Here’s what research shows about the mental health benefits of ginger

Image: Here’s what research shows about the mental health benefits of ginger

Ginger is a natural anti-inflammatory that also offers other health benefits. In fact, the versatile plant can even help boost your mental health.

Ginger (Zingiber officinale) comes from the rhizome or root of a flowering plant native to China, but the spice can grow in any area that is warm and humid. Aside from its use as a natural remedy for digestive disorders, ginger can also be used to address arthritis, memory loss and dementia, and muscle aches and pains.

Thanks to scientific research, experts are beginning to understand how ginger works. To date, research has identified over 100 compounds in ginger. More than 50 of these are antioxidants, which is crucial to brain health since the organ is vulnerable to free radical damage.

Ginger is often used as an anti-inflammatory, making it a popular natural remedy for arthritis. The plant’s anti-inflammatory property can also help people with brain disorders like ADHD, Alzheimer’s, anxiety, brain fog, and depression, which are often associated with chronic inflammation of the brain. Experts believe that ginger’s anti-inflammatory effects on the brain are due to two unique compounds called 6-shogaol and 10-gingerol.

Like the Indian spice turmeric, ginger also has a compound called curcumin. This compound is a natural antibacterial, antifungal, anti-inflammatory, antioxidant, and antiviral. Curcumin is a potent herbal brain supplement ingredient that can help address anxiety, brain aging, depression, and neurodegenerative diseases. (Related: What Happens To Your Body When You Start Eating Ginger Every Day.)

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Ginger for brain health

Your body is constantly under attack from oxidative stress. Oxygen in the body splits into single atoms with unpaired electrons, and electrons can often be found in pairs. These atoms, called free radicals, scavenge the body to find other electrons so they can become a pair. When these atoms are paired, they cause damage to cells, DNA, and proteins. Studies show that free radicals are linked to diseases like Alzheimer’s disease, atherosclerosis, cancer, and Parkinson’s, among others.

Your brain is prone to free radical damage since it requires a lot of oxygen. Free radicals are caused by common factors like:

  • Air pollution
  • Fried food
  • Grilled meat
  • Lack of sleep
  • Radiation from your mobile phone and computer
  • Stress

Antioxidants in ginger can also protect the brain from further damage and memory loss after a stroke.

Ginger increases the level of two of the most important brain chemicals: dopamine and serotonin. Depression is strongly associated with deficient levels of both chemicals.

Dopamine is called the “motivation molecule” because it helps you focus and be productive. Dopamine is also in charge of your pleasure-reward system. Meanwhile, serotonin is known as the “happiness molecule” because it helps sustain a positive mood.

The spice is traditionally used to treat memory loss and dementia and research has determined that ginger can help improve other cognitive functions besides memory. According to a study, healthy adults given dried ginger supplements showed improvements in attention, reaction time, and working memory.

People with diabetes also rely on ginger as a natural remedy because it can help control blood sugar, especially if you are diagnosed with Type 2 diabetes. Ginger has antioxidants called gingerols that enhance insulin sensitivity and prevent certain neurological diabetic complications.

Ginger is an effective remedy that can minimize the pain of migraine headaches. The spice has similar effects to sumatriptan, a commonly prescribed migraine drug that narrows blood vessels to the brain. But unlike sumatriptan, which is associated with negative side effects, ginger can relieve migraines without any side effects.

Suggested ginger dosages

Ginger, which comes in many forms, can be used as a food and as a supplement. Ginger supplements are available as capsules, crystals, essential oils, extracts, loose powder, and tinctures.

A typical dose of ginger is one gram, and the best way to ingest this dose is by taking two ginger capsules. Most supplements contain at 500 milligrams (mg) per capsule.

Below are some ginger dosage equivalents:

  • One teaspoon of fresh, grated ginger root
  • Two droppers (or two milliliters [ml]) of liquid ginger extract
  • Two pieces of crystallized ginger (about a one-inch square and 1/4 inch thick for each piece)
  • Four cups of ginger tea (Make the tea by steeping two teaspoons of grated ginger in 32 ounces of water for five to 10 minutes.)

Possible ginger side effects and interactions

When consumed as a food, especially fresh, ginger is considered very safe with little to no side effects. However, when too much ginger is consumed in other forms, especially powdered ginger, it may cause side effects such as bloating, gas, heartburn, and nausea.

Ginger also functions as a blood thinner. Avoid taking it as a supplement if you take blood-thinning medication such as warfarin. If you take diabetes or high blood pressure medications, talk to a healthcare professional to determine adjustments to your medication if you want to take supplemental ginger.

Ginger is a versatile herbal remedy that can help relieve digestive upset, and it also offers various benefits for brain health and function. Add fresh ginger to your diet or take it as a supplement to enjoy its many benefits and improve both your physical and mental well-being.

Visit to read more articles about ginger and other natural cures that can help improve your mental health.

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Accumulating evidence suggests curcumin and turmeric can treat psychiatric disorders

Living with a psychiatric disorder can be devastating for both sufferers and their loved ones. Unfortunately, many of the solutions offered by modern medicine do more harm than good while offering little in the way of relief. Thankfully, researchers have discovered that a compound in the popular Indian spice turmeric has the potential to effectively treat psychiatric disorders like bipolar disorder and depression.

You may have heard the fanfare about turmeric’s anti-inflammatory properties, which it gets from a compound within the spice known as curcumin. It has long been used in traditional Chinese medicine and has been gaining popularity in Western medicine in recent years. This polyphenol is being revered for its protective, anti-inflammatory and antioxidant properties, and is being used to help fight cancer and stop the cognitive decline of neurodegenerative disorders like Alzheimer’s. Non-toxic and affordable, it’s showing a lot of promise in helping deal with many of the health problems facing people today.

Image: Accumulating evidence suggests curcumin and turmeric can treat psychiatric disorders

The same anti-inflammatory qualities that make it so good at addressing issues like arthritis can also extend to mood disorders. Not only does it reduce levels of tumor necrosis factor alpha and inflammatory interleukin-1 beta, but it also reduces salivary cortisol concentrations while raising the levels of plasma brain-derived neurotrophic factor.

A study carried out by researchers at Australia’s Murdoch University found that curcumin extracts reduced people’s anxiety and depression scores. They noted that it was particularly effective at alleviating anxiety. Moreover, even low doses of the spice extract were effective in addressing depression. In addition, the researchers found it worked quite well on those with atypical depression, which is a marker of bipolar depression.

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Growing evidence of curcumin’s usefulness in addressing psychiatric disorders

Curcumin has been found in other studies to be just as effective as one of the most popular SSRI antidepressants on the market, Prozac, making it an excellent option for those who wish to avoid the negative side effects of this psychiatric medication. It works by raising levels of dopamine and serotonin, two vital neurotransmitters related to depression. In addition, because depression is believed to be caused by chronic inflammation, it makes sense that curcumin’s ability to reduce inflammation could alleviate depression.

Interestingly, studies have also found that when curcumin is taken either alone or with saffron, it reduces the symptoms of anxiety and depression in those suffering from major depressive disorder. When taken alongside the herb fenugreek, meanwhile, it can reduce fatigue, stress and anxiety in those with extreme occupational stress. Curcumin supplementation has also been shown to significantly improve compulsiveness and memory loss in those with obsessive-compulsive disorder.

It’s also worth noting that curcumin can be taken alongside antidepressants safely; studies have even shown taking the two together can enhance their effectiveness. However, it’s important to keep in mind that antidepressants carry a lot of risks, so it’s worth exploring whether curcumin alone could be enough to alleviate an individual’s depression.

The idea of curcumin helping with mood is supported by a study that was published in the American Journal of Geriatric Psychiatry earlier this year. In that study, researchers found that participants who took curcumin supplements noted mood improvements, and they plan to explore this connection in a study of patients with depression. The researchers expressed optimism that curcumin could be a safe way to provide people with cognitive benefits; they also discovered the spice can improve memory.

Now, researchers are looking for ways to increase curcumin’s bioavailability so that people can enjoy the benefits of this all-star natural treatment. In the meantime, be sure to add black pepper to your dishes when cooking with turmeric or look for curcumin supplements that contain piperine, a black pepper extract, as this boosts its bioavailability.

Drop Dead Dangerous .

Nothing, perhaps, is sweeter than the first feeble cry of a newborn to a mother. Prabha Subramanian, after two long and gruelling hours in a labour room, heard three such intermittent cries on a hot August afternoon before she slipped into a much-needed post-delivery slumber. The mother of three healthy triplets woke up to a reality she had never imagined for herself. The lingering flowery fragrance of baby powder gave her a headache; the constant clatter in her household as everyone desperately attended to the needs of the infants made her look for solace in her bedroom, shielded by her curtains. Every time she fed her babies, she only wished that they would finish soon and she could return to her do-not-disturb zone. The 29-year-old mother of three first hated her babies, and this unwelcome feeling of ‘hatred’ was soon replaced by guilt. She knew she needed help and approached her doctor in Thiruvananthapuram, who after listening to her mildly broke the news that she was suffering from postpartum depression.

In the skies of faraway France, Andreas Lubitz carefully spiked the cockpit coffee of the flight captain with diuretic drugs. As the sick skipper went to the bathroom, the co-pilot seized the opportunity to take control of the Germanwings Airbus 320.  He then plunged the aircraft—and all 150 people on board—into a mountainside on the French Alps on March 24 this year.His were the hands that pushed the botox on pop queen Madonna’s face. He was the creator of model and actress Stephanie Seymour’s never-changing youthful looks. Worried Hollywood celebrities rushed to his address when they saw the first signs of the much-dreaded wrinkles or age spots. He gave them new faces to face the world; he made them sparkle. He was found dead in his Miami home in the US on April 5. He was Fredric Brandt, a celebrity dermatologist.

Somewhere in France, India or the US, there lurked a menace that linked these otherwise unrelated incidents. Lubitz was clinically depressed, as it was revealed after his death and the intentional accident of the jet. Brandt had suffered from severe to mild bouts of depression for decades and he chose death as the only escape from this condition. Here in India, Bollywood actress Deepika Padukone recently talked about how she struggled to overcome depression and finally emerged a winner with the help of family, friends and doctors. According to WHO, India is the most depressed country in the world. And India also has the highest suicide rate than any other country. Alarming as it may sound, experts are of the opinion that if people’s views on depression are not altered or if the rate at which it is growing is not slowed, it will only be a matter of few years for it to turn into an epidemic. “If we look at the statistics, it is easy to conclude that depression will turn into an epidemic if not treated in time. Ninety per cent of people who commit suicide have some kind of psychiatric ailment and 75 per cent of people with mental illness have depression,” says Dr Samir Parikh, director, Mental Health and Behavioural Sciences at Fortis Healthcare, Delhi. Every month, around 150-200 patients who visit Parikh are diagnosed with depression. And the number grows into hundreds of lakhs if we take into account the patients of doctors across the country. These are just the reported cases.

Due to low awareness on the illness, many fail to seek professional help and end on a sad note. What is more worrying is that it may happen to people of any age group. “I have come across patients who are as young as 10 to 12 years old. Depression is also common among elderly people who live an isolated life. I had a patient in her eighties whose children had abandoned her as they had to pursue their life abroad. With no one to talk or bond with, isolation led her to depression,” says Dr Sameer Malhotra, Head of the Department of Mental Health and Behavioural Sciences, Max Healthcare, Delhi. Depression, according to Malhotra, is on the rise among the middle-class people. While he hesitates to share the number of cases he sees every month, he agrees that it’s way beyond hundreds.
As we listened to Padukone talking at length about the ‘pittish feeling in her stomach’ or a ‘certain emptiness’ within her, there  might have occurred a moment of doubt making us believe that, maybe, depression is a disease of the rich and affluent, or maybe it is an ailment that affects a population following a certain lifestyle. But, before we write off depression as a lifestyle disease or a condition that is difficult to understand, we need to get our facts correct. The causes of depression are many, including familial, and some diseases may trigger depression as a side effect.

Dr Geetha Desai, Associate Professor in the Department of Psychiatry, National Institute of Mental Health and Neuro Sciences  (NIMHANS), Bengaluru, says, “If a woman has a

history of vulnerability such as a biological or genetic predisposition to a mental disease, then there are more chances of her suffering from that disease, given a set of environmental factors. For instance, if she has suffered from mild depression, then chances that she may develop postpartum depression after having a baby are more.” Depression, just like any other ailment, too is a medical condition and caused by biochemical imbalance in the brain. “Deficiencies in two chemicals in the brain, serotonin and norepinephrine, are thought to be responsible for certain symptoms of depression, including anxiety, irritability and fatigue,” says Parikh. Genetics, personality and environmental are some of the other factors related to depression. “Depression can run in the family. For example, if one identical twin has depression, the other  has a 70 per cent chance of developing the illness sometime in life. People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic, appear to be vulnerable to depression,” adds Parikh. “Biochemical imbalance plays a huge part. But I won’t deny that even psychological and social issues are important. Because when we see a person suffering from depression, we not only give him medicines to treat biological imbalance, we also address his psychological issues,” says Dr Sangeeta Datta of Guwahati.

Forty-year-old Wasim Ahmed was happy when he was elevated to a post that he was longing for, for quite some time. He, however, had to stay back in the office after duty hours. The life he wished after the promotion did not materialise. Long hours at work made outings with his family rare. He started making mistakes and the work piled up. Some thought he had become lazy, but the management forced him to take a break. So, he consulted G Zaileshia, a Kochi-based clinical psychologist and psychotherapist. “I advised him on time management. He was able to change his life and work,” says Zaileshia.Change in lifestyle, continuous exposure to violence, neglect, abuse or poverty may make people, who are already susceptible to depression, all the more vulnerable to the illness. Depression, however, could still occur under ideal living circumstances. “There is a feeling that only those who are weak have depression, or that people can self-impose the illness and so on. But depression,  like any other medical illness, can happen to anyone,” says Parikh. It, however, can also happen without any reason. “Depression can be independent of all these causes. It is called endogenous depression,” adds Dr B N Gangadhar, Professor of Psychiatry at NIMHANS.

Experts believe that the prominence of the Internet, smartphones and social media has a tremendous influence on children and young adults. “People spend hours on their cellphones, laptops and messaging services like WhatsApp. These things cause a lot of communication gap. It also leads to a lack of sleep among young adults. Substance abuse is also a stimulating factor,” observes Dr Chandra Chud Vanapalli, Consultant Psychiatrist at Care Hospital, Hyderabad.  Pointing out that marital stress is one of the most common factors leading to depression in women, he says, “The most common is relationship issues between wife and husband. Because of communication gap, they have problems. After a few months, small issues can turn into big ones.”Explaining that a lack of communication, misunderstanding and excessive stress are some of the primary reasons that lead  to stress and suicidal tendencies, doctors are of the opinion that working women are most vulnerable. “They have to face stress from office as well as home. Some of them have to take care of their in-laws and children, and deal with work pressure at the same time. The situation becomes worse when the husband does not cooperate,” Dr Vanapalli explains.

While symptoms of depression may begin from a person feeling low and emotionally empty, losing productivity to irritability, developing insomnia and lack of appetite and shunning company, Dr Alexander Gnanadurai, Associate Professor of Psychology at Madras Medical College, says the signs should not be taken lightly when they recur or persist for a long time, and the patient should be taken to a psychiatrist.

Depression has three stages—mild, moderate and severe. While the patient shows four types of symptoms in the first stage, it graduates to six in the next stage and eight in the subsequent one. “Usually, patients try to fight out the previous two stages, thinking they will recover eventually. When they do not, they come to us—when the depression has taken a severe form and become difficult to treat,” says Gnanadurai.

Social stigma associated with the disease is one of the reasons for the rise in cases of depression. “We have blood investigation to identify malaria; we have CT scan and other tests to identify disorders in the brain; whereas people don’t try to identify depression. There is a lot of stigma involved, as friends and relatives of the individual feel embarrassed. Even though a patient is depressed, he never admits it. Half of the people are not even aware that they need a psychiatrist. Those who are aware don’t seek help because they feel psychiatrist are mental doctors who prescribe sleeping pills,” says Vanapalli, adding, “Most people don’t know what depression is and just label people as depressed. There is a specific criterion to diagnose a patient with depression and if people are depressed for a day, then it is not depression. You can label an individual as a patient suffering from mild, moderate or severe depression only when he meets the criteria for diagnosis. The person has to be depressed for a minimum of two weeks to fall into the category.”

What is worse is that, if not treated in time, it may aggravate to a stage where a patient will reach a point of no return. For 16-year-old Pallavi Mishra, her world came to an end when she failed in her board exams. Her mark sheet carried more than just her scores. In that piece of paper, she held her death sentence. A week after her results were announced, she was found dead in her room. “Suicide is a big concern. It is the eighth highest killer in the world,” adds Parikh. According to Dr Ashok Pai, Chairman of the Karnataka Suicide and Mental Health Task Force, depressive people have a low threshold for emotional stress and may be suicidal. “Of a number of students who fail the SSLC exams, only a handful commit suicide. This is because their mind responds differently to stress,” he says.

Like herds of locusts feeding on crops, depression pulled the ropes around thousands of farmers in Andhra Pradesh and Telangana. Economic burden was the reason that caused mass depression in the states and later the epidemic of suicide. Similarly, Tamil Nadu has been recording a significant number of suicides year after year. According to  the National Crime Records Bureau (NCRB) figures for 2013, the state recorded 16,601 suicides, only 21 less than Maharashtra that occupied the first rank in the ignominious table. In other words, one in eight suicides in the country was reported in Tamil Nadu. The suicide rate was 24.3 per lakh population, alarmingly higher than the national average of 11. State capital Chennai has a higher suicide rate of 28.2, having recorded as many as 2,450 suicides in 2013. Curiously, Tamil Nadu has a large share of the suicides reported among children below 14 years and elderly above 60. Of the 2,891 cases of children suicides across the country, 345 or 11.9 per cent were from the state—only five less than Madhya Pradesh at the top. In Assam, around 15,000 suicides were reported between 2008 and 2012. As the NCRB does not directly attribute the suicides to depression, it is difficult to link the illness to the cause of deaths. However, as many as 26.3 per cent of the suicides were due to ‘illness’, of which maximum cases were due to ‘insanity’.

The treatments for depression, however, differ from patient to patient. “While patients with mild depression respond to counseling and psychotherapy, the ones with severe depression have to be administered antidepressants. The medication usually ranges from six months to one year. The suicidal ones, on the other hand, are counselled and in many cases given electroconvulsive therapy (ECT) to change their mind,” says Gnanadurai. But more than medication, it is the support of the family that matters the most. It was Padukone’s mother who saw the first signs of depression in her otherwise cheerful daughter and made her visit a counsellor for advice. A lot depends on the patient and his or her understanding of the condition, and a willingness to cooperate.

Scientists identify brain molecule that triggers schizophrenia-like behaviors, brain changes

Scientists at The Scripps Research Institute (TSRI) have identified a molecule in the brain that triggers schizophrenia-like behaviors, brain changes and global gene expression in an animal model. The research gives scientists new tools for someday preventing or treating psychiatric disorders such as schizophrenia, bipolar disorder and autism.

“This new model speaks to how schizophrenia could arise before birth and identifies possible novel drug targets,” said Jerold Chun, a professor and member of the Dorris Neuroscience Center at TSRI who was senior author of the new study.

The findings were published April 7, 2014, in the journal Translational Psychiatry.

What Causes Schizophrenia?

According to the World Health Organization, more than 21 million people worldwide suffer from schizophrenia, a severe psychiatric disorder that can cause delusions and hallucinations and lead to increased risk of suicide.

Although psychiatric disorders have a genetic component, it is known that environmental factors also contribute to disease risk. There is an especially strong link between psychiatric disorders and complications during gestation or birth, such as prenatal bleeding, low oxygen or malnutrition of the mother during pregnancy.

In the new study, the researchers studied one particular known risk factor: bleeding in the brain, called fetal cerebral hemorrhage, which can occur in utero and in premature babies and can be detected via ultrasound.

In particular, the researchers wanted to examine the role of a lipid called lysophosphatidic acid (LPA), which is produced during hemorrhaging. Previous studies had linked increased LPA signaling to alterations in architecture of the fetal brain and the initiation of hydrocephalus (an accumulation of brain fluid that distorts the brain). Both types of events can also increase the risk of psychiatric disorders.

“LPA may be the common factor,” said Beth Thomas, an associate professor at TSRI and co-author of the new study.

Mouse Models Show Symptoms

To test this theory, the research team designed an experiment to see if increased LPA signaling led to schizophrenia-like symptoms in animal models.

Hope Mirendil, an alumna of the TSRI graduate program and first author of the new study, spearheaded the effort to develop the first-ever animal model of fetal cerebral hemorrhage. In a clever experimental paradigm, fetal mice received an injection of a non-reactive saline solution, blood serum (which naturally contains LPA in addition to other molecules) or pure LPA.

The real litmus test to show if these symptoms were specific to psychiatric disorders, according to Mirendil, was “prepulse inhibition test,” which measures the “startle” response to loud noises. Most mice—and humans—startle when they hear a loud noise. However, if a softer noise (known as a prepulse) is played before the loud tone, mice and humans are “primed” and startle less at the second, louder noise. Yet mice and humans with symptoms of schizophrenia startle just as much at loud noises even with a prepulse, perhaps because they lack the ability to filter sensory information.

Indeed, the female mice injected with serum or LPA alone startled regardless of whether a prepulse was placed before the loud tone.

Next, the researchers analyzed brain changes, revealing schizophrenia-like changes in neurotransmitter-expressing cells. Global gene expression studies found that the LPA-treated mice shared many similar molecular markers as those found in humans with schizophrenia. To further test the role of LPA, the researchers used a molecule to block only LPA signaling in the brain.

This treatment prevented schizophrenia-like symptoms.

Implications for Human Health

This research provides new insights, but also new questions, into the developmental origins of psychiatric disorders.

For example, the researchers only saw symptoms in female mice. Could schizophrenia be triggered by different factors in men and women as well?

“Hopefully this animal model can be further explored to tease out potential differences in the pathological triggers that lead to disease symptoms in males versus females,” said Thomas.

In addition to Chun, Thomas and Mirendil, authors of the study, “LPA signaling initiates schizophrenia-like brain and behavioral changes in a mouse model of prenatal brain hemorrhage,” were Candy De Loera of TSRI; and Kinya Okada and Yuji Inomata of the Mitsubishi Tanabe Pharma Corporation.

Forget Prozac, Psychobiotics Are the Future of Psychiatry.

For millennia, the human race has sought to combat psychological disorders through the intervention of natural – and eventually synthetic – chemicals. Originally, the sources for these psychoactive substances were the various fruits and flowers, including the Areca tree (betel nut), the poppy (opium), and the coca plant (cocaine). But in the 20th Century, new actives were being created in the lab thanks in part to the discovery of lysergic acid, better known as LSD, in 1938.


By the middle of the 1950s, the psychiatric community was fascinated by the idea that mental health could be restored through the direct use of drugs or in combination with traditional psychotherapy. The idea took off in the 1960s as research continued to elucidate the biology of psychiatry.  It essentially created a new avenue for psychiatric treatment: psychopharmacology. This inevitably led to the synthesis of a new compound, 3-(p-trifluoromethylphenoxy)-N-methyl-3-phenylpropylamine, which eventually became known as fluoxetine, and then, as we have all come to know it, Prozac.  By the late 1980s, it was known by another name:  the wonder drug.

Today, pharmacologic compounds for psychiatric treatment are numerous and up to 20% of all Americans are taking some type of psychotropic medication totalling some $34 billion dollars annually. While there have been calls for a reduction in use of these chemicals, primarily due to the fact that many are ineffective, there is a constant pressure from the public to have all their problems solved by a pill.

There is a different – and less costly – course to deal with stress and other psychological problems although until recently, there has been little to no attention paid to this option.  The treatment does not involve an individual chemical but rather a plethora of them which act to reduce inflammation, calm stress and bring about a more pleasant mood.  With a new article out this week from the Alimentary Pharmabiotic Centre in Cork, Ireland, there is even hope that severe and chronic mental health problems such as post-traumatic stress disorder (PTSD) may one day be a thing of the past.

They are called quite simply, Psychobiotics.

According to the authors, Timothy G. Dinan – whose name sounds as catchy as that of another psychiatric pioneer, Timothy F. Leary – Catherine Stanton and John F. Cryan, a psychobiotic is “a live organism that, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness.”  These live organisms are comprised not only of probiotics but also other bacteria known to produce psychotropic signals such as serotonin and dopamine.

While this concept may raise some eyebrows, this postulate has credence.  There have been several examples in humans where the introduction of a probiotic has led to improvement of mood, anxiety and even chronic fatigue syndrome. But there appears to be a disconnect between the idea of ingesting a bacterium that stays in the gut and psychiatric behavior, which is controlled by the brain.

The answer lies in the fact that many psychiatric illnesses are immunological in nature through chronic low level inflammation. There is a plethora of evidence showing the link between gut microbiota and inflammation and studies on probiotic strains have revealed their ability to modulate inflammation and bring back a healthy immunological function.  In this regard, by controlling inflammation through probiotic administration, there should be an effect of improved psychiatric disposition.

The authors bring up another reason why psychobiotics are so unique in comparison to most probiotics.  These strains have another incredible ability to modulate the function of the adrenal cortex, which is responsible for controlling anxiety and stress response. Probiotic strains, such as Lactobacillus helveticus and Bifdobacterium longum have shown to reduce levels of stress hormones and maintain a calmer, peaceful state.  There may be a host of other probiotic bacteria with the same ability although testing has been scant at best.

Finally, the last point in support of psychobiotics is the fact that certain strains of bacteria actually produce the chemicals necessary for a happy self.  But as these chemicals cannot find their way into the brain, another route has been found to explain why they work so well.  They stimulate cells in the gut that have the ability to signal the vagus nerve that good chemicals are in the body.  The vagus nerve then submits this information to the brain, which then acts as if the chemicals were there.  If these probiotics were used in combination with those that stimulate the production of opioid and cannabinoid receptors, such as Lactobacillus acidophilus, the result would be more than just a calming effect; there would be a natural high.

There is little doubt that there needs to be more research into the role of psychobiotics in mental health.  Even the authors suggest that clinical studies need to be performed along with more fundamental research.  However, unlike drugs such as Prozac and LSD, which are highly regulated, probiotics are readily available on store shelves.  This in effect could allow everyone to join in a citizen science movement similar to that of the Erowid culture, which focuses on the effect of natural psychoactives.  All that would be needed is a hub and a name, say PSYCHOgerms, in order to identify the psychological wonders – and admittedly, duds – of the probiotic world.  Should this happen, it may help one day to move past the era of pharmapscyhology and head straight into the more natural world or psychobiotics.

It’s time to listen to the voices in your head.

Voice-hearing is no longer seen merely as a psychiatric disorder, and could teach us a lot about how language operates in the brain.
eleanor longden

Eleanor Longden delivers a TED talk on voice-hearing.

Hearing voices in your head when there’s no one around … that’s a sign of madness, right?

In the popular imagination voice-hearing is often viewed with fear and suspicion, frequently reified as a chaotic, corrupted symptom of illness. But that is changing, with a growing acceptance of voice-hearing as a profoundly human experience that can no longer be reduced to a mere symptom of psychiatric disorder. The work of Intervoice: The International Hearing Voices Network, and the enthusiastic response to Eleanor Longden’s 2013 TED talk, which recounts her own journey to recovery from a demoralising psychiatric diagnosis, indicate the growing possibilities for people living with the experience to raise their voices with a sense of power and pride.

This movement towards a better public understanding of voice-hearing has been mirrored by an increased interest in the scientific issues it raises. In recent years, academics from such diverse disciplines as psychology, philosophy, medical humanities, cognitive neuroscience, anthropology, theology and cultural studies have begun to reclaim it as a rich, diverse and complex human experience – one that offers abundant possibilities for scientific inquiry.

Take, for example, the idea that voices often relate to trauma or adversity, particularly those suffered in childhood. This view, which has found expression in the personal stories of many voice-hearers, has been supported by a growing body of scientific evidence. But why should traumatic experiences early in life lead many years later to the experience of hearing a voice, or what psychiatrists call an auditory verbal hallucination?

Recent investigations suggest that voice-hearing may provide fresh insights into traumatic memory, and how real-life conflicts become embodied in voices via dissociation (a defensive psychological response to trauma in which thoughts, emotions and memories become disconnected from one another). In turn, the experience that many voice-hearers describe – that of a disembodied “other” dynamically interacting with and intruding upon one’s sense of self – invites exploration into how representations of selfhood are generated and maintained.

Another approach that has proved fruitful is the idea that voice-hearing relates to one very ordinary aspect of people’s experience: their inner speech. Most of us report talking to ourselves silently in our heads as we go about our business, and it has been proposed that voices result when a person generates a bit of inner speech but, for whatever reason, doesn’t recognise it as their own. This view has received support from numerous studies with voice-hearing psychiatric patients, including findings that similar networks in the brain are activated when people hear voices as when they produce inner speech.

Many problems remain however, including the fact that we know very little about the phenomenal properties of ordinary inner speech, such as whether it has the qualities of a dialogue or a monologue, whether it is fully expanded like ordinary conversation or whether it sometimes has a compressed, note-form quality. Voice-hearing itself comes in an even more baffling array of varieties, from experiences that have the full perceptual force of listening to a person speaking to those that are much more ephemeral and thought-like.

Perhaps most importantly, the view of voices as disordered inner speech does not ring true with many voice-hearers’ experience. And yet, at some level, an explanation of voice-hearing must have something to do with how language operates in the brain. Perhaps the biggest challenge facing research in this area is to try to link, and draw on the relative merits of, the trauma and inner speech models. How can adverse experiences early in life, perhaps through the complex, multifaceted mechanisms of memory, lead to alterations in the way words are processed in the brain, and in turn to the sense that one’s self has been overtaken by other selves? Whatever the future for research in this area, it will require a continued focus on voice-hearing as a complex, heterogeneous phenomenon with many scientific secrets to reveal.

Patient-Targeted Googling: The Ethics of Searching Online for Patient Information.

With the growth of the Internet, psychiatrists can now search online for a wide range of information about patients. Psychiatrists face challenges of maintaining professional boundaries with patients in many circumstances, but little consideration has been given to the practice of searching online for information about patients, an act we refer to as patient-targeted Googling (PTG). Psychiatrists are not the only health care providers who can investigate their patients online, but they may be especially likely to engage in PTG because of the unique relationships involved in their clinical practice. Before searching online for a patient, psychiatrists should consider such factors as the intention of searching, the anticipated effect of gaining information online, and its potential value or risk for the treatment. The psychiatrist is obligated to act in a way that respects the patient’s best interests and that adheres to professional ethics. In this article, we propose a pragmatic model for considering PTG that focuses on practical results of searches and that aims to minimize the risk of exploiting patients. We describe three cases of PTG, highlighting important ethical dilemmas in multiple practice settings. Each case is discussed from the standpoint of the pragmatic model.

Source: H

Psychotic depression.

This patient works as a psychiatrist in the hospital where she is treated, and has been admitted, for depressive disorder. She tells her story, and describes her feelings about other health professionals’ attitudes towards her

I had an easy early life. My family was a combination of conservative and intellectual, and throughout medical school I fitted in. There were, perhaps, a number of warning signs of what was to come—a long period of blackness after a relationship ended, and one of poorly controlled mood before final exams—but hardly different from many others. I was unaware at that time of family history.

I coped well with the stress of house jobs followed by a number of senior house officer jobs and a period of travelling. I then decided, for romantic and literary reasons, to do my GP training year in Cornwall. It was hard work, but all went well until, after my marriage, I found myself rather unexpectedly—though not unhappily—pregnant. Quite suddenly my life fell apart. I don’t remember feeling depressed, but I became terrified of everything, afraid to eat, and convinced the baby would die. I saw a psychiatrist, who dispensed with note taking as it might apparently affect my career, and ended up briefly in a psychiatric hospital before being looked after by one of my fellow GPs, my husband, and my mother-in-law. I had no idea what was wrong with me.

When I was around five months pregnant, we moved back to Edinburgh and went to our GP, who immediately referred me to a psychiatrist, who sent me straight to the local hospital. I had last been there as a medical student, several of my friends and colleagues worked there, and my previous life as a doctor was instantly shattered. I had hoped to train as a psychiatrist myself, and I thought that possibility was now extinguished, that anyone who had been a psychiatric inpatient would never be accepted as a colleague.

I don’t really know how I felt—bleak and exhausted, but also sad and angry, especially when I saw other doctors apparently confident and successful. I had a series of admissions, both before and after my baby was born.

What was my diagnosis? How to classify the feelings of fear, terrible fatigue, anxiety, and blackness? Depression was what I was told, but I formed an unshakeable conviction that everyone thought I had a personality disorder. Looking back, I still think my personality was sorely tested by my experiences. I did improve with electroconvulsive therapy and medication, but hated taking them.

Finally, after a period of relative stability, I managed to return to work, to a junior hospital post. I hadn’t worked for two and a half years, and felt incompetent and inadequate. I subsequently finished my GP training, but realised I would be unlikely to get a job given my medical history. When I look back now, I wonder how I had the courage, or the cheek, to apply for a psychiatric training scheme. One of my psychiatrists advised me not to, and I am generally very reluctant to do things others disapprove of, but I think I knew I would always regret not doing it.

I had a long commute, as I, and others, felt I could not work locally. I loved the work and think I was good at it, but I can’t pretend it wasn’t emotionally draining. I have always felt like two people—the psychiatrist and the psychiatric patient—and it is very difficult when they overlap. I even use two names, as do many female doctors, but I think my reasons are slightly different.

My training proceeded well, and I was lucky to experience no problems with exams. Life was not straightforward, though. I had an early stillbirth, and, perhaps inevitably, a relapse followed. But I picked myself up, and staggered through another pregnancy as well as my training. Looking back, I think I was very anxious for some years after this, but relatively well otherwise, at least partly due to my always supportive husband. I think I took medication for much of the time, but certainly had some lucky periods where I didn’t.

My husband has always found the switch from spouse to carer and back rather difficult, particularly during periods of recovery, and especially given that I don’t really appreciate what I’m like when ill. He also finds my occasional non-compliance with medication understandably infuriating. But I admit I worry more about the potential effect on my three daughters. Any illness in a parent is both frightening and annoying for children, and mine isn’t an easy one to understand, or indeed to explain to friends or teachers. Worse, I’ve not always been there for them, and one of them has experienced emotional difficulties. I can’t prove that my illness caused this, but I’m pretty sure it contributed, and I shall always bear the guilt.

Six years ago I gained a consultant post in addiction psychiatry in the local hospital where I had been a patient. I had been a trainee with my colleagues, and, for the first time, had not divulged my history. In fact, I thought they knew and was rather mortified when I subsequently discovered this was not the case. But I couldn’t quite believe it—a job near my home in the specialty of my choice. Initially, I found that walking past wards where I had been a patient was troubling, but I gradually stopped thinking of myself as a patient.

Unfortunately I have since had episodes of illness, one necessitating an admission out of area and another resulting in a series of electroconvulsive therapy as a day patient in the hospital where I work. I still find the experience of illness troubling and confusing—in many ways it makes me feel like a different person. When I read a textbook description of psychotic depression, my diagnosis, I can’t marry it with how I feel. I do feel low, but also agitated and frightened, and simply very ill. I still fear that others think I have a personality disorder. And this, for me, is one of the harder aspects. I work in a hospital where I’ve had some significant admissions and treatment. I find it hard when I speak with doctors who have treated me. But what is far worse is the uncertainty as to whether others—doctors and nurses—have seen me as a patient, or have listened to the inevitable hospital gossip, and formed opinions.

My memories of my periods of illness are very muddled, and I simply don’t know who knows or who has treated me. My close colleagues are hugely supportive, but I’ve heard talk about psychiatric patients, including about healthcare professionals, and it’s not all kind. It’s difficult to sit in a ward round talking with a nurse I suspect may have seen me in much unhappier circumstances, and I can’t help wondering whether people think I shouldn’t work here. My current plan is to be more open and to tell people, but that’s not easy either. Often they’re very embarrassed, and I don’t want my patient status to become the most important thing that people know about me.

Some day I hope my two selves will become less separate, and my working life will become more comfortable. Until then I will try to comply with my psychiatrist’s advice, try to remain well, and to make sure the psychiatrist remembers what the patient experiences.

A clinician’s perspective

Rebecca meets the diagnostic criteria for recurrent depressive disorder (ICD-10 code F33), and during an episode she often has psychotic symptoms. At her most ill, Rebecca is convinced that she is a terrible doctor, about to be referred to the General Medical Council, and a burden on others. Her view that she has a personality disorder rather than depression, which I do not agree with, also comes to the fore. Reassurance, rational challenge, and cognitive therapy do not cut much mustard at these times.

Depression that may benefit from treatment is so common—affecting about 5% of the population at any one time, about 20% each year, and 50% over the average lifetime—that it is part of most lives in some way. Psychotic depression is, however, rare, with a lifetime risk of only 0.35%. In other words, less than one in 100 people with depression will have psychotic symptoms. There is much debate about how to manage “everyday” depression, but psychotic depression needs treatment to avoid the risks of dehydration, starvation, and suicide. Electroconvulsive therapy is the evidence based treatment of choice and can be lifesaving.

It took almost two years of drug treatment, including two courses of electroconvulsive therapy, before Rebecca recovered from her first episode 20 years ago. She completed her training under the cloud of her illness but had good spells, sometimes without treatment. About four years ago, another course of electroconvulsive therapy, in another health district, was followed by a return to maintenance treatment with lithium and fluoxetine. Towards the end of last year, we avoided hospital admission with quetiapine augmentation, but some combination of Rebecca stopping that drug, going back to full time work, and perhaps a naturally worsening episode underneath it all led to a relapse earlier this year.

Reinstating and then maximising the dose of quetiapine helped a bit, affording some respite from insomnia but bringing weight gain. Rebecca and her husband suggested electroconvulsive therapy, done locally to reduce disruption to the family but as an outpatient to minimise the chances of bumping into colleagues. All the medical and nursing staff involved went out of their way to make it go successfully with a minimum of fuss. We have recently added tri-iodothyronine hormone augmentation, with apparent success, so that quetiapine can be reduced. Once Rebecca has been well for 6-12 months, we could phase out medication.

Rebecca is now back to her usual self—an excellent clinician and active in educating students, mentoring trainees, audit, and research. Her abilities make her a highly valued member of the team, and a dry and often self deprecatory wit contribute to her popularity around the hospital and beyond.

I admire Rebecca for having the courage of her convictions and publishing this piece. It is brave to do so, but I doubt that anyone will think less of her for having depression, and most will applaud her in being so open about it. As she says, it will allow her to know that everyone knows, or at least could know, rather than having to deal with the uncertainty of not knowing and people being unable to talk about it. This will not, of course, preclude insensitive remarks, even if they are made in the guise of empathy or with the best of intentions. What we really need to reduce and ultimately defeat the stigmatisation of psychiatric disorders, and to allow people to practise talking about them with some sophistication, is capable people like Rebecca saying how it is: that one can have severe psychiatric disorders, respond to treatment, and get back to a productive, happy life at work and with family.

What are the learning points from all of this? For starters, that careers advice is best left out of doctor-patient consultations. That the vicissitudes of life as a clinician or academic are as nothing compared with accepting and managing a major illness and the treatment for it. That it is difficult for people to share their innermost thoughts with a doctor, especially if he or she is a colleague. I am reminded of the primacy of patient experience, the power clinicians have, and the trust required in and of them. It may not be straightforward having a doctor as a patient, but it is a lot easier than it is for a doctor to be a patient. Being a doctor is almost always easier than being a patient. Having a colleague as a patient helps one to appreciate the inevitable but necessary power imbalance in the doctor-patient relationship. Perhaps that is why I was so pleased that Rebecca told me, at our most recent appointment, that it was the first time she hadn’t been nervous about seeing me.

Preparing this text has crystallised these thoughts for me. I hope the article contributes to de-stigmatising depression among doctors and others, and helps Rebecca and those around her manage her illness as best we all can.

Stephen M Lawrie

Useful resources for patients and health professionals

  • Doctors Support Network (—A confidential self help group for doctors
  • Depression Alliance (—Provides information and support services in the UK
  • Royal College of Psychiatrists (—UK professional and educational body for psychiatrists; provides educational material and information for psychiatrists and general public
  • Samaritans (—National charity providing confidential emotional support
  • Befrienders Worldwide with Samaritans (—Worldwide confidential emotional support
  • National Institute of Mental Health (—Provides mental health information and education in the US
  • Beyondblue (—National, independent, not for profit organisation working to address issues associated with depression, anxiety, and related disorders in Australia

Source: BMJ

Cannabis Use Associated with Neuropsychological Decline, Drop in IQ .

Persistent cannabis use, especially when begun during adolescence, leads to measurable neuropsychological decline by midlife, according to a study in the Proceedings of the National Academy of Sciences.

Researchers followed a birth cohort of some 1000 New Zealanders. The subjects’ cannabis use was periodically measured, starting at age 18 and continuing through age 38. Intelligence testing was done during childhood and again at age 38.

Use of cannabis at least 4 days per week was associated with neuropsychological decline by age 38. The decline was especially notable among adolescents who were cannabis dependent (8-point loss in IQ by adulthood). The overall effect persisted after controlling for education and use of other drugs and tobacco.

Asked to comment, Barbara Geller of Journal Watch Psychiatry said: “The belief that cannabis represents a more benign recreational drug than alcohol is belied by this research and by reports of increased vulnerability to psychosis in adolescent-onset users.”

Source: PNAS