Tonsils – the brain’s drain

Have you suffered challenges to your mental health?

Depression has the third highest burden of all diseases in Australia (13%) [1] and also third globally [2].

Almost half (45%) Australians will experience a mental illness in their lifetime [3].

One in five, about 20%, Australians aged 16-85 experience a mental illness in any year:

• 11.5% have one disorder and 8.5% have two or more disorders.
• 14% of Australians suffer from anxiety disorders.
• 6% depressive disorders [4].

The age with the highest prevalence of mental illness is between 18-24 years of age.

21.2% of adolescents between 15-19 years of age met the criteria for a probable serious mental illness [5].

Six Australians die from suicide every single day, with a further 30 people will attempt to take their own life [6].

Suicide is the leading cause of death for people Australians aged 25-44 and the second leading cause of death for young people aged 15-24 [7].

Australians are more likely to die by suicide than skin cancer.

Indigenous Australians experience double the rate of suicide when compared to non-indigenous Australians [8].

The LGBT community experiences four times the rate when compared with those identified as heterosexual [9].

In 2011, men accounted for 76% of deaths from suicide [10], yet an estimated 72% of males don’t seek help for mental disorders.

54% of sufferers with mental illness do not seek treatment [1], which is only compounded by the delay in treatment due to problems with detection, social stigma and accurate diagnosis.

Individuals with mental illness accessing treatment are half that of people seeking treatment with physical disorders [11].It’s time to raise awareness for mental health.

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References

1. Australian Institute of Health and Welfare. (2014). Australia’s Health 2014. AIHW: Canberra.
2. World Health Organisation. (2008). The global burden of disease: 2004 update.
3. Australian Bureau of Statistics. (2009). National Survey of Mental Health and Wellbeing: Summary of Results, 4326.0, 2007. ABS: Canberra.
4. Kitchener, B.A. and Jorm, A.F. (2009). Youth Mental Health First Aid: A manual for adults assisting youth. ORYGEN Research Centre, Melbourne.
5. Ivancic, L., Perrens, B., Fildes, J., Perry, Y. and Christensen, H. (2014). Youth Mental Health Report, June 2014. Mission Australia and Black Dog Institute, Sydney.
6. The Australian Senate. (2010). The Hidden Toll: Suicide in Australia Report of the Senate Community Affairs References Committee. Commonwealth of Australia, Canberra.
7. http://www.aihw.gov.au/deaths/causes-of- death
8. Australian Bureau of Statistic. (2012). Australian Health Survey: First Results. ABS, Canberra.
9. National Mental Health Commission. (2013). A Contributing Life, the 2013 National Report Card on Mental Health and Suicide Prevention. NMHC, Sydney.
10. Department of Health and Ageing. (2013). National Mental Health Report 2013: tracking progress of mental health reform in Australia 1993 – 2011. Commonwealth of Australia, Canberra.
11. Commonwealth of Australia. (2010). National Mental Health Report 2010. Canberra, Australia.

Globally, more than 50% of all people are infected [8], with the prevalence of escalating with age. [9]

Helicobacter Pylori is a gram-negative bacterium that colonises within the human gastrointestinal tract (this includes the mouth).

Symptoms:

• Belching
• Nausea
• Vomiting
• Difficulty swallowing
• Abdominal discomfort
• Upper abdominal bloating
• Decreased appetite
• Peptic ulcers
• Bad breath
• Heartburn
• Reoccurring oral plaque
• Gingivitis
• Tooth cavities

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Risks:

• H. Pylori infection is the main cause of chronic gastritis, with an infection rate between 80%-95% in sufferers. [7]
• It is present in almost all cases of duodenal ulcers and most cases of gastric ulcer [10] with as many as 90% of individuals with ulcers being infected.
• H. Pylori is a significant contributing factor for the risk of gastric cancers.
• H. Pylori burrows deep within parietal cells (cells that secrete stomach acid), not only does this make it harder to eradicate, but this also leads to unique symptoms within the host. One factor being hypochlorhydria (low levels of stomach acid secreted within the body); this prevents the host from sterilising bacteria in food, reduces the ability to obtain nutrients desired from food and the inability to assimilate certain key minerals, such as zinc or iron.
• Reduced intrinsic factor (IF) production is also likely for individuals suffering from a H. Pylori infection. IF is essential to bind with vitamin B12, preventing further breakdown from stomach acid along with attaching to the surface of the ileum to allow for absorption of B12 into the body.
• H. Pylori can also block vitamin C absorption, thus compounding to the amount of oxidative damage inflicted onto the body.
• H. Pylori infection augments the gastric mucosal damage induced by NSAIDs.
• H. Pylori antagonises Aspirin-induced delayed ulcer healing due to suppression of acid secretion by the enhancement of PGE2 possibly derived by COX2 expression.
• Benefits:
  Due to the nature of the parasite being a gram-negative bacteria, it shifts the immune system more towards a Th1 mediated response as opposed to Th2 – this can reduce the severity of allergies, asthma and other humeral/mucosal reactions.

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Benefits:

Due to the nature of the parasite being a gram-negative bacteria, it shifts the immune system more towards a Th1 mediated response as opposed to Th2 – this can reduce the severity of allergies, asthma and other humeral/mucosal reactions.

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References:

1. Morales-Espinosa R, et al., Oral Microbiol Immunol. 2009
2. Nguyen AM, et al., Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995
3. Miyabayashi H, et al., Helicobacter. 2000
4. Gebara EC, et al., J Clin Periodontol. 2006
5. Dye BA, et al., Am J Public Health. 2002
6. Eskandari A, et al. Med Oral Patol Oral Cir Bucal.
7. Abro AH, et al. J Ayub Med Coll Abbottabad. 2011
8. Saudi J Gastroenterol. 2014
9. J Gastrointestin Liver Dis. 2011
10. J Gastroenterol Hepatol. 2011
11. Surveillance of Helicobacter pylori antibiotic resistance in England and Wales; Public Health England, 2008
12. Jernberg, C, et al. 2010

Below are alternative methods which have been studied for their efficacy and effectiveness in combating postpartum depression.

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Saffron

A double-blind, randomised, placebo-controlled trial was conducted on 60 new mothers diagnosed with PPD. After 8 weeks, results showed that the saffron group experienced a 96% remission rate for postpartum depression from just 15-mg Saffron per day, more than double the remission rate of placebo group ‘Researchers concluded that saffron can have a safe and significant mood-elevating impact for those suffering from postpartum depression who want to safely breast-feed their newborns’ (8)

When compared with antidepressant medications, saffron has been found to have similar efficacy – without the side effects.

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Folate

In placebo-controlled trials, folate has been used as an adjunctive treatment to fluoxetine. Findings indicated significantly greater improvement in the folate group, a difference most pronounced in women (14)

94% of women who received fluoxetine, with the addition of folate 500 mcg per day, were treatment responders, compared with 61% of those who received fluoxetine and placebo

It is recommended that women of reproductive age consume 0.4–1 mg folate daily to reduce the risk of neural tube birth defects.

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Exercise

Exercise is integral to optimal health in pregnancy, as well as in the prevention of heart disease, obesity, and diabetes, along with other comorbid diseases. Regular physical activity (after selectively auditing through 216 studies) during pregnancy, pregnancy, and puerperium, or in the postnatal period itself as compared to inactivity, was found to reduce the risk of developing depression in pregnant women and after the birth of a child (6)

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Massage

A meta-analysis of 17 RCTs of massage therapy in depressed people concluded that massage therapy is significantly associated with reduced depressive symptoms (11), decreased urinary levels of cortisol (12); and increased urinary levels of serotonin and dopamine (13)

The purpose of this post is to raise awareness and display the vast array of possible paths one could take in supporting their own mental well-being when combatting PPD.

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Infant Massages

Infant massage improves mother-infant interaction for mothers with postnatal depression (7)

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Seafood

In a large Danish prospective cohort study of more than 54,000 women, participants who were in the lowest quartile of self-reported fish intake during pregnancy were at increased risk of being treated for depression with an antidepressant up to 1-year postnatally (9). Rather than extrapolating this solely to benefits Omega-3, it is important to take into account that sociodemographic characteristics not only influence food availability in house-hold diets but also emotional statue

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Bright Light Therapy

In participants who received at least three weeks of bright light therapy each morning for 1-hr had improvements in their depression scores by a mean of 49%; among participants who completed at least 5 weeks, scores improved by 59% (10)

Caveats in this field of research are that the study pools are low most likely due to the ‘cost vs return’ of investing into studies in this sector

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References:

1. J Midwifery Womens Health. 2013 Nov-Dec; 58(6): 643–653.
2. Lindah l V, Pearson J L, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health 2005;8:77–87.
3. Phytomedicine. 2017 Dec 1;36:145-152. doi: 10.1016/j.phymed.2017.10.005. Epub 2017 Oct 7.
4. Clin Obstet Gynecol. 2009 Sep; 52(3):456-68.
5. Acta Obstet Gynecol Scand. 2001 Mar; 80(3):251-5.
6. Medicina (Kaunas). 2019 Sep 2 ;55(9). Epub 2019 Sep 2. PMID: 31480778
7. J Affect Disord. 2001 Mar;63(1-3):201-7. PMID: 11246096
8. J Integr Med. 2013 Nov;11(6):377-83. doi: 10.3736/jintegrmed2013056.
9. Strom M, Mortensen EL, Halldorsson TI, et al. Fish and long-chain n-3 polyunsaturated fatty acid intakes during pregnancy and risk of postpartum depression: a prospective study based on a large national birth cohort. Am J Clin Nutr 2009; 90:149–55.
10. Oren DA, Wisner KL, Spinelli M, et al. An open trial of morning light therapy for treatment of antepartum depression. Am J Psychiatry 2002;159:666–9.
11. Hou WH, Chiang PT, Hsu TY, et al. Treatment effects of massage therapy in depressed people: a meta-analysis. J Clin
    Psychiatry 2010;71:894–901.
12. Field T, Diego M, Hernandez-Reif M, et al. Pregnancy massage reduces prematurity, low birthweight and postpartum depression. Infant Behav Dev 2009;32:454–60.
13. Field T, Diego MA, Hernandez-Reif M, et al. Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol 2004;25:115–22.
14. Coppen A, Bailey J. Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial. J Affect Disord 2000;60:121-30.
15. Mischoulon D, Fava M. Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence. Am J Clin Nutr 2002;76:1158S 61S.
16. Roder C, Schaefer M, Leucht S. Meta analysis of effectiveness and tolerability of treatment of mild to moderate depression with St. John’s Wort [in German]. Fortschr Neurol Psychiatr 2004;72:330–43.

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