[dropcap]D[/dropcap]epression is a mood disorder characterized by absence of cheerfulness, dejection, and loss of interest or pleasure in living, making the person dysfunctional and unable to cope with or perform tasks of daily living.
More than a feeling, this negative psychological status can range from mild to profound and can involve other parts of the body, causing physical problems such as poor digestion, constipation, weight gain or weight loss, mentrual irregularities in females, and impotence in males.
Q: How is depression identified?
A: According to the American Psychiatric Association, depression is a psychic condition that lasts for more than a month and involves four or more of these symptoms:
Abnormal appetite.
Diminished ability to concentrate or think properly.
Feelings of worthlessness.
Low energy or fatigue.
Physical inactivity or hyperactivity.
Sleep disturbances.
Thoughts of death.
Grief or sadness at the loss of a loved one or a similar event or remorse for sin is normal. However, depression that is prolonged usually involves imbalances of nerve chemicals called neurotransmitters. Imbalances can result from health disorders such as hormonal imbalances, low blood sugar, stress, drug side effects, or nutrient deficiencies.
What Is Depression In Celiac Disease and/or Gluten Sensitivity?
Child with autism stacking cans. Courtesy Wikimedia.
What Is Autism and Learning Disabilities?
[dropcap]A[/dropcap]utism and learning disabilities constititute a non-progressive psychiatric syndrome appearing in childhood characterized by withdrawal from communication with others often accompanied by repetitive or primitive behaviors.
Primary gastrointestinal pathology may play an important role in the inception and clinical expression of autism.
Autistic children often manifest complex biochemical and immunological abnormalities.1 Following are four main features involving the digestive tract:
1) Brain dysfunction from an abnormal gut. Common characteristics of hepatic encephalopathy (brain dysfunction caused by liver disease) and a form of autism associated with developmental regression and immune caused gastrointestinal pathology (abnormal) in an apparently healthy child, have led to the proposal that there may be similar mechanisms of toxic brain dysfunction caused by gluten and casein proteins.
Gluten in wheat and casein in cow milk are called exomorphines because they act like morphine (opioid) in the brain. Aberrations in opioid biochemistry are common in autism.
2) Characteristic intestinal pathology. Many autistic children with gut symptoms have ileocolonoic lymphoid nodular hyperplasia and inflammation of the intestinal lining. The colon lesion consisting of a mucosal infiltrate of yo T cells and Celiac Disease8+ T cells and crypt cell proliferation is enhanced significantly, and the basement membrane is thicker than in normal or disease groups. Neutrophil and eosinophil mucosal infiltration and absence on colonic epithelium of HLA-DR antigen suggests a T-helper -2 dominated immune response.
The corresponding small intestinal lesion also shows a distinct inflammatory reaction in which immune-mediated epithelial cell damage is predominant and blood anitibodies of the IgG type colonizes with complement.
3) Intestinal permeability abnormalities. A subset of children with autism were found to display increased immune reactivity to gluten, the mechanism of which appears to be distinct from that in celiac disease. The increased anti-gliadin antibody response and its association with gastrointestinal symptoms points to a potential mechanism involving immunologic and/or intestinal permeability abnormalities in affected children.2
4) Secondary dysbiosis. Anaerobic dysbiosis develops in the colon caused by fermentation of the overload of undigested food arriving from the small intestine. Billions of microbes in the colon normally breakdown undigested food, however, in autism, the process is dysfunctional and produces byproducts that are toxic to the brain resulting in encephalopathy.
What Is Autism and Learning Disabilities In Celiac Disease and/or Gluten Sensitivity?
Sources:
Wakefield AJ, Puleston M, Montgomery SM, Anthony A, O’Leary JJ, Murch SH. Review Article: the concept of entero-colonic encephalopathy, autism, and opioid receptor ligands. Aliment Parmacol Ther. 2002; 16:663-674. [↩]
Lau NM, Green PH, Taylor AK, Hellberg D, Ajamian M, Tan CZ, Kosofsky BE, Higgins JJ, Rajadhyaksha AM, Alaedini A. Markers of Celiac Disease and Gluten Sensitivity in Children with Autism. PLoS One. 2013 Jun 18;8(6):e66155. Print 2013. [↩]
[dropcap]D[/dropcap]evelopmental delay is failure in infants and young children to meet expected milestones, such as smiling for the first time or taking the first steps, due to an impairment in physical, learning, language, or behavior areas.
These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime.1
What Is Developmental Delay In Celiac Disease and/or Gluten Sensitivity?
Sources:
Developmental Disabilities: Delivery of Medical Care for Children and Adults. I. Leslie Rubin and Allen C. Crocker. Philadelphia, Pa, Lea & Febiger, 1989. [↩]
[dropcap]A[/dropcap]pathy is an abnormal emotional state that is characterized by indifference to things which others find interesting, moving or exciting, and diminished motivation to perform regular daily activities.
The neural mechanisms of apathy are postulated to involve the brainstem and forebrain circuits that regulate goal-directed behavior.1
What Is Apathy In Celiac Disease and/or Gluten Sensitivity?
[dropcap]I[/dropcap]nability to concentrate is a mental dysfunction characterized by trouble fixing the mind on one subject to the exclusion of all other thoughts.
What Is Inability To Concentrate In Celiac Disease and/or Gluten Sensitivity?
[dropcap]A[/dropcap]nxiety or worry is a distressing emotional state of mind or mood that is characterized by a vague uneasiness, unpleasant feelings of apprehension or anticipation of danger and by interference with normal functioning, ranging from mild qualms and easy startling to occasional panic.
Q: What causes anxiety?
A: Anxiety can be a normal response to stress such as making an important decision, illness, divorce, problems at work or preparing for an exam.
In a dangerous situation, profound physiological changes rapidly prepare us for a “fight or flight” response by release of adrenalin hormone. Adrenalin speeds up metabolism to make available quick energy, tightens muscles in readiness, and speeds up the heartbeat and breathing so that more oxygen is made available to the brain and muscles.
Anxiety becomes a maladaptive disorder when it is excessive, unrealistic, or not provoked and impairs the ability to lead a normal life.
Anxiety that is part of a person’s personality is called “trait anxiety.” Anxiety that comes and goes is “state anxiety,” as in state of mind, and is usually due to unresolved stress or an underlying health problem.
[dropcap]I[/dropcap]nsomnia is a distressing sleep disorder that includes inability to fall asleep, inability to stay asleep, and inability to get deep sleep depending on the type of insomnia.
Q: What are the types of insomnia?
A: There are two types of insomnia: primary or secondary which have different causes.
1. Primary insomnia is characterized by sleeplessness due to reduction of synthesis of neurotransmitters (brain chemicals) in the central nervous system (brain) required for sleep, especially melatonin. Melatonin is produced during the night hours by the pineal gland from tryptophan, an essential amino acid derived from food.
Neurotransmitters are released when the axon terminal of a presynaptic neuron (nerve cell) is stimulated and acts by stimulating or inhibiting a target nerve cell.
2. Secondary insomnia has many causes. It can be a feature of malnutrition, lack of exercise, heartburn, mental disorders such as dementia and psychosis, emotional disorders such as depression and anxiety, guilt, worry, many conditions that involve itchiness, pain, disability, and a side effect of certain medications.
What Is Insomnia In Celiac Disease and/or Gluten Sensitivity?
What Is Attention Deficit Hyperactive Disorder (ADHD)?
[dropcap]A[/dropcap]ttention deficit hyperactive disorder (ADHD) is a maladaptive behavioral disorder characterized by a persistent pattern of inattention and impulsivity, or both, that are developmentally (age) inappropriate. For these problems to be diagnosed as ADHD, they must be out of the normal range for a child’s age and development.
Inattention results from difficulty concentrating which gives the impression of not listening. The person’s speech or writing, such as when telling stories, can be disorganized.
Most children with ADHD also have at least one other developmental or behavioral problem. Depression, lack of sleep, learning disabilities, tic disorders, and behavior problems may be confused with, or appear with, ADHD. Every child suspected of having ADHD should be carefully examined by a doctor to rule out possible other conditions or reasons for the behavior.
An MRI (magnetic resonance imaging) study investigating whole-brain cortical thickness (outer layer of the brain) in male and female children, adolescents, and adults with ADHD supports the hypothesis that brain abnormalities in ADHD represent abnormal brain development rather than developmental delay.
Q: What is the abnormal development problem?
4 lobes of the human brain making up each hemisphere (side). In this drawing, the frontal is blue, the parietal is yellow, the temporal is green, and the occipital lobe is pink. Courtesy Wikimedia
A: Differences occur in the right side of the brain only. Reduced cortical thickness in people of all ages with ADHD was observed predominantly in the frontoparietal region (forehead and top). However, increased cortical thickness was observed predominantly in the occipital lobe (back). The brain thickness differences were correlated with severity of ADHD.1
ADHD is the most commonly diagnosed behavioral disorder of childhood. It affects about 3 – 5% of school aged children and is diagnosed much more often in boys than in girls.2
What Is ADHD In Celiac Disease and/or Gluten Sensitivity?
Sources:
Almeida Montes LG, Prado Alcántara H, Martínez García RB, De La Torre LB, Avila Acosta D, Duarte MG. Brain cortical thickness in ADHD: age, sex, and clinical correlations. J Atten Disord. 2013 Nov;17(8):641-54. doi: 10.1177/1087054711434351. [↩]
PET scan showing schizophrenia. Courtesy Wikimedia.
What Is Schizophrenia?
[dropcap]S[/dropcap]chizophrenia is a thought disorder characterized by psychotic symptoms and inappropriate and bizarre behavior.
Schizophrenia involves dysfunction in any of these areas:
Cognition which are thinking skills that include intellect, language, mathematical ability, memory, perception, reasoning, judgment, learning, and imagination.
Interpersonal relationships.
Ability to work or attend education.
Ability to take care of physical and financial needs.
Q: What are psychotic symptoms?
A: In psychosis the symptoms vary but include loss of contact with reality shown by hallucinations, delusions, disorganized speech, and disorientation. Some may be depressed or manic. Some may be withdrawn and mute while others may become violent if frustrated or thwarted.
In hallucinations, affected persons see what is not real such as a burgler in the process of robbing them but which is not really happening or hear voices that are not real.
In delusions, affected persons may express strange ideas, claim to read minds or that they are a famous person living or dead.
Early-onset schizophrenia with onset before age 18 is defined by the same diagnostic criteria as in adults because it is continuous with adult schizophrenia. The onset before age 12 years comprises less than 1% of adult cases, and onset from age 12–18 years constitutes about 12–33% of all adult cases of schizophrenia.1
What Is Schizophrenia In Celiac Disease and/or Gluten Sensitivity?
Sources:
Pagsberg AK, Tarp S, Glintborg D, Stenstrøm AD, Fink-Jensen A, Correll CU, Christensen R. Antipsychotic treatment for children and adolescents with schizophrenia spectrum disorders: protocol for a network meta-analysis of randomised trials. BMJ Open. 2014 Oct 10;4(10):e005708. doi: 10.1136/bmjopen-2014-005708. [↩]
What Is Depression?
What Is Irritability?