Tag Archives: mental illness

Anxiety – It’s not a ‘real’ disease until it is

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“I feel awful, doc”, one man said to me today. “I’m never going to call a cold ‘the flu’ again”, he said as he shivered away under three jumpers, aching and mildly delirious.

It’s the middle of winter here in Australia, and Influenza A is cutting a swathe through the community. Everyone who walks in with a stuffy nose thinks they have ‘the flu’, that is, until they actually get Influenza and they realise just how atrocious having the real flu is.

It’s the same with mental health and illness. So many people think think that anxiety or depression aren’t real diseases. They think that everyone gets a bit sad at times, or gets a bit stressed, so depression and anxiety aren’t real diseases, they’re just normal emotions, or what weak people experience because they don’t have the inner strength to cope.

Such stigma isn’t helped when people who like to think they’re experts in mental health write blogs which declare that “anxiety is a signal that we need to listen to, not an illness we need to manage. It is a reaction to life’s challenges, not a biological disease to be treated.”

Yes, that’s right people, pretend experts are quick to tell you that the debilitating condition you’re experiencing isn’t a real disease.

Saying “Anxiety isn’t a real disease, it’s just a warning sign, a normal part of life” is a bit like saying, “You don’t really have Influenza, you just have a cold. Harden up princess … you don’t need to be ventilated in ICU, it’s just a virus. I took some Vitamin C and I was better in just a couple of days. What’s wrong with you?”

Part of the problem is because of how we use the word “anxiety”, which can mean different things to different people. To a lot of people, being anxious is the same as being a little frightened. To others, it’s being really scared, but with good reason (like if you were confronted by a very venomous snake).

Medically speaking, anxiety isn’t just being frightened or stressed. After all, it’s normal to be frightened or stressed. A little bit of fear is protective. There are dangers all around us, and our brain is our “don’t get killed” organ. If we had no fear at all, we’d end up becoming road kill. A little bit of fear, in the right amount, for the right reason and in the right place and time, is actually very protective.

But to label all anxiety as normal, or to claim that anxiety is not a mental illness is obnoxious and ignorant.

That’s because anxiety at the wrong time and in the wrong amount can disrupt our day-to-day tasks and make it hard to live a rich and fulfilling life. At the extreme, anxiety disorders are as debilitating as any major illness.

There are six main disorders that come under the “anxiety disorders” umbrella, reflecting either an abnormal focus of anxiety or an abnormal intensity:
1. Panic Disorder (abnormally intense anxiety episodes)
2. Social Anxiety Disorder (abnormal anxiety of social interactions)
3. Post-traumatic Stress Disorder (abnormally intense episodes of anxiety following trauma)
4. Obsessive-Compulsive Disorder (abnormally intense and abnormally focussed anxiety resulting in compulsive behaviours)
5. Specific phobias (abnormally focussed anxiety on one particular trigger), and
6. Generalised Anxiety Disorder (abnormal anxiety of everything)

The common underlying theme of anxiety is uncertainty. Clinical psychologists Dan Grupe and Jack Nitschke from the University of Wisconsin wrote in Nature Reviews Neuroscience that “Anxiety is a future-orientated emotion, and anticipating or ‘pre-viewing’ the future induces anxiety largely because the future is intrinsically uncertain.” [1]

The fear of uncertainty that defines anxiety comes from genetic changes that affect the structure and function of the brain, primarily in the regions of the amygdala and the pre-frontal cortex. As a result of these changes, the brain processes information incorrectly.

For example:
> the brain thinks that threats are more likely and will be worse than they are,
> the brain spends more time looking for possible threats,
> the brain fails to learn what conditions are safe, which is aggravated by avoidance, and
> the brain assumes that unavoidable uncertainty is more likely to be bad than good.

It’s important to understand at this point that anxiety disorders aren’t the result of poor personal choices. They’re the result of a genetic predisposition to increased vulnerability to early life stress, and to chronic stress [2]. The other way of looking at it is that people who don’t suffer from anxiety disorders have a fully functional capacity for resilience [3,4].

The main point of this post is simply this – pretend experts are everywhere, and they are usually various combinations of ignorant, stupid or lazy. They might try and tell you that your debilitating anxiety isn’t really a mental illness, but they’re usually the ones who have never experienced just how atrocious a true anxiety disorder is. Don’t listen to them, no matter how many equally ignorant followers they have on social media. Just like Influenza can make you really sick but there is treatment, so it is with an anxiety disorder – the anxiety disorder may be much harder to get through, but with the right treatment and support, you can get through it.

~~~

If you are struggling with anxiety or depression, help … real help … is available. See your general practitioner or psychologist, or if you’re in crisis and you need to talk to someone urgently:

In Australia
> you can call either Lifeline on 13 11 14, or
> BeyondBlue provides a number of different support options
> the BeyondBlue Support Service provides advice and support via
>> telephone 24/7 (call 1300 22 4636)
>> daily web chat (between 3pm–12am) and
>> email (with a response provided within 24 hours) via their website https://www.beyondblue.org.au/about-us/contact-us.
In the US
> call the National Suicide Prevention Lifeline by calling 1-800-273-TALK (8255).
In New Zealand
> call Lifeline Aotearoa 24/7 Helpline on 0800 543 354
In the UK
> Samaritans offer a 24 hour help line, on 116 123
For other countries, Your Life Counts maintains a list of crisis services across a number of countries: http://www.yourlifecounts.org/need-help/crisis-lines

References
1. Grupe DW, Nitschke JB. Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective. Nature reviews Neuroscience 2013 Jul;14(7):488-501.
2. Duman EA, Canli T. Influence of life stress, 5-HTTLPR genotype, and SLC6A4 methylation on gene expression and stress response in healthy Caucasian males. Biol Mood Anxiety Disord 2015;5:2.
3. Wu G, Feder A, Cohen H, et al. Understanding resilience. Frontiers in behavioral neuroscience 2013;7:10.
4. Russo SJ, Murrough JW, Han M-H, Charney DS, Nestler EJ. Neurobiology of resilience. Nature neuroscience 2012 November;15(11):1475-84.

Dr Caroline Leaf and Zombie Chemical Imbalance Myth

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Sometimes if you tell a story often enough, people forget that it’s just a story and it takes on a life of its own. It’s like a zombie … the story isn’t real but it continues to wander around eating people’s brains and it’s very hard to kill off.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist. She also believes that reading a few blogs from fringe psychologists entitles her to call herself a mental health expert. She is the Christian church’s pin-up girl for the Dunning-Kruger effect.

Dr Leaf recently posted a blog on “The Chemical Imbalance Myth”. It’s a zombie. She’s posted on this before (on the 26th of October 2015 to be precise) but her blog post in 2015 was so inaccurate that she later took it down, only for it to resurface later on her website (in the section dubiously titled “Scientific FAQ”).

And like every good zombie, it’s resurfaced again. Dr Leaf hasn’t changed any of the inaccuracies that forced her to take down the original post, but instead added a couple of extra bits in, mixed it up a little and then just served it up, like a reheated bowl of rancid Christmas scraps.

I won’t go through each and every point like I did with her previous iteration of this blog, although if you want to review my more in-depth analysis of this subject, then please feel free to read my previous blog post: https://cedwardpitt.com/2015/10/26/dr-caroline-leaf-and-the-myth-of-chemical-imbalances-myth/. But I thought it was worth highlighting a couple of key things from this year’s fetid reincarnation which are so flawed that not even a B-grade science fiction writer would seriously entertain them.

THE MIND AND THE BRAIN

Dr Leaf says:

“In other words, mental ill-health is a thought disorder based in the mind, which changes the brain physiologically and is a response to the complex and multifaceted challenges of life.” This is based on her underlying assumption that the brain doesn’t control the mind, but instead the mind controls the brain.

However, she also says that “Psychotropic drugs can directly affect our health, with side effects such as an increased risk of suicide, loss of sexual ability, potential brain shrinkage, agitation, insomnia, weight gain and obesity-related diseases like diabetes, lethargy, mental fog, emotional apathy, homicide”.

This statement is really ignorant and prejudiced; psychiatric drugs don’t make people into murderers for a start.

But the most striking flaw of all is that Dr Leaf is contradicting herself. She confidently asserts that psychotropic medications and their terrible chemical imbalances have ghastly side effects on emotional and cognitive functions such as “mental fog” and “emotional apathy”. But how can that be? After all, if the brain does not control the mind as she says, then the medications affecting the brain would not have any effect on the mind.

Dr Leaf can’t have it both ways – either her entire ministry is built on a false premise (the brain really controls the mind after all) or her dire assertions about psychiatric medications are unfounded (chemical imbalances in the brain can’t cause effects on the mind).

One way or the other, Dr Leaf has a serious problem in her reasoning.

Real science has clearly demonstrated that the mind is a product of the brain. Things that alter the structure of the brain (trauma, tumours) or the function of the brain (medications like ropinirole, every day drugs like caffeine, or illicit drugs like LSD) can all cause changes in how the mind functions with resulting changes in behaviour.

If Dr Leaf isn’t able to get the basics of science right and make even the most basic cogent argument then how can she be trusted to speak to more complicated issues surrounding mental health and illness.

DR LEAF’S RESEARCH

Dr Leaf has never been one to undersell her scientific work. Accordingly, in her blog post she says:

Following a similar research path, I have also demonstrated, using my research on the power of mind-action in changing the brain, that mental disorders are primarily based in the mind …

I have researched the effectiveness of mind action techniques (which are thought-based) in overcoming the negative effects of neurological issues such as TBI, dementias, movement disorders, autism, aphasia, and learning disabilities, emotional trauma as well as various cognitive, emotional and mental health issues …

My Geodesic Learning Theory has been shown not only to be effective in mental health care, but also treating physical damage to the brain that occurs in Traumatic Brain Injury (TBI), learning disabilities and to improve learning techniques in both schools and the corporate world …

my research and experience indicated that many of these conditions were influenced by, or originated in, a disorder of the mind that was either caused by a trauma or negative thinking patterns. In other words, mental ill-health is a thought disorder based in the mind, which changes the brain physiologically and is a response to the complex and multifaceted challenges of life.

And yet the reality is that Dr Leaf only did one PhD in South Africa, and has not done any other university based research since. Her PhD did not look at “the power of mind-action in changing the brain”. In fact, her research didn’t focus on mental health or illness at all, and it certainly didn’t focus on dementias, movement disorders, autism, aphasia, and learning disabilities, emotional trauma, cognitive, emotional or mental health issues.

Her PhD was the evaluation of her Geodesic Learning Theory on a group of very normal students in a South African School. None of them had dementia. None of the other conditions were mentioned either. The overall results were likely due to chance, and in some cases, her intervention made the students grades worsen. The only other research that Dr Leaf performed was a similar intervention in come schools in Dallas, but the results were much the same as her PhD and given the unflattering results, this study was never published in a peer-reviewed journal.

Dr Leaf should know what she studied for her own research, and yet her description in her current blog post is so strikingly different from what is on the public record. So again, this begs the question – how can someone who is so wrong about her own research be trusted with any level of authority in any other subject?

PREJUDICE AGAINST MENTAL ILLNESS

For someone who claims to be an expert on mental health, Dr Leaf is extremely callous and dismissive of those people who suffer from mental illnesses. She repeatedly uses quotation marks to refer to mental illnesses, like ‘“diseases” like depression’ as if to suggest that they aren’t illnesses at all. Can you imagine if this same level of disrespect was applied to someone with a physical disability? That people in wheelchairs have the “disability” of paraplegia, for example. It’s extremely disrespectful and intolerant whether it is speaking about a physical disability or a mental illness.

The other thing which is highly inappropriate is her scare-mongering about psychiatric treatments. Psychiatric patients are not imprisoned, drugged, locked in solitary confinement and compelled to “live their days marinating in their own excrement.” I doubt whether Dr Leaf has ever set foot in a psychiatric facility. She is simply regurgitating the information fed to her by alarmist groups such as Mad In America, a group of psychologically trained rogue extremists – the Taliban of the world of psychiatry. It’s propaganda in it’s purest form, but Dr Leaf takes it at face value and repeats it no matter how inaccurate it actually is.

Dr Leaf’s criticism of modern psychiatry is breathtaking in it’s ignorance, especially in the face of published science, but what makes it more concerning is that it is internally inconsistent her own teaching, and this isn’t the first time that she’s contradicted herself.

Dr Leaf should take down this ignorant, inaccurate and intolerant post. This particular zombie myth needs to be buried once and for all.

Fake science is no joke

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Happy Easter everyone.

I went to church this morning, and came home to get a lamb ragu going in the slow cooker, and thought I would just hop onto Facebook to see what was going on in the world. I was greeted with this:

“Your body literally treats negative thoughts like an infection.” Dr Peter Amuaquarshie

Oh dear … oh dear, oh dear, oh dear …

Easter is meant to be about redemption, about hope, about God’s great love for us. Clearly #TheDrLeafShow isn’t any of that.

Unfortunately, this is more pseudoscience from Dr Leaf and her cabal.  And while it might also be April Fools Day, fake science is no joke.

Dr Peter Amua-Quarshie has been in cahoots with Dr Leaf since the beginning of her teaching. He has supplied most of the illustrations for Dr Leaf’s ministry over the years, so I’m sure he’s profiting handsomely from Dr Leaf’s enormous sales and influence.

It’s so sad to see academics trade their integrity and sell their soul for the sake of the ill-gotten gains of popular pseudoscience.

Your body doesn’t “literally” treat negative thoughts like an infection. Our thoughts have literally no bearing on our immune function. In research work that has intentionally studied thought separately to stress, thought has not been associated with any significant changes in stress or health behaviour [1]. It’s also been confirmed that thought alone does not lead to detrimental biological changes, such as significant changes in immune function [2].

If anything, it’s the other way around – our immune system and our thoughts respond to physical changes in our bodies internal milieu. For example, an adrenaline surge causes us to feel fear and engage in fight or flight behaviours, and to respond quickly to injury, the balance of our immune system’s cells and cytokines changes to prepare for possible injury.

Another example, a physical infection from a microbe of some kind (bacterial or virus) causes a flood of chemical mediators called cytokines to float around the blood stream. This inflammatory response leads to an immune system that is better able to fight off infection, but it also changes our feelings and our thoughts – this flood of cytokines is the reason why we feel tired, achey and miserable when we’re sick.

Having “negative thoughts” is not the same as having an infection. Infections are disease states, whereas “negative thoughts” are normal and more often than not, beneficial. It’s normal to feel sad. It’s normal to feel angry. It’s normal to feel disgusted or embarrassed. These feelings are adaptive. Without them, we wouldn’t grow or change. Without them, we couldn’t have a rich, full life.

Dr Leaf claims that her goal is to “equip and empower you to use your mind to overcome labels and mental ill health (depression, anxiety, etc) to live a more fulfilled and successful life.” It’s a bit hard to do that by promoting fake science.

For his part, Amua-Quarshie should know better. He’s a teaching academic by trade and has a medical degree from the University of Ghana, after all. Unfortunately, it appears that Dr Amua-Quarshie has been exiled from mainstream academia, leaving a full-time position as an Adjunct Professor (lecturer) at the University of Wisconsin-Stout in Menomonie, Wisconsin and is now working as a lecturer in a school for chiropractors (Parker University, Dallas, Texas).

Though that’s more of an aside. The bottom line here is that Dr Leaf might claim that she wants people to overcome ‘labels and mental ill health’ but she isn’t going to do that by promoting such obvious mistruths that mislead people into fearing normal, adaptive human emotions. She isn’t promoting a more fulfilled and successful life, she’s promoting imbalance. She’s promoting false hope.

I know it’s April Fools, but believe me, this is no joke.  Fake science is misleading and harmful.  If Dr Leaf really wants people to live a more fulfilled and successful life, she should refrain from using it.

References
1. Doom, J.R. and Haeffel, G.J., Teasing apart the effects of cognition, stress, and depression on health. Am J Health Behav, 2013. 37(5): 610-9 doi: 10.5993/AJHB.37.5.4
2. Segerstrom, S.C. and Miller, G.E., Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychol Bull, 2004. 130(4): 601-30 doi: 10.1037/0033-2909.130.4.601

More love, not less guns?

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Wow.

Just … wow.

Dr Caroline Leaf is no stranger to ignorance and controversy – she thinks that our minds can create matter, that our thoughts can control our genetic expression, and that psychiatric medications are a leading cause of death. So it should come as no surprise when she proves the Dunning-Kruger Effect over and over again.

Still, I found her podcast and meme today utterly breathtaking.

Dr Leaf, communication pathologist and self-titled cognitive neuroscientist-cum-life-guru continues to weigh in on the gun debate every time there’s a mass shooting. I wouldn’t if I were her, but fools rush in.

At least Dr Leaf has finally stopped blaming mental illness or psychiatric medication for causing such mass murders. That said, there’s still more twisting and contorting in her statement than at a pretzel convention.

Dr Leaf has relinquished one over-simplistic solution in favour of another. Yes, mass shootings aren’t related to mental illness, but can you really say with a straight face that mass shootings occur because of a lack of love? So we should all hold hands and sing Kumbayah? Have a few more hugs? Dr Leaf’s suggestion is childish and inane.

Since 1996, Australia’s number of mass shootings has been zero. Australia’s gun-related homicide and suicide rate also fell. Why? It’s not because we all started loving each other more down here after 1996. It’s because, amongst other reasons, the Australian government introduced gun law reform, drastically reducing the number of guns available within the general population.

Perhaps living in Texas has rubbed off on her, or perhaps Dr Leaf is an NRA sympathiser. I honestly don’t know why Dr Leaf is so afraid to speak directly to the problem. Most of the US and the entire rest of the world can see the issue for what it is. If it wasn’t so tragic, her dance around the issue would be comical.

Dr Leaf is welcome to her opinion, but she can not claim any level of moral or professional authority on this issue. Her “years of experience in the mental health field” are zero, as is her credibility as an expert. Encouraging more love with the same number of handguns and semi-automatics on the street is not going to prevent more casualties.

Guns cause mass shootings, not psychiatric drugs

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Las Vegas, Nevada – the latest of many places in America joined by the shared ignominy of senseless mass violence.

Each victim (and there are so many [1]) deserve respect – their lives, their stories, their memory, honoured. Their families should be allowed to mourn, their community given space to heal.

Their loss should not be used as an ideological segue to opportunistically push an unrelated viewpoint. To do so would be obnoxious, like someone attending a wake so they could try and sell life insurance to those who are grieving.

And yet, Dr Caroline Leaf has done just that, using the deaths of nearly five-dozen people as an opportunity to push the idea that psychiatric medications are somehow to blame for the actions of those who perpetrate mass murder (http://drleaf.com/blog/mental-health-news-october-2017/).

“One factor that is rarely discussed in both the mainstream media and among politicians is psychiatric drug-induced violence. It is too easy to label the perpetrator as an evil maniac with mental health problems without looking at the correlation between psychotropic drugs and violence.”

In my opinion, I think it’s abhorrent that Dr Leaf would be so callous as to use such an abject tragedy to push her ideological barrow, but sadder still that she is simply wrong.

The key factor in gun-related deaths isn’t psychiatric medications, but guns.

From 1996 to 2011, the use of any psychotropic medication in Australia roughly doubled (from about 55 to 130 ‘defined daily doses per 1000 population per day’ [2: p234, 3]). In the same period, Australia’s number of mass shootings fell to zero. Australia’s gun-related homicide and suicide rate also fell [4].

Why? Because after the tragedy of Port Arthur in 1996, the Australian government introduced gun law reform, drastically reducing the number of guns available within the general population. Admittedly, experts argue whether the gun law reform was a decisive factor or just one of many in the reduction of gun-related deaths in Australia [4].

But irrespective, the statistics decimate Dr Leaf’s irrational hypothesis on psychiatric medications. There is no link to psychiatric medications and mass murder. Indeed, those who suffer from mental illness are more likely to be the victims of violence, not the cause of it [5, 6].

Dr Leaf attempts to soften the blow at the end of her newsletter. “That is not to say everyone who takes these medications will become violent – we should not fear or isolate people that are suffering from mental health disorders”. But her repeated claim that these egregious acts of violence are caused by psychiatric medications makes her words ring hollow.

In publishing her latest blog, Dr Leaf’s motives may have been benevolent, but her actions have left much to be desired. She has dishonoured the victims of Vegas. She has targeted the wrong cause. Her actions have created many more victims of what is already a senseless tragedy.

References

[1] Berkowitz B, Gamio L, Lu D, Uhrmacher K, Lindeman T. The math of mass shootings. 2015 [cited 2017 October 12]; Available from: https://www.washingtonpost.com/graphics/national/mass-shootings-in-america/
[2] Australian Statistics on Medicines 1997. In: Commonwealth Department of Health and Family Services, editor. Canberra: Commwealth of Australia, 1998.
[3] Stephenson CP, Karanges E, McGregor IS. Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011. Aust N Z J Psychiatry 2013 Jan;47(1):74-87.
[4] Fact check: Have firearm homicides and suicides dropped since Port Arthur as a result of John Howard’s reforms? RMIT ABC Fact Check 2016 [cited 2017 October 12]; Available from: http://www.abc.net.au/news/factcheck/2016-04-28/fact-check-gun-homicides-and-suicides-john-howard-port-arthur/7254880
[5] Mental Health Myths and Facts. 2017 [cited 2017 October 12]; Available from: https://www.mentalhealth.gov/basics/myths-facts/index.html
[6] Metzl JM, MacLeish KT. Mental illness, mass shootings, and the politics of American firearms. Am J Public Health 2015 Feb;105(2):240-9.

Post script: A picture says a thousand words:

http://www.canberratimes.com.au/world/heres-why-australia-will-never-understand-the-us-obsession-with-guns-20171003-gyt7ys.html

If you have been distressed by the Las Vegas shooting or you have concerns about your mental health, please talk to your general practitioner or psychologist.

If you need urgent assistance, please talk to someone straight away:
In Australia:
Lifeline ~ 13 11 14
BeyondBlue ~ 1300 22 4636 or https://www.beyondblue.org.au/about-us/contact-us
Suicide Callback Service ~ 1300 659 467 or https://www.suicidecallbackservice.org.au

USA:
National Suicide Prevention Lifeline ~ 1-800-273-TALK (8255)

New Zealand:
Lifeline Aotearoa 24/7 Helpline ~ 0800 543 354

UK:
Samaritans ~ 116 123

For other countries: Your Life Counts maintains a list of crisis services across a number of countries: http://www.yourlifecounts.org/need-help/crisis-lines.

Dr Caroline Leaf – Howling at the moon

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The night is darkest just before the dawn, so says the age-old phrase.  It’s funny how we just accept these old adages as true, but when you actually think about it, they’re nothing more than a concoction of the imagination.  The night isn’t darker just before dawn – it’s just as dark when the sun goes down as it is before the sun comes up again.

In the same way, we so often accept things said by ‘experts’ as truth when in reality, they’re also just some particularly imaginative concoctions.

Take, for example, Dr Leaf’s latest e-mail newsletter and blog for June 2017.  In it, she merrily gloated about how a recent UN Human Rights report “exposed the current failings of diseased-based psychiatry” and “challenges the dominant narrative of brain disease and its overreliance on psychoactive drugs”.  The smugness is palpable – she finally has something more authoritative to try and back up her psychiatric antagonism than just the collective ranting of an outspoken, ill-informed fringe group.

Dr Leaf is a communication pathologist (essentially an academic speech pathologist) though she continues to delusionally claim that she’s a cognitive neuroscientist.  She also grandiosely believes her training in speech pathology make her a mental health expert, above psychiatrists with actual medical training and decades of real clinical experience.  She might feel vindicated by this report and her ill-formed friends, but her view is naive and her narrative is based on inaccurate statistics and logical fallacy.

For example, this paragraph encapsulates Dr Leaf’s statistical errancy and general self-deception: “Several of my previous blogs, as well as some of my FAQs, deal with the current state of mental health care, which has crippled so many lives, led to countless deaths, and left millions of people thinking that there is ‘something wrong with my brain.’ Indeed, an estimated 20% of the American population take psychiatric drugs, which amounts to a staggering cost of $40 billion, as mental health advocate Robert Whitaker points out (a 50-fold increase since the late 1980s).”

It’s a “see-I-told-you-so” attempted justification, except that modern mental health care has not “crippled so many lives” or “led to countless deaths.”  It’s actually untreated mental illness which really cripples people’s lives, or ends them.  Suicide is an unspoken epidemic that is so often the end result of undiagnosed or untreated mental illness.  Suicide is the major cause of premature death among people with a mental illness and it’s estimated that up to one in ten people affected by mental illness die by suicide.  Up to 87% of people who die by suicide suffer from mental illnesses. There are more deaths by suicide than deaths caused by skin cancer and car accidents.  Up to three percent of adults have attempted suicide within their lifetime and it’s estimated that for every completed suicide, at least six other people are directly impacted in a significant way [1].

On the flip side, the use of any anti-psychotic medication for a patient with schizophrenia decreased their mortality by nearly 20% [2]. In another study, the mortality of those with schizophrenia who did not take anti-psychotics was nearly ten times that of the healthy population, but taking anti-psychotic medication reduced that by a factor of five! [3]  Dr Correll and colleagues summarised the literature, noting that, “clozapine, antidepressants, and lithium, as well as antiepileptics, are associated with reduced mortality from suicide. Thus, the potential risks of antipsychotics, antidepressants and mood stabilizers need to be weighed against the risk of the psychiatric disorders for which they are used and the lasting potential benefits that these medications can produce.” [4]

As for her example taken from the equally prejudiced Robert Whitaker that “an estimated 20% of the American population take psychiatric drugs, which amounts to a staggering cost of $40 billion … (a 50-fold increase since the late 1980s)”, even if it were true, it’s simply misleading and ill-informed.  Twenty percent of the US population might be taking “psychiatric drugs” but some of them might be taking them for different reasons.  For example, tricyclic anti-depressants are no longer used primarily for depression but have found a niche in the treatment of chronic and nerve-related pain.  And so what if there’s been a 50-fold increase in the use of psychiatric medications since the 1980’s, that doesn’t mean they’re being used inappropriately.  Her analogy is like saying that because there has been a 900-fold increase in the number of road deaths since the turn of the century [5], cars are being used inappropriately and we should all start travelling by horse-back again.

It’s the height of arrogance for Dr Leaf to sit in her ivory tower and condemn modern psychiatry based on her utopian fantasy, but mental illness affects real people and causes real suffering – like the two heart-broken parents told a Parliamentary Enquiry in Australia a few years back, “We would rather have our daughter alive with some of her rights set aside than dead with her rights (uselessly) preserved intact.” [6]

Dr Leaf may smugly think the sun is shining on her, but she’s still in the darkness of night, barking and howling at the moon like a rabid dog.  If she really wants to step into the light, she should try looking at the mountain of scientific evidence supporting modern psychiatry and if that’s not enough for her, then she should at least look at all those afflicted and distressed because the mental illness they or their loved one suffered from was ignored in favour of an ideology that claims to support human rights but which ignores the most basic human right of all, the right to life.

References
[1]        Corso PS, Mercy JA, Simon TR, Finkelstein EA, Miller TR. Medical costs and productivity losses due to interpersonal and self-directed violence in the United States. Am J Prev Med 2007 Jun;32(6):474-82.
[2]        Tiihonen J, Lonnqvist J, Wahlbeck K, et al. 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet 2009 Aug 22;374(9690):620-7.
[3]        Torniainen M, Mittendorfer-Rutz E, Tanskanen A, et al. Antipsychotic treatment and mortality in schizophrenia. Schizophrenia bulletin 2015 May;41(3):656-63.
[4]        Correll CU, Detraux J, De Lepeleire J, De Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World psychiatry : official journal of the World Psychiatric Association 2015 Jun;14(2):119-36.
[5]        “List of motor vehicle deaths in US by year” https://en.wikipedia.org/wiki/List_of_motor_vehicle_deaths_in_U.S._by_year Accessed 18 June 2017
[6]        “A national approach to mental health – from crisis to community – First report” 2006 Commonwealth of Australia http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Former_Committees/mentalhealth/report/c03 Accessed 18 June 2017

Kintsukuroi Christians

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When I was a kid growing up, there wasn’t much that my father couldn’t repair.

Dad was extremely gifted with his hands, a talent that I certainly didn’t inherit. He was able to take a problem, come up with a practical solution in his mind’s eye, then build it out of whatever scraps of wood, metal or plastic he could lay his hands on. It was the ultimate expression of frugality and recycling that comes from a limited income and four growing children.

Dad was also able to resurrect nearly everything that broke in our house. Plates, cups, teapots, toys, tools … it seemed there wasn’t anything that couldn’t be fixed by the careful application of Araldite.

Araldite, for those unfamiliar with it, is some sort of epoxy resin that, in the right hands, possesses mystical properties of adhesion. It would stick anything to anything.

Dad’s gift for repairing things with Araldite meant that a lot of our things were patched up. Some of our most loved possessions were the most cracked. Despite being glued together several times, each item was still functional. Maybe not as pretty as it may have once been, but still useful, and more importantly, still treasured. Each time the Araldite came out, it taught me that whilst all things have the capacity to be broken, they also have the capacity for redemption.

There’s an ancient Japanese tradition that shares the same principles. For more than 400 years, the Japanese people have practiced kintsukuroi. Kintsukuroi (pronounced ‘kint soo koo ree’) is the art of repairing broken pottery with gold or silver lacquer, and the deep understanding that the piece is more beautiful for having been broken.

The edges of the broken fragments are coated with the glue made from Japanese lacquer resin and are bonded back into place. The joints are rubbed with an adhesive until the surface is perfectly smooth again. After drying, more lacquer is applied. This process is repeated many times, and gold dust is also applied. In kintsukuroi, the gold lacquer accentuates the fracture lines, and the breakage is honoured as part of that piece’s history.
Mental illness is a mystery to most people, shrouded by mythology, stigma, gossip or Hollywood hype. It’s all around us, affecting a quarter of the population every year, but so often those with mental illness hide in plain sight. Mental illness doesn’t give you a limp, a lump, or a lag. It affects feelings and thoughts, our most latent personal inner world, the iceberg underneath the waters.

On the front line of medicine, I see people with mental health problems every day, but mental health problems don’t limit themselves to the doctor’s office. They’re spread throughout our everyday lives. If one in four people have a mental health problem of one form or another, then one in four Christians have a mental health problem of one form or another. If your church experience is anything like mine, you would shake hands with at least ten people from the front door to your seat. Statistically speaking, two or three of them will have a mental illness. Could you tell?

It’s a fair bet that most people wouldn’t know if someone in their church had a mental illness. Christians battling with mental illness learn to present a happy façade, or face the judgment if they don’t), so they either hide their inner pain, or just avoid church altogether.
Experiencing a mental illness also makes people feel permanently broken. They feel like they’re never going to be whole again, or good enough, or useful, or loved. They’re often treated that way by well-meaning but ill-informed church members whose idea’s and opinions on mental illness is out-of-date.

The truth is that Christians who have experienced mental ill-health are like a kintsukuroi pot.

Mental illness may break them, sure. But they don’t stay broken. The dark and difficult times, and their recovery from their illness is simply God putting lacquer on their broken pieces, putting them back together, and rubbing gold dust into their cracks.
We are all kintsukuroi Christians – we’re more beautiful and more honoured than we were before, because of our brokenness, and our recovery.

I’m pleased to announce that my book, Kintsukuroi Christians, is now available. I’ve written this book to try and bring together the best of the medical and spiritual.
Unfortunately, good scientific information often bypasses the church. The church is typically misled by Christian ‘experts’ that preach a view of mental health based on a skewed or outdated understanding of mental illness and cognitive neuroscience. I want to present a guide to mental illness and recovery that’s easy for Christians to digest, adopting the best spiritual AND scientific perspective.

In the book, I look at some scientific basics. Our mental world is based on the physical world. Our mind is a function of the brain, just like breathing is a function of our lungs. Just as we can’t properly understand our breathing without understanding our lungs, so it is that if we’re going to understand our thinking and our minds, we are going to have to understand the way our brain works. So the first part of this book will be an unpacking of the neurobiology of thought.

We’ll also look at what promotes good mental health. Then we’ll look at what causes mental illness, specifically looking at the most common mental health disorders. I will only look at some of the most common disorders to demonstrate some general principles of psychiatric illnesses and treatments. This book won’t be an encyclopaedia, and it doesn’t need to be. I hope to provide a framework so that common and uncommon mental health disorders can be better understood. I also discuss suicide, which is sadly more common than most people realise, and is rarely discussed.

I know mental illness is difficult, and we often look at ourselves or others as though the brokenness is abhorrent, ugly and deforming.
My hope is that through Kintsukuroi Christians, you’ll see the broken pieces are mended with gold, and realise that having or recovering from a mental illness doesn’t render someone useless or broken, but that God turns our mental brokenness into beauty.

Kintsukuroi Christians is available to purchase from good Christian bookstores around the world including:

Kooyong = https://www.koorong.com/search/product/kintsukuroi-christians-christopher-pitt/9780994596895.jhtml

Amazon US = https://www.amazon.com/Kintsukuroi-Christians-TURNING-MENTAL-BROKENNESS/dp/0994596898/

Amazon UK = https://www.amazon.co.uk/Kintsukuroi-Christians-TURNING-MENTAL-BROKENNESS/dp/0994596898/

Smashwords = https://www.smashwords.com/books/view/720425

~~

Mental illness can be challenging. Sometimes learning about mental illness can bring up difficult feelings or emotions, either things that you’ve been through yourself, or because you develop a better understanding of what a loved one is going through or has been through. Sometimes old issues that have been suppressed or not properly dealt with can bubble up to the surface. If at any point you feel distressed, I strongly encourage you to talk to your local doctor, psychologist, or pastor. If the feelings are so overwhelming that you need to talk to someone quickly, then please don’t delay, but reach out to a crisis service in your country

In Australia
Lifeline 13 11 14, or
BeyondBlue
Call 1300 22 4636
Daily web chat (between 3pm–12am) and email (with a response provided within 24 hours)  https://www.beyondblue.org.au/about-us/contact-us.

USA = National Suicide Prevention Lifeline 1-800-273-TALK (8255)

New Zealand = Lifeline Aotearoa 24/7 Helpline 0800 543 354

UK = Samaritans (24 hour help line) 116 123

For other countries, Your Life Counts maintains a list of crisis services across a number of countries: http://www.yourlifecounts.org/need-help/crisis-lines.

Black is the new black – Mental illness touches more of us than we realise (or want to admit)

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I rarely get sick.

I say this while superstitiously touching my wooden desk to try and avoid putting the mockers on myself.  Thankfully, I have a fairly robust immune system and, after years or working in hospital paediatrics and general practice, and having been sneezed at or coughed on multiple times a day, I have been exposed to just about every variation of the cold virus and influenza possible.

Even for those of us with an immune system as solid as a prize bull, we still get sick every now and then.  We all get upper respiratory viruses so commonly that we just consider it a normal part of life.  Most people will take some paracetamol or ibuprofen and keep going.  Some people will go to their GP, and while a most will (… should …) come away some simple reassurance, occasionally some will need a prescription medication for a nastier bacterial infection.  An even smaller percentage will need admission to hospital because of a much more severe infection.

I read an interesting blog this week on Psychology Today by Dr David Rettew.  Its provocative title was, “Is Mental Illness the Rule Rather Than the Exception?”

The blog discussed the study being carried on in Dunedin which has been following a cohort of a thousand people for the last thirty-five years.  This particular study looked for common factors that were shared by those people who had never been affected by a certifiable psychiatric disorder.  What was interesting was that only seventeen percent of the people in that cohort had NOT been affected by a mental illness at some point in that thirty-five-year time frame.

Now for the average Australian, there are some obvious kiwi jokes going begging here (like, I’d be depressed too if I had to live in New Zealand, or how can someone tell if a sheep is really depressed or not, etc. etc.).  All jokes aside, seventeen percent of people not affected … that’s a remarkable figure.  In researching my latest book (soon to be released …) I had come across the figure of fifty percent of people had a lifetime prevalence of any mental illness.  That’s one in every two, and chances are that if you weren’t the person affected, you would know someone who was affected, but the Dunedin figures are even higher.  If you can accurately extrapolate them, four out of every five people will be affected by mental illness at some point in their lives.

The inevitable response from modern psychiatry’s critics is entirely predictable – there will be claims that the DSM5 is simply making diseases out of normal human life experiences, that our humanity is being pathologised and over-medicated for the benefit of big Pharma.

But as Rettew points out in a separate blog post, something may be such a common occurrence as to be considered part of the normal human experience but it can still be a pathology.  The common cold is so common that it’s a normal part of life, but it’s still a disease.

Whether four out of every five people will be affected by mental illness or one out of two, whatever the number, the idea that most of our population will be afflicted with a mental illness at some point in their lives isn’t necessarily a negative thing.  As Rettew also discusses, we don’t arbitrarily change the definitions of physical illnesses to match how many people we think should suffer from them, and neither should we arbitrarily change the diagnostic boundaries of mental illness so less people appear mentally unwell.

We need to accept that, at times, people will be functionally impaired to varying degrees because of mental illness just like people will be functionally impaired by physical illness.  We need to treat mental illness with the same respect as we would physical illness.

In the same way that not all physical illnesses require medication, neither do all mental illnesses.  By and large, most mental illnesses that people suffer from will be short lived and self-limiting, the psychiatric equivalent of having a cold.  Some people will need treatment for their mental illness, but usually this takes the form of structured behavioural therapy like ACT or CBT.  Occasionally, people will need to take a medication and very occasionally, some people will need to be hospitalised because of their mental illness.

For too long, mental illness has been viewed from an extreme perspective – mental illness is uncommon and severe. The nuances of mental illness have been lost or ignored in the white noise of ignorance and sanctimony.  The lack of subtlety and understanding has failed us as a community.  When treated early, mental illness has a much better prognosis, but the stigma, fear and misunderstanding perpetuated by the all-or-nothing approach has left a lot of people without treatment and therefore with worse outcomes overall.

If people were to realise that most of us will be touched by mental illness at some point, then perhaps there would be more understanding and less judgement, something that would lead to less suffering because of mental illness.

That would only be a good thing.

~~~~~

If you think you might be affected by mental illness or if you would like to know more, see your local GP, family physician or psychologist.  On line information can be found at many reputable sites including Beyond Blue – https://www.beyondblue.org.au

Dr Caroline Leaf – Increasing the stigma of mental illness again

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Let me tell you a story.

A couple of years ago, one of my patients was an elderly gentleman in his late seventies.  He was living in a nursing home at the time, but because of his history of psychosis, he remained on a treatment order – a requirement by law that if he was to remain outside of a mental facility, he had to have regular anti-psychotic medication every few weeks.

This man was on a treatment order because his disease caused him to have delusions.  He misinterpreted what was going on around him, and would not consider that he could be wrong.  In his particular case, he was convinced that his next-door neighbour was a paedophile, and he was planning to ambush his neighbour and castrate him.  Luckily the police had taken my patient into custody before he got the opportunity.  With treatment, my patient had clear thoughts, although needed close supervision.  Without his medication, he became confused and violent.

According to a post on the blog Mad in America and promoted by Dr Caroline Leaf, my patient’s diagnosis was spurious, and he was denied his basic human rights by being forced to take medications.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist.  She is also a self-declared expert in mental health, despite not having any professional training in medicine, psychiatry, psychology or even cognitive neuroscience for that matter.

Indeed, if she had any experience or expertise in mental health, she would have recognised the basic factual errors and logical fallacies that riddled the post she quoted from.

Take the quote that Dr Leaf posted on social media.  The full quote from the Mad in America post is:

“Despite the fact that no one in history, not even the omnipotent American Psychiatric Association – which produces and profits mightily from the ‘Bible’ of mental disorders — has come up with a halfway good definition of “mental illness,” and despite the fact that the process of creating and applying the labels of mental illness is unscientific, any of those labels can be used to deprive the person so labeled of their human rights. This is terrifying. It ought to terrify those who are so labeled and those who are not, because deprivation of human rights on totally arbitrary grounds is inhumane and immoral.”

This is the same tired, emotionally laden and misleading rhetoric that’s so often barked in fervent paroxysms through the foaming lips of those opposed to modern psychiatric practice:

  1. There is no good definition of ‘mental illness’
  2. The American Psychiatric Association is just a profit-driven cabal
  3. The DSM5 (which the author alludes to as the ‘Bible’ of mental disorders) is unscientific
  4. Psychiatric diagnoses are unscientific
  5. Any psychiatric diagnosis can be used as a trigger to force people into unwanted treatments or incarceration
  6. Therefore psychiatric diagnosis and treatment is against basic humans rights and is inhumane and immoral.

Inhumane and immoral hey?  Tell that to my patients neighbour who almost became a eunuch except for that “inhumane and immoral treatment” of my former patient.

Caplan claims just don’t stand up to any rational scrutiny.

  1. There are lots of good definitions of mental illness … modern psychiatry critics just don’t like them. But take the definition used by the CDC, “Mental illness is defined as … ‘health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.’” There’s nothing wrong with this definition. It describes mental illness and helps differentiate mental illness from variations of mood, thought and behaviour that are part of the everyday human experience.
  1. The American Psychiatric Association isn’t the only group to have created a classification of psychiatric illnesses. The World Health Organisation publishes the International Classification of Diseases, or the ICD, which is also used for psychiatric diagnosis. Is the WHO an evil profit-driven junta too?
  1. The DSM, the ICD, and any other system of diagnosis, are simply different classification systems. Over the last century, clinicians have noted clusters of symptoms and have tried to classify them into common groups. How is that unscientific?  It’s no different to scientists looking at the different characteristics of various animals and creating a taxonomy, to provide a common system and language for clinicians and researchers across disciplines and across countries.The DSM system isn’t perfect, but what system ever is?  As knowledge of neuroscience grows, the classifications are reviewed and tightened in an ongoing process of improvement.  If those who oppose the DSM want to come up with something better, they’re welcome to put something forward.
  1. The old saying goes that medicine is an art and a science. Human beings, as nuanced as we are, often don’t fit into diagnostic criteria as easily as we would like. That doesn’t invalidate the diagnostic criteria or make the process unscientific as critics of modern psychiatry would have us believe, just like an unusual and hard-to-classify form of cancer doesn’t invalidate the other cancer classifications that are well defined.  Psychiatry, by it’s nature, relies on verbal report from patients rather than a clean-cut blood test or piece of tissue under a microscope, so at this stage in history, it seems imprecise.  That doesn’t make it any less scientific.
  1. The allegation that any psychiatric diagnosis can any be used to deprive the person so labeled of their human rights is utter nonsense. It’s a giant scarecrow – it seems really scary, but on closer inspection, it’s just a tarted-up mound of straw.People are never forced into treatments unless they really are “dangerous to themselves and/or others”.  This rule can’t be invoked willy-nilly.  There are multiple checks and balances, and a whole school of civil rights lawyers expectantly circling, ready for the whiff of blood in the water (http://www.mhrt.qld.gov.au/?page_id=2 is an example of the process in my home state, but each jurisdiction has their own version).

Caplan rightly pointed out that those with mental illness were less likely to be the perpetrators of violence and more likely to be the victims, but that doesn’t negate the need for protection of the community from those with mental illness who have shown violent intent and no capacity to control their behaviour.

If you want to find a group that really are suffering from inhumane and immoral deprivations of their human rights, then that would be Christians.  Around the globe, millions of Christians are oppressed, imprisoned, tortured, raped, and murdered every year.

Time and space preclude a full analysis of Caplan’s post, but what’s really important is that both the American Psychiatric Association and the U.S. Department of Health and Human Services’s Office of Civil Rights, an independent ombudsman, dismissed formal appeals by Caplan relating to her hysterical claims of inhumane forced psychiatric treatment.  Dr Leaf conveniently left that out of her social media post.

Instead, Dr Leaf chose to publish one of the most alarming quotes from an article heavy on scaremongering, from a disaffected author on an extremist blog.  If Dr Leaf was a real expert on mental health instead of being a self-declared one, she would have easily seen how nonsensical Caplan’s post was.

By posting this quote on social media today, it’s highly likely that Dr Leaf has caused harm to thousands of vulnerable Christians by unnecessarily increasing the stigma and fear of a mental health diagnosis.  This, in turn, is likely to lead to these same vulnerable Christians missing out on (drug and non-drug) treatment which would help them rise to their true potential in God and in life, leaving them trapped and suffering in their mental destitution.

Dr Leaf has a track record of misinformation when it comes to mental health.  Christians suffering mental illness need more support, not more stigma.  It’s time Dr Leaf stepped aside, and stopped making things worse.

Cutting through the Paleo hype

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Fad diets come and go. One of the most popular fad diets of recent times is Paleo.

The Palaeolithic diet, also called the ‘Stone Age diet’, or simply ‘Paleo’, is as controversial as it is popular. It’s been increasing in popularity over the last few years, and has had some amazing claims made of it by wellness bloggers and celebrity chefs. Advocates like ‘Paleo’ Pete Evans of MKR fame, claim that the Palaeolithic diet could prevent or cure poly-cystic ovarian syndrome, autism, mental illness, dementia and obesity [1].

So what does the published medical literature say? Is there really good research evidence to support the vast and extravagant claims of Paleo?

About 10 months ago, I started reviewing the medical research to try and answer that very question. My review of the medical literature turned up some interesting results, and so rather than post it just as a blog, I thought I would submit it to a peer-reviewed medical journal for publication. After a very nervous 9-month gestation of submission, review, and resubmission, my article was published today in Australian Family Physician [2].

So, why Paleo, and what’s the evidence?

Why Paleo?

The rationale for the Palaeolithic diet stems from the Evolutionary Discordance hypothesis – that human evolution ceased 10,000 years ago, and our stone-age genetics are unequipped to cope with our modern diet and lifestyle, leading to “diseases of civilization” [3-9]. Thus, only foods that were available to hunter-gatherer groups are optimal for human health – “could I eat this if I were naked with a sharp stick on the savanna?” [10] Therefore meat, fruits and vegetables are acceptable, but grains and dairy products are not [11].

Such views have drawn criticism from anthropologists, who argue that that there is no blanket prescription of an evolutionarily appropriate diet, but rather that human eating habits are primarily learned through behavioural, social and physiological mechanisms [12]. Other commentators have noted that the claims of the Palaeolithic diet are unsupported by scientific and historical evidence [13].

So the Palaeolithic diet is probably nothing like the actual palaeolithic diet. But pragmatically speaking, is a diet sans dairy and refined carbohydrates beneficial, even if it’s not historically accurate?

Published evidence on the Palaeolithic Diet

While the proponents of the Palaeolithic diet claim that it’s evidence based, there are only a limited number of controlled clinical trials comparing the Palaeolithic diet to accepted diets such as the Diabetic diet or the Mediterranean diet.

Looking at the studies as a whole, the Palaeolithic diet was often associated with increased satiety independent of caloric or macronutrient composition. In other words, gram for gram, or calorie for calorie, the Paleo diets tended to make people fuller, and therefore tend to eat less. Of course, that may have also been because the Paleo diet was considered less palatable and more difficult to adhere to [14]. A number of studies also showed improvements in body weight, waist circumference, blood pressure and blood lipids. Some studies showed improvements in blood sugar control, and some did not.

The main draw back of clinical studies of Paleo is that the studies were short, with different designs and without enough subjects to give the studies any statistical strength. The strongest of the studies, by Mellburg et al, showed no long-term differences between the Palaeolithic diet and a control diet after two years [15].

The other thing to note is that, in the studies that measured them, there was no significant difference in inflammatory markers as a result of consuming a Palaeolithic diet. So supporters of Paleo don’t have any grounds to claim that Paleo can treat autoimmune or inflammatory diseases. No clinical study on Paleo has looked at mental illness or complex developmental disorders such as autism.

Other factors also need to be considered when thinking about Paleo. Modelling of the cost of the Palaeolithic diet suggests that it is approximately 10% more expensive than an essential diet of similar nutritional value, which may limit Paleo’s usefulness for those on a low income [16]. Calcium deficiency also remains a significant issue with the Palaeolithic diet, with the study by Osterdahl et al (2008) demonstrating a calcium intake about 50% of the recommended dietary intake [17]. Uncorrected, this could increase a patients risk of osteoporosis [18].

To Paleo or not to Paleo?

The bottom line is the Paleo diet is currently over-hyped and under-researched. There are some positive findings, but these positive findings should be tempered by the lack of power of these studies, which were limited by their small numbers, heterogeneity, and short duration.

If Paleo is to be taken seriously, larger independent trials with consistent methodology and longer duration are required to confirm the initial promise in these early studies. But for now, claims that the Palaeolithic diet could treat or prevent conditions such as autism, dementia and mental illness are not supported by clinical research.

If you’re considering going on the Palaeolithic diet, I would encourage you to talk with an accredited dietician or your GP first, and make sure that it’s right for you. Or you could just eat more vegetables and drink more water, which is probably just as healthy in the long run, but without the weight of celebrity expectations.

Comparison of the current Australian Dietary Guidelines Recommendations [19] to the Palaeolithic diet [17]

Australian Dietary Guidelines The Palaeolithic Diet
Enjoy a wide variety of nutritious foods from these five groups every day:  
Plenty of vegetables, including different types and colours, and legumes/beans Ad libitum fresh vegetables and fruits
Fruit
Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as bread, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley All cereals / grain products prohibited, including maize and rice
Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans Ad libitum lean meats and poultry, fish, eggs, tofu, nuts and seeds, but all legumes prohibited
Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced fat milks are not suitable for children under 2 years) All dairy products prohibited
And drink plenty of water. Ad libitum water (mineral water allowed if tap water unavailable)

References

[1]        Duck S. Paleo diet: Health experts slam chef Pete Evans for pushing extreme views. Sunday Herald Sun. 2014 December 7.
[2]        Pitt CE. Cutting through the Paleo hype: The evidence for the Palaeolithic diet. Australian Family Physician 2016 Jan/Feb;45(1):35-38.
[3]        Konner M, Eaton SB. Paleolithic nutrition: twenty-five years later. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition 2010 Dec;25(6):594-602.
[4]        Eaton SB, Eaton SB, 3rd, Konner MJ. Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications. European journal of clinical nutrition 1997 Apr;51(4):207-16.
[5]        Eaton SB, Konner M. Paleolithic nutrition. A consideration of its nature and current implications. The New England journal of medicine 1985 Jan 31;312(5):283-9.
[6]        Kuipers RS, Luxwolda MF, Dijck-Brouwer DA, et al. Estimated macronutrient and fatty acid intakes from an East African Paleolithic diet. The British journal of nutrition 2010 Dec;104(11):1666-87.
[7]        Eaton SB, Konner MJ, Cordain L. Diet-dependent acid load, Paleolithic [corrected] nutrition, and evolutionary health promotion. The American journal of clinical nutrition 2010 Feb;91(2):295-7.
[8]        O’Keefe JH, Jr., Cordain L. Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer. Mayo Clinic proceedings 2004 Jan;79(1):101-08.
[9]        Eaton SB, Eaton SB, 3rd, Sinclair AJ, Cordain L, Mann NJ. Dietary intake of long-chain polyunsaturated fatty acids during the paleolithic. World review of nutrition and dietetics 1998;83:12-23.
[10]      Audette RV, Gilchrist T. Neanderthin : eat like a caveman to achieve a lean, strong, healthy body. 1st St. Martin’s Press ed. New York: St. Martin’s, 1999.
[11]      Lindeberg S. Paleolithic diets as a model for prevention and treatment of Western disease. American journal of human biology : the official journal of the Human Biology Council 2012 Mar-Apr;24(2):110-5.
[12]      Turner BL, Thompson AL. Beyond the Paleolithic prescription: incorporating diversity and flexibility in the study of human diet evolution. Nutrition reviews 2013 Aug;71(8):501-10.
[13]      Knight C. “Most people are simply not designed to eat pasta”: evolutionary explanations for obesity in the low-carbohydrate diet movement. Public understanding of science 2011 Sep;20(5):706-19.
[14]      Jonsson T, Granfeldt Y, Lindeberg S, Hallberg AC. Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutrition journal 2013;12:105.
[15]      Mellberg C, Sandberg S, Ryberg M, et al. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial. European journal of clinical nutrition 2014 Mar;68(3):350-7.
[16]      Metzgar M, Rideout TC, Fontes-Villalba M, Kuipers RS. The feasibility of a Paleolithic diet for low-income consumers. Nutrition research 2011 Jun;31(6):444-51.
[17]      Osterdahl M, Kocturk T, Koochek A, Wandell PE. Effects of a short-term intervention with a paleolithic diet in healthy volunteers. European journal of clinical nutrition 2008 May;62(5):682-85.
[18]      Warensjo E, Byberg L, Melhus H, et al. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. BMJ 2011;342:d1473.
[19]      National Health and Medical Research Council. Australian Dietary Guidelines. Canberra: National Health and Medical Research Council; 2013.