If you think that mental illness will always happen to someone else, think again. The full lifetime risk of developing a mental health disorder may be as high as 46%, at least in the crazy ole US of A, and that figure comes from a population study that specifically excluded the homeless (1). The real figure is therefore likely to be somewhat higher, maybe even as high as 50%; and while some nations show a lower incidence – for example, Denmark claims a roughly 35% lifetime risk (2) – current trends are negative (3), so mental illness will surely impinge upon your life at some point if it hasn’t done so already.
It is a truism that most people affected by mental illness are not detected as early as they should be in the course of their illness, and most of those who are detected are neither particularly well diagnosed or treated. The medics’ standard response is to say that changes must be made, lessons will be learned u.s.w. The odd band-wagon-jumping politician sometimes steps in and says pretty much the same thing. Most of the time, however, they are talking about new and improved pharmaceutical interventions.
Their pharmaco-centric mind-set is not surprising. Big Pharma is one of the biggest games in town. It exerts far too much influence on university curricula designed to brain-wash medical students, and on post-qualification ‘education’ thereafter, much of which is little more than drug detailing. It rents professors and politicians and in general, behaves like a slightly less ethical but considerably more lethal Mafia (4).
Big Pharma’s successful buying out of the FDA, for example, allowed them to promote anti-depressants and anxiolytics direct to potential consumers via TV commercials, which hugely increased psychotropic drug sales (5). This was probably not entirely helpful, as anecdotal evidence continues to emerge that anti-depressant use can trigger suicidal and homicidal psychosis in some patients (6), particularly if combined with other psychotropic drugs (7); and long-term anxiolytic use may increase the risk of dementia and death (8-10).
To be fair to the pharma companies (and I like to be fair, mostly), if the anxiolytic drugs dementia story is true, the increased risk may only develop in certain sub-groups of patients, and it may be partly due to neuroprogression (see below).
Meanwhile, the market for psychotropes continues to grow.
The numbers of individuals presenting with a major depressive episode appear to be increasing with each birth cohort (1). There is evidence also that the average age of onset of depression is falling, from around 40 in 1988 to around 20 in 2017; with the incidence of major depressive disorder (MDD) rising by over a third in adolescents and young adults between 2005 and 2015 (11).
Another seemingly unrelated trend is that the average age of the onset of dementia is falling, by 15 years since 1980 (12, 13). Because it is starting earlier, there are more neurodegenerative deaths in older patients. Among the over-75’s, neurodegenerative deaths have increased by 300% in men since 1989, and by 500% in women (12).
The depression and dementia trends may seem unrelated, but are probably linked. They are both signs of increased neuroprogression (14).
Until recently depression was thought of as a transient disorder, a temporary lowering of mood which would eventually pass and leave the patient pretty much where he – or more likely she – was before the depressive episode. A bit like a cold, for example, but in the brain. That rather benign idea, however, has metamorphosed into something altogether more malignant.
Recent research into brain structures and chemistry in depressed patients has shown clear signs of progressive brain damage in the limbic system, the hippocampus and the medial pre-frontal cortices (15 – 17). While these signs of damage may not occur in all depressed individuals (16), common findings include neuro-inflammation, altered astrocyte and microglial behavior, reduced neurogenesis, neuroplasticity and synaptic density, and increased neuronal death (15 – 18). This is, in short, a pattern of accelerated brain ageing (18); and this underlying deterioration of brain function explains why clinicians often see in their patients an increasing frequency of depressive episodes, and a progressive failure to respond to treatment (19).
Similar signs of progressive brain damage have been found in bipolar (20) and PTSD patients (21), who also often show clinical progression.
The current theory is that high levels of stress produce high and sustained levels of cortisol in the blood and in the brain, which eventually damages synapses and neurones in the circuits underlying affective and cognitive processes. The loss of these connections then contributes to the symptoms of MDD and PTSD, highly comorbid disorders that appear to have similar neurobiological underpinnings (22).
All of this relates back to a recent blog post on resilience.
There are signs that our resilience is failing. The servicemen who fought in World Wars or more accurately Bankster Wars One and Two experienced absolutely appalling conditions for months at a time, yet the numbers diagnosed with shell shock (the old term for PTSD) were relatively small. At the slaughterhouse of Passchendaele, roughly 1% of the Allied forces reported with shell shock and 75% of those were able to return to active service without specialist treatment (23).
Fast-forward a half-century to Vietnam, a war notable for the fact that while the US armed forces slaughtered Vietnamese men, women and children with abandon and often from a great distance, more GI Joes died by their own hand after the war than were killed in active service. Fast-forward another half-century and although hard data is very difficult to obtain, it looks as if US military in the 21st Century have become even more vulnerable.
It is typical of politicians and the MIC to prioritize offensive technology over defensive systems, and to discard damaged veterans; but the mounting numbers of mentally disabled military personnel has become a huge problem, which can no longer be brushed under the carpet (24).
I believe several different factors have damaged Western resilience.
Firstly, there is the truly dreadful state of the food universe. Americans consume almost 2/3 of their calories in ultra-processed foods (25), have omega 6: ratios that average at around 25 (26), and a depression-inducing dysbiosis (27). This shoddy nutritional combination means that their brains, including that part of the brain where resilience resides (the VTA), is functionally and possibly structurally compromised, and the brains’ owners are therefore predisposed to poor impulse control and depressive illness.
Secondly, our schools have been undermined by a generation of intelligent but idiot (and I’m being kind) teachers and parents, whose attempts to shield their precious ones from risk and stress have left them hopelessly unfit to cope with the vicissitudes of life. This means that the millenials’ already sub-standard VTA’s are under-exercised, and under-developed. Their consequent lack of stamina, inability to deal constructively with problems and tendency to run for HR and/or lawyers at the drop of a hat, explain why many employers I know will not even invite them to interview. (Having said that, I have the honor and privilege of working with a large number of the very best of the millenials who are coherent, focused, altruistic and working to make the world a better place. They are the shock troops of the Zinzino-army.)
And thirdly, there have been the giant sucking sounds of jobs being outsourced to low pay economies, and the financial blood of the nation being drained by the bankster parasites. These twin factors have created vast swathes of the USA and Europe where there is no work, no prospects and little opportunity for children and young adults to develop identity and self-respect. This desert landscape is eroded further by the distorting mirror of Zuckerberg’s insidious FaceBook.
No wonder the neo-opioids are sweeping through the West, bringing addiction, family breakdown, suicides and OD’s in their wake. The Sackler cartel made billions of shekels in the process, but the entrepreneurial citizens of Guangdong also found a way to make a buck or two in the Fentanyl Wars (28), in a weirdly inverse version of the 19th century Opium Wars.
Which brings us to ketamine, the former horse tranquilizer. It does work, and surprisingly quickly, to alleviate depression and to undo some of the brain damage linked to this condition (29, 30). Other drugs are being developed (ie 31), but your best options are the natural compounds Affron and HydroCurc. These treat depression and anxiety safely, effectively and extremely rapidly. I believe they will also prove to be excellent resilience enhancers and long-term protectors against neuroprogression.
For details of these compounds, see previous post ‘The Brilliance of Resilience’.
- Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):593-602.
- Pedersen CB, Mors O, Bertelsen A, Waltoft BL, Agerbo E, McGrath JJ, Mortensen PB, Eaton WW. A Comprehensive Nationwide Study of the Incidence Rate and Lifetime Risk for Treated Mental Disorders. JAMA Psychiatry. 2014;71(5):573-581
- Olfson M, Druss BG, Marcus SC. Trends in mental health care among children and adolescents. N Engl J Med. 2015 May 21;372(21):2029-38.
- Winter JC, Fiorella DJ, Helsley SE, Rabin RA. Partial generalization of (-)DOM to fluvoxamine in the rat: implications for SSRI-induced mania and psychosis. Int J Neuropsychopharmacol. 1999 Sep;2(3):165-172.
- Gray SL, Dublin S, Yu O, Walker R, Anderson M, Hubbard RA, Crane PK, Larson EB. Benzodiazepine use and risk of incident dementia or cognitive decline: prospective population based study. BMJ. 2016 Feb 2;352:i90.
- Shash D, Kurth T, Bertrand M, Dufouil C, Barberger-Gateau P, Berr C, Ritchie K, Dartigues JF, Bégaud B, Alpérovitch A, Tzourio C. Benzodiazepine, psychotropic medication, and dementia: A population-based cohort study. Alzheimers Dement. 2016 May;12(5):604-13.
- Billioti de Gage S, Bégaud B, Bazin F, Verdoux H, Dartigues JF, Pérès K, Kurth T, Pariente A. Benzodiazepine use and risk of dementia; a population based study. BMJ. 2012 Sep 27;345:e6231
- Mojtabai R, Olfson M, Han B. National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults. Pediatrics. 2016 Dec;138(6). pii: e20161878.
- Pritchard C, Rosenorn-Lanng E. Neurological deaths of American adults (55-74) and the over 75’s by sex compared with 20 Western countries 1989-2010: Cause for concern. Surg Neurol Int 23-Jul-2015;6:123
- Pritchard C, Rosenorn-Lanng E, Silk A, Hansen L. Controlled population-based comparative study of USA and international adult [55-74] neurological deaths 1989-2014. Acta Neurol Scand. 2017 Dec;136(6):698-707.
- Ruiz NAL, Del Ángel DS, Olguín HJ, Silva ML. Neuroprogression: the hidden mechanism of depression. Neuropsychiatr Dis Treat. 2018 Oct 30;14:2837-2845.
- Belleau EL, Treadway MT, Pizzagalli DA. The Impact of Stress and Major Depressive Disorder on Hippocampal and Medial Prefrontal Cortex Morphology. Biol Psychiatry. 2019 Mar 15;85(6):443-453.
- Sánchez-Morla EM, López-Villarreal A, Jiménez-López E, Aparicio AI, Martínez-Vizcaíno V, Roberto RJ, Vieta E, Santos JL. Impact of number of episodes on neurocognitive trajectory in bipolar disorder patients: a 5-year follow-up study. Psychol Med. 2019 Jun;49(8):1299-1307
- Pandey GN. Inflammatory and Innate Immune Markers of Neuroprogression in Depressed and Teenage Suicide Brain. Mod Trends Pharmacopsychiatry. 2017;31:79-95.
- Holmes SE, Scheinost D, Finnema SJ, Naganawa M, Davis MT, DellaGioia N, Nabulsi N, Matuskey D, Angarita GA, Pietrzak RH, Duman RS, Sanacora G, Krystal JH, Carson RE, Esterlis I. Lower synaptic density is associated with depression severity and network alterations. Nat Commun. 2019 Apr 4;10(1):1529.
- Fornaro M, Anastasia A, Novello S, Fusco A, Pariano R, De Berardis D, Solmi M, Veronese N, Stubbs B, Vieta E, Berk M, de Bartolomeis A, Carvalho AF. The emergence of loss of efficacy during antidepressant drug treatment for major depressive disorder: An integrative review of evidence, mechanisms, and clinical implications. Pharmacol Res. 2019 Jan;139:494-502.
- Tsai SY, Gildengers AG, Hsu JL, Chung KH, Chen PH, Huang YJ. Inflammation associated with volume reduction in the gray matter and hippocampus of older patients with bipolar disorder. J Affect Disord. 2019 Feb 1;244:60-66.
- Miller MW, Lin AP, Wolf EJ, Miller DR. Oxidative Stress, Inflammation, and Neuroprogression in Chronic PTSD. Harv Rev Psychiatry. 2018 Mar/Apr;26(2):57-69.
- Goodkind M, Eickhoff SB, Oathes DJ, Jiang Y, Chang A, Jones-Hagata LB, Ortega BN, Zaiko YV, Roach EL, Korgaonkar MS, Grieve SM, Galatzer-Levy I, Fox PT, Etkin A. Identification of a common neurobiological substrate for mental illness. JAMA Psychiatry. 2015;72:305–315.
- A D Macleod. Shell shock, Gordon Holmes and the Great War J R Soc Med. 2004 Feb; 97(2): 86–89.
- Baraldi LG, Martinez Steele E, Canella DS, Monteiro CA. Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study. BMJ Open. 2018 Mar 9;8(3):e020574.
- Vitas Labs: Zinzino dried blood spot data base, currently over 300,000 samples
- Valles-Colomer M, Falony G, Darzi Y, Tigchelaar EF, Wang J, Tito RY, Schiweck C, Kurilshikov A, Joossens M, Wijmenga C, Claes S, Van Oudenhove L, Zhernakova A, Vieira-Silva S, Raes J. The neuroactive potential of the human gut microbiota in quality of life and depression. Nat Microbiol. 2019 Apr;4(4):623-632.
- Canada Border Services Agency. Drug Analysis Report, 2016
- Krzystyniak A, Baczynska E, Magnowska M, Antoniuk S, Roszkowska M, Zareba-Koziol M, Das N, Basu S, Pikula M, Wlodarczyk J. Prophylactic Ketamine Treatment Promotes Resilience to Chronic Stress and Accelerates Recovery: Correlation with Changes in Synaptic Plasticity in the CA3 Subregion of the Hippocampus. Int J Mol Sci. 2019 Apr 8;20(7).
- Treccani G, Ardalan M, Chen F, Musazzi L, Popoli M, Wegener G, Nyengaard JR, Müller HK. S-Ketamine Reverses Hippocampal Dendritic Spine Deficits in Flinders Sensitive Line Rats Within 1 h of Administration. Mol Neurobiol. 2019 Apr 29. doi: 10.1007/s12035-019-1613-3.
- Robertson OD, Coronado NG, Sethi R, Berk M, Dodd S. Putative neuroprotective pharmacotherapies to target the staged progression of mental illness. Early Interv Psychiatry. 2019 Jan 28. [Epub ahead of print]