Tag Archives: depression

The Prospering Soul – Christians and Depression Part 2

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For most church-goers, putting the terms “Christian” and “depression” in the same sentence just doesn’t seem natural. In part 1, we looked at what depression is and why depression affects a lot more of the church than the church is aware of.

In this instalment, we’ll look at some general ways to handle depression, and what the Bible says about being depressed.

In the first blog, I explained how I understood depression as the end result of the brains capacity to deal with the demands of life. Too many demands or not enough resources overwhelms the brain and low mood is the end result.

So how do you manage depression? Well, if the system is failing because of increased demand or decreased capacity to cope, then it’s logical to manage depression by decreasing demand and increasing capacity to cope.

We can increase our capacity to cope by increasing our brains capacity to grow new nerve branches, and to make the cells more efficient at doing their job.

Increasing the growth of new nerve cell branches (in science speak – ‘synaptogenesis’) involves increasing the growth factors. BDNF has been proven to be increased by anti-depressant medications [1, 2] and by exercise [3, 4]. There may be some evidence that diet might improve depression in a similar way although the evidence is weak [5], so we should take that with a grain of salt.

The next way of managing depression is to increase the capacity to cope. The way we do that is through psychological therapies. There are several styles of psychological therapies, too many for me to discuss them all here. In the real world, most psychologists use a mix of a number of techniques that they tailor to the needs of their patient. I’m going to quickly outline the two most commonly used therapies.

Cognitive Behavioural Therapy, or CBT for short, is “based on the theory that emotional problems result from distorted attitudes and ways of thinking that can be corrected. The aim is to treat difficulties by problem solving, finding better strategies for coping, and overcoming irrational fears.” [6] Essentially it’s the combination of two different therapies, Cognitive therapy, and Behavioural therapy. Cognitive therapy, as the name suggests, assumes that people have mental health problems because of patterns of irrational thinking. Behavioural therapy is quite broad, but looks to challenge the thinking patterns with action (for example: gradual exposure to something a person is afraid of).

CBT is the most well researched form of psychotherapy, and has a lot of evidence for it’s effectiveness [7]. Though there is good evidence that it’s the behavioural arm that gives it any clout [8, 9]. Trying to change your mental health just by trying to change your thoughts is generally ineffective.

In the last couple of decades, a new wave of psychological therapies has emerged from this idea that Cognitive Behavioural Therapy is just Behavioural Therapy with bling. The most notable is Acceptance and Commitment Therapy, or ACT for short. ACT is different to CBT in that ACT doesn’t rely on the idea of changing thoughts, but on simply accepting them. ACT “is a psychological therapy that teaches mindfulness (‘paying attention in a particular way: on purpose, in the present moment, non-judgementally’) and acceptance (openness, willingness to sustain contact) skills for responding to uncontrollable experiences and thereby increased enactment of personal values.” [10]

According to ACT, you don’t have to change your thoughts, because thoughts aren’t that powerful to begin with – they’re just words. Sometimes they’re true, and sometimes they’re helpful, but if we spent all of our time trying to fight them, we miss out on experiencing the joy in the present moment, and we can lose sight of the values that guide us into our future fulfilment.

The common link between good psychotherapy is that their therapeutic effect comes from improving skills in different areas that the patient lacks. That is, psychological therapies increase the capacity of the patient to cope with things that would have otherwise wouldn’t have handled well and would have caused distress.

The last way to manage depression is to limit the excessive demands that have been placed on the system in the first place, or in other words, reduce the unnecessary stressors. People who are depressed tend to be bad at this, but there are a few basic skills that are common to all stress management techniques that can form the platform of ongoing better skills in this area. The full list will be a blog for another time, but the simplest technique is to breathe!

It’s really simple. 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.

To recap, there are three main ways to manage depression – increase the brains ability to process the incoming information, increase the capacity to cope, and decrease the amount of stress that our brains have to process.

The fourth way to help manage depression is prayer. There is limited scientific information on the effects of prayer on depression, although a small randomised controlled trial did show that prayer with a prayer counsellor over a period of a number of weeks was more effective than no treatment [11]. But the Bible encourages us, “Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.” (Philippians 4:6-7)

And Jesus himself called to those heavy in heart, “Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light.” (Matthew 11:28-30)

One final thought. It’s sometimes hard to understand how strong Christians can become depressed in the first place. After all, the Bible says that the fruit of the Spirit is joy (Galatians 5:22). 1 Peter 1:8 seems to suggest that every Christian should be “filled with an inexpressible and glorious joy.”

So when you’re filled with the opposite, it makes you feel like a faithless failure, and Christians without depression assume a similar thing for Christians they know who are suffering from depression. It’s the logical conclusion to draw after all – if the fruit of the Spirit is joy, and you are not filled with joy, then you mustn’t be full of the Spirit.

But when you look through the greatest heroes in the Bible, you see a pattern where at one point or another in their lives, they went through physical and emotional destitution. Sure, their lives had some pretty amazing highs, but they often experienced some amazing lows as well. Moses spent forty years in the wilderness, and when God appeared to him in the burning bush, he argued with God about how weak and timid he was (Exodus 3 and 4).

In 1 Kings 18, Elijah had just seen God rain down fire to supernaturally consume his sacrifice, capture and kill four hundred and fifty prophets of Baal, and watched God break the drought over Israel. At the height of this run of amazing connection to God, Jezebel the evil queen threatened him, and he ran for his life in a panic and asked God to kill him, twice, over the period of a couple of months (1 Kings 19).

Peter had spent three years with Jesus, the Messiah himself, hearing him speak and watching him perform miracle after miracle after miracle. Peter even saw the empty tomb first hand on the very first Easter Sunday, but still, he gave up on life with God and went back to his former occupation, which turned out to be lots of hard work for very little reward (John 21:1-3).

The same pattern is also seen in King David, Gideon, and a number of other great leaders through the Bible. The take home message is this: it’s human nature to suffer from disease and dysfunction. Sometimes it’s physical dysfunction. Sometimes it’s emotional dysfunction. It’s not a personal or spiritual failure to have a physical illness. Why should mental illness be treated any different?

As the stories of Moses, Elijah and Peter testify, being a strong Christian doesn’t make you impervious to low mood or emotional fatigue. Hey, we’re all broken in some way, otherwise why would we need God’s strength and salvation! Having depression simply changes your capacity to experience the joy and love of God. Closing your eyes doesn’t stop the light, it just stops you experiencing the light. Being depressed makes it hard to experience God’s love, but it doesn’t stop God’s love.

In the 80’s and 90’s, a popular Christian musician was a man named Carmen. One of his best known songs had these words,

“When problems try to bury you and make it hard to pray, it may seem like Friday night, but Sunday’s on the way!”

It’s really hard when you’re afflicted by the dank darkness of depression. But nothing will separate us from the love of God (Romans 8:35-39), including depression. You may not feel it, but God’s love is there, and Sunday’s on the way.

Remember:

  1. Depression is a common mental health condition that can have prolonged and devastating consequences. Depression is characterised by either a sadness or a lack of joy which are abnormal in their intensity and their duration, but also affects sleep, appetite and motivation. It’s caused by abnormalities in genes which affect the brains ability to grow new nerve cell branches, and which also affect in-built coping mechanisms, so stress is both more likely to occur in people who are more prone to depression, and the stress is then handled poorly, overloading their emotional capacity.
  1. The management of depression is three-pronged: to improve the brains ability to grow new nerve cells through exercise and/or medication, to learn new ways to cope with distress, and to decrease the amount of stress in the first place.
  1. Christians are not immune from depression, and it’s important for Christians to understand that Christians suffering from depression are not weak, or failing in their spiritual walk, or are unloved by God. The love of God is always present, even if they are unable to process it properly. As dark and dismal as depression can become, there is hope. It may seem like Friday night, but Sunday’s on the way.

References

[1]        Duman RS, Li N. A neurotrophic hypothesis of depression: role of synaptogenesis in the actions of NMDA receptor antagonists. Philosophical transactions of the Royal Society of London Series B, Biological sciences 2012 Sep 5;367(1601):2475-84.
[2]        Anderson I. Depression. The Treatment and Management of Depression in Adults (Update). NICE clinical guideline 90.2009. London: The British Psychological Society and The Royal College of Psychiatrists, 2010.
[3]        Karatsoreos IN, McEwen BS. Resilience and vulnerability: a neurobiological perspective. F1000prime reports 2013;5:13.
[4]        Rimer J, Dwan K, Lawlor DA, et al. Exercise for depression. The Cochrane database of systematic reviews 2012;7:CD004366.
[5]        Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. The American journal of clinical nutrition 2014 Jan;99(1):181-97.
[6]        NowOK. Cognitive Behavioural Therapy. Dictionary of Psychotherapy 2015 [cited; Available from: http://www.dictionary.nowok.co.uk/cognitive-behavioural-therapy-cbt.php
[7]        Ruiz FJ. Acceptance and Commitment Therapy versus Traditional Cognitive Behavioral Therapy: A Systematic Review and Meta-analysis of Current Empirical Evidence. International journal of psychology and psychological therapy 2012;12(3):333-58.
[8]        Longmore RJ, Worrell M. Do we need to challenge thoughts in cognitive behavior therapy? Clinical psychology review 2007 Mar;27(2):173-87.
[9]        Dobson KS, Hollon SD, Dimidjian S, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. Journal of consulting and clinical psychology 2008 Jun;76(3):468-77.
[10]      Smout M. Acceptance and commitment therapy – pathways for general practitioners. Aust Fam Physician 2012 Sep;41(9):672-6.
[11]      Boelens PA, Reeves RR, Replogle WH, Koenig HG. A randomized trial of the effect of prayer on depression and anxiety. Int J Psychiatry Med 2009;39(4):377-92.

If you’re suffering from depression or any other mental health difficulties and need help, see your GP or a psychologist, or if you’re in Australia, 24 hour telephone counselling is available through:

Lifeline = 13 11 14 – or – Beyond Blue = 1300 22 4636

The Prospering Soul – Christians and Depression Part 1

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In the average charismatic church, from the time you park your car in the parking lot, to the time the music starts at the beginning of the service, the smiles of at least a hundred people beam at you, and at least one third of those smiles are also attached to enthusiastic handshakes and exhortations like, “Isn’t it great to be in church this morning!”

When you’re a Christian, especially at the happy-clappy end of the church spectrum, you’re supposed to be constantly full of the Holy Spirit and experiencing the joy of the Lord.

Which is why for most church-goers, putting the terms “Christian” and “depression” in the same sentence just doesn’t seem natural, even though depression affects a lot more of the church than the church is aware of.

So, how much of the church is affected by depression? The lifetime prevalence (how likely you are to suffer from depression at one stage through your life) is about twenty-five percent, or about one in four people. The point prevalence (those who are suffering from clinical depression at any particular time) is about six percent.

I used to attend a church which had a regular congregation of about 2500 people. So statistically, one hundred and fifty people in that congregation are suffering from depression every Sunday, and more than 600 will experience depression in their lifetime.

And by ‘depression’, we’re not talking about feeling a little sad … that Bill Shorten might become Prime Minister one day, or Ben Hunt can’t catch, or that One Direction isn’t the same without Zayn. Sadness for genuine reasons … you broke up with a long term partner, someone stole your purse out of your bag, or there’s the threat of redundancies at your office … also doesn’t mean you’re depressed.

The DSM5 is the current standard for psychiatric diagnoses around the world. I’ve included the full definition of depression at the end of this blog, but suffice to say, depression is more than just unhappiness. Proper depression symptoms “cause clinically significant distress or impairment in social, occupational or other important areas of functioning.” In other words, you’re so low that your social life or work is affected, and for more than two whole weeks. It’s also important to know that depression isn’t just low mood but can also be experienced as “Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day”.

Depression has a number of causes and correlations. People who are chronically unwell, be that from chronic pain, long term illness such as cancer or autoimmune disease, or life threatening illnesses such as those who’ve suffered from heart attacks or meningitis, have a higher rate of depression. People who have experienced significant physical or psychological trauma also have a higher rate of depression. In fact, stress of any form is highly correlated with depression (that is, people who suffer from any severe stress are more likely to develop depression).

This observation led to a theory about the development of depression, called the Stress Exposure Model of depression [1] – You develop depression because you’ve suffered from stress. This is one of the most common assumptions about depression in our society, and there are some important consequences from this line of thinking. Like, if being stressed is the cause of depression then the cure for depression is simply reducing stress. This is probably why most people assume that depression is a choice, or a simple weakness, and why depressed people are often told just to snap out of it.

But there’s more to depression than just better dealing with stress. Fundamentally, I understand depression as the end result of the brains capacity to deal with the demands of life. Too many demands or not enough resources overwhelms the brain and low mood is the end result.

Some depression is predominantly biological. People with biological depression can’t effectively deal with even a normal amount of demand on their system, because their brain doesn’t have the resources to process the incoming signals correctly or efficiently. The main biological cause is a deficiency of a growth factor called BDNF, which is needed for the nerve cells to grow new branches, which enable the brain to process new information. This theory is called the Neurotrophic Hypothesis of Depression [2] (‘neuro’ = nerve and ‘trophic’ = growth). BDNF isn’t the only critical factor in the biological story of depression. There are many others, including the stress hormone system [3], the serotonin system [4] and the dopamine/rewards system [5].

Some depression is predominantly psychological. There are certain situations in which there’s so much going on and so much change and adaptation is required, and the brains coping systems simply can’t cope. So, severe and sudden stressors would fit into this category. For example, people trying to cope with natural disasters, or a tragedy like a massive house fire.

Most of the time, depression is a combination of both biological and psychological. Genetic factors change our capacity to handle the incoming. The nerve cells don’t have enough BDNF and are slow to grow new branches. Genetics are also important in determining other mechanisms of resilience, and people with poor resilience are also more prone to depression [6-8]. Genetic factors also determine other factors involved in the way we process the incoming stream of sensory input – our personality. People with the neurotic personality type, the classical introverts/pessimists, are more prone to depression, because of the way their brain naturally biases the flavour of the incoming information [9]. What’s also very interesting is that these tendencies to depression also tend to create more stress [1, 10]. So stress is important to the risk of depression, but ironically, it is the risk of depression which influences the risk of stress.

The risk of depression is related to an increased tendency towards stress, and poor processing of that stress because of personality factors and a reduced capacity to cope. All three of these factors are influenced by a broad array of genetic factors.

What’s also important to see here is that being depressed isn’t because of “toxic thinking” or because of “negative confessions”. What we say and what we think are signs of what is going on underneath, not the cause of it. And more importantly, you can make as many faith-filled confessions as you like, but if they don’t help you to change your capacity to cope, then they’re just hot air.

In the next instalment, we’ll look at ways to handle depression, and what the Bible says about being depressed.

References

[1]        Liu RT, Alloy LB. Stress generation in depression: A systematic review of the empirical literature and recommendations for future study. Clinical psychology review 2010 Jul;30(5):582-93.
[2]        Duman RS, Li N. A neurotrophic hypothesis of depression: role of synaptogenesis in the actions of NMDA receptor antagonists. Philosophical transactions of the Royal Society of London Series B, Biological sciences 2012 Sep 5;367(1601):2475-84.
[3]        Hauger RL, Risbrough V, Oakley RH, Olivares-Reyes JA, Dautzenberg FM. Role of CRF receptor signaling in stress vulnerability, anxiety, and depression. Annals of the New York Academy of Sciences 2009 Oct;1179:120-43.
[4]        Caspi A, Hariri AR, Holmes A, Uher R, Moffitt TE. Genetic sensitivity to the environment: the case of the serotonin transporter gene and its implications for studying complex diseases and traits. The American journal of psychiatry 2010 May;167(5):509-27.
[5]        Felten A, Montag C, Markett S, Walter NT, Reuter M. Genetically determined dopamine availability predicts disposition for depression. Brain and behavior 2011 Nov;1(2):109-18.
[6]        Karatsoreos IN, McEwen BS. Resilience and vulnerability: a neurobiological perspective. F1000prime reports 2013;5:13.
[7]        Wu G, Feder A, Cohen H, et al. Understanding resilience. Frontiers in behavioral neuroscience 2013;7:10.
[8]        Russo SJ, Murrough JW, Han M-H, Charney DS, Nestler EJ. Neurobiology of resilience. Nature neuroscience 2012 November;15(11):1475-84.
[9]        Hansell NK, Wright MJ, Medland SE, et al. Genetic co-morbidity between neuroticism, anxiety/depression and somatic distress in a population sample of adolescent and young adult twins. Psychological medicine 2012 Jun;42(6):1249-60.
[10]      Boardman JD, Alexander KB, Stallings MC. Stressful life events and depression among adolescent twin pairs. Biodemography and social biology 2011;57(1):53-66.

The DSM5 Formal Diagnostic Criteria for Depression

A. Five (or more) of the following symptoms have been present during the same 2- week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

(Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.)

  • Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
  • Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
  • Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
  • Insomnia or hypersomnia nearly every day.
  • Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
  • Fatigue or loss of energy nearly every day.
  • Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
  • Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
  • Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

B. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.
C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

Dr Caroline Leaf – Still Contradicted by the Latest Evidence, Scripture and Herself

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Leaf Cognitive Neuroscientist

Dr Caroline Leaf is a communication pathologist, world renowned author, public speaker, and self-titled cognitive neuroscientist. Her influence continues to grow. She is regularly invited to speak at some of the world’s largest churches. She spoke at her first TEDx conference in February, and she’s about to host her own conference for the second time. She has more than 120,000 Facebook followers, with many more on Twitter and other social media platforms. And she continues to top the sales charts of Christian best sellers.

She is a self-marketing machine.

But there are cracks appearing. More and more, people are realizing that beneath the facade of her numerous Instagram posts, happy snaps, and the allure of popular success, Dr Leafs teachings on science and the Bible don’t match up with actual science and good theology. While many in the church adorn themselves with her teaching, a growing minority are starting to realise that the Emperor has no clothes.

Almost two years ago to the day, I sat in the congregation of Kings Christian Church on the Gold Coast, and heard Dr Leaf speak live for the first time. What I heard troubled me, and I blogged about my concerns to open a dialogue on Dr Leaf and her teaching. Her husband, Mr Mac Leaf, dismissed my concerns out of hand, which only steeled me to take further action. Now, two years of intense research, dozens of posts and a book later, people are starting to take notice.

Not that Dr Leaf has changed her tune. Her fundamental teaching still relies on the idea that our thoughts control our physical and mental health, and toxic thinking causes disease because our thoughts change our DNA and the expression of our genes through epigenetics. And, if we ‘detox’ our thoughts, we will be restored to the health that God intended. Dr Leaf is also expanding her ministry to the subject of mental health and she plans to release a book on food in early 2016.

Dr Leaf can spruik whatever she likes, but her claims of expertise and her scientific and scriptural legitimacy are crumbling.

This post is a little longer than usual, but I’ve divided it up for easier reading:

  1. Dr Leaf is contradicted by her own qualifications
  2. Dr Leaf is contradicted by science
  3. Dr Leaf is contradicted by scripture
  4. Dr Leaf is contradicted by Dr Leaf

1. Dr Leaf is contradicted by her own qualifications

In her books, on TV, at churches, and in promotional material, Dr Leaf describes herself as a ‘cognitive neuroscientist’.

However, Dr Leaf does not have formal qualifications in neuroscience, has not worked at a university as a neuroscientist, has not worked in any neuroscience research labs, nor has she published any papers in neuroscience journals.

Actually, Dr Leaf is trained as a communication pathologist. A communication pathologist is an allied health professional which seems to be unique to South Africa where Dr Leaf trained. It’s a synthesis of audiology and speech pathology. It qualified her to work as a therapist, which Dr Leaf did for children with traumatic brain injuries. Dr Leaf also researched a narrow band of educational psychology as part of her PhD, and she also worked in a number of schools and for educational boards in South Africa. Dr Leaf hasn’t performed any university based research since her PhD was published in 1997.

In contrast, true cognitive neuroscientists actively carry out research into the biological basis of thoughts and behaviours – either mapping behaviours to certain brain regions using electrical currents from the brain, or with functional brain imaging like fMRI, or stimulating or suppressing the activity of a region of the brain and seeing how a person responds.

Simply having some training in neuroanatomy and psychology doesn’t make you a cognitive neuroscientist. Completing a PhD that involved a model for learning doesn’t make you a cognitive neuroscientist. Reading a lot of books on neuroscience doesn’t make you a neuroscientist either, just like reading the Bible doesn’t automatically make you a Pastor.

So no matter how much Dr Leaf may try to convince us that she’s an expert cognitive neuroscientist, truth be told, she is not.

Of more concern is that Dr Leaf is also trying to position herself as an expert in the fields of mental health and nutrition. But if she can’t get her facts right in an area in which she’s had some training, then it’s unlikely Dr Leaf’s teaching will be reliable in areas that she’s had no formal training or experience whatsoever.

I might add, Dr Leaf’s insistence that she’s a cognitive neuroscientist and an expert on mental health and nutrition is also quite insulting for real psychologists, neuroscientists and nutritionists whose opinions are ignored in favour of a self-titled expert whose only ‘authority’ comes by popular demand, not training or experience.

2. Dr Leaf is contradicted by science

There are so many examples of Dr Leaf being directly contradicted by the science that she claims expertise in that I don’t have room in this blog to outline them all. What I can do in this limited space is to outline Dr Leaf’s most egregious and ironic fallacies as a taster.

The 98 percent

One of Dr Leaf’s most fundamental assertions is that “75 to 98 percent of mental and physical illness comes from ones thought life” [1]. She uses this little factoid all the time to justify her belief in the power of thoughts.

However, her statement is completely wrong. When considered in the historical and global context [2], most of human illness is related to preventable diseases that are so rare in the modern western world because of generations of high quality public health and medical care.

For example, Hunter et al state that, “diarrhoeal disease is the second most common contributor to the disease burden in developing countries (as measured by disability-adjusted life years (DALYs)), and poor-quality drinking water is an important risk factor for diarrhoea.” [3]

De Cock et al write, “Recent estimates of the global incidence of disease suggest that communicable diseases account for approximately 19% of global deaths” and that “2.5 million deaths of children annually (are) from vaccine-preventable diseases.” [4]

Routine screening with the much-maligned pap smear has decreased the death rate from cervical cancer in women by as much as 83% [5]. And having a competent midwife and obstetric support during childbirth can decrease the odds of dying in childbirth from 1 in 6 to less than 1 in 30,000 [6].

Midwives, vaccinations, pap smears, clean drinking water and internal plumbing have nothing to do with our individual thought life. We take all of this for granted in the first-world, so the impact of our thought life becomes artificially inflated. In reality, modern medicine and civil engineering, not our thought life, have everything to do with our good health..

Though what makes this meme such a good example of the weakness of Dr Leaf’s teaching is not just because it’s contradicted by actual science, but in trying to justify her conjecture, Dr Leaf has resorted to twisting, misquoting, and generally fudging information from her ‘sources’ in order to make them support her false conclusions.

For example, Dr Leaf quoted a source on genetics that was over thirty years old, from a time when genetic studies were still in the dark ages. She also misquotes her sources, significantly changing the meaning of the quotes in the process. One source didn’t even mention the figure she attributed to it. As if that’s not bad enough, Dr Leaf also cites biased sources, pseudoscientists, and other sources that directly contradict her assertion [7; Ch 10].

This pattern of relying on mistruths and factoids to paper over the gaping cracks in her irrational assertions is repeated throughout her teaching.

The heart is a mini-brain

Dr Leaf believes that the human heart acts as a mini-brain. She states that the heart has its own thought functions, is an electrophysiological regulator of every cell in the body, and is the source of the human conscience.

Such an assertion is ludicrous, and science proves it to be so – the “still small voice” comes from our brains [8-10], and everyday office-based medical tests prove that the electromagnetic signal from the heart is too small to have any meaningful influence on our body’s cells, let alone our thinking [7: Ch 11].

You control your DNA with your thoughts

Dr Leaf believes that our thinking can influence our DNA. She said this in her 2013 book [1: p35], and several times on her social media streams. The problem for Dr Leaf is that there is no credible scientific evidence that DNA is controlled by thoughts.

Her main evidence comes from a poster presentation at a 1993 psychotronics conference titled, “Local and nonlocal effects of coherent heart frequencies on conformational changes of DNA” [11]. She describes this paper as, “An ingenuous experiment set up by the HeartMath Foundation (which) determined that genuine positive emotion, as reflected by a measure called ‘heart rate variability’, directed with intentionality towards someone actually changed the way the double helix DNA strand coils and uncoils. And this goes for both positive and negative emotions and intentions.” [1: p111]

Actually, the experiment was based on faulty assumptions, and so full of flaws in the methodology and analysis, that it could show nothing at all [7: Ch 13]. All it could prove was that Dr Leaf was so desperate to grasp hold of anything that seemed to support her theory that she was willing to use a twenty-year-old study from a group of pseudoscientists that also believe in occult practices like ESP and telekinesis (http://psychotronics.org).

On and on, the same pattern continues. She claims that our thoughts are powerful enough to control our DNA and our brain, except that the opposite is true – it’s our DNA code, with some influence from our environment, that creates our pattern of neurons responsible for our stream of thoughts. She teaches that thoughts cause stress, when again, the evidence is the opposite – psychological stress starts as a subconscious process which changes our stream of thoughts. Dr Leaf teaches that in order to improve our mental and physical health, we need to fight any ‘negative’ or ‘toxic’ thoughts, when studies show that cognitive therapy isn’t effective when compared to behavioural activation. (This is explained in more detail, and with the appropriate references, in my book [7]).

Dr Leaf even goes so far as to say that our thoughts can control physical matter! [1: p33,38]

Over and over again, Dr Leaf’s teaching conflicts with modern science. That Dr Leaf also regularly misquotes her sources and relies on unpublished opinion from pseudoscientists and new-age practitioners also brings her reputation as an expert scientist into disrepute.

3. Dr Leaf is contradicted by scripture

In her books and on social media, Dr Leaf often quotes scripture in an attempt to reinforce her reputation as some form of Biblical expert. Everything’s fine when she simply quotes scripture, but problems arise when she tries to interpret it. Like her use of science, Dr Leaf often misquotes or paraphrases scripture, or uses it out of context, in order to try and Biblically justify her tenuous hypotheses.

2 Timothy 1:7

One of Dr Leaf’s favourites is 2 Timothy 1:7: “For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.” Dr Leaf interprets the phrases of “spirit of fear” and “a sound mind” as “anxiety” and “mental wholeness” respectively. For example, on the 12th of May 2014, she posted to her social media feeds, “Your mind is all-powerful. Your brain simply captures what your mind dictates. 2 Timothy 1:7” And in her book “Switch on your brain” [1], she said on page 33, “For now, rest in the assurance that what God has empowered you to do with your mind is more powerful and effective than any medication, any threat, any sickness, or any neurological challenge. The scripture is clear on this: You do not have a spirit of fear but of love, power and a sound mind (2 Tim 1:7).”

Simply checking the verse in its full context, and in a different translation, shows it in a completely different light to the way Dr Leaf promotes it. From the NIV, “I am reminded of your sincere faith, which first lived in your grandmother Lois and in your mother Eunice and, I am persuaded, now lives in you also. For this reason I remind you to fan into flame the gift of God, which is in you through the laying on of my hands. For the Spirit God gave us does not make us timid, but gives us power, love and self-discipline. So do not be ashamed of the testimony about our Lord or of me his prisoner. Rather, join with me in suffering for the gospel, by the power of God.” (2 Timothy 1:5-8)

The Greek word for “fear” in this scripture refers to “timidity, fearfulness, cowardice”, not to anxiety or terror. The Greek word that was translated “of a sound mind” refers to “self-control, moderation”, not to mental wholeness. So Paul is teaching Timothy that God doesn’t make him timid, but full of power, love and self-control. Paul is simply saying that through the Holy Spirit, we have all the tools: power, love and the control to use them, so we don’t have to be afraid.

This scripture has nothing to do with our mental health. It certainly doesn’t say that our minds are “more powerful and effective than any medication, any threat, any sickness, or any neurological challenge”. Dr Leaf’s use of this scripture is misleading.

Proverbs 23:7

Another favourite of Dr Leaf’s is Proverbs 23:7, “For as he thinketh in his heart, so is he”.

She used this scripture a number of times on her social media feeds, including on the 4/2/2015, “‘The more you believe in your own ability to succeed, the more likely it is that you will. Shawn Achor’ – ‘For as he thinketh in his heart, so is he …’ Proverbs 23:7”, and the 29/5/2015, “Mind In Action: ‘Genes cannot turn themselves on or off. In more scientific terms, genes are not ‘self-emergent’. Something in the environment has to trigger gene activity.’ Dr Bruce Lipton’ – That ‘something’ is your thoughts! Read Proverbs 23:7”. Dr Leaf also used the same scripture to try and explain how the woman with the issue of blood managed to obtain her healing [1: p111].

What’s interesting is how Dr Leaf only ever uses the first half of this verse. The whole verse (in the King James Version) reads, “For as he thinketh in his heart, so is he: Eat and drink, saith he to thee; but his heart is not with thee.”

So what’s with the second half of the verse? What’s the eating and drinking half of the verse got to do with our thought life?

The explanation is that this verse has nothing to do with our thought life at all. Dr Leaf has simply been misquoting it for years, and no one checked to see if she’s right. According to the Pulpit commentary found on the Bible Hub website, “The verb here used is שָׁעַר (shaar), ‘to estimate … to calculate’, and the clause is best rendered, ‘For as one that calculates with himself, so is he’. The meaning is that this niggardly host watches every morsel which his guest eats, and grudges what he appears to offer so liberally … He professes to make you welcome, and with seeming cordiality invites you to partake of the food upon his table. But his heart is not with thee. He is not glad to see you enjoy yourself, and his pressing invitation is empty verbiage with no heart in it.” (http://goo.gl/nvSYUh)

Thus, the scripture does not prove that our thoughts define us as Dr Leaf would suggest. Dr Leaf’s use of this scripture is misleading.

James 1:21

Another example, on the 26 May 2014 on her social media feeds, Dr Leaf said, “James 1:21 How you react to events and circumstances of your life is based upon your perceptions” and then a week later, “James 1:21 Our thoughts and perceptions have a direct and overwhelmingly significant effect of the cells of our body” (4/6/2014).

Except that James 1:21 actually says, “Wherefore lay apart all filthiness and superfluity of naughtiness, and receive with meekness the engrafted word, which is able to save your souls”, and has absolutely nothing to do with our perceptions and our cellular biology.

The same pattern is repeated on social media and in her books. Dr Leaf finds scriptures where one version mentions words like “thinking” or “choice”, isolates them from their context and reinterprets them to suit her meaning, rather the actual meaning of the verse in the original language and the original context.

4. Dr Leaf is contradicted by Dr Leaf

Not only is Dr Leaf’s teaching contrary to science and scripture, but even her own teaching contradicts itself. Dr Leaf also makes claims about her research and achievements that aren’t backed up by her published papers.

To gift or not to gift …

In her 2009 book, “The gift in you” [12], Dr Leaf teaches about the gifts that we have, specifically, our gifts are something uniquely hardwired into our brain, something that we cannot change even if we wanted to, and that it’s our brain structure that gives rise to the way in which we think, the actions that we take, and the gifts we are given from God.

On page 47, Dr Leaf said,

“The mind is what the brain does, and we see the uniqueness of each mind through our gifts. This, in itself is delightful and, intriguing because, as you work out your gift and find out who you are, you will be developing your soul and spirit.” (Emphasis added)

This quote in and of itself isn’t actually that significant until we compare it to a quote from the first chapter of Dr Leaf’s 2013 book, “Switch on your brain.” [1]

“The first argument proposes that thoughts come from your brain as though your brain is generating all aspects of your mental experience. People who hold this view are called materialists. They believe that it is the chemicals and neurons that create the mind and that relationships between your thoughts and what you do can just be ignored.
So essentially, their perspective is that the brain creates what you are doing and what you are thinking. The mind is what the brain does, they believe, and the ramifications are significant. Take for example, the treatment of depression. In this reductionist view, depression is a chemical imbalance problem of a machinelike brain; therefore, the treatment is to add in the missing chemicals.
This view is biblically and scientifically incorrect.” [1: p31-32] (Emphasis added)

So … our gifts are hardwired into our brain and can’t be changed because our mind is what our brain does OR our brain is what our mind does, so our gifts aren’t uniquely hardwired into our brain, and we should be able to change our gifting if we want to, based on our choices. Which is it? It can’t be both. Dr Leaf’s fundamental philosophies are mutually exclusive.

Now, we all make innocent mistakes. No one is perfectly congruent in everything they say. But this isn’t just getting some minor facts wrong. These statements form the foundation for Dr Leaf’s major works, and are in print in two best selling books, from which she has used to present countless sermons and seminars around the globe.

To summarise, Dr Leaf has directly called her own beliefs and teaching “biblically and scientifically incorrect”, and not noticed. The confusion and embarrassment are palpable.

But wait, there’s more.

(Not) Making a Difference

From the pulpit, in her books, and in her promotional material, Dr Leaf refers to her ground-breaking research – how her “Switch On Your Brain 5 Step Learning Process” and the Geodesic Information Processing model (which underpins her program), have helped thousands of children to increase their learning and improve their academic results.

For example, Dr Leaf claims that, “The Switch On Your Brain with the 5-Step Learning Process® was assessed in a group of charter schools in the Dallas [sic]. The results showed that the students’ thinking, understanding and knowledge improved across the board. It was concluded that The Switch On Your Brain with the 5-Step Learning Process® positively changed the way the students and teachers thought and approached learning.” (http://drleaf.com/about/dr-leafs-research/ – Original emphasis)

In her TEDx talk, Dr Leaf stated, “I wasn’t sure if this was going to have the same impact cause until this point I’d been working one on one. Well I’m happy to tell you that we had the same kind of results … The minute that the teachers actually started applying the techniques, we altered the trend significantly.” and,
“I stand up here saying this with conviction because I have seen this over and over and over in so many different circumstances … in this country I worked in Dallas for three years in charter schools, and we found the same thing happening.” [13]

Though there is the minor problem of her research results not demonstrating any actual change.

In Dr Leaf’s first case, Dr Leaf herself admitted that the demonstrated improvement of her single patient was just as likely to be related to spontaneous improvement, and not Dr Leaf’s intervention. In Dr Leaf’s PhD thesis, the students improved almost as much in the year without Dr Leafs intervention as they did with her program. In the Dallas charter schools study, Dr Leaf’s intervention either disadvantaged the students or showed no significant difference. In academic circles, Dr Leaf’s research hasn’t so much as generated a stale whimper [14].

So while Dr Leaf may claim that her research has changed the learning and lives of thousands of students all over the world, but her own published research disputes her claims.

The Emperor has no clothes, but no one wants to say anything

In Hans Christian Andersen’s legendary tale, the Emperor was conned by two swindlers into believing that “they were weavers, and they said they could weave the most magnificent fabrics imaginable. Not only were their colors and patterns uncommonly fine, but clothes made of this cloth had a wonderful way of becoming invisible to anyone who was unfit for his office, or who was unusually stupid.”

If you don’t know the story, you can read it here. In the end, the Emperor was duped so badly that he paraded in front of all his subjects au naturel, but “Nobody would confess that he couldn’t see anything, for that would prove him either unfit for his position, or a fool. No costume the Emperor had worn before was ever such a complete success.”

My analogy here is not to suggest that Dr Leaf is deliberately conning the church. Rather, our natural instinct is to suppress our own judgement, even when it’s right, in favour of everyone else’s. We assume information to be true because others in authority tell us it is. We assume that the Emperor must be wearing something because the trusted ministers and noblemen are holding his imaginary train high in the air.

Likewise, it’s very natural for Christians to believe that Dr Leaf’s teaching must be ok because our pastors and leaders vouch for it. Our pastors and leaders vouch for Dr Leaf’s teaching because it’s been endorsed by world-renowned Christian leaders like Kenneth Copeland and Joyce Meyer. And no one wants to say anything, because they don’t want to look sheepish (or be ostracised). Dr Leaf’s ministry may look like a complete success, but only until someone finally says, “But, the Emperor has no clothes …”

It’s time to call Dr Leaf’s ministry for what it is. In my humble opinion, I suggest that Dr Leaf’s ministry is not based on scientific acumen, but on popularity and reputation. And her reputation, in turn, is based on slick self-promotion and an availability cascade (a self-reinforcing process by which an idea gains plausibility through repetition).

Dr Leaf’s teachings are not supported by science, nor by scripture. Her own fundamental philosophies contradict each other. Her assertions about her title and the results of her work are in conflict with her own official data.

Our church leaders need to come clean about why they publicly endorse Dr Leaf’s ministry. I can justify why I think Dr Leaf should not be preaching from our pulpits – in this and many other blog posts, and in my 68,000 word rebuttal to Dr Leaf’s published works. Can Kenneth Copeland and Joyce Meyer, or churches such as Cottonwood Church or Hillsong Church, produce evidence where they performed due diligence on Dr Leaf’s scientific credibility before endorsing her ministry? I would be happy to publish any responses they may be willing to make, complete and unabridged.

If Dr Leaf is preaching at your church, politely ask your pastor to produce his or her evidence that Dr Leaf’s teaching is scientifically and scripturally sound. If your church leaders can’t show that Dr Leaf’s teachings are scientifically and scripturally accurate, then politely ask them why she’s been invited to preach from their pulpit or to sell her wares in your church? Feel free to share your experiences in the comments section.

Critics and sceptics love to use any opportunity they can to embarrass the church, but by parading our own naivety, we’re simply embarrassing ourselves.

It’s time we dressed ourselves in God’s glory, not our own ignorance and ignominy.

References

[1]        Leaf CM. Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. Grand Rapids, Michigan: Baker Books, 2013.
[2]        World Health Organization. GLOBAL HEALTH ESTIMATES SUMMARY TABLES: DALYs by cause, age and sex. In: GHE_DALY_Global_2000_2011.xls, editor. Geneva, Switzerland: World Health Organization,, 2013.
[3]        Hunter PR, MacDonald AM, Carter RC. Water supply and health. PLoS medicine 2010;7(11):e1000361.
[4]        De Cock KM, Simone PM, Davison V, Slutsker L. The new global health. Emerging infectious diseases 2013 Aug;19(8):1192-7.
[5]        Dickinson JA, Stankiewicz A, Popadiuk C, Pogany L, Onysko J, Miller AB. Reduced cervical cancer incidence and mortality in Canada: national data from 1932 to 2006. BMC public health 2012;12:992.
[6]        Ronsmans C, Graham WJ, Lancet Maternal Survival Series steering g. Maternal mortality: who, when, where, and why. Lancet 2006 Sep 30;368(9542):1189-200.
[7]        Pitt CE. Hold That Thought: Reappraising the work of Dr Caroline Leaf. 1st ed. Brisbane, Australia: Pitt Medical Trust, 2014.
[8]        Mendez MF. The neurobiology of moral behavior: review and neuropsychiatric implications. CNS spectrums 2009 Nov;14(11):608-20.
[9]        Zysset S, Huber O, Ferstl E, von Cramon DY. The anterior frontomedian cortex and evaluative judgment: an fMRI study. NeuroImage 2002 Apr;15(4):983-91.
[10]      Glascher J, Adolphs R, Damasio H, et al. Lesion mapping of cognitive control and value-based decision making in the prefrontal cortex. Proceedings of the National Academy of Sciences of the United States of America 2012 Sep 4;109(36):14681-6.
[11]      Rein G, McCraty R. Local and nonlocal effects of coherent heart frequencies on conformational changes of DNA. Proc Joint USPA/IAPR Psychotronics Conf, Milwaukee, WI; 1993; 1993.
[12]      Leaf CM. The gift in you – discover new life through gifts hidden in your mind. Texas, USA: Inprov, Inc, 2009.
[13]      Leaf CM. Ridiculous | TEDx Oaks Christian School | 4 Feb 2015. YouTube: TEDx, 2015;20:03.
[14]      Pitt CE, The TEDx Users Guide to Dr Caroline Leaf, cedwardpittcom; 2015   Mar 26, https://cedwardpitt.com/2015/03/26/the-tedx-users-guide-to-dr-caroline-leaf/

Seven Elements of Good Mental Health: 5. Be grateful – The Prospering Soul

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Life shouldn’t just be about avoiding poor health, but also enjoying good health. Our psychological health is no different.

Before we take a look at poor mental health, let’s look at some of the ways that people can enjoy good mental health and wellbeing. This next series of posts will discuss seven elements that are Biblically and scientifically recognised as important to people living richer and more fulfilling lives.

These aren’t the only ways that a person can find fulfilment, nor are they sure-fire ways of preventing all mental health problems either. They’re not seven steps to enlightenment or happiness either.   But applying these principles can improve psychosocial wellbeing, and encourage good mental health.

5. Be grateful

As I was trolling through Facebook the other day, I came across this post by Sir Richard Branson, founder of Virgin: “Thanked an airport security worker, he said I was the first to say #ThankYou in three years. Shocked! Saying thank you should be second nature …”

Richard Branson Thank You

Perhaps the security worker was exaggerating for the billionaire, or perhaps everybody hates airport security at the airport where he works. At any rate, three years is a long time to go without someone saying thanks.

As Sir Richard said, “Saying thank you should be second nature …”. Saying thanks is a small part of the much larger psychology of gratitude, which is “part of a wider life orientation towards noticing and appreciating the positive in the world” [1]. In fact, there are several components to the overall orientation of gratitude, including “(1) individual differences in the experience of grateful affect, (2) appreciation of other people, (3) a focus on what the person has, (4) feelings of awe when encountering beauty, (4) behaviors to express gratitude, (5) focusing on the positive in the present moment, (6) appreciation rising from understanding life is short, (7) a focus on the positive in the present moment, and (8) positive social comparisons.” [1]

The research suggests that people who are naturally grateful tend to be less angry and hostile, less depressed, less emotionally vulnerable, and experienced positive emotions more frequently. Gratitude also correlated with traits like positive social functioning, emotional warmth, gregariousness, activity seeking, trust, altruism, and tender-mindedness. Grateful people also had higher openness to their feeling, ideas, and values, and greater competence, dutifulness, and achievement striving.

However, these effects may be simply an association of gratitude with other personality traits. In other words, people who are naturally optimistic or conscientious are also more likely to be thankful, rather than the thankfulness causing someone to be more optimistic or conscientious. There are a few studies that show gratitude interventions improving self-worth, body image, and anxiety, although the evidence is that while gratitude was better than doing nothing, it was equal to, not superior to, currently accepted psychological interventions.

Even though gratitude may not be better than standard psychological treatments, it’s better than being ungrateful.  It’s also something that the Bible exhorts us to do (“In everything give thanks, for this is the will of God in Christ Jesus, concerning you.” – 1 Thess 5:18).  And let’s face it, it’s pretty easy to do.

The best studied gratitude intervention is a gratitude diary – writing something down every day that you are thankful for [1]. It doesn’t have to be long. A single sentence or phrase is good enough. Not that it has to be written if that’s not your thing. I had a friend who was determined to do a gratitude journal, but she also has a love and a knack for photography. So, she decided to take a photo a day of something that she was grateful for, and post it on Facebook. She had her moments where she doubted herself, struggled to find a subject of her gratitude, or struggled to find something unique, especially after day 300, but the end result was amazing. She grew in her gratitude and her photographic skill, and I often found myself blessed by her beautiful images and insights.

So, be thankful and express it in your own unique way.

References

[1]        Wood AM, Froh JJ, Geraghty AW. Gratitude and well-being: a review and theoretical integration. Clinical psychology review 2010 Nov;30(7):890-905.

Seven Elements of Good Mental Health: 4. Show some SSAS – The Prospering Soul

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Life shouldn’t just be about avoiding poor health, but also enjoying good health. Our psychological health is no different.

Before we take a look at poor mental health, let’s look at some of the ways that people can enjoy good mental health and wellbeing. This next series of posts will discuss seven elements that are Biblically and scientifically recognised as important to people living richer and more fulfilling lives.

These aren’t the only ways that a person can find fulfilment, nor are they sure-fire ways of preventing all mental health problems either. They’re not seven steps to enlightenment or happiness either.   But applying these principles can improve psychosocial wellbeing, and encourage good mental health.

4. Show some SSAS

SSAS stands for Supple, Strong and Skilful. This applies physically and mentally.

Physical fitness is good for us. This isn’t the main point of the blog, but I have never seen a study that shows exercise to be a bad thing. Ultimately, it’s not how fat you are that’s important for your longevity, it’s how fit you are [1, 2]. And the way to get fit is to exercise.

Physical exercise is not just good for the body but good for the brain as well. While the exact pathways are still being determined, there’s good evidence that moderate regular physical activity improves the balance of pro- and anti-inflammatory mediators in the body and in the brain. In the brain, this improves the overall function of our brain cells and their ability to form new pathways, which in turn, has been shown to improve mood disorders like anxiety and depression [3].

But being SSAS isn’t just about what being physically fit and active can do for your mood, but it also relates to being psychologically flexible and using psychological skills to leverage your strengths rather than just fighting with your weaknesses. One of the keys here is acceptance. Remembering your values that we spoke about in key 1 as your guide, exploit the things that you’re good at, using them to gain some self-confidence and momentum. Accept the things that can’t be changed in your life. Then when you have some momentum, learn some new skills to increase your resilience and strengthen your weaknesses.

I say this because sometimes we spend so much time focussing on all the bad things in our lives that we forget about the good things that we already have or can already do. It would be like an athlete spending all their time in the gym, getting really fit and strong, but never getting onto the field or court. It’s important that we courageously challenge ourselves to turn our weak points into strong points, but it’s more important to do what we can to help others around us.

References

[1]        Barry VW, Baruth M, Beets MW, Durstine JL, Liu J, Blair SN. Fitness vs. fatness on all-cause mortality: a meta-analysis. Progress in cardiovascular diseases 2014 Jan-Feb;56(4):382-90.
[2]        Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. Journal of the American College of Cardiology 2014 Apr 15;63(14):1345-54.
[3]        Moylan S, Eyre HA, Maes M, Baune BT, Jacka FN, Berk M. Exercising the worry away: how inflammation, oxidative and nitrogen stress mediates the beneficial effect of physical activity on anxiety disorder symptoms and behaviours. Neuroscience and biobehavioral reviews 2013 May;37(4):573-84.

The Prospering Soul – Just what is mental health?

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When Paul wrote to the church at Thessalonica a couple of thousands years ago, he said, “May God himself, the God who makes everything holy and whole, make you holy and whole, put you together—spirit, soul, and body—and keep you fit for the coming of our Master, Jesus Christ.” (1 Thessalonians 5:23 -The Message)

The modern western church has two out of three. As modern Christians, we have the fitness of the Spirit pretty well down, and we’re not too shabby on our physical fitness either. Unfortunately, we still have a way to go on the Soul thing.

In 2013, Rick Warren stood in front of his church after the suicide of his son, and promised he would work to reduce the stigma of mental illness in the Christian church (http://swampland.time.com/2013/07/28/rick-warren-preaches-first-sermon-since-his-sons-suicide/). Rick Warren experienced the stigma and destruction of poor mental health first hand. So have many others in the church, as have I.

It’s my passion to help the Christian church prosper, our bodies, our spirits, AND our souls.   Over the next few months, I’ll be doing a series of blogs on mental health, to encourage and help those in the church battling mental illness, and everyone else in the church to know how to assist them in their battle.

Together, we can help to eliminate the stigma and destruction that mental health can bring into the lives of Christians, and that we may prosper in all things and be in health, just as our soul prospers (3 John 1:2).

To start with, it would help if we knew what it meant to be in good mental health, and what separates mental health from mental illness. The distinction isn’t always so obvious. There are a few ways to define or conceptualise mental health and illness, but to cut through the thousands of words of medical and scientific jargon, the difference between good mental health and bad mental health is often to do with changes to our thinking, mood, or behaviour, combined with distress and/or impaired functioning. [1] Our mental health is intimately linked with our physical health, and often physical illness will lead to changes to our thinking, mood, or behaviour, combined with distress and/or impaired functioning too, although strictly speaking, that’s not a pure mental health disorder.

What IS important for the average church goer to understand is that we all experience some changes to our mental health at different times in our lives. For example, we all experience grief and loss at some time in our lives, and at that time, it’s normal to experience extreme sadness, sleeplessness, anger, or guilt. What differentiates grief from depression is the trigger, and the time the symptoms take to resolve. In general, how we perceive our thoughts and behaviours, and how much any signs and symptoms affect our daily activities can help determine what’s normal for us.

There are some common signs that can help in knowing if professional help may be needed. This isn’t an exhaustive list, but if you or a loved one experiences:

  • Marked change in personality, eating or sleeping patterns
  • Inability to cope with problems or daily activities
  • Strange or grandiose ideas
  • Excessive anxiety
  • Prolonged depression or apathy
  • Thinking or talking about suicide
  • Drinking alcohol to excess or taking illicit drugs
  • Extreme mood swings or excessive anger, hostility or violent behaviour

then consult your family doctor or psychologist, or encourage your loved one to seek help. With appropriate support, you can identify mental health conditions and explore treatment options, such as medications or counselling.

Many people who have mental health conditions consider their signs and symptoms a normal part of life or avoid treatment out of shame or fear. If you’re concerned about your mental health or a loved one’s mental health, don’t hesitate to seek advice.

If you or a loved one have, or still struggle with, mental illness, I welcome your comments.

I can’t give specific counselling or advice in this forum, but if you are suffering from mental health problems and need help, see your GP or a psychologist, or if you’re in Australia, 24 hour telephone counselling is available through:

Lifeline = 13 11 14 – or – Beyond Blue = 1300 22 4636

References

  1. National Institute of Mental Health, Mental Health: A Report of the Surgeon General, U.S. Department of Health and Human Services, Editor 1999, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services: Rockville, MD.

Gluten mad!

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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

Don’t stress about stress, part 2

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ThatWhichDoesNotKillUs

In the last blog post, we looked at some of the different ways of looking at stress outside of the medical field – the stress on a guitar string, the power band of the car engine, and the action of gravity on our bodies. In this post, I want to expand on those metaphors, using them to help us understand how we can respond to stress, and why stress isn’t our enemy, but it actually brings out our best if managed in the right way.

One of the reasons why gravity gives you strong muscles and bones, and zero gravity gives you weak muscles and bones, is because of resistance.

Movement involves work. We do “work” everyday in simple everyday activities, because our muscles and bones have to apply a certain amount of force in order to overcome gravity. Our muscles adapt by growing the muscle fibres to provide that force, and bones remodel themselves to provide the maximum resistance to the loads that gravity and the muscles put through them. We’re not aware of this day-to-day because we never experience prolonged changes in our gravitational fields.

But when we need to do more work than our muscles are accustomed to, our muscle fibres increase in strength, first as the nerve networks that supply the muscles become more efficient, after about two weeks of ongoing training, the fibres themselves increase in size [1, 2]. The growth in muscle fibres is caused by three related factors: mechanical tension, muscle damage and metabolic stress [2]. Mechanical tension involves “force generation and stretch”. In other words, the muscle fibres are stretched just beyond their usual capacity, and they actively fight against the resistance. This damages the weaker muscle fibres, which are repaired. The remaining muscle fibres are forced to adapt by growing larger because of the stimulation of growth factors [2].

One of my favorite “Demotivator” posters says, “That which does not kill me postpones the inevitable” [3]. Of course, the phrase that they’ve parodied is, “That which does not kill us makes us stronger.” Why is there truth to that idiom? Adversity occurs when life circumstances come against us. In other words, adversity resists us. In the arm wrestle between adversity and overcoming, work is involved. We have to fight back.

In a similar way, we grow when adversity pushes us just beyond what we have done before, stretching us. We may sustain some damage in the process, but that helps to reduce our weaknesses, and forces us into growth as we heal. When we push back against adversity, the “cells” of our character grow.

Of course, we all know examples where muscles fail under intense or prolonged loads. I vividly remember the pictures of the UK’s Paula Radcliffe, succumbing to the grueling hills and scorching Athens heat with only four miles left in the 2004 Olympic Marathon. Muscle failure from excessive stretch or excessive endurance parallels the allostatic load response, which is what people commonly referred to as ‘stress’.

Scientific evidence that stress is positive

There have been recent studies in animals that demonstrate that stress is physically as well as mentally enhancing.

Neurogenesis is the process of new nerve cell formation. Studies of rodents placed under intermittent predictable stressors showed an increase in neurogenesis within the hippocampus, which is the part of the brain related to learning and memory. Along with this enhancement of neurogenesis, the function of the hippocampus increased, specifically hippocampal-dependent memory, with a reduction in depression and anxiety-like behaviours.

As Petrik et al noted in their review, “Contrary to stress always being ‘bad’, it has long been appreciated that stress has an important biological role, and recent research supports that some amount of stress at the right time is actually useful for learning and memory.” [4]

Lessons from stress

So what can we learn from stress? How do we use the stress that we are exposed to every day to make us grow strong and durable?

Firstly, like the guitar string, we need to learn when we are in tune, at the peak of our productivity. Or like the car engine, what it feels like to be in the power band. When we know where our sweet spot is, we can operate within it, achieving our best in life without doing ourselves harm. This is the first point that we need to identify on our own personal stress/productivity curve. This is the point of maximum productivity.

The other life principle to be gained from the car engine analogy is that not all of us are high performance engines. I would love to think that I’m a F1 racing engine – highly tuned, supreme power – but I recognise my limitations. I would even settle for a 5-litre V8, but I know that I’m probably more like a well-tuned V6. We are what we are. Sometimes we apply the most stress to ourselves when we try to drive in the power band of someone else’s engine. We need to accept who we are.

It seems logical that if too much stress is bad for us, then having little or no stress is good for us. But like the new guitar string, minimal stress makes us unproductive. Like zero gravity on the body, little or no stress makes us weak.

And we need to understand that a bit more stress is ok. It’s inevitable that we are going to be stressed beyond what we usually cope with at times. But without that challenge, there would be no growth. Challenges usually hurt. You can’t have growth without pain. In the muscle analogy, at the stretch at which peak growth occurs, muscle fibres tear and the lactic acid build up in the remaining cells can be very uncomfortable. The key is learning how far we can push ourselves before we start to falter and fail. This is the second point we need to discover on our personal stress/productivity curve. This is the point of maximum growth.

Once we understand our own individual points of maximum productivity and growth, we can use them as guides to our personal growth and achievement. Actually, I should specify that these are our starting points, since as we face challenges and experience growth, the points will change slightly. We can remap those points and continue in our pattern of growth and development.

Pushing ourselves into just enough stress to achieve growth, then pulling back to rest and restore, is a pattern of growth that is seen in many facets of the natural world and the human body. Body builders and athletes use this method all the time in their training. They push themselves with more repetitions and heavier weights, or longer or faster runs, then they pull back to consolidate their gains. During our adolescence, our bodies naturally go through growth spurts – periods of rapid growth followed by a plateau, before the next burst of growth hormone hits us again. Even tree rings demonstrate that growth and consolidation occur all the way through the natural world.

This is the Stressed-Rest cycle. The studies in animals on neurogenesis strengthen the theory, because it was the animals that experienced bursts of stress that showed enhanced neurogenesis, memory and reduced depression/anxiety behaviours.

If you want maximum personal growth, constant stress does not help. There has to be times of rest. Some people think that rest time is wasted time, reducing productivity. But as explained, without rest time, productivity rapidly falls away. Without rest, stress goes bad, leading to allostatic overload.

So in summary, excessive stress is bad. But if all stress were bad, then we would all crumple any time that something became difficult. So stress is not a force for evil. Stress is part of our normal everyday lives, and is vital if we are to see ongoing personal growth.

We know from living life that we all don’t fall in a heap when things go wrong. We have in-built ways of coping that help us to absorb troubles and adversities and like emotional photosynthesis – turn them into fuel for growth.

This is the science of resilience, the counterbalance to the forces of stress that help us cope and adapt in a rapidly changing natural and social environment, the Yang to allostatic overload’s Yin. A discussion on the science of stress is not complete without a discussion of resilience, which I’ll discuss in the next blog in this series.

References

  1. Hortobagyi, T. and Maffiuletti, N.A., Neural adaptations to electrical stimulation strength training. Eur J Appl Physiol, 2011. 111(10): 2439-49 doi: 10.1007/s00421-011-2012-2
  2. Schoenfeld, B.J., The mechanisms of muscle hypertrophy and their application to resistance training. J Strength Cond Res, 2010. 24(10): 2857-72 doi: 10.1519/JSC.0b013e3181e840f3
  3. Adversity. Demotivators [cited July 2013]; Available from: http://www.despair.com/adversity.html.
  4. Petrik, D., et al., The neurogenesis hypothesis of affective and anxiety disorders: are we mistaking the scaffolding for the building? Neuropharmacology, 2012. 62(1): 21-34 doi: 10.1016/j.neuropharm.2011.09.003

Bad choices cause brain damage?

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“To err is human; to forgive, divine.”  Alexander Pope.

I’m not perfect.  At least, not the last time I checked.  And we’re all the same, aren’t we.  We all know through experience that we all stuff things up on a fairly regular basis.  We make bad choices.  We’re human!

Dr Caroline Leaf, Communication Pathologist and self-titled Cognitive Neuroscientist, believes that these bad choices literally cause brain damage.  Her fundamental assumption is that our thoughts control our brain [1: p33].  These thoughts can be healthy or they can be toxic.  Toxic thoughts “are thoughts that trigger negative and anxious emotions, which produce biochemicals that cause the body stress.” [2: p19]

Dr Leaf’s assumption is that thoughts and bad choices cause our brain cells to shrivel or die. “Once your body is truly in stress mode and the cortisol is flowing, dendrites start shrinking and even ‘falling off’” [2: p32].  She also says that, “We have two choices, we can let our thoughts become toxic and poisonous or we can detox our negative thoughts which will improve our emotional wholeness and even recover our physical health.” [2: p21]

It sounds a little extreme.  We all make bad choices, and we all experience stress.  When we’re stressed, do our memories really go missing, or the dendrites of nerve cells shake and fall like tree branches in a storm?  If we make a bad choice, do we really get brain damage?  Lets see what the scientific literature has to say.

Imagine walking along a path in a forest and you see a snake, only inches in front of you on the path.  What do you do? When faced with a high level of acute stress, the brain switches into a binary mode – fight/flight or freeze. Self-preservation has to kick in.  The only decision you have to make then and there is whether to run, to try and kill the snake before it kills you, or stop dead still and hope that the snake ignores you and slithers away.

At that point, most memory is redundant, as is a high-level analysis of snake species, or any other cognitive pursuit.  The brain doesn’t need them at that precise moment.  If they did engage, they would just get in the way.  Switching the thinking parts of your brain off focuses your attention on the immediate danger.  It’s an adaptive survival response.  Meantime, your memories and your theoretical knowledge about snakes don’t disappear.  They are still there, unchanged.  It is false to suggest that the memories “shrink”.

We’ve all experienced “mental block”.  Sometimes when we get into a situation, like an exam or a business meeting, our stress levels are high, and binary mode kicks in again, although this time it can be a hindrance.  This phenomenon of mental block under high stress was first proposed in 1908 and is currently known as the Yerkes-Dodson Law, a fundamental principle of the behavioural sciences [3].  Similar to the stress-productivity curve, Yerkes and Dodson proposed a U-shaped curve to represent the relationship between arousal (which could be either level of consciousness or stress) and behavioural performance.  At low arousal, there is poor performance.  At the mid-point of arousal, there is peak performance, and at high arousal, performance diminishes.

But again, our memories don’t shrink, and our nerve cell branches don’t fall off.  Once we reduce our level of arousal, we move away from the fight/flight/freeze mode, and everything is still there (and we perform better, according to Yerkes-Dodson).

Dr Leaf has a favourite analogy of “neurons as trees”.  And if neurons are trees, then the branches can “fall off”.  But neurons are not trees and dendrites are not tree branches.  The dendrites do not ‘fall off’ the neuron.  The neurons in the brain have mechanisms for ongoing brain plasticity – the ability of the brain to adapt to the challenges and changes in its internal and external environment that are constantly occurring.  If the brain needs to build a new circuit to encode a new piece of information, then it grows new dendrites and creates new synapses.  But the brain is limited by the amount of energy it can consume, and therefore the number of synapses it can maintain.  So the brain trims unnecessary dendrites, a process called “synaptic pruning”.

Synaptic pruning is a normal process. Chechik and Meilijson confirm that, “Human and animal studies show that mammalian brains undergoes massive synaptic pruning during childhood, removing about half of the synapses until puberty.” [4]

Synaptic pruning is not deleterious, but beneficial.  Chechik and Meilijson also note that, “synaptic overgrowth followed by judicial pruning along development improves the performance of an associative memory network with limited synaptic resources.” [4] So synaptic pruning is a normal physiological process, and occurs in all of us for many reasons, predominantly to improve the efficiency of our neural networks.  Perhaps synaptic pruning associated with the stress response is also an adaptive process?

Synaptic pruning also occurs in other physiological states that have nothing to do with stress or thought, such as the effects of oestrogen during the menstrual cycle and at menopause [5, 6].

A link between stress and dendrite loss has been discovered, but it is not consistent.  Some authors like Kopp and Rethelyi suggest that “severe stress for a prolonged period causes damage in hippocampal pyramidal neurons, especially in the CA3 and CA4 region and reductions in the length and arborization of their dendrites.” [7] However, Chen et al writes, “Whereas hippocampus-mediated memory deficits commonly were associated with—and perhaps result from—loss of synapse-bearing dendrites and dendritic spines, this association has not been universal so that the structure–function relationship underlying the effects of stress on hippocampal neurons has not been resolved.” [8]

It’s more accurate to think that chronic stress causes dendritic remodeling in animals [9], in which some nerve cells prune their synapses, which others grow them, and energy is diverted away from new nerve cell formation to the new synapses that are needed to cope with the stress.

A number of scientists have pointed out that patients with depression or anxiety, who normally have high levels of stress, have a smaller hippocampus and larger amygdala, so stress and depression must cause the smaller brain regions [9].  There may be some reduction in the number of synapses within the hippocampus and the frontal lobes of the brain, which may account for the change in size observed by a number of researchers.  But the modern thinking on these changes is that they are associated with depression, not caused by depression [10] (Correlation does not equal causation).

So, stress is associated with depression, but this is because genetic defects in one or multiple genes reduce the ability for the brain cells to produce synaptic branches.  It’s this decrease in the number of synapses that contributes to the typical changes in the brain seen at autopsy of patients who suffered from depression or anxiety [11].  The reduced ability of the nerve cells to grow synapses means that new branches can’t grow fast enough to process the stress signals properly [11, 12].  The poor signal transmission leads to a predisposition towards mood disorders like anxiety and depression [10, 11, 13-15], and less synaptic branches means both a smaller volume of the hippocampus, and an inability to process stress signals leads to a larger, overactive amygdala.

In summary, synaptic pruning is not due to toxic thinking or bad choices, unless every one of us engages in nothing but toxic thinking from early childhood to puberty, and menopause causes bad choices and toxic thoughts.  Stress doesn’t cause dendrites to fall off, but causes a reorganization of the dendrites to adapt to the new signals. The reduced capacity to form new dendrites makes those prone to mood disorders more vulnerable to stress, and depression or anxiety is the end result.

We are all bound to make bad choices and to have stress.  They don’t cause brain damage.  Which if you’re not perfect like me, is good news.

References

1.         Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan

2.         Leaf, C., Who Switched Off My Brain? Controlling toxic thoughts and emotions. 2nd ed. 2009, Inprov, Ltd, Southlake, TX, USA:

3.         Cohen, R.A., Yerkes–Dodson Law, in Encyclopedia of Clinical Neuropsychology, Kreutzer, J.S., et al., Editors. 2011, Springer Science+Business Media LLC: New York ; London. p. 2737-8.

4.         Chechik, G., et al., Neuronal regulation: A mechanism for synaptic pruning during brain maturation. Neural Comput, 1999. 11(8): 2061-80  http://www.ncbi.nlm.nih.gov/pubmed/10578044

5.         Chen, J.R., et al., Gonadal hormones modulate the dendritic spine densities of primary cortical pyramidal neurons in adult female rat. Cereb Cortex, 2009. 19(11): 2719-27 doi: 10.1093/cercor/bhp048

6.         Dumitriu, D., et al., Estrogen and the aging brain: an elixir for the weary cortical network. Ann N Y Acad Sci, 2010. 1204: 104-12 doi: 10.1111/j.1749-6632.2010.05529.x

7.         Kopp, M.S. and Rethelyi, J., Where psychology meets physiology: chronic stress and premature mortality–the Central-Eastern European health paradox. Brain Res Bull, 2004. 62(5): 351-67 doi: 10.1016/j.brainresbull.2003.12.001

8.         Chen, Y., et al., Correlated memory defects and hippocampal dendritic spine loss after acute stress involve corticotropin-releasing hormone signaling. Proc Natl Acad Sci U S A, 2010. 107(29): 13123-8 doi: 10.1073/pnas.1003825107

9.         Karatsoreos, I.N. and McEwen, B.S., Psychobiological allostasis: resistance, resilience and vulnerability. Trends Cogn Sci, 2011. 15(12): 576-84 doi: 10.1016/j.tics.2011.10.005

10.       Palazidou, E., The neurobiology of depression. Br Med Bull, 2012. 101: 127-45 doi: 10.1093/bmb/lds004

11.       Karatsoreos, I.N. and McEwen, B.S., Resilience and vulnerability: a neurobiological perspective. F1000Prime Rep, 2013. 5: 13 doi: 10.12703/P5-13

12.       Russo, S.J., et al., Neurobiology of resilience. Nature neuroscience, 2012. 15(11): 1475-84

13.       Felten, A., et al., Genetically determined dopamine availability predicts disposition for depression. Brain Behav, 2011. 1(2): 109-18 doi: 10.1002/brb3.20

14.       Bradley, R.G., et al., Influence of child abuse on adult depression: moderation by the corticotropin-releasing hormone receptor gene. Arch Gen Psychiatry, 2008. 65(2): 190-200 doi: 10.1001/archgenpsychiatry.2007.26

15.       Hauger, R.L., et al., Role of CRF receptor signaling in stress vulnerability, anxiety, and depression. Ann N Y Acad Sci, 2009. 1179: 120-43 doi: 10.1111/j.1749-6632.2009.05011.x

Dr Caroline Leaf – Serious questions, few answers (Part 2)

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Yesterday I published the first part of an essay discussing the presentation of Dr Caroline Leaf, Audiologist, Communication Pathologist, and self-titled cognitive neuroscientist, at Kings Christian Church, Gold Coast.

Tonight I want to continue dissecting some of the more pertinent statements that she made, including her view of the mind-brain connection, a smattering of smaller issues, her over-reliance on case studies, and her opinion on the cause and treatment of ADHD.

Tomorrow I will publish the last, and most important part of my essay – That Dr Leaf believes that ‘toxic’ thoughts are sinful, and why this single statement unravels her most fundamental premise.

THE MIND IS IN CHARGE OF THE BRAIN

A large part of her sermon was based on her next premise, that the mind changes the brain, and not the other way around. That is half true. The mind influences the brain, and how we think will have effects on neural pathways within the brain. But for a cognitive neuroscientist to state that the brain does not influence the mind is somewhat concerning.

There are several reasons why her assertion is deeply flawed. For starters, where else does the mind or thought come from other than our neural networks? Thought is built on our neural connections. To say that the brain does not influence thought is like saying that the foundation of a building doesn’t influence the bricks.

There are clinical reasons as well. These come from a few areas – firstly the research that showed that newborn babies (who do not have thought like we have thoughts) are pre-wired for emotions which are refined as we learn. There is no time for neonates to have enough stimulation to form those emotions and reactions if it was from our mind.

Secondly, people with brain injuries or tumours can have personality or mood changes. The most famous was a man in the 1800’s called Phineas Gage, who on 13 September 1848 was packing explosives into rock with a tamping iron (a long, tapered, smooth crow-bar). History says that the explosives sent the tamping iron through his left face and skull, taking a fair chunk of his frontal lobe with it. Depending on who you believe, Gage’s personality changed after his physical recovery, reportedly from a moral, respectful man into a cursing, angry one (Kihlstrom 2010). Some reports of his story were that Gage made an almost full recovery, but assuming that some of the historical record is true, changes to his brain changed his mental function, ie: his thoughts.

Further, I have personally seen two patients with personality changes secondary to brain tumours. The first was a woman in her late 20’s who had six months of worsening anxiety, who did not seek help despite my referrals, until she had a seizure and the diagnosis was made. Then there was the sad case of a girl in her pre-teens who had only two weeks of rapidly escalating sullenness then aggression then violence. Her parents initially thought she was moody, and when they brought her into the Emergency Department they thought she was perhaps in the middle of a psychotic episode. It turned out that she had a very aggressive tumour near her frontal lobe.

It is clear from these cases, and from a basic understanding of the concept of thought, that changes to the brain result in changes to thoughts and the mind, and vice versa.

SOME MISCELLANEOUS ISSUES

If I had the time I would like to look at many others issues that she raised, but this isn’t a book. Suffice it to say that she claimed that stress prunes our “thought trees” although the evidence is only in animal models and only related to severe stress (Karatsoreos and McEwen 2011). She also stated that EVERY thought we EVER have is stored in ALL of our cells (so some random fibroblast in my big toe is somehow affected by my thought about tonights dinner), and that ALL our thoughts are stored in our gametes (our sperm and eggs) and are passed down to our 4th generation (but packed, like in a metaphysical zip-lock bag, and only opened if we choose to have the same thoughts.) And here I was thinking that nurture had something to do with learned behaviour.

ASD/ADHD – MORE OPINION THAN FACT?

She also claimed that 55-70% of ASD/ADHD cases are over-referred and the problem is in educational modeling. This one made me mad.

Not even professorial level researchers know exactly what’s going on in ASD/ADHD, so her statement is a brave one to make, especially without referencing her evidence.

She then espoused the party line of ADHD ignorance – that Ritalin is evil and all you need to do is stop their sugar intake and feed them organic foods and give them supplements. Ritalin isn’t perfect, to be sure, but it is the most effective treatment that’s currently available. If dietary measures and educational measures were effective, then ritalin wouldn’t be prescribed. I have never met a parent that has wanted their child on ritalin. Most of them have tried educational/psychological measures or dietary controls first. The reason why ritalin is prescribed is because dietary and psychological interventions on their own do not adequately control the symptoms, or fail altogether.

To confirm that I’m not just having a rant, there is published scientific literature to back me up. In their recently published meta-analysis, Nigg et al (2012) state, “An estimated 8% of children with ADHD may have symptoms related to synthetic food colors.” Eight percent. That’s all! That’s ninty-two percent of children with ADHD (real ADHD, not just rambunctious children with lots of energy) DID NOT have symptoms due to food colourings. Their conclusions: “A restriction diet benefits some children with ADHD. Effects of food colors were notable but susceptible to publication bias or were derived from small, nongeneralizable samples.” In terms of sugar, Kim and Chang (2011) note that, “children who consumed less sugar from fruit snacks or whose vitamin C intake was less than RI was at increased risks for ADHD (P < 0.05).” (emphasis added) The study was only of about 100 children, but the result was statistically significant. It wasn’t a chance effect.

The misinformation she stated as fact from the pulpit promotes scare-mongering and ignorance throughout the church, which has flow on effects. Church members with children with ADHD or ASD will avoid standard medical treatment on Dr Leaf’s advice. When her treatments fail in the majority of cases, those parents will either live with unnecessarily heightened stress because of their child’s poorly controlled condition, or the guilt of using ritalin, all the while believing that they are ruining their childs brain.

This also places the hosting church in a bind. Do they stand behind their guest speaker, or do they support the advice of the medical community? Is their duty of care to the reputation of the guest speaker or to the congregation under their protection? What would happen if Dr Leaf’s advice lead to the death or disability of a person in their congregation? Would they be libel?

CASE STUDIES – INSPIRATIONAL STORIES, BUT POOR SCIENTIFIC EVIDENCE

Dr Leaf also told a lot of stories of how everyone afflicted came to her and how she healed them all. If you took her at face value, she would have you believe that people with ASD, ADHD, anorexia, OCD, depression etc, just needed a glimpse of their self-worth and their inner gift and they would be cured. While her stories were inspirational, the world of scientific research demands more. If Dr Leaf’s insights are worth more than the hot air she produces when espousing them, then they should be put to the wider research community so they can pass through the fire of peer review. If peer review prove her insights to be valid, I would be happy to apply them and promote them.

Tomorrow, I will publish the last, and probably the most important part of my essay – that Dr Leaf believes that ‘toxic’ thoughts are sinful, and why this single statement unravels her most fundamental premise.

REFERENCES

Crum, A. J., P. Salovey and S. Achor (2013). “Rethinking stress: the role of mindsets in determining the stress response.” J Pers Soc Psychol 104(4): 716-733.

Karatsoreos, I. N. and B. S. McEwen (2011). “Psychobiological allostasis: resistance, resilience and vulnerability.” Trends Cogn Sci 15(12): 576-584.

Kihlstrom, J. F. (2010). “Social neuroscience: The footprints of Phineas Gage.” Social Cognition 28: 757-782.

Kim, Y. and H. Chang (2011). “Correlation between attention deficit hyperactivity disorder and sugar consumption, quality of diet, and dietary behavior in school children.” Nutr Res Pract 5(3): 236-245.

Leaf, C. (2009). Who Switched Off My Brain? Controlling toxic thoughts and emotions. Southlake, TX, USA, Inprov, Ltd.

Nigg, J. T., K. Lewis, T. Edinger and M. Falk (2012). “Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives.” J Am Acad Child Adolesc Psychiatry 51(1): 86-97 e88.