Fear and Hypervigilance

To be completed

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Reminder: Not medical advice, consult doctor before, etc.

What is hypervigilance and how fear plays a part?

Complications for the person, their family, and the public perception

How to think about recovery, management, and responsibility without distributing blame (the emotionally charged aspect of this topic makes it hard to work on recovery without divisiveness). 

Each condition to address:

•  What is it?
• What may cause it and what are the commonalities between sufferers?
  • Endocrine
  • Anatomy/physiology
  • Environmental
  • Evolution/anthropology
  • Fetal development
  • Maternal/paternal health before conception
  • Genetics/epigenetics
  • Immune system
  • Nervous system
  • Psychology
• What are some potential ways of managing symptoms?
  • Breathwork
  • Sleep and Circadian Rhythm
  • Nutrition
  • Trauma recovery
  • Social/Communal integration
  • Exercise
  • Purpose
  • Environment tailored
  • Tools: eustress

Exposure therapy/Flooding

Systematic Desensitization

• Backfill mental skills
• Walk through experience, list triggers of fear from 0-100
• Put them into environments in imagination or reality
• Once they can get the heart rate down the can rewire the response

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Anxiety Disorder

Oxytocin improves autism attachment issues: https://nieuws.kuleuven.be/en/content/2020/love-hormone-improves-attachment-issues-in-people-with-autism?fbclid=IwAR3Xw0zDN4AgPqDsZwPQsIjUPvSuVycVkqFy79g5IRhywEC1iUDXImkC-5U

Meditation lowers biomarkers of stress and anxiety: https://www.sciencedaily.com/releases/2017/01/170124111354.htm

Ritualization as a coping mechanism for anxiety: https: https://www.sciencedirect.com/science/article/pii/S0960982215006521

Panic Attacks

PTSD & Generalized Trauma

Trauma & REM

Eye movement desensitization reprocessing (EMDR) or ketamine treatment for trauma. Similar features to REM sleep.

EMDR

Recalling an emotional/traumatic situation while walking led to a less intense experience for the creator. Looking side to side seems to be the major cause of recovery.

Eyes back and forth laterally while recounting the events. Eye movements you unconsciously make while moving through space, associated with motor system. Suppresses activity in the amygdala, which is critical for the fear response. Must be lateral eye movements to suppress the emotional load to the trauma.

Ketamine / PCP

Dissociative anesthetic. They both function to disrupt the activity of the NMDA receptor, which opens to trigger LTP during an intense event. Ketamine can block a cross over response to certain stimuli that mimic a traumatic event that usually trigger a PTSD event. Emotion can still occur without the plasticity if giving it to somebody who just went through a horrible experience.

Blocks emotion from experience (dissociative).

Self-Therapy

REM sleep, ketamine, and EMDR. All ways of lowering reactivity and plasticity to trauma and hyper-emotionality.

Major, Long-Lasting Benefits of Gratitude Practice

Regular gratitude practice can create resilience to trauma by reframing/buffering their prior traumatic experiences and inoculating them from traumas that may arise in the future.

Gratitude practice has also been shown to benefit social relationships across the board.

The neurochemical aspect of gratitude can be on par with the benefits of high intensity exercise.

Extinguishing (Reducing) Fears

Rather than strengthening connections, we need to weaken them by associating the previously fearful experience with a new, more positive, one. You can’t just extinguish the fear.

Many treatments for PTSD, such as SSRIs, benzodiazepines (anxiolytics), antipsychotic drugs, or beta blockers/adrenergic blockers. Some people may get some sort of relief by using these drugs, but none are based on the neurobiology of fear. Someone may have a reduction in the sensation of fear.

Cognitive (Narrative) Therapies for Fear

Prolonged exposure therapy, cognitive behavioral therapy, and cognitive processing. The experience of fear when they retell their trauma for the first time, there is a tremendous anxiety response. Sometimes greater than the actual experience of the trauma itself. They are asked to speak in full sentences, provide full rich detail, how they felt during and after, etc. The next few retellings progressively diminish the anxious feelings.

The retelling is important. Taking a traumatic experience and making it boring, uncoupling the threat reflex from the narrative (fear extinction).

Can be done in a therapist’s office and can be written out in a journal. Although, it is important to have the right social support available to relearn better/healthier behaviors and responses.

Repetition of Narrative, Overwriting Bad Experiences with Good

Clearing away the association first. Then there is the need to relearn a new narrative. The fear circuits that underlie trauma need to be mapped into new experiences that are of a positive association. Also, that it be linked back to the traumatic experience. Enjoying something despite the fact that something happened.

The top-down circuitry, from the PFC to the threat reflect circuits, are not like the other connections (glutamatergic and excitatory), they are inhibitory, preventing activation of the threat activation. This is why we need to attach a new positive memory onto the previous fear response, to make the reliving of the experience much less likely. However, extinction is essential first. A sense of reward tacked back.

The PFC has an amazing ability to attach meaning and rationalization as a tool to rewire our circuitry.

EMDR: Eye Movement Desensitization Reprocessing

Moving the eyes side to side while recounting a traumatic narrative. Lateral eye movements reduce/inhibit fear reflex circuitry. The eye movements reduce activation of the amygdala activation and related circuits, which reduces anxiety and the amplitude of the threat reflex and SNS. These are the eye movements that we make when we are ambulating/moving through space, though some sort of self-generated motion. Forward movement and fear are generally incompatible (neither fleeing or freezing).

Particularly useful for single event trauma, not so much for relieving trauma from multiple events, such as a bad marriage.

EMDR only really attaches to the extinction portion of trauma recovery. Retelling while reducing the physiological experience with the exercise. However, there isn’t much of a victory over the trauma if you just bypass the experience by removing the physiology.

Social Connection & Isolation Are Chemically Powerful

Tachykinin is activated in neurons in the central amygdala very soon after a traumatic experience (fear inducing) appears. It sets in motion changes in gene expression and potentiation (LTP) that reinforce that fearful experience. Leading to low to moderate levels of anxiety and even aggression. Levels are further increased by social isolation. Social connection (conversing with, eating with, physical contact) with people we trust serve to reduce effectiveness of tachykinin.

It is important to access social connection outside of the clinician/therapist situation.

Trans-Generational Trauma

We have the capacity to inherit a predisposition to certain trauma. Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults.

https://pubmed.ncbi.nlm.nih.gov/18349090/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3923835/

If you had a parent, bias towards father, that experienced abuse, this causes changes in his genetics (in his sperm), that can be passed onto offspring, such that the offspring have a lower threshold to develop trauma or extreme fear to certain events. A predisposition, not a specific fear.

What gets passed on is a propensity for the threat reflex to get activated and attached to a wider variety of inputs and experiences. A gene modification increasing predisposition.

PTSD Treatments: Ketamine, MDMA, oxytocin

Ketamine is a dissociative anesthetic – as making a patient feel like they were getting out of a cockpit of a plane, but observing themselves doing it. It changes the rhythm of cortical activity (1-3Hz rhythm), in layer 5 of the retrosplenial cortex. Brings us to the PFC top-down input, allowing the patient to recount their trauma while feeling while feeling none or a different set of emotional experiences than the traumatic experience. A replacement of emotional experience. Diminishing the old with dissociation, extinction, then relearning.

MDMA is a powerful synthetic drug that creates a dopamine and serotonin releasing state at the same time. Dopamine is usually related to seeking whereas serotonin is more about relaxing and being satiated. The combination of these two are not that normal. People report feelings of connection or resonance with people or things. MDMA causes massive releases of oxytocin too. The dopamine release is related to the euphoria, the serotonin leads to the safety and comfort. For trauma, this allows a fast relearning of new associations to the experience, without the need for many repetitions.

How Do You Know If You Are Traumatized?

The insular is associated with determining whether or not one’s internal sensations are reasonable or not, given the circumstances. The main effect of inhibiting the insula was that the intensity of the outside experience was not consistent with the physiological response. Then anything paired with that experience would elicit that problem.

Recalibrating the relationship between inside and outside events can potentially reduce the amount of trauma we experience.

Deliberate Brief Stress Can Erase Fears & Trauma

Daily short bouts reversed/alleviate symptoms of stress in mice.

Erasing Fears & Traumas In 5 Minutes Per Day

When it comes to trauma, anxiety, and PTSD it is not just the state that you are in or that you got into, it’s how you got there and whether you had anything to do with it.

The insula calibrates how we feel internally vs. what is happening externally. We have a system that can generate threat responses, and in the case of PTSD, anxiety, high stress, etc., that system can get ramped up so that it takes very little – maybe even a memory or an association we aren’t aware of – to trigger the symptomology.

Most drug treatments just suppress the arousal. By doing this you just create a different miscalibration. Doing a physiological sigh is a way to calm the system when the early signs of stress start to arise. Using cyclic hyperventilation, unless you are prone to panic attacks, can be a good way to elicit minor stress daily on your own terms. Recalibrating your stress threshold via deliberate reactivation of the sensations of the body without the fear being attributed. It seems it could be used in a therapeutic setting to awaken the threat response with your own agency, before addressing the traumatic issue.

All you need is self-directed adrenaline release. Could be a cold shower or hyperventilating. Do it in conjunction with support.

Nutrition, Sleep, & Other General Support Erasing Fear & Trauma

Sleep regularly for better functioning fear circuits. Dysregulated means we can have a higher propensity for sympathetic activation.

“If the tide is high enough, the boat can leave the shore.”

Supplements for Anxiety, Fear: Saffron, Inositol, Kava

Saffron (30mg) has been reliable in treating the effects of anxiety. Inositol (18g for a full month) is on par with antidepressants. Also used for OCD. Don’t take before treatment because you’ll short-circuit the extinguishing effect. Driving the trauma/anxiety deeper into the system. Kava has been shown to have a potent effect on anxiety by increasing GABA, inhibiting the threat reflex.

Schizophrenia

Nutrient Power Notes

Schizoaffective Disorder:

• This condition is a mixed thought, mood, and perceptual disorder consisting of delusional thinking, moods ranging from depression to mania, and perceptual hallucinations and illusions.
• Many of these patients also exhibit obsessive-compulsive tendencies, internal anxiety, and catatonic tendencies. Typically, this is an adult-onset condition featuring a mental breakdown after a history of high achievement.
• A review of the chemistry database for 500 persons with this diagnosis revealed that virtually all had evidence of undermethylation.

Paranoid Schizophrenia:

• Usually involves auditory hallucinations and paranoia along with other symptoms.
• More than 85% exhibited overmethylation. This condition is often misdiagnosed, and a careful study of 250 patients with classic symptoms indicated overmethylation in 94% of the patients. With more accurate diagnosis, the incidence of this chemical imbalance could approach 100%. A typical feature of this illness is a mental breakdown after age 15.

Schizophrenia typically develops between the ages of 15-25 for males and 16-35 for females. The symptoms, especially hallucinations, delusions, paranoia, and radical changes in personality. 

Biological Psychiatry

Atypical antipsychotic medications usually result in impressive benefits, but most patients remain handicapped compared to their pre-breakdown condition, experience serious side effects that may become permanent, and may experience gradual loss of brain cortex volumes.

Dopamine Theory:

• Symptoms of paranoid schizophrenia could be produced in normal persons by increasing dopamine activity through the use of amphetamines.
• This theory can explain psychosis and other positive symptoms of schizophrenia, but it cannot explain the cognitive, socialization, and other negative symptoms that are classic features of the disorder. 

Glutamate Theory:

• Phencyclidine hydrochloride (PCP) administered to normal persons can induce psychosis that closely resembles schizophrenia. The main action of PCP is to reduce glutamate activity at NMDA receptors. This theory received strong support when it was learned that increasing NMDA activity (using glycine supplements) was effective in reducing schizophrenia symptoms. NMDA receptors are unique in that neurotransmission requires simultaneous docking of both glutamate and glycine molecules.
• Early research indicates that D-serine and Dcycloserine are most effective for undermethylated schizophrenia, with sarcosine better suited for overmethylated patients. In addition, D-serine has become a promising treatment for addictions to opiates, cocaine, alcohol, and other substances.

Oxidative Stress Theory:

• Glutathione (GSH) levels are depleted by oxidative free radicals and are low in brains of those with schizophrenia. Moreover, low GSH reduces glutamate activity at NMDA receptors, a condition that can produce hallucinations, delusions, and other classic symptoms of schizophrenia.
• The many sources of oxidative stress in the brain include heavy metals, viruses, bacteria, injury, inflammation, emotional stress, nuclear radiation, and high iron levels.
• Fortunately, the brain is protected by several antioxidant factors including GSH, metallothionein, selenium, superoxide dismutase (SOD), catalase, vitamin C, and cysteine.
• The strong heritable predisposition for schizophrenia suggests that weak antioxidant protection is the culprit in most cases.

Epigenetics Theory:

• A study of identical twins discordant for schizophrenia found epigenetic DNA methylation abnormalities in the schizophrenics but not in their twin brothers. In other studies, schizophrenics had higher levels of methylation than depressive controls, resulting in lower gene expression of GAD67, an enzyme that produces the neurotransmitter GABA; the researchers found that methionine worsened symptoms, while valproic acid increased histone acetylation and provided benefits.

Excessive dopamine activity associated with an elevated methyl/folate ratio involves underproduction of a complex chemical called dopamine active transporter (DAT). This transporter removes dopamine from synapses, sending it back to the original cell for reuse. Overmethylation results in reduced expression of DAT and excessive dopamine activity. This biochemical abnormality is a hallmark of paranoid schizophrenia.

In contrast, the epigenetic effect of undermethylation is to reduce activity of serotonin, dopamine, and norepinephrine. In addition, undermethylation appears to influence synaptic NMDA receptor activity and is associated with schizoaffective disorder and delusional disorders. Reduced activity of norepinephrine usually coincides with reduced adrenaline activity that may contribute to catatonic symptoms that are characteristic of schizoaffective disorder and delusional disorder.

Viral insult may alter gene expression and contribute to the illness and impact of schizophrenia.

Biochemical Classification of the Schizophrenias

90% of the cases: overmethylated schizophrenia (42%), undermethylated schizophrenia (28%), and a condition of severe oxidative stress termed pyrrole schizophrenia (20%).

Differential Diagnosis Factors

Patients who are overmethylated or pyroluric usually exhibit warning signs of the disease before the age of 10, but undermethylated patients may be symptom-free until the breakdown. Chemical analyses of blood and urine provide about 50% of the information required for accurate diagnosis. Symptoms, traits, physical signs, medical history, and family history are equally useful in identifying a patient’s schizophrenia biotype.

Symptoms during initial breakdown:

• Persons who become more physically active and report hearing voices are likely to be overmethylated.
• Patients who shut down with catatonic symptoms usually exhibit undermethylation.
• Schizophrenics who exhibit wild mood swings, great fears, and deteriorate under stress are likely to have pyrrole disorder.

Response to psychiatric medications:

• Dramatic worsening of psychiatric symptoms after serotonin-enhancing SSRIs suggests folate insufficiency and methyl overload. Similarly, worsening of psychosis after a benzodiazapine medication suggests a low methyl/folate ratio.

Family History:

• More than 50% of schizophrenia patients have at least one relative with a serious mental illness.

Dominance of hallucinations or delusions:

• Most patients exhibiting severe delusions are undermethylated, whereas most patients with a dominant symptom of auditory hallucinations are overmethylated. Most pyrrole disorder patients exhibit both delusions and auditory hallucinations.

Psychiatric medication issues:

• Recovered schizophrenics who completely eliminate psychiatric medication are likely to relapse within a year.
• After several months of nutrient therapy, some patients report great improvement in psychosis symptoms, anxiety, depression, socialization, and cognition while simultaneously experiencing extreme physical tiredness and reduced energy.

Recovery Timeline:

• Mentally ill patients with pyrrole disorder usually improve significantly during the first two to four weeks of nutrient therapy, with progress continuing for two to four months.
• Most overmethylated psychotics are greatly troubled during the first three weeks of treatment, with clear improvement beginning during week four.
• Delusional undermethylated patients usually report little or no progress over the first four to six weeks and then experience a gradual recovery during the next six months. Many of these patients report a return to a normal life.

Overmethylation Biotype of Schizophrenia

Laboratory indications include whole blood histamine levels below 40 ng/ml, absolute basophil levels below 30, and serum copper higher than 120 mcg/dl. This schizophrenia phenotype involves excessive activity at dopamine and norepinephrine receptors, possibly caused by epigenetic inhibition of dopamine active transporters (DATs) and norepinephrine transporters (NETs) and elevated copper levels. Primary symptoms usually include auditory hallucinations, paranoia, agitation, and extreme anxiety. The most common diagnosis is paranoid schizophrenia.

Judy – 26 (Overmethylation):

• High anxiety, auditory hallucinations, mother had severe anxiety and depression, Judy loved art and music but didn’t do well in school. However, she had plenty of friends.
• Depressed blood histamine level of 10 ng/ml, and she was diagnosed with overmethylation. Elevated copper and depressed zinc levels.
• Judy was treated with folic acid, zinc, niacin and vitamins B-6, B-12, C, and E, which she took along with her medication. Her nutrient therapy was aimed at reducing norepinephrine and dopamine levels while increasing GABA. She reported a worsening of anxiety the first three weeks, followed by clear improvement during month two. Within six months, her symptoms had nearly disappeared and she returned to work after a year’s absence. Her psychiatrist has weaned her from Tegrerol and Zoloft, and she continues on a low dose of Zyprexa.

Robert – 25 (Overmethylation):

• High anxiety and auditory hallucinations. No family history of mental illness, he had food and chemical sensitivities and allergy treatment as a child.
• He had been very sociable prior to his psychosis symptoms but had become a loner. He exhibited several overmethylation symptoms including difficulty sleeping, low libido, nervous legs, and ringing in the ears (tinnitus). He had a heavy beard, and his chest was covered with thick black hair.
• Robert’s testing indicated overmethylation (depressed blood histamine of 26 ng/ml), and he was placed on a regimen of folic acid, vitamins B-3, B-6, B-12, C, and E together with supplements of zinc, manganese, and chromium. At his annual follow-up visit, Robert reported that the voices had disappeared and he felt in good health.

Undermethylation Biotype of Schizophrenia

Severely depressed methyl/folate ratio is present in about 28% of the schizophrenia population. The dominant symptom is usually delusions, although mild hallucinations are sometimes present. Laboratory indications are whole blood histamine above 70 ng/ml, elevated blood basophils, and depressed SAMe/SAH ratio.

Most undermethylated persons in the general population are high achievers in good mental health. However, most mentally ill persons exhibiting this imbalance respond to methylation therapies. This form of schizophrenia involves low activity of serotonin, dopamine, and norepinephrine, possibly caused by epigenetic overexpression of SERT (serotonin transporter), DAT, and NET transporters at synapses. Low glutamate activity at NMDA receptors is also suspected. Typical symptoms include delusions, OCD behaviors, high internal anxiety, and catatonic tendencies.

Common symptoms include belief that the CIA or FBI is following them, that their parents are aliens, or that a satellite in outer space is beaming painful rays into their brain. Most undermethylated schizophrenics have ritualistic behaviors and strong obsessive compulsive tendencies. They may have extreme inner anxiety that is hidden behind a calm exterior.

David – 22 (Undermethylation):

• After a breakup he was diagnosed with schizoaffective disorder (thought Russian agents were out to get him), hospitalized for 10 days, and medicated with Zyprexa, Depakote, and Zoloft. Despite significant improvement, David was unable to resume his studies or hold a job. He reported a 50-pound weight gain and had isolated himself from his friends.
• A biochemical evaluation revealed symptoms of undermethylation, including a history of seasonal allergies, perfectionism, competitiveness in sports, and sparse chest hair.
• His blood histamine level was extremely elevated at 170 ng/ml, and he was treated with SAMe, methionine, calcium, magnesium, zinc, serine, and vitamins A, B-6, C, D, and E. His family reported no change for six weeks, followed by slow improvement. After a year of nutrient therapy, David reported a nearly complete recovery, and his psychiatrist weaned him from Depakote and Zoloft and reduced the dosage of Zyprexa.

George – 21 (Undermethylation):

• George was diagnosed with paranoid schizophrenia, the same condition that had afflicted his mother. He was evaluated by a psychiatrist but refused to comply with medication.
• His evaluation revealed several undermethylation symptoms including hayfever, high libido, excessive saliva and tears, sparse chest hair, and chain smoking.
• His blood histamine and absolute basophil levels were both elevated, and he was treated with methionine, calcium, magnesium, zinc, chromium, and vitamins A, B-6, C, D, and E. In addition, he was given the nutrient inositol to help with sleep. George had chronic problems with compliance, but he reported significant improvement after six months.
• At a follow-up visit, he no longer was weighted down with metal and agreed to see a psychiatrist and receive low-dose medication support. After several years of wellness, he stopped compliance with his medication and nutrients, and his delusions returned within a few months.

Pyrrole Disorder Biotype of Schizophrenia

This phenotype involves a severe overload of oxidative stress that impairs brain function. This condition usually results in very elevated levels of pyrroles in urine along with severe deficiencies of zinc and vitamin B-6.

Most persons with elevated pyrroles have mild symptoms that do not interfere with daily living. However, about 20% of schizophrenics exhibit a severe version of this imbalance and report improvement following aggressive therapy with zinc and vitamin B-6. This condition involves free-radical oxidative stress and depleted levels of glutathione, metallothionein, and other protective proteins causing inhibition of glutamate activity at NMDA receptors.

Primary symptoms of pyrrole disorder generally include the following:

• Extreme mood swings
• Sensitivity to light and noise
• Poor stress control
• Severe anxiety
• Little or no dream recall
• Preference for spicy foods
• Abnormal fat distribution

A study of 67 schizophrenics found that pyrolurics were very deficient in arachidonic acid. This may explain the symptoms of dry skin and abnormal fat distribution associated with this disorder. Many pyroluric schizophrenics report benefits from supplements of primrose oil, a source of omega-6. Non-pyrrole schizophrenia phenotypes generally exhibit low omega-3 levels and omega-6 overload. A recent study reported biotin deficiency in pyrrole patients.

Most pyroluric schizophrenics report symptoms of zinc and vitamin B6 deficiency from early childhood. Physical symptoms include delayed growth, poor wound healing, dry skin, white spots on fingernails, delayed puberty, acne, and inability to tan. Most pyrolurics have a history of academic underachievement that has been attributed to severe vitamin B6 deficiency that can impair short-term memory. Mood swings may occur many times daily, and a common diagnosis is rapid-cycling bipolar disorder. The onset usually occurs during a period of extreme stress. Schizophrenics with this imbalance may have a combination of delusions and auditory hallucinations. They live in a world of fear and do not attempt to hide their anxieties.

Mary – 29 (Pyrrole):

• She suffered a severe mental breakdown when her mother was killed in a car accident. After many unsuccessful medication trials, she became suicidal with daily episodes of hysteria.
• A biochemical evaluation revealed several classic symptoms of pyrrole disorder, including morning nausea, aversion to sunlight, absence of dream recall, history of severe sunburn, preference for spicy Mexican and Indian foods, and abnormal menstrual cycles. She also exhibited the classic pyroluric fat distribution, with a slender neck and thin wrists and ankles along with huge amounts of fat at her midsection and upper thighs.
• Lab testing showed a single abnormality: a urine pyrrole level exceeding 150 μg/ml, more than 10 times the normal level. Her nutrient therapy involved very high doses of zinc and vitamin B-6 together with augmenting nutrients. She responded quickly, and the family reported great improvement after 30 days. She returned for a follow-up evaluation in three months and appeared to be completely recovered, despite the absence of psychiatric medication.

Overmethylation and Copper Overload

A common aggravating factor in overmethylated schizophrenia that results in more-extreme norepinephrine elevations. The usual result is greatly heightened anxiety, paranoia, and increased auditory hallucinations. Moreover, copper elevations are associated with zinc depletion, and zinc is an important factor in maintaining GABA levels. The combination of high norepinephrine and low GABA levels is a recipe for extreme anxiety. Female patients with this combination of imbalances tend to experience early mental breakdowns, frequently during puberty. Treatment of this condition must be gradual since rapid removal of excess copper from the body could cause temporary worsening of psychiatric symptoms.

Undermethylation and Pyrrole Disorder

Unlike most pyrrole patients, these persons usually have a history of high accomplishment in academics and career prior to their mental breakdown. After onset of the illness, many are plagued by severe mood swings, extraordinary delusional beliefs, and episodes of rage. Successful treatment of this hybrid condition often results in early improvement in behavior control followed by a four-to-six-month period before the delusions begin to fade away.

Low-Incidence Biotypes

Gluten intolerance appears to be responsible for an additional 4% of persons diagnosed with schizophrenia. The remaining 6% involve a collection of relatively rare mental illness biotypes, including thyroid deficiency, polydipsia, homocysteinuria, drug-induced psychosis, and porphyria.

Gluten Intolerance:

• Many cases of childhood schizophrenia can be traced to celiac disease.
• This disorder can also occur in young adults, most commonly in the third decade of life. This condition is associated with incomplete breakdown of gluten proteins in the GI tract, resulting in small proteins called gluteomorphins that can pass into the bloodstream and access the brain. The net result can be brain inflammation and disturbed function of brain receptors. Early symptoms include bloating, excessive gas, and explosive bowel movements.

Thyroid Deficiency:

• Dr. Pfeiffer reported that about 1 case of schizophrenia in 200 resulted from severe thyroid deficiency and that standard treatment with either Synthroid or Armour thyroid often resulted in complete recovery.

Polydipsia:

• Very low serum sodium and potassium levels, and urine with a water-like specific gravity of 1.000 with very low creatinine levels.

Homocysteinuria:

• The usual cause is a genetic lack of an enzyme needed to control levels of the amino acid homocysteine. Most cases can be traced to deficiency of the cystathionine β-synthase (CBS) enzyme (converts homocysteine and serine to cytathionine) or the methylenetetrahydrofolate reductase (MTHFR) enzyme (converts homocysteine to methionine).
• Dysfunction in these enzymes causes impairment to the methylation cycle and reduced production of glutathione and other antioxidants. This condition can be treated with supplements of vitamins B-6 and B-12 in conjunction with folic acid, serine, and trimethylglycine (TMG).

Drug-induced schizophrenia:

• Most patients with drug-induced schizophrenia that persists after abstinence exhibit the undermethyation biotype.

The Porphyrias:

• A group of inherited or acquired disorders of certain enzymes in the heme biosynthetic pathway. Typical symptoms include abdominal pain, hallucinations, depression, paranoia, and anxiety.
• Coproporphyria is the most common type of porphyria inappropriately diagnosed as schizophrenia. Porphyrin molecules contain rings of pyrrole groups, and severe elevations of urine pyrroles and toxic metals are usually present along with a pronounced lack of zinc and vitamin B-6.
• Despite the presence of these correctable chemical imbalances, nutrient therapy has generally resulted in disappointingly minor improvements in these patients.

The Walsh Theory of Schizophrenia

They believe a proper theory of schizophrenia must include the following elements:

• Separate causation for the major phenotypes
• Explanation for the mental breakdown event that usually occurs in late adolescence or young adulthood
• Explanation for the lifelong persistence of schizophrenia after the mental breakdown
• Explanation of why this familial (heritable) disorder violates classical laws of Mendelian genetics

Thesis 1: Predisposition to schizophrenia involves fetal programming errors that cause lifelong vulnerability to oxidative stresses. These programming errors can result from a variety of causes: (a) an abnormal in utero methylation environment, (b) exposure to environmental toxins, (c) genetic weakness in oxidative protection, and (d) medication side effects.

Thesis 2: The mental breakdown event is triggered by overwhelming oxidative stress that alters DNA and histone marks that regulate gene expression. Cancer research has provided examples of cumulative oxidative stresses that eventually alter gene marks, producing an enduring disease condition. The onset of schizophrenia occurs when oxidative stresses exceed the threshold level needed to alter chromatin marks that control gene expression.

Thesis 3: Epigenetic changes are responsible for continuing psychotic tendencies after the breakdown event. A psychotic breakdown is usually followed by a lifetime of mental illness and misery, despite intensive therapies. This often-permanent change in functioning results from altered DNA or histone marks that regulate gene expression. Since the deviant marks are maintained during future cell divisions, the condition doesn’t go away.

Thesis 4: The three major phenotypes of schizophrenia develop in individuals who exhibit overmethylation, undermethyation, or overwhelming oxidative stress:

• A. Overmethylation: About 42% of persons diagnosed with schizophrenia exhibit severe overmethylation together with oxidative overload. Mental breakdowns generally occur during severe physical or emotional traumatic events that sharply increase oxidative stress and produce deviant gene marks. This schizophrenia biotype is a sensory disorder that generally involves auditory, tactile, or visual hallucinations. This condition is associated with elevated activity of dopamine and norepinephrine and reduced glutamate activity at NMDA receptors. The most common DSM-IV-TR diagnosis is paranoid schizophrenia.
• B. Undermethylation: About 28% of persons diagnosed with schizophrenia exhibit undermethylation together with weak antioxidant protection. Mental breakdowns generally occur during severe physical or emotional traumatic events that produce a separate set of altered gene marks. This schizophrenia biotype essentially is a thought disorder with delusions and catatonic tendencies as the primary symptoms. This condition is associated with low activity at serotonin, dopamine, and NMDA receptors. The most common DSM-IV-TR diagnoses are schizoaffective disorder or delusional disorder.
• C. Severe oxidative overload: The third major schizophrenia phenotype develops in persons with an inborn severe deficit in antioxidant protection. This condition is arbitrarily termed pyrrole disorder due to the presence of excessive pyrrole levels in blood and urine. Mental breakdowns occur for these persons during periods of extreme physical or mental stress in which deviant epigenetic marks are established. This condition is characterized by extraordinary anxiety and rapid mood swings, and it often involves both auditory hallucinations and delusional beliefs. Brain chemistry abnormalities include (a) depressed glutamate activity at NMDA receptors and (b) very depressed GABA activity.

Thesis 5: Failure to follow classical laws of genetic inheritance results from the epigenetic nature of schizophrenia. Schizophrenia is strongly heritable (runs in families) but fails to obey Mendel’s classic laws of genetic inheritance. There are countless examples of identical twins where one sibling develops the disorder and the other does not. In addition, intensive research efforts to identify the schizophrenia gene (or genes) have met with little success. Epigenetics provides two explanations for the non-Mendelian nature of schizophrenia:

• (a) environmental insults are required to produce deviant epigenetic marks, and environmental conditions are highly variable for different individuals, and
• (b) transgenerational epigenetic inheritance contributes to schizophrenia heritability by transmitting deviant epigenetic marks to one’s children and grandchildren.