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"Mental Health" And "The Rest of MedicinE" ----Putting some of the Pieces together

1/23/2023

Conjecture

One of the things that some researchers have noticed about Mental Health Treatment ----

It hasn't tended to matter as much what THERAPY as much as whether the THERAPIST was "KIND" and "NICE"
Now there are a lot of ways you could look at that --- you could say --- hey, these people just need somebody to be nice to them ---
And I'm sure there are exceptions --- but by and large MENTAL HEALTH THERAPISTS are "KIND" and "NICE."
- Former Director of the National Institute of Mental Health Thomas Insel recognized that when he said Mental Health Professionals try to help people "CHANGE" through "COMPASSION."
- At the same time he was trying to DIPLOMATICALLY deliver the MESSAGE that Mental Health professionals hadn't achieved the same level of professionalism as expected in the rest of medicine.
Further --- many of the issues facing "MENTAL HEALTH PATIENTS" are NOT SHORT TERM ---
- and the question is HOW IS SOMEONE GOING TO "COPE" OVER THE LONG-TERM.
I don't think the answers we've come up with over the MANY MILLENIA (prayer, meditation, art, music, etc.) and more RECENT ANSWERS are necessarily WRONG ----
- MEDICATION: One of the things that even limited GENETIC TESTING is showing --- that MEDICATION might work well for one person but not another ---
  - even if those people have relatively similar SYMPTOM CLUSTERS.
- COGNITIVE BEHAVIOR THERAPY --- can be helpful --- can be HARMFUL when the TRUE NATURE of the issue is NOT UNDERSTOOD by the PRACTITIONER.
  - So it's going to be hard for the PRACTITIONER to EDUCATE the PATIENT if the PRACTITIONER'S UNDERSTANDING isn't on SOLID GROUND.

One of the things that we're having to address is the INDIVIDUAL who is not neatly fitting into our CATEGORIES --- whether our DIAGNOSTIC CATEGORIES or TREATMENT MODALITIES
- So a lot of people are being MISSED until there is a CRISIS

Further --- despite the fact that it is terribly INTELLECTUALLY INCONVENIENT for our Society and its SYSTEMS --- it appears that PSYCHIATRIC DISORDERS are often additional manifestations at least in part of MATERNAL IMMUNE ACTIVATION and SHARED GENES.
- Further --- it appears not just to be a DYSREGULATION of the BRAIN or the CENTRAL NERVOUS SYSTEM ---
- But multiple systems of the body --- the IMMUNE SYSTEM, ENDOCRINE SYSTEM, the METABOLISM, the MICROBIOME -- etc.?

Additionally --- while TRAUMA is important --- it's TRAUMA often working on "HIGHLY REACTIVE CELLS" that is an additional part of the EQUATION.

Finally, I don't think the "REST OF MEDICINE" can be COMPETENT or as PROFESSIONAL as we might assume if "MENTAL HEALTH" is not fully INTEGRATED into the REST OF MEDICINE.

Image Credit: Shutterstock

3 Big Take Aways from the Research

Maternal Immune Activation

People with Mental Illness Die Earlier than the Rest of the Population

***Physical Health Issues, the Immune System & Mental Health

University of Michigan
"The Study of Bipolar Disorder is the Study of Humanity" (2017)

1:38: begins discussing research at the University of Michigan regarding the CELLS of people with "BIPOLAR DISORDER."

NIMH (National Institute of Mental Health
5 Disorders Share Some of the Same Genes (2013)

David and Goliath
Osmar Schindler (1888)

600 Research Institutions Take on the DSM & the American Psychiatric Assn.

Analysis of shared heritability in common disorders of the brain (2018)

Shared Genes & Psychiatric Disorders

University of Virginia School of Medicine

Shocking New Role Found for the Immune System: Controlling Social Interactions (2016)

From the YouTube Summary:

• Researchers determine that the immune system affects – and even controls – social behavior.

• Blocking a single type of immune molecule made mouse brains go hyperactive and caused abnormal behavior; restoring it fixed both.

• Discovery could have enormous implications for neurological conditions such as autism and schizophrenia.

• “It’s crazy, but maybe we are just multicellular battlefields for two ancient forces: pathogens and the immune system. Part of our personality may actually be dictated by the immune system.”

In a startling discovery that raises fundamental questions about human behavior, researchers at the University of Virginia School of Medicine have determined that the immune system directly affects – and even controls – creatures’ social behavior, such as their desire to interact with others.

"So could immune system problems contribute to an inability to have normal social interactions? The answer appears to be yes, and that finding could have great implications for neurological diseases such as autism-spectrum disorders and schizophrenia.

“The brain and the adaptive immune system were thought to be isolated from each other, and any immune activity in the brain was perceived as sign of a pathology. And now, not only are we showing that they are closely interacting, but some of our behavior traits might have evolved because of our immune response to pathogens,” explained Jonathan Kipnis, PhD, chairman of UVA’s Department of Neuroscience.

“It’s crazy, but maybe we are just multicellular battlefields for two ancient forces: pathogens and the immune system. Part of our personality may actually be dictated by the immune system.”

Long-Term Use of Tylenol During Pregnancy May Raise Risk of Autism, ADHD

1/15/2023

Val's Take

This is sort of another chink in the armor of the MEDICAL COMMUNITY and also RESEARCH COMMUNITY ----

I'm not so concerned that THEY'RE NOT PERFECT ---
- I'm concerned about our EXPERT CLASS --- the ROLE they want to play in the SOCIETY and we want them to play
  - when the FOUNDATIONS of the EXPERTISE are often NOT AS SOLID as we all might hope.
I'm really wanting to get to the ISSUE not of INDIVIDUAL PRACTITIONERS PROVIDING SUB-STANDARD CARE --- but of a STANDARD of CARE that is SUSPECT.

So one of the reasons why the law focuses on STANDARD OF CARE ----
- is to have a BENCHMARK that is KNOWN or SHOULD BE KNOWN to the PRACTITIONER ---
- & the idea is that makes it FAIR to hold the PRACTITIONER --- ACCOUNTABLE --- for the STANDARD OF CARE.

Holding people "ACCOUNTABLE" ---
- Generally, the Criminal Law for Poor People and crimes of specific intent and
- The Civil Law for many Corporations, Professionals and others where the issue is often negligence and/or fraud.

Holding people "ACCOUNTABLE" is a lot different than SOLVING PROBLEMS.
- I've seen a lot of SCAPEGOATING in both the CRIMINAL & CIVIL LAW SYSTEMS ---
  - and it is DESTRUCTIVE.

The move to PROBLEM-SOLVING COURTS and COLLABORATIVE JUSTICE is an attempt to address some of these issues.

Long-Term Use of Tylenol During Pregnancy May Raise Risk of Autism, ADHD

Researchers say pregnant women who use acetaminophen products for four weeks or more can increase their unborn child’s risk of autism and ADHD.

Cont. from Column 1

There's a lot of HIERARCHY in the Medical Disciplines -- and Mental Health has traditionally not been at the top of it.When someone like myself RAILS AGAINST the DSM and THE MENTAL HEALTH PROFESSION NOT BEING ON TOP OF THE RESEARCH Where would the BANDWIDTH even come to address those issues?The National Institute of Mental Health?

NIMH has some fantastic LONG TERM PROJECTS such as the RDoC (the Research Domain Criteria Program)
BUT MEANWHILE . . .

US CRIMINAL JUSTICE is struggling and we're often relying on PSYCHOLOGICAL EXPERTS who aren't really getting the SUPPORT they need to be RELIABLE EXPERTS.

Psychiatry & The Criminal Justice System: Simplicity on the Near Side of Complexity

Translational Medicine Friday

We're riffing off NPR's Science Friday to create Translational Medicine Friday.

We'll be collecting Research Article recommendations for Clinicians with regard to Cognitive Disability.

There is much in the RESEARCH JOURNALS and we'll just be SKIMMING THE SURFACE.

The POINT is to INCREASE FUNDING for TRANSLATIONAL RESEARCH at the Federal Level for the National Institutes of Health, the Centers for Disease Control, the Nation's Research & Teaching Hospitals and possible collaborations with Medicare and Medicaid providers.

Translational Medicine Friday

"Mental Health" And "The Rest of MedicinE" ----Putting some of the Pieces together

Long-Term Use of Tylenol During Pregnancy May Raise Risk of Autism, ADHD

Translational Medicine Friday

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