Friday, February 26, 2021

Comments by Kelly Brogan, MD, ABIHM

Showing 3 of 3 comments.

  • Hello! I welcome the commentary and think that this brings an important layer of sophistication to discussions that are rarely had between different “camps”. My involvement in this forum is with the explicit intention of bringing awareness to a functional medicine approach to mental health and wellness. This model explores the multi-factorial contributors to health outcomes with a focus on modifiable environmental factors (exposure to agricultural and industrial chemicals, nutrient density and allergenicity of diet, stressors, etc) that may be driving the manifestation of genetic vulnerabilities. In the intellectual circles that I learn in, there is tremendous concern about skyrocketing incidences of neurodevelopmental delay, autoimmune, and allergic phenomena in the pediatric population. Autism can be left entirely out of the conversation, and there can still be a significant conversation to be had.
    When I say that our children are toxic, I am referring to the evidence that our children are born with cord blood, pre-polluted with >200 known neurotoxic elements through antenatal exposure. Of course, that term was not a “slur” and not even an adjective, but rather an acknowledgement of what many environmental experts believe to be a crisis of regulation in this country that is jeopardizing newborns and mothers every day.
    In this model, autism may be viewed as a condition in which perinatal stress and environmental factors play a significant role. If autism is a state not to be pathologized, I suppose the change in DSM criteria would be celebrated. I am interested in this perspective, although, in my practice and personal connections, I have far more exposure to mothers whose services will now be eliminated, and whose support of parenting would seemingly require more than mentorship by an autistic adult.
    I wonder how the affronted community discusses their perspective with mothers of autistic children with impairments severe enough that they *cannot* communicate or function to an extent that would be considered a mental health variant, but rather definitively a struggle. Many of these children also suffer from gastrointestinal and autoimmune dysfunction that is likely related to mitochondrial derailment and microbiota abnormalities. These are problems that have been successfully adressed through the functional medicine/biomedical model using non-medication interventions. These problems are highly related to and reflective of what is happening in the brain. The gut and the brain are more connected than the average psychiatrist is equipped to address or assess. Like many other illnesses, it may be a matter of degree that distinguishes suffering from special.
    Nonetheless, all of this discussion skirts my greater agenda, which is to comment on the mercurial nature of psychiatric pathologizing (which I believe we could all agree on), and my concerns that shifts in diagnostic criteria may be serving pharmaceutical agendas to deliver more product (psychotropics and vaccinations) to more and more individuals without raising any red flags around ever-increasing rates of pediatric chronic illness.