Add Some Spice to Your…Brain

Put on your thinking caps.  It’s one of those posts.

1 in 100 people on average have or will develop schizophrenia.  When I heard that statistic, I was shocked.  I didn’t realize it was so common.  Okay, so it’s only 1% of the population? Still.  Go to a Lady Gaga concert.  Now do the math.  In my opinion, that’s too many people walking around in one venue with such a burdensome illness.  The good news is that researchers are trying to figure out schizophrenia’s etiology and pathogenesis so that they can do something about it.  That’s great news for the next few generations.  It’s tough for people in the now who are so intimately acquainted with this disease.

The latest research has given us a few theories.  One of these theories is the cytokine theory.  If you have RA, then you’ll know what cytokines are.  They are proteins, and they do many, many things in the body, but for the sake of this discussion I am going to discuss them in the context of the immune system.  One thing that they are associated with is inflammation:

The pathogenesis of schizophrenia has yet to be fully characterized. Gene–environment interactions have been found to play a crucial role in the vulnerability to this disease. Among various environmental factors, inflammatory immune processes have been most clearly implicated in the etiology and pathology of schizophrenia. Cytokines, regulators of immune/ inflammatory reactions and brain development, emerge as part of a common pathway of genetic and environmental components of schizophrenia. Mater- nal infection, obstetric complications, neonatal hypoxia and brain injury all recruit cytokines to mediate inflammatory processes. Abnormal expres- sion levels of specific cytokines such as epidermal growth factor, interleukins (IL) and neuregulin-1 are found both in the brain and peripheral blood of patients with schizophrenia. Accordingly, cytokines have been proposed to transmit peripheral immune/ inflammatory signals to immature brain tissue through the developing blood–brain barrier, perturb- ing structural and phenotypic development of the brain. This cytokine hypothesis of schizophrenia is also supported by modeling experiments in animals. Animals treated with specific cytokines of epidermal growth factor, IL-1, IL-6, and neuregulin-1 as embryos or neonates exhibit schizophrenia-like behavioral abnormalities after puberty, some of which are ame- liorated by treatment with antipsychotics. In this review, we discuss the neurobiological mechanisms underlying schizophrenia and novel antipsychotic candidates based on the cytokine hypothesis. (online source)

This implies that schizophrenia is neurodevelopmental meaning that the disease’s etiology actually begins prenatally.  The next question is: Does pro-inflammatory action continue postnatally and into and past the prodrome of the disease?

A January 2014 study published in Psychiatry Weekly suggests the affirmative:

Activation of inflammatory pathways is one among many hypotheses exploring the pathophysiology of schizophrenia. A number of studies suggest that prostaglandin E2 (PGE2), C-reactive protein, and proinflammatory cytokines are all increased in schizophrenia patients. Furthermore, schizophrenia patients who respond to treatment have shown lower inflammatory markers compared to treatment outset. The same is also seen in major depressive disorder, bipolar disorder, and regarding oxidative stress markers. “One may be led to believe that vulnerability to mental illness may somehow be related to neuroinflammation,” says Dr. Christoph Correll, “and therefore the question becomes: could symptoms be reduced by reducing inflammation?” (Psychiatry Weekly)

So, what do we do with this information? And, what about this mention of major depressive disorder and bipolar disorder? Neuroinflammation is possibly present there as well?

Let’s start here:

Anti-inflammatory and anti-oxidant properties of Curcuma longa (turmeric) versus Zingiber officinale (ginger) rhizomes in rat adjuvant-induced arthritis.  

Here’s the abstract:

Turmeric (rich in curcuminoids) and ginger (rich in gingerols and shogaols) rhizomes have been widely used as dietary spices and to treat different diseases in Ayurveda/Chinese medicine since antiquity. Here, we compared the anti-inflammatory/anti-oxidant activity of these two plants in rat adjuvant-induced arthritis (AIA). Both plants (at dose 200 mg/kg body weight) significantly suppressed (but with different degrees) the incidence and severity of arthritis by increasing/decreasing the production of anti-inflammatory/pro-inflammatory cytokines, respectively, and activating the anti-oxidant defence system. The anti-arthritic activity of turmeric exceeded that of ginger and indomethacin (a non-steroidal anti-inflammatory drug), especially when the treatment started from the day of arthritis induction. The percentage of disease recovery was 4.6-8.3% and 10.2% more in turmeric compared with ginger and indomethacin (P < 0.05), respectively. The present study proves the anti-inflammatory/anti-oxidant activity of turmeric over ginger and indomethacin, which may have beneficial effects against rheumatoid arthritis onset/progression as shown in AIA rat model.

Here’s the thing about animal studies.  If you want to know what’s going to be happening in medicine and pharmacology ten to twenty years from now, then you have to look at present animal studies.  That’s where the cutting edge of medicine is because this is where researchers are asking the questions about modern diseases.  What is the one thing that scientists keep running into when they talk about disease onset and progression? Inflammation.  It is a marker for disease.  Inflammation in the body is the immune system at work, and it’s been in the news for the last decade.

What is the important takeaway from one animal study about arthritis? Turmeric was more potent than indomethacin (NSAID) in treating rheumatoid arthritis onset and progression in animal models.  Turmeric! A spice! This means that turmeric interacts with the body’s cytokines, and this is really important.  My next question is: Does turmeric cross the blood/brain barrier?

Turmeric has been in use since ancient times as a condiment and due to its medicinal properties.  Curcumin, the yellow colouring principle in turmeric, is polyphenolic and major active constituent. Besides anti-inflammatory, thrombolytic and anticarcinogenic activities, curcumin also possesses strong antioxidant property. In view of the novel combination of properties, neuroprotective efficacy of curcumin was studied in rat middle cerebral artery occlusion (MCAO) model. Rats were subjected to 2 h of focal ischemia followed by 72 h of reperfusion. They were pre-treated with curcumin (100 mg/kg, po) for 5 days prior to MCAO and for another 3 days after MCAO. The parameters studied were behavioural, biochemical and histological. Treatment with curcumin could significantly improve neurobehavioral performance compared to untreated ischemic rats as judged by its effect on rota-rod performance and grid walking. A significant inhibition in lipid peroxidation and an increase in superoxide dismutase (SOD) activity in corpus striatum and cerebral cortex was observed following treatment with curcumin in MCAO rats as compared to MCAO group. Intracellular calcium levels were decreased following treatment with curcumin in MCAO rats. Histologically, a reduction in the infarct area from 33% to 24% was observed in MCAO rats treated with curcumin. The study demonstrates the protective efficacy of curcumin in rat MCAO model. (Anti-ischemic effect of Curcumin on Rat Brain)

This study was addressing strokes; however, it proves one thing.  Turmeric crosses the blood/brain barrier and acts as a neuroprotective agent.  If that’s not enough, here’s one more article discussing turmeric’s action in the brain regarding Alzheimer’s Disease:

This paper discusses the effects of curcumin on patients with Alzheimer’s disease (AD). Curcumin (Turmeric), an ancient Indian herb used in curry powder, has been extensively studied in modern medicine and Indian systems of medicine for the treatment of various medical conditions, including cystic fibrosis, haemorrhoids, gastric ulcer, colon cancer, breast cancer, atherosclerosis, liver diseases and arthritis. It has been used in various types of treatments for dementia and traumatic brain injury. Curcumin also has a potential role in the prevention and treatment of AD. Curcumin as an antioxidant, anti-inflammatory and lipophilic action improves the cognitive functions in patients with AD. A growing body of evidence indicates that oxidative stress, free radicals, beta amyloid, cerebral deregulation caused by bio-metal toxicity and abnormal inflammatory reactions contribute to the key event in Alzheimer’s disease pathology. Due to various effects of curcumin, such as decreased Beta-amyloid plaques, delayed degradation of neurons, metal-chelation, anti-inflammatory, antioxidant and decreased microglia formation, the overall memory in patients with AD has improved. This paper reviews the various mechanisms of actions of curcumin in AD and pathology. (The effects of curcumin (turmeric) on Alzheimer’s Disease: An overview)

If the cytokine theory or even the microglial theory is true and the etiology of schizophrenia is related to or even partially related to an immune response, then turmeric fits the bill as an adjunct treatment.  It has a very low side-effect profile particularly when you compare it to lithium and antipsychotics.  Turmeric is also a broad spectrum anti-viral.  I have been taking it for two years, and I rarely get sick.  I also rarely need to take ibuprofen since taking turmeric faithfully.  It truly is as effective as an NSAID, when taken daily, for managing chronic pain.

For detailed information on turmeric, read this: Linus Pauling Institute Macronutrient Information Center

And wouldn’t you know it, someone recently finished a clinical trial using curcumin as an adjunct therapy in treatment for schizophrenia: Open-label study using Curcumin C-3 Complex in Schizophrenia.  The results aren’t posted yet, but I’m dying to know what they are.


Interesting Times

This is in no way a helpful post.  This is a, “I’ve been in the house for a month, and I’m going crazy” post.

I will never take my ability to drive a car or simply walk anywhere or carry a cup of coffee or get up in the middle of the night to go to the bathroom or empty the dishwasher or my self-reliance for granted.

I am still on crutches.  Four weeks didn’t seem so long when Dr. A told me about it in the pre-op appointment, but you know how cocky those bone breakers are.  “It’s four weeks on crutches and three months of PT.”  Three months is a long time.  Four weeks? I guess that’s not so bad.

It’s bad.  It’s bad because it isn’t four weeks on crutches.  It’s four weeks of 10% weight-bearing on the surgical side.  After four weeks, it’s another two weeks of practicing weight-bearing which is a long and painful process.  So, really, it’s another two weeks of trying to learn to walk again, and I still can’t drive! Well, I can only drive a few blocks.  This is intolerable! Yesterday was my first day of beginning the weight-bearing exercises.  I did not enjoy it.  I am trying to remember that I once walked.  Surely, I will walk again and this will be but a happy memory.  It feels like an impossibility right now.  I never imagined that a torn anything in a hip could cause this much trouble!

What has been the most interesting thing in this entire endeavor, however, has been observing my husband.  I’ve written a little bit on this blog about my marriage.  The past two years have been challenging what with Grace’s sharp decline.  It’s not uncommon to experience relational difficulties when a child is diagnosed with a severe health condition or mental illness.  I have been down and out.  I can’t go into the basement to do laundry.  I can’t carry the laundry baskets.  I can’t really clean anything.  I can’t vacuum.  I am just now able to get into the kitchen and cook although it’s awkward as hell.  He has had to do everything, and this is a man who has never done that.

I have suspected for a few years now that he was on the autism spectrum–high functioning, mind you.  He is so similar to our youngest daughter in temperament.  He has on more than a few occasions said how similar he was to her as a child.  She has high-functioning autism (HFA).  Part of me has wanted to dismiss this idea because I have wanted to believe that all his quirks and very annoying habits would change given time and effort.  I have, however, only seen the chasm between us grow wider over the past two years.  In the wake of Grace’s illness, I have sought greater emotional intimacy, and he has sought out more time alone.  He has morphed into Spock, that pointy-eared bastard as Bones once called him, and I have become the single-minded and overly emotional Jim Kirk.  We are at odds.  All the time.

So, forced into a submissive state of dependence, I have observed.  I have done my best to practice what I have internalized from DBT.  Observing without judging.  It is amazing what can be learned when we suspend judgment.  I have watched a man try as hard as he can to look after me and meet my needs while trying his hardest to meet the needs of his children.  The physical needs.  Driving to and from school.  Feeding.  Doing laundry.  Helping with homework.  I can help with homework, but this was physics homework.  I will hiss and skitter under furniture at the mere mention of the P-word.  He has gone to the grocery store.  He has barely worked.

What I have seen is that he can’t be emotional and practical at the same time.  He has modes of operation.  Sort of like Mr. Rogers and his sweater.  He requires a ritual to move from one mode to another.  I could write at length about the rituals he requires to make the transition from one persona to another and his intense need for solitude.  This lack of emotional affect or even cognitive empathy, however, is what causes him to act like an asshole.  He isn’t trying to be a jerk.  He just isn’t able to infuse any of his actions with any meaningful emotional content.  He behaves like Spock.  If I’m Jim Kirk in the relationship, then I’m constantly trying to provoke an emotional response in him which looks like baiting behavior.  Where’s the passion, Spock? Why do you appear to be so cold? Do you even care about us? You look miserable!

His response is completely rational.  Of course, he cares.  Look at what he’s doing.  He ticks off what needs to be done.  We are provided for.  Once the items are checked off the list, he then retreats into his bedroom and disappears for hours.  If we need him, we simply need to tell him.  He cannot anticipate a need.  He cannot read the cues.  He does ask so that he’ll know, but he will never be capable of “reading” people or a situation and understanding what is required.  Emotional intimacy is not something that he truly wants.  He doesn’t have a social drive.  He wants his family to be happy.  He works hard to provide opportunities so that we can pursue happiness.  It never occurred to me that he didn’t see himself as a part of that happiness.  He saw us going out into the world to engage in that pursuit while he happily stayed in his cloister pursuing his.  It is a shock to me.

This is what I have learned during my convalescence.  I told him the night before last very casually that I wondered if Milly might have inherited her ASD from him.  “I wonder if you might be very high functioning on the autism spectrum.”  His response? “Oh, I know that I am.”

Really? Since when? And, if that’s true, then what does that mean going forward?

Uhura loved Spock.  Jim was his friend.  On any given day lately, this is my inner monologue:


Interesting times, interesting times.  It’s a good thing he doesn’t have bangs (watch the clip to understand the reference).


Eight Classes of Schizophrenia

“New research shows that schizophrenia isn’t a single disease but a group of eight genetically distinct disorders, each with its own set of symptoms. The finding could be a first step toward improved diagnosis and treatment for the debilitating psychiatric illness.”

Sounds very interesting, doesn’t it? If you want to know more, then read on…

Schizophrenia not a single disease but multiple genetically distinct disorders

Emotional Education

I’ve utilized therapy since I was 16.  I’ve always viewed therapy as a resource.  I have never fully understood the stigma applied to therapy until I was older.  Until I met my husband.

I suggested that he find a therapist a few years into our marriage, and he made a weird snorting sound and scoffed, “I will never do that.  That’s for broken people.”  I took that in and pondered.  I went to therapy.  Did he see me as broken? What a weird point of view.

Our youngest daughter was diagnosed with an autism spectrum disorder and comorbid anxiety disorder when she was three.  I took her to play therapy.  He seemed supportive.  Was she broken?

Then Eadaoin hit puberty and her subtle social anxiety soon became an anxiety disorder, and she required medication and therapy, too.  Was she broken?

Then the Big S invaded our home.  Grace developed childhood-onset schizophrenia, and therapy was the least of our problems.  Maybe she really was broken, but I was going to do whatever it took to put her back together again.

And guess who didn’t have the resiliency, communication skills, or emotional maturity to deal with any of it?


Of every member of my family, guess who is doing the most poorly?


Not Grace.  Not Milly.  Not Eadaoin.  Not even me.


You see, we all leave our families of origin with deficiencies, and we all have coping skills in place to compensate for those deficits.  We could have had the most wonderful parents, but there is no such thing as a perfect parent.  Even if our parents were perfect, we don’t grow up in the vacuum of our homes.  We go to school.  We make friends.  We travel, get jobs, and participate in extracurricular activities.  A lot happens to us as we are developing, making and losing friends, experiencing middle and high school.  We don’t emerge from the first 18 years of our lives unscathed.  Not a one of us.

We were not born knowing how to act or knowing what to do.  We learn by watching how the people around us act.  We learn what to say by modeling what others around us say.  We learn how to manage conflict by modeling how our family managed conflict.  Some people realize at a young age that what they are witnessing isn’t right.  They, however, don’t know what the healthy way is so they might fumble their way through.

This is where therapy comes in.  Contrary to popular belief, the therapeutic experience isn’t lying back and talking about your father while some mustachioed man smokes a pipe and writes on a legal pad.  In fact, that sounds a whole lot like the beginning of a porn film.  No, therapy doesn’t have to be client-centered at all (the Rogerian approach).  It can be entirely skills-based–a DBT skills group, for example.  The point is that “therapy” doesn’t have to be the four-letter word that so many people I’ve met think that it is.

Therapy is our gateway to growing up.  When we find a therapist that we like and trust, we can actually do the work of maturing and growing into the adults that we have always wanted to be.  How?

  • A good therapist walks with you through those memories that are holding you back in order to help you resolve them so that you no longer carry them, and they no longer define you.
  • A good therapist helps you learn to talk about your feelings so that you can communicate effectively within your relationships.
  • A good therapist validates you and your life experiences.  This is key because we need validation to feel safe and sane.
  • A good therapist teaches you how to self-validate so that you are no longer beholden to others for your validation and sense of self.
  • A good therapist models empathy which, hopefully, will teach us how to do the same.
  • A good therapist teaches us how to be empowered in our relationships forsaking victim thinking, codependency, and caretaking.
  • A good therapist provides a reality check and tough love when necessary so that we learn what true accountability in relationships looks like.
  • A good therapist guides us into learning distress tolerance so that we can give up maladaptive coping strategies that harm us and our relationships.
  • A good therapist provides insights into what motivates us so that we learn to become curious about ourselves and why we make certain choices.
  • A good therapist legitimizes separation, individuation, and differentiation from our parents which is so often the root of our suffering.
  • A good therapist teaches us a better way to think and shows us where we are believing negative things and, thusly, how those negative beliefs manifest in negative behaviors.

Therapy is the environment in which we continue developing as humans except that we have the opportunity to develop into better humans.  Therapy is meant to teach us so that we are equipped to deal with whatever life throws at us.

Who do you suppose does better in a crisis? The person who trusts themselves or the person who is rootless, anxious, and doesn’t trust anyone? Part of becoming an educated person is receiving an emotional education as well.  One of my favorite college professors once told a group of women that her goal in teaching us was to create educated women.  When asked what that meant, she replied, “To be truly educated means that you are critical thinkers.  It means that if you don’t know the answer to a question, then you know how to go about finding it.”

This is what it means to be emotionally educated.  It means that you are a critical thinker when it comes to yourself.  You are self-aware.  You understand your motives.  You know what you need.  You can self-advocate.  You can trust others.  You trust yourself.  You know how to ask for what you want, and you are not beholden to others for your sense of worth or sense of calm.  If you find yourself in difficult situations for which you are not equipped, then you know how to go about equipping yourself.  You know the skills you have, and you know the ones you need.  Lastly, you take responsibility for yourself–your actions, your feelings, your desires, and your needs.

This is what therapy can do for us.  All of those inadequacies that we see today? Those deficits in our personalities that we try to hide out of shame? Reframe them.  They are just opportunities when you put them in a therapeutic environment.  What if you simply need to learn a new skill? We will all be developing and maturing until the day we die, picking up more wisdom as we go.  Engaging in your own emotional education is not something to be ashamed of.  It should be celebrated.

Remaining emotionally illiterate because someone somewhere once said that only weak people see shrinks? I think that’s the least educated view of all.

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