in the way of good quality human clinical trials. And we still don’t know exactly which strains of probiotics are the most helpful for different conditions [18, 19]. But given that they are unlikely to be harmful, it may be worth trailing a course of probiotics, and see how you feel in 30 days.

The bottom line – stress is not the enemy. Sure, if it isn’t handled right, stress can overwhelm us and make us sick, but most of the time, stress makes us productive and strong, and helps us to grow. So, don’t stress about stress.

References

  1. McEwen, B.S. and Wingfield, J.C., What is in a name? Integrating homeostasis, allostasis and stress. Horm Behav, 2010. 57(2): 105-11 doi: 10.1016/j.yhbeh.2009.09.011
  2. Chrousos, G.P., Stress and disorders of the stress system. Nat Rev Endocrinol, 2009. 5(7): 374-81 doi: 10.1038/nrendo.2009.106
  3. McEwen, B.S., Stressed or stressed out: what is the difference? J Psychiatry Neurosci, 2005. 30(5): 315-8 http://www.ncbi.nlm.nih.gov/pubmed/16151535
  4. Keng, S.L., et al., Effects of mindfulness on psychological health: a review of empirical studies. Clin Psychol Rev, 2011. 31(6): 1041-56 doi: 10.1016/j.cpr.2011.04.006
  5. Jallo, N., et al., The biobehavioral effects of relaxation guided imagery on maternal stress. Adv Mind Body Med, 2009. 24(4): 12-22 http://www.ncbi.nlm.nih.gov/pubmed/20671330
  6. Trakhtenberg, E.C., The effects of guided imagery on the immune system: a critical review. Int J Neurosci, 2008. 118(6): 839-55 doi: 10.1080/00207450701792705
  7. Baird, C.L. and Sands, L., A pilot study of the effectiveness of guided imagery with progressive muscle relaxation to reduce chronic pain and mobility difficulties of osteoarthritis. Pain Manag Nurs, 2004. 5(3): 97-104 doi: 10.1016/j.pmn.2004.01.003
  8. Morone, N.E. and Greco, C.M., Mind-body interventions for chronic pain in older adults: a structured review. Pain Med, 2007. 8(4): 359-75 doi: 10.1111/j.1526-4637.2007.00312.x
  9. Fletcher, G.F., et al., Statement on exercise: benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation, 1996. 94(4): 857-62 http://www.ncbi.nlm.nih.gov/pubmed/8772712
  10. Warburton, D.E., et al., Health benefits of physical activity: the evidence. CMAJ, 2006. 174(6): 801-9 doi: 10.1503/cmaj.051351
  11. Rimer, J., et al., Exercise for depression. Cochrane Database Syst Rev, 2012. 7: CD004366 doi: 10.1002/14651858.CD004366.pub5
  12. DeBoer, L.B., et al., Exploring exercise as an avenue for the treatment of anxiety disorders. Expert Rev Neurother, 2012. 12(8): 1011-22 doi: 10.1586/ern.12.73
  13. MacDonald, R.A., Music, health, and well-being: a review. Int J Qual Stud Health Well-being, 2013. 8: 20635 doi: 10.3402/qhw.v8i0.20635
  14. Knox, D., et al., Acoustic analysis and mood classification of pain-relieving music. J Acoust Soc Am, 2011. 130(3): 1673-82 doi: 10.1121/1.3621029
  15. Balasubramaniam, M., et al., Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psychiatry, 2012. 3: 117 doi: 10.3389/fpsyt.2012.00117
  16. Field, T., et al., Preterm infant massage therapy research: a review. Infant Behav Dev, 2010. 33(2): 115-24 doi: 10.1016/j.infbeh.2009.12.004
  17. Moraska, A., et al., Physiological adjustments to stress measures following massage therapy: a review of the literature. Evid Based Complement Alternat Med, 2010. 7(4): 409-18 doi: 10.1093/ecam/nen029
  18. Bested, A.C., et al., Intestinal microbiota, probiotics and mental health: from Metchnikoff to modern advances: Part II – contemporary contextual research. Gut Pathog, 2013. 5(1): 3 doi: 10.1186/1757-4749-5-3
  19. Bested, A.C., et al., Intestinal microbiota, probiotics and mental health: from Metchnikoff to modern advances: part III – convergence toward clinical trials. Gut Pathog, 2013. 5(1): 4 doi: 10.1186/1757-4749-5-4

Going green – why envy is an adaptive process

The Bible says, in Job 5:2, “For wrath kills a foolish man, And envy slays a simple one.”

A German proverb goes, “Envy eats nothing, but its own heart.”

Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, posted today on her social media feeds, “Jealousy and envy creates damage in the brain … but … celebrating others protects the brain!”

Yes, sometimes envy isn’t good for us. Emotions guide our thought process, and like all emotions that are out of balance, too much envy can cloud our better rational judgement and bias our perception of the world. Thankfully, envy doesn’t literally eat out our hearts or literally cause brain damage.

If anything, envy when experienced in a balanced way can actually improve our brain functioning. According to real cognitive neuroscientists, envy and regret are emotions that help us because they both fulfil the role of effectively evaluating our past actions, which improves our choices in the future. As Coricelli and Rustichini noted, “envy and regret, as well as their positive counterparts, share the common nature that is hypothesized in the functional role explanation: they are affective responses to the counterfactual evaluation of what we could have gotten had we made a different choice. Envy has, like regret, a functional explanation in adaptive learning.” [1]

When it comes to the human psyche, there is no black or white, good vs evil distinction between different feelings or emotions. B-grade life coaches and slick pseudoscience salespeople dumb down our emotions into a false dichotomy because it helps sell their message (and their books). Every emotion can be either helpful or unhelpful depending on their context in each individual.

As Skinner and Zimmer-Gembeck wrote, “Emotion is integral to all phases of the coping process, from vigilance, detection, and appraisals of threat to action readiness and coordinating responses during stressful encounters. However, adaptive coping does not rely exclusively on positive emotions nor on constant dampening of emotional reactions. In fact, emotions like anger have important adaptive functions, such as readying a person to sweep away an obstacle, as well communicating these intentions to others. Adaptive coping profits from flexible access to a range of genuine emotions as well as the ongoing cooperation of emotions with other components of the action system.” [2]

If you find your thoughts and feelings tinged by the greenish hue of envy, don’t worry, it’s not necessarily a bad thing. Your heart isn’t going to consume itself and you won’t sustain any brain damage. Use envy or regret as tools of learning, tools to help you evaluate your choices so that you make a better choice next time. Having balanced emotions is the key to learning and growing, coping with whatever obstacles life throws at us.

References

  1. Coricelli, G. and Rustichini, A., Counterfactual thinking and emotions: regret and envy learning. Philos Trans R Soc Lond B Biol Sci, 2010. 365(1538): 241-7 doi: 10.1098/rstb.2009.0159
  2. Skinner, E.A. and Zimmer-Gembeck, M.J., The development of coping. Annu Rev Psychol, 2007. 58: 119-44 doi: 10.1146/annurev.psych.58.110405.085705

Dr Caroline Leaf and the law of great power

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Tonight as I was flicking through Facebook one last time, a post caught my eye. It read,

“The thought you are thinking right now is impacting every single one of the 75-100 trillion cells in your brain and body at quantum speeds”

Dr Leafs social media gem gave me an eerie sense of deja vu. It was only the end of October when she posted the same factoid on social media. Today’s version has been tweaked slightly, although in all fairness, I can’t describe it as an upgrade.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. On the 23rd of October 2014, she posted this on her social media stream, “Every thought you think impacts every one of the 75-100 trillion cells in your body at quantum speeds!”

On comparing the pair, Dr Leaf has added “brain” into the number of cells under the influence, and then massaged the opening slightly. I already had significant concern about the scientific validity of the previous meme in October. That hasn’t changed. Rather than improving the accuracy of her meme, Dr Leaf’s changes have left it missing the mark.

The fundamental fallacy that thoughts are the main controlling influence on our brain is still there. Thought is simply a conscious projection of one part of the overall function of our brain. Our brains function perfectly well without thought. Thought, on the other hand, doesn’t exist without the brain. Our brain cells influence our thoughts, not the other way around.

The myth of “quantum speeds” is still there. Our neurones interact with each other via electrochemical mechanisms. Like all other macroscopic objects, our brains follow the laws of classical physics. It’s not that quantum physics doesn’t apply to our brains, because quantum mechanics applies to all particles, but if you think you can explain macroscopic behaviour using quantum physics, then you should also try and explain Schrodingers Cat (see also chapter 13 of my book [1] for a longer discussion on quantum physics). Dr Leaf is particularly brave to make such bold statements about quantum physics when even quantum physicists find it mysterious.

What made me slightly embarrassed for Dr Leaf is the new part of her statement. In my blog on Dr Leaf’s previous attempt at this meme, I pointed out that Dr Leaf’s estimate of the number of cells in our body was more than three times that of the estimate of scientists at the Smithsonian (http://www.smithsonianmag.com/smart-news/there-are-372-trillion-cells-in-your-body-4941473/?no-ist). The fact that Dr Leaf so badly estimated, when all she needed to do was a one line Google search, suggested that she just made the number up. Failing to cite her source eroded at her credibility as a scientist.

Today, Dr Leaf still claims that there are 75-100 trillion cells in the brain and the body. The Smithsonian still hasn’t changed its estimate. Dr Leaf still hasn’t cited her source, and has ignored a world-renowned scientific institution. Perhaps Dr Leaf believes she knows more than the scientists at the Smithsonian? Perhaps she has a better reference? We’ll never know unless she cites it.

Taken as a whole, her meme is no closer to the truth than it was six weeks ago. Some may ask if it really matters. “Who cares if we have 37.2 trillion cells or 100 trillion cells or even 100 billion trillion”. “So what if our thoughts influence us or not.” If this was just a matter of a pedantic argument between some scientists over a coffee one morning,then I’d agree, it wouldn’t be so important. But Dr Leaf claims to be an expert, and more than 100,000 people read her memes on Facebook and many more on Twitter, Instagram, and the various other forms of social media she is connected to. Nearly every one of those people take Dr Leaf at her word. Ultimately the issue is trust.

If Dr Leaf can misreport such a simple, easily sourced fact, and not just once but twice now, then what does that mean for her other factoids and memes that she regularly posts on social media? If Dr Leaf incorrectly says that every thought we think impacts every cell in our body, then hundreds of thousands of people are wasting their mental and physical energy on trying to control their thoughts when it makes no real difference, and if anything might make their mental health worse [2, 3].

This is more than just a pedantic discussion over a trivial fact.  These memes matter to people, and can potentially influence the health and wellbeing of many thousands of lives.

Peter Parker, quoting Voltaire, said, “With great power comes great responsibility.”  Just because Spiderman said it doesn’t diminish the profundity of that statement.  This law of great power applies to Dr Leaf as much as it does to Spiderman.  I hope and pray that she gives this law of great power the consideration it deserves.

References

  1. Pitt, C.E., Hold That Thought: Reappraising the work of Dr Caroline Leaf, 2014 Pitt Medical Trust, Brisbane, Australia, URL http://www.smashwords.com/books/view/466848
  2. Garland, E.L., et al., Thought suppression, impaired regulation of urges, and Addiction-Stroop predict affect-modulated cue-reactivity among alcohol dependent adults. Biol Psychol, 2012. 89(1): 87-93 doi: 10.1016/j.biopsycho.2011.09.010
  3. Kavanagh, D.J., et al., Tests of the elaborated intrusion theory of craving and desire: Features of alcohol craving during treatment for an alcohol disorder. Br J Clin Psychol, 2009. 48(Pt 3): 241-54 doi: 10.1348/014466508X387071

Dr Caroline Leaf and the cart before the horse, take two

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In between her sightseeing in the UK and ballet concerts in the Ukraine, Dr Leaf, communication pathologist and self-titled cognitive neuroscientist, took the time to post some more memorable memes.

Today, Dr Leaf posted, “A chaotic mind filled with thoughts of anxiety, worry, etc. sends out the wrong signal right down to the level of our DNA.”

Hmmm, that one looked familiar … actually, Dr Leaf posted the exact same phrase on the 5th of October this year.  I’m all for recycling, but of renewable resources, not tired ideas.

This meme has been soundly rebuffed before, and the idea that the mind controls our DNA has been thoroughly dismantled.  Reposting it won’t make it any truer.

This meme is better off being put into the trash than the recycling bin.

(For more information on the rebuttal of the mind over matter meme, see also “Hold that thought: Reappraising the work of Dr Caroline Leaf“, “Dr Caroline Leaf: Putting thought in the right place” Part 1 and Part 2, “Dr Caroline Leaf and the matter of mind over genes“, “Dr Caroline Leaf, Dualism, and the Triune Being Hypothesis”, “Dr Caroline Leaf and the Myth of the Blameless Brain” and “Dr Caroline Leaf and the Myth of Mind Domination” just to name a few references).