Birthing Bliss, Birthing Trauma, and the Role of the Perinatal Patient


KellyBroganMD.com
Dr. Kelly Brogan
February 8, 2020

I remember looking out of my living room window, drawing on my connection to all the women in the world who had felt this energy before, all that were in that moment, and all that would in time to come. This energy, this incredible power, was like a wave that I was riding for a brief window of my life, and sharing with my baby to move us through time into a new type of union. To me, this wasn’t anything to resist, to be afraid of, or to suppress. All I had to do was be there to witness, and keep my mind from getting in the way.

I came to a place of strong advocacy for homebirth because I am a tireless student of research, opinions, and “radical” theory espoused by critical thinkers. I believe in being an informed individual first and a patient second and surrendering my decision-making to a physician trained to perceive childbirth as a pathological process requiring management was not consistent with that perspective.  I knew that there were caregivers out there who believed in supporting the body’s natural process in a gentle way and who knew how to provide that support, actively and passively.  These are midwives.  They are the primary birth attendants in most of the 40+ nations in the world with more favorable maternal and infant mortality rates than our own.

So, how does a woman get to a place where she can turn her back on a society that teaches birth is a painful nuisance at best and a horror show of danger at worst?

Through active engagement in informed consent.  A careful review of some of the epidemiologic literature and an excellent book on the subject called Pushed by Jennifer Block will inform that prospective mother of the fact that countries with the best maternal/infant outcomes have 20-30% of their babies at home, and a caesarean rate of no higher than 15%.  In these healthy births, labor begins spontaneously, the woman is free to move about for whatever duration necessary, and she pushes in an intuitive position.

This soon-to-be-birthing reader might be prompted to question some of the casually accepted “rules” of hospital birth including induction of labor post-dates, the ban on eating and drinking, and active intervention after 24 hours after rupture of membranes.  She might note that continuous electronic fetal monitoring is a ubiquitous mandate in the hospital setting despite an absence of randomized, controlled studies demonstrating any benefit with regard to maternal/infant outcomes (and a noted higher association with caesarean section given the attendant immobilization and anxious interpretations of “the strip”).  Here is the informative Lamaze-sponsored handout I give my patients which highlights the discrepancy between known evidence (including Cochrane reviews, and even ACOG recommendations) and common practice, often militantly imposed.

Pushed discusses a WHO study which identified that only 10% of maternity care is justified by scientific evidence (as opposed to insurance constraints, convenience, liability, and habitual practice).  This wouldn’t be such a concern if the risks associated with interfering in a physiologic birth weren’t so troubling.  Here are some tidbits she reviews:

  • Infants born by caesarean are 3x more likely to die in the first month, and mothers are 2x more likely to die.  Caesarean carries risks of infection including necrotizing fasciitis, organ damage, adhesions, hemorrhage, embolism, hysterectomy, dehisance, poor respiratory adaptation for the baby, and future development of a major undesirable – placenta acreta (at an incidence of 1/533 in 2005 births from 1/19,000 births in 1970)
  • Epidurals decrease blood pressure, slow contractions, and lengthen labor, increasing the likelihood of tearing, fever, and instrumental delivery
  • Vaginal birth after caesarean has a rate of rupture of 1/200 which is comparable to the rate of miscarriage with an amniocentesis, but is all but impossible to obtain given the reflexive second, third, and fourth caesarean birth plans
  • Homebirth is comparably safe with lower intervention rates according to common sense and seminal studies.

The problem with the application of these interventions is that they serve to disempower the laboring woman, and force her to cope with the unintended consequences of the intervention domino effect.  Wresting autonomy from an individual in the interest of a questionably-evidenced system has feed-forward implications for generations.  Perhaps both psychiatry and obstetrics are guilty of pathologizing processes that scare us, and in our effort to subdue, we use crude and inexact implements in acute settings without consideration of the collateral damage.

Even the donning of a hospital gown on arrival puts a woman in the role of a sick patient rather than a conduit for life’s most transcendent contact with creation.  I hear frequent reviews from my patients, stating, “the room looked like a battle ground”, “I felt like I was drugged…like it wasn’t my baby”, “I was offered an epidural so many times, I thought I really needed one”.  This is not an arena in which we can expect Ina May Gaskin’s “sphincter law” to play out successfully – a woman needs a sense of calm, safety, and privacy open her body to the world and bring forth a baby.

Interfering with the sophisticated process of a physiologic birth may have unintended short, medium, and long-term effects.  Studies like this allude to the role of vaginal birth in the foundational seeding of the infant’s microbiome, but are there any benefits with regard to mom’s postpartum mood?  Does mode of delivery influence the risk of postpartum depression?  To my mind, it certainly seems possible that disruption in oxytocin feedback loops through interference with the hypothalamic-pituitary-adrenal-gonadal axis would set a woman up for near-term difficulty buffering the transition to new motherhood.  If a physiologic birth is interfered with, the woman is left to go through the motions unaided by appropriate hormonal cascades – like walking across hot coals without shoes.

Despite the intuitive connection between a mother’s birth-related trauma and postpartrum depression, data addressing the question of whether mode of delivery influences risk is equivocal: some propose no risk associated with caesarean, like this study in which depressive symptoms after caesarean were resolved by 6 months and this that suggested being a housewife with a history of depression were primary risk factors, and this metanalysis. Others, like this Armenian study, suggest that caesarean, and particularly elective caesarean, may put a woman at greater risk for postpartum mood disturbance.  A prospective cohort study in China found that, at two weeks, by Edinburgh Postnatal Depression Scale (EPDS), women were 2x more likely to be depressed if they had a surgical birth. Myriad confounders compromise this data, and I would argue that a woman’s psychological orientation toward self-empowerment – what an empowered birth looks like to her – may be more important than the disruption of the hormonal cascade.

The mind is a powerful filter.  Perhaps the most provocative study I have come across is an fMRI evaluation of women responding, in multiple brain regions, to their own baby’s cry, and how this response is blunted after a surgical birth.  Could this evolve to be corrected for?  I would imagine so, but it suggests that surgical birth should be reserved for the <10% of true emergencies that could not otherwise have been prevented by allowing a woman to labor at her own pace, in her own comfort zone, without any interventions… the way it’s been done for millions of years.

Read More At: KellyBroganMD.com

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This post originally appeared on Mad in America as Birthing Bliss, Birthing Trauma and the Role of the Perinatal Patient.

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Kelly Brogan, MD

Kelly Brogan, M.D. is a Manhattan-based holistic psychiatrist, author of the New York Times bestselling book, A Mind of Your Own, and co-editor of the landmark textbook, Integrative Therapies for Depression. She completed her psychiatric training and fellowship at NYU Medical Center after graduating from Cornell University Medical College, and has a B.S. from MIT in Systems Neuroscience. View full bio. Want to share this article on your own blog? View our reposting guidelines.

Book Review: Tavistock Institute – Social Engineering The Masses by Daniel Estulin | #SmartReads #SocialEngineering

“The conscious and intelligent manipulation of the organized habits and opinions of the masses is an important element in democratic society. Those who manipulate this unseen mechanism of society constitute an invisible government which is the true ruling power of our country. …We are governed, our minds are molded, our tastes formed, our ideas suggested, largely by men we have never heard of. This is a logical result of the way in which our democratic society is organized. Vast numbers of human beings must cooperate in this manner if they are to live together as a smoothly functioning society. …In almost every act of our daily lives, whether in the sphere of politics or business, in our social conduct or our ethical thinking, we are dominated by the relatively small number of persons…who understand the mental processes and social patterns of the masses. It is they who pull the wires which control the public mind.”
– Edward Bernays, Propaganda

BreakawayIndividual.com
Zy Marquiez
February 5, 2020

Social Engineering is a pervasive issue that plagues everyone in society, but it is not covered as often or in-depth as it needs to be.  Thankfully, this book helps shed light upon this complex subject from many angles.

Tavistock Institute – Social Engineering The Masses by Daniel Estulin is as disturbing in its implications as it is comprehensive in scope. The book is a veritable crash course into many of the most powerful aspects of social engineering of society.

Estulin details many of the most sophisticated social engineering tools in an incisive way. This alone in and of itself is power, because it allows the incisive/inquiring individual to do their due diligence in seeing what’s what in this esoteric subject.

Various topics are discussed, spearheaded by the actual Tavistock Institute, the Nazis, MK Ultra, Mind Control, Music, Media, the killing of JFK, Drugs, and much more.

More precisely, it touches upon “social turbulence”, which is whittling down the population through a variety of modalities, with increasing intensity, to soften up a population and lead them into psychosis.

There is also the aspect of disassociation touched upon from many angles which is highly intriguing although very disturbing.

Estulin also covers how victimology, which “is premised upon the theory that individuals can be put through trauma by being exposed to shockingly visual accounts of violence”.  Also noted is what role in how Wikileaks is part of the social engineering agenda, and how that directly ties to mass media.

Mass media’s control mechanism is also sifted through with a fine-tooth comb, as well as aspects of it such as “idiotspeak”, which is when the media oversimplifies complex subjects so much, literally covering them only in one or two sentences that  could be called ‘sound bytes’, that it serves to dumb down the population by default.  This is further implemented by no direct and thought-provoking discussion followed up.  And when that does follow, it’s nigh always to suit some government and corporate agenda via the propaganda machine.

One unexpected, but vital component introduced by Estulin was the subject of music, and how it plays a role in the mental manipulation of the population. Although not exhaustive, it is quite a meaningful area that goes oft-overlooked even in the alternative media.

Science fiction, the work of H.G. Wells, as well as many other authors/writers’ work is analyzed creating a broad landscape of research that only strengthens the blatancy of the dilemma.

And anchoring all that, there is also an analysis of the subject of Edward Bernay’s and Walter Lippmann’s work with on propaganda and public opinion.

Beyond that still, there are still many other subjects that get touched upon, most of which are still employed, today, at this very moment.

This book by Estulin allows you to see the careful web of deception, manipulation and control that has been weaved over a mostly unsuspecting populace.

The main strength of this book is the veritable enormity of footnotes/references that allow those inquiring minds to see where he is coming from, whist leaving crumbs for those that wish to follow up on their own research, which I highly appreciate.

Credibility is a vital, and credibility in a subject like this is even more so.  Estulin has done an absolutely outstanding job in piecing this together.

This is a book that needs to be part of everyone’s library.  Period.  You need to know this stuff.  It’s not only being used against you, but your children, and future generations as well. Subjects covered in this book are way too important to gloss over.  The research that has taken place into social engineering, which Estulin discusses was done for a reason, and that was to employ it, and there are signs of this everywhere if you know what to look at.

You are implored because nobody else is looking out for your well being.  This book gives your mind range and versatility in order to deal with what’s already here, and what’s worse, what’s coming.

Be mindful, because social engineering is nigh everywhere. No, that’s not exaggeration, that’s a fact. This book makes that very crystal clear.

Buy it because you will not regret it.

Buy it because you need to know.

Buy this book because everything discussed in this book is being used against you, your family, and kith/kin.

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Suggested Reading & Viewing:

Logical Fallacies Employed In Every Day Life
The Minds Of Men [Documentary] | Social Engineering & Mind Control
Socratic Logic V 3.1 by Peter Kreeft PhD
Getting Things done by David Allen
Dumbing Us Down by John Taylor Gatto
Lesson’s From Orwell’s 1984
Against Public Schooling – How Public Education Cripples Our Kids By John Taylor Gatto
Social Engineering 101
The Emergence Of Orwellian Newspeak & The Death Of Free Speech
What Is An Elite Curriculum?
A Mind Of Your Own – The Truth About Depression by Dr. Kelly Brogan
Social Engineering 101
What Is An Elite Curriculum?
Invisible Influence by Kevin Hogan

Book Review: A Mind Of Your Own: The Truth About Depression And How Women Can Heal Their Bodies To Reclaim Their Lives by Kelly Brogan M.D. and Kristin Loberg | #SmartReads #MentalHealth #Depression

“Psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests.”
– Dr. Allen Frances, author of Saving Normal

“Probably as much as 75% of the medicine of sickness is unnecessary and its cost can be avoided.”
–  Dr. Ghislaine Lanctot, Author Of The Medical Mafia

MS

BreakawayIndividual.com
Zy Marquiez
February 1, 2020

Dr. Kelly Brogan’s work first became known to me when she addressed countless health issues in an article she penned years back that was shared via the website GreenMedInfo.com which is an absolutely superb website about health.  From that moment forward, Brogan became one of my ‘go-to’ alternative medical doctors whose work I attempt to read as much as possible given how mental health issues are increasing significantly each year.

Bottom line: A Mind Of Your Own: The Truth About Depression And How Women Can Heal Their Bodies To Reclaim Their Lives by Kelly Brogan M.D and Kristin Loberg shows the reader many of the inherent issues within Big Pharma and Big Psych while also outlining many proactive steps individuals can take to take charge of their health in significant ways.

Not only is the reader seamlessly shown countless examples of very troublesome issues regarding medications doled out like candy by Big Pharma and doctors, but also how this health for-profit system of ‘medicine’ is set up by loose strings, which care not for people’s health rights and simply care for profits.

For example, did you know that the U.S. and New Zealand are the only countries which allow drug companies to advertise directly to consumersPrior to 1997, there was a ban in place that restricted pharmaceuticals from advertising to consumers – known as drug-to-consumer-advertising, or DTCA- but this ban was removed, to the detriment of the populace.[1]

Why is this important?  Because that law was in place to protect individuals from the highly specialized, and yet misleading advertising of all drugs.

Another point of serious concern is how the great majority of prescription drugs sold take place due to DTCA.  As Dr. Kelly Brogan notes in her milestone book, which homes in on the efficiency of this specialized advertising:

“It’s been calculated that DTCA [drug-to-consumer advertising] is responsible for nearly half (49 percent) of requests for drugs.  And fully seven out of ten times doctors prescribe based on appeal by patients who learned through their computers and televisions that they have an “imbalance” that must be fixed with a pill.”[2][Bold & Underline Emphasis Added]

Predictably, all that already-disturbing information leads to prescription drugs being doled out at 4 Billion per annum[3], it’s no wonder that Medical Errors are the third leading cause of death.[4]  According to a new John Hopkins study, which is covered by the Washington Post:

“Their analysis, published in the BMJ, shows that ‘medical errors’ in hospitals and other health care facilities are incredibly common and may now be the third leading cause of death in the United States — claiming 251,000 lives every year, more than respiratory disease, accidents, stroke and Alzheimer’s.”[5][Click here to read the study named Medical Error – The Third Leading Cause Of Death In The US]

You, as an astute reader, might be wondering, okay, what does that have to do with psychiatry?  Excellent question.

About 10% of Americans take anti-depressants, which equates to about 30 million people.  With the downright disconcerting facts that Dr. Brogan brings up in her book A Mind Of Your Own, many of the people that will be railed by the medical system will be within the psychiatric field, and a significant portion of them will be children as well.

What’s disturbing about this is that, as Dr. Brogan herself cautions, most drug research is in fact, short term:

Their patients have never consented to the long-term effects of these medications because pharmaceutical research is, by nature, short term.  There is no incentive on the part of the pharmaceutical  companies to take a good look at what happens to the average individual when she takes a medication for a decade or so.”[6][Bold & Underline Emphasis Added]

As an individual who’s had a few friends that have depression and continues to meet people with it randomly through life, and also as a person who has a great interest in all of health, the information presented within this book is paramount to understanding the larger landscape of Big Pharma and health as a whole within the United States.

One of the greatest strengths A Mind Of Your Own showcases is the fact that this book is chock-full of real verifiable data that would shock most people who haven’t begun doing their own research about what happens within Big Pharma and the psychiatric field.

Thankfully, not only is this book rather easy to comprehend, but the reader can feel the honesty and concern that have been staples of Brogan throughout her work. This is vital, because in the arena of medicine there are countless doctors who care more about prescribing pills, than they do about the welfare of the patient and actually solving the problem.  This is known personally to me and my family via my many hospitalizations due to poor health, doing exactly what the doctors suggested which was always taking more pills, which never solved any problems.  It was only when seeking my own solutions following nutrition, getting off of medications, and many steps that true healing began taking place for me.

On that note, this is where Dr. Brogan shines because she is doing what should be undertaken by most if not all doctors or concerned individuals within the medical establishment, which is outlining the dangers so many people are going through in respect to side effects by the overmedication of America, as well as – and arguably more important – offering solutions/alternatives to the for-profit (and not for-health) medical system. 

Brogan’s book on the mental health in America is quite unique and reminiscent of the work of another author.  A Mind Of Your Own reminds me of a book called Toxic Psychiatry by Peter R. Breggin M.D., who not only outlines glaring problems within the psychiatric establishment, but also, like Brogan, covers issues with medications that most people would consider safe, but aren’t as safe as they are made out to be by medical doctors.

To be precise, I’m not implying that the Dr. Brogan’s work takes from Dr. Breggin. What I am saying however is that both doctors have great concern regarding mainstream health, and seem to share very similar values in how they think patients should be treated in respect to actual solutions that don’t revolve simply around handing out prescriptions non-stop without seeking to actually solve the underlying issues.

With that said, this particular book ventures into myriad paths.  It rightly gives an extensive look into the flawed theory of depression but also shows how that theory is an outright fallacy.  It also covers many of the ways in which depression symptoms can manifest in people, which at times may be solved with specific vitamins, which is something that goes directly against the Big Pharma prescription medication model.

Keeping all of the above in mind, one would expect that with tens of millions of lives at stake, and with dozens of side effects to boot per medication, a more thorough process would be in place to safeguard individuals against possible iatrogenic mistakes that plague the populace en mass.  But such is not the case unfortunately.

Another great notion Brogan centers in on within her book is done in her chapter called The Great Psychiatric Pretenders.  Within it, Brogan details not only how the one-size-fits-all type of care that is carried out in America is inefficient, but she also provides a few of the circumstances that create bedlam within individuals and are often categorized as depression, but are incorrectly diagnosed.  Please read that again. 

It’s imperative to know this because people are walking around thinking a pill is the only solution to their problems when there are other possible solutions that may be possible.

Brogan also sheds light with a cursory glance at the fact that serious drug fraud has taken place in the past which is unknown to many.

Although there aren’t many doctors out there standing up for what’s right within medicine, Dr. Brogan and a growing number of others are, such as the aforementioned Dr. Peter R. Breggin, Dr. Mercola, Dr. Duzanne Humphries, Dr. Sircus, Dr. Natasha Campbell-Mcbride, Dr. Russell Blaylock, Tetyana Obukhanych Ph.D, and more, are forming new grounds in the field of health – true health.  Each of these individuals all put out very high quality information regularly and are concerned with various aspects of health. But don’t take my word for it, do your own research so you can be better informed.  I cannot stress the ‘do your own research’ part enough

It is vital for individuals as a community to support these people, because they’re in it to HELP people and refuse to throw people under the bus merely for profit.

In any case, if you’ve read any of Dr. Brogan’s work, A Mind Of Your Own employs the same high quality standards of research and thoughtfulness.  Brogan pulls no punches in her journey not only outlining the dangers within the prescription drugs given for depression that individuals should be concerned about, but also in offering holistic solutions that many do not realize are available.

If you’ve made it this far and are really interested in the topic, do yourself a favor and purchase this book. That, or perhaps recommend it to people that might find great value in it because they will find information that’s not only deep, but quite extensive. The information in this book can really change the course of someone’s life if they realize what’s out there.  I’ve seen it happen myself with friends and recommend it any chance I get, whether the person is interested in depression, mental health in a general sense, or merely seeking a deeper understanding of pervasive issues within the pharmaceutical industry.

Anchoring down, not only does holistic psychiatrist Brogan absolutely eviscerate the Depression is a “chemical imbalance” theory with ample data and serious research, but she also gives the reader precise methods in which they can retake their health back, while also seeking to empower women in countless ways.

Now, if that’s not self-empowerment, what is?

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Suggested Viewing:

Depression: Busting Myths & Finding Answers (Full Interview w/Dr. Kelly Brogan)

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Sources & References:

[1] Dr. Joseph Mercola, The Great Bird Flu Hoax, p. 39.
[2] Dr. Kelly Brogan M.D., A Mind Of Your Own – The Truth About Depression, p. 52.
[3] http://www.naturalnews.com/037226_drug_prescriptions_medical_news_pills.htm
[4] https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/researchers-medical-errors-now-third-leading-cause-of-death-in-united-states/?utm_term=.d262ea291b26
[5] http://www.bmj.com/content/353/bmj.i2139
[6] Dr. Kelly Brogan M.D., A Mind Of Your Own – The Truth About Depression, p. 35.

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If you find value in this information, please share it.  This article is free and open source.  All individuals have permission to republish this article under a Creative Commons license with attribution to Zy Marquiez and  BreakawayIndividual.com

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About The Author:

Zy Marquiez is an avid book reviewer, inquirer, an open-minded skeptic, yogi, and freelance writer who aims at empowering individuals while also studying and regularly mirroring subjects like Consciousness, Education, Creativity, The Individual, Ancient History & Ancient Civilizations, Forbidden Archaeology, Big Pharma, Alternative Health, Space, Geoengineering, Social Engineering, Propaganda, and much more.

Depression Caused by Genetics? Most Likely Not


Source: KellyBroganmd.com
February 1, 2020

Since the discovery of DNA, the central dogma of genetic translation has lured us in with a simple path from genes to illness. With the completion of the Human Genome Project, however, we were forced to begin to explore the limitations of the mutation model of illness and our assumptions about the biology behind illness and health. Despite this sobering reality, and the history of genetic studies of depression coming up empty-handed, many of the 30 million people in the US taking medication still believe that genes play a role in their “disease.” Frustration with the field’s current approach has been seeping into the industry. In 2017, Dr. Thomas Insel, former director of the National Institutes of Mental Health, said “I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs-I think $20 billion-I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness.”

Many gene candidate studies have been sifting through haystacks, trying to pinpoint the exact snippets of DNA sequence that might be causing you to feel lethargic, unmotivated, and generally terrible. Your depression, they say, is your own DNA betraying you.

A new study is helping us understand how the field’s previous genetically-inclined direction of study might have been nothing more than a distraction.

New Study Finds No Correlation Between Candidate Genetic Biomarker Genes and Depression

A recently published study in the American Journal of Psychiatry found no support for the association between genetic polymorphisms and the development of “Major Depressive Disorder.” 1 A team of Colorado researchers compiled data gathered from the UK Biobank (with over 502,682 individuals from 22 centers across the UK between 2006 and 2010) and closely examined 18 candidate genes hypothesized to be genetic underpinnings of depression and found that previous depression candidate gene findings were most likely Type 1 errors—or false positives.

Using the UK Biobank data, collected from online mental health questionnaires and DNA samples, the researchers were able to analyze the relationship between several depression phenotypes and moderators, and supposed genetic markers for the different manifestations of depression.

But more importantly, the researchers tried to replicate the results of studies that have implicated the top 16 candidate genetic loci for causing depression. Performing analyses with a much larger sample size than those of previous false-positive studies, their results debunked the idea that these loci were actually linked to depression. Out of these 16, only three attained statistical significance, but those results are consistent with the low power to detect small associations.

Led by Richard Border and Dr. Matthew Keller, the research team suggested that the field should abandon the idea that depression is genetic.

“Our results demonstrate that historical depression candidate gene polymorphisms do not have detectable effects on depression phenotypes. Furthermore, the candidate genes themselves (with the possible exception of DRD2) were no more associated with depression phenotypes than genes chosen at random.”

Their study is the most comprehensive and well-powered investigation of historical candidate polymorphism and candidate gene hypotheses in depression to date.

What Had We Misunderstood?

How is it that the multitudes of previous peer-reviewed studies were able to be published with false positive findings? There might be several reasons.

1. Most candidate gene research had small samples sizes.

Earlier candidate gene studies analyzed small sample sizes and were, simply, underpowered.2 Between 2000 and 2009, the median sample size of these studies was 345.

Without enough data points, though, results of these studies don’t really mean anything, especially when trying to generalize a complex disorder to an entire population. That’s just basic statistics.

Even though the results of those studies might have revealed associations between genetic variations and depression, studies that gathered more data points have revealed no correlation.3 That could explain why targeted, well-powered genetic association studies of depression and other with larger samples didn’t support the candidate gene hypothesis. Genome-wide association studies have found that individual single-nucleotide polymorphisms across large samples exert small effects on genetically complex traits like depression.4

2. Some of these studies used incorrect analytic methods and inadequate control designs.

Researchers have suggested that the majority of published candidate gene studies have actually used incorrect analytic methods and inadequate control for population stratification.5,6 Since genetic phenotypes can take lifetimes to manifest themselves, the multitudes of confounding factors make it difficult to properly design controls. Improper analytics and experimental designs would account for the inconsistent results that these types of studies have yielded over the years.7 8 9 10

3. Clinical utility of identifying individual gene mutations is unclear.

Even if we could pinpoint individual gene mutations that caused depression, there’s no real point in doing so. Clinical utility has always been one of the critical limitations in building gene-environment models in psychiatry.11 Looking for gene markers might even be counterproductive to people’s healing, focusing efforts on allopathic medicine that seeks to marginalize the role of lifestyle factors in lieu of the one pill for one ill approach to symptom management.

4. Publication bias

Over the past years, this body of literature has shown significant publication bias. For example, the top nine of the 18 identified genes in the American Journal of Psychiatry study accounted for 86.59% of the studies. When so much effort and time is going into chasing these biomarkers, it’s easy for an entire field to get tunnel vision.

So Now What?

As humans, we’re inclined to seek certainty and answers—but this study shows that the answers to questions about the origins of depression are not in our DNA.

Through the lens of root-cause resolution, depression can be seen as an invitation to explore imbalances that can range from nutritional to psychospiritual. Recent research has been helping us deconstruct our assumptions and explore new frameworks including depression as a form of evolutionary mismatch. Maybe we should be moving past a reductive and misleading interpretation of depression to understanding that our bodies create symptoms when things out of alignment. Depression is that symptom—indicating to us that our lifestyles are often a mismatch with our biology. We don’t need drugs to “fix” depression. The way out of depression doesn’t require new ancestry, it can be found through simple steps towards self-ownership and attending to lifestyle habits that are asking to be transformed.

References

  • 1 Border, R., Johnson, E., Evans, L., Smolen, A., Berley, N., Sullivan, P., & Keller, M. (2019). No Support for Historical Candidate Gene or Candidate Gene-by-Interaction Hypotheses for Major Depression Across Multiple Large Samples. American Journal Of Psychiatry, 176(5), 376-387. doi: 10.1176/appi.ajp.2018.18070881
  • 2 Munafò MR: Reliability and replicability of genetic association studies. Addiction 2009; 104:1439–1440
  • 3 Bosker FJ, Hartman CA, Nolte IM, et al: Poor replication of candidate genes for major depressive disorder using genome-wide association data. Mol Psychiatry 2011; 16:516–532
  • 4 Burton PR, Hansell AL, Fortier I, et al: Size matters: just how big is BIG? Quantifying realistic sample size requirements for human genome epidemiology. Int J Epidemiol 2009; 38:263–273
  • 5 Keller MC: Gene 3 environment interaction studies have not properly controlled for potential confounders: the problem and the (simple) solution. Biol Psychiatry 2014; 75:18–24
  • 6 Border R, Keller MC: Commentary: Fundamental problems with candidate gene-by-environment interaction studies: reflections on Moore and Thoemmes (2016). J Child Psychol Psychiatry 2017; 58: 328–330
  • 7 Stoltenberg SF, Burmeister M: Recent progress in psychiatric genetics: some hope but no hype. Hum Mol Genet 2000; 9:927–935
  • 8 Buckland PR: Genetic association studies of alcoholism: problems with the candidate gene approach. Alcohol Alcohol 2001; 36:99–103
  • 9 Munafò MR: Candidate gene studies in the 21st century: a metaanalysis, mediation, moderation. Genes Brain Behav 2006; 5(suppl1):3–8
  • 10 Munafò MR, Gage SH: Improving the reliability and reporting of genetic association studies. Drug Alcohol Depend 2013; 132:411–413
  • 11 Munafò MR, Zammit S, Flint J: Limitations of gene 3 environment interaction models in psychiatry. J Child Psychol Psychiatry 2014; 55:1092–1101

    Read More At: KellyBroganMD.com

New Insights on Gut Permeability and Depression


Source: KellyBroganMD.com
Kelly Brogan MD Team

If you know what depression feels like – the brain clouding, the flat moods, the tiredness – you’re not alone. Over 300 million people around the world have depression, and yet there’s a lot that we still don’t quite understand.1

Thankfully, the medical field is developing some new insights that just might help us understand depression better. In a new 2019 study, researchers decided to examine the potential mechanisms of major depressive disorder in teenage girls and found some evidence that could help us better understand exactly how gut permeability (leaky gut) can lead to inflammation, which in turn, leads to depression.

New Insight into Leaky Gut and Depression

In this 2019 study, Baylor College of Medicine researchers are directly looking at gut permeability and major depressive disorder, a study that is the first of its kind.2

With a sample of forty-one 12–17 year-old teenage girls who were medically healthy, the study measured the severity of the girls’ depressive symptoms, the activity of the autonomic nervous system, intestinal permeability, or gut leakiness, and the number of inflammatory cytokines.

To measure whether the girls were depressed, an interviewer performed the Children’s Depression Rating Scale-Revised (CDRS-R) and a clinical interview.  The CDRS-R is a rating scale that requires interviews of both child and parent to understand the severity of a child’s depression. Over the past few decades, the CDRS-R has become the most widely used rating scale for assessing severity and change in depression for clinical trials involving children and adolescents.3 In order to collect data on the autonomic nervous system activity, researchers measured pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) data, which are indicators for the activity levels of the sympathetic nervous system and parasympathetic nervous system respectively. They measured the leakiness of the gut using the lactulose-mannitol ratio (LMR), which involves having the teens first fast overnight and then ingesting a premeasured amount of lactulose and mannitol. The researchers then collected the urine for four hours after ingestion. By looking at the ratio of lactulose and mannitol that passed through the gut lining, researchers could calculate the permeability of the gut lining, or how “leaky” it was. To measure inflammation, the researchers took blood samples and measured inflammatory cytokines.

They found that in unmedicated teenage girls between the ages of 14-17, depression severity was associated with increased intestinal permeability, as measured by the lactulose to mannitol ratio. The leakier the gut, they found, the more severe the depression and depressive symptoms. They saw that the higher the concentration of the cytokine IL-1β, the more severe the depression. They also found that increased intestinal permeability may be the path between sympathetic nervous system activation and depression severity. Additionally, their evidence suggested that increased intestinal permeability may activate the innate immune system and push the development of depression.

The result of this study also helps clarify the mechanisms through which activating the sympathetic nervous system can increase gut permeability and activate the innate immune system—two things that are likely contributing to depression symptoms.

The Brain, The Gut, and the Immune System

If you’re wondering why intestinal permeability is related to depression, let’s back up and walk through the whole pipeline.

We start with the immune system. Throughout the last century, psychiatry has been exploring the role of the immune system in certain presentations of depression. Importantly, the gut houses over 70% of our immune system, which makes sense given that the lining of your gut is the barrier between your insides and the outside world. The gastrointestinal epithelium usually forms a single-cell-thick barrier that prevents the free movement of toxicants, microbes, and microbial antigens from entering into the rest of your body. This lining usually does a good job absorbing things we need (like food) and interfacing with foreign things that might wreak havoc—which is probably why most of our immune cells are located in the gut.4 The relationship between the gut and the brain is both complex and important. We’ve all felt the butterflies in our stomachs when we’re nervous or anxious, but it turns out that the relationship between the brain and the gut is actually bidirectional. Not only can our brains affect how our guts feel, but our gut can relay its state of calm or alarm to the nervous system and send those immune reactions up the vagus nerve to the brain.

To understand how the gut and depression are related, we should first better comprehend the triggers for inflammation, what inflammation is, and how it happens.

Stress Drives Inflammation

So what IS inflammation in the first place? Inflammation is the body’s defensive response to stresses, like injury or the ingestion of bodily-incompatible chemicals. Upon approaching a stressor, the immune system kicks into a higher gear to heal the body.

Stress is a catch-all term, a trigger that links hormones to inflammation. Essentially, when the body thinks something is wrong, the body releases hormones that tell the body to be on the lookout and get on defense, and inflammation occurs. These triggers can come in all forms, many of which are actually staples of modern American life, from sugar to stress to pesticides and pollution to anxiety to beyond. Whether psychological or physiological, stress drives the inflammation response by telling the brain to release cortisol, the steroid hormone that acts as nature’s built-in alarm system and makes it for our bodies to use blood sugar for energy so that we can flee from whatever is causing the stress.5

Once inflammation is started, not only does inflammation cause more inflammation, but recent studies have linked low-grade inflammation to depression. When inflammation reaches the brain, cells begin to take their limited supply of tryptophan to produce more anxiety-provoking chemicals like quinolinate.6 Medical literature has found that inflammation seems to be a consistent marker of depressive symptoms, like flat mood, slowed thinking, avoidance, alterations in perception, and metabolic changes.

How does inflammation get provoked in the gut?

So let’s understand how exactly a leaky gut can lead to inflammation – the body’s language of imbalance.

When the body is stressed, the junctions between cells in the stomach can be less effective than they should be.7 This allows bacteria and toxicants to enter the bloodstream that can continue to cause widespread inflammation and possibly trigger a far-reaching reaction from the immune system.8 Having leaky gut cause inflammation sets off a problematic chain of events because the gut has a direct link to the brain through the vagus nerve.9

The medical field has been slowly inching up on a fuller understanding of the link between intestinal permeability (“leaky gut”) and depression. Previous studies focusing on depression and have found the chemical hints of leaky gut. For example…

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