What’s the cause?

Recently on these two podcasts, Found My Fitness and The Drive, medical professionals discuss their new understanding of Alzheimer’s. My simplified summary of these podcasts is that we are now seeing that there are several subtypes of Alzheimer’s. These subtypes are actually unique diseases that all have similar effects, yet a unique cause. The scientific community seems to be aware of the following subtypes: the first is characterized by systemic inflammation, the second type shows reduction in support for synaptogenesis, and the third type characterized by environmental toxin exposure from molds or heavy metals. They even named another type 1.5, as it seems to be a mix of the first and second types. When medical providers thought it was only one disease, then the cures that were being applied were probably unlikely to apply to all types of the disease, as they had different causes. If someone’s Alzheimer’s is related to mold exposure from their homes, then reducing systemic inflammation via dietary intervention may have little impact. I’m wondering if we will see similar discoveries in mental health.

I think it’s likely that we will discover multiple subtypes of depression, anxiety, and other mental health concerns. I think it’s likely there will be overlaps between the subtypes, such as the type 1.5 for Alzheimer’s. When I review studies on the treatment of depression (broccoli sprouts to support neuroimmune system, curcumin, transcranial magnetic stimulation) so many of treatments provide improvement for a portion of the people in the study, yet not one treatment provides benefit for all the people. Is it possible that the reason for this partial effectiveness is that there are many subtypes of depression?

What could be the causes of some of the subtypes of depression? My guesses are:

  • Distressing Beliefs
  • Childhood Trauma
  • Behavioral Patterns
  • Rigid Neuropathways/Default Network
  • Overactivity of Immune System/Inflammation
  • Poor Nutrition
  • Poor Gut Health
  • Sedentary Lifestyle
  • Poor Sleep
  • Social Stress

When counselors are lucky, we see clients that are only suffering from depression that is connected to beliefs, emotions, stress, and traumas. We have the tool set to support clients in these cases. What happens when the client is suffering from multiple subtypes or a subtype that is outside of our professional lane? What if we started with interventions with the highest benefit and least risk, and find ways to keep these affordable for our clients? Could we partner with professionals in other fields and find ways to offer group consultations to keep costs low? A childhood obesity clinic offered parents group informative sessions by a nutritionist on dietary advice for their children. All the parents had a similar concern and they all needed similar support from the nutritionist, and the group information sessions made them more affordable.

As mental health counselors, can we build a network of providers that can affordably support our clients? Maybe a nutritionist, you partner with, offers a monthly class on nutritional recommendations for depression and you offer a class on distress tolerance skills or something else that would be supportive to her clients. These classes can have a fee and be a referral source. We could each have a network of many other providers from different fields.

When we have clients that aren’t responding to our tools, maybe it’s not because they are resistant, maybe it’s because their depression has a different cause.

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