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  • Therapeutic Lifestyle Changes/Natural Antidepressants

    Evolutionary biology and neurophysiology psychoeducation for patients and their families

    Dr Peter ParryConsultant Child & Adolescent Psychiatrist, LCCH, CYMHS, Brisbane, Queensland Senior Lecturer, University of QueenslandVisiting Senior Lecturer, Flinders University

    Gwinganna October 2015

  • Leon EisenbergChair APA Section of Child Psychiatry (amongst innumerable posts and honours)Brainless Psychiatry v Mindless Psychiatry

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  • Biopsychosocial Model George Engel

  • Australasian Psychiatry Mar 06*

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  • Chief-editorsHorton (The Lancet): How tainted has medicine become? Lancet 2002 heavily and damagingly so.Angell (NEJM): Drug Companies & Doctors: A story of Corruption New York Review of Books 2009Smith (BMJ): Medical journals have become an extension of the marketing arm of pharmaceutical companies. PLoS Med 2005

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  • BackgroundRelief without Drugs 1970 best-seller.Ainslie Meares, Australian psychiatrist

  • Course at APA, San Francisco, 2009Yoga of the East and West: Integrating Breath Work and Meditation into Clinical Practice.Patricia Gerbarg, M.D., Richard Brown, M.D. www.breath-body-mind.com

  • Course at APA, San Francisco, 2009

  • Course at APA, San Francisco, 2009

  • Course at APA, San Francisco, 2009

  • Vagus the wanderer - Nerve

  • Pneumogastric NerveCharles Darwin (1872):

    The Expression of Emotions in Man and AnimalsHeart, guts and brain communicate intimately via the "pneumogastric" nerve, the critical nerve involved in the expression and management of emotions in both humans and animals.

  • Course at APA, San Francisco, 2009

  • Course at APA, San Francisco, 2009

  • Lifestyle treatment of depressionEvolutionary paradigm.Hunter-gatherer tribe.

  • Evolutionary Perspective

  • Evolutionary perspectivePsychoeducation re nervous system

  • Evolutionary perspectivePsychoeducation re nervous systemSympathetic (Stress/Survival) Nervous SystemFight, Flight, Freeze, Faint/Feigned DeathAmygdalae, Almonds, Alarms, ADRENALINFrontal lobes offline

  • Evolutionary perspectivePsychoeducation re nervous systemParasympathetic (Peaceful) Nervous SystemRest & Digest, Recover & GrowVagus NerveBreath: Sigh, Yawn, Laugh, SobGABA (Gamma-Aminobutyric Acid)

  • Evolutionary perspective on depressive reactionsAttachment Loss Grief moving on and reattaching survival of tribe/group

    Status Loss Survival

    Unmet expectations demoralisation - Survival

  • Grief & Trauma

  • Status battles &High expectations

  • Lifestyle treatment of depressionInflammatory theory of depressionAcute stress is manageable. HPA system swings into gear with sympathetic nervous system response followed by parasympathetic relaxation and repair phase.Chronic stress is bad. Stress (current and unresolved), inactivity, poor sleep, poor diet, toxic load (tobacco, alcohol, obesity), sympathetic overdrive. HPA axis dysfunction.HPA dysfunction leads to inflammation body and nervous system.Pro-inflammatory cytokines.

  • Biological Psychiatry 2009;65:732-741

  • Engaging young people in using a breathing-relaxation techniqueHas a teacher or counsellor ever taught you how to use slow breathing techniques to help

    yeah, Ive tried that it doesnt work for me!!

    OK I believe you it hasnt worked for you when youve tried it up to now. But actually it has worked for you when you havent tried it Ill tell you why {come in with the sales spiel}

  • The SpielDraw brain and spinal cord plus eye and optic nerve and schematic body with heart, lungs, guts, diaphragm muscle.within brain draw brainstem = autonomic N.S. autopilot = reptilian braindraw hemispheric limbic system with amygdalas (alarms) = mammalian braindraw frontal lobes = thinking/verbal brainDescribe fight/flight/freeze

    Sympathetic N.S., adrenalin, amygdalas, frontal lobes switch off = survival/stress N.S.Need a circuit breaker to turn it off = parasympathetic peaceful N.S. = vagus nerve

  • Breath and the Vagus NerveVagus nerve = feedback from diaphragmamygdalas will listenI know for certain you already use this breathing-relaxation technique!??? (their expression)yawning, sighing, laughing, sobbingthe valsalva manoevre stimulates vagus.Enact a yawn, sigh etchow this is same as a yoga breathdogs, chimpanzees use of yawning as communicationhumour helps!!

  • Course at APA, San Francisco, 2009

  • Breath and the Vagus Nervevictorious

  • Breath and the Vagus NerveElite athletes are trained to use it.AFL/NRL footballers lining up for goalsOlympic runners & swimmersJohnny Wilkinson in Rugby, David Beckham in SoccerSingers and performers e.g. Australias Got Talent, X Factor etcPoliticians making speechesJulia Gillard speaking with slow diaphragmatic breathing and exaggerated Australian drawl

  • Breath and the Vagus NerveShow how similar breathing-relaxation is to yawning.the sound ocean breathing on the lengthened out-breath.

    Practice it in session (incl parents)

    Self-disclosurefor sleep, daily stress, exams etcYou shouldnt preach this if dont practice it!

  • Course at APA, San Francisco, 2009

  • Mindfulness is an Open SkyMindfulness is a Mountain

  • Mindfulness-Based Cognitive Therapy

  • Lifestyle treatment of depressionSleepDraw graph sleep architecture level 1 to 4Explain value of deep sleep cell repair, clear inflammatory debris (cytokines)EEG patterns delta rhythm stage 4.CSF flushing of neurons with resolvins - clean out debrisTeens need 9 hrs average for full dose stage 4 hardware clean up and full dose REM stage 1 dreaming software cleanup.Circadian RhythmPineal gland, Supra-chiasmatic nucleus (SCN)Melatonin = sleep chemical, SCN = clockNeed for sunshine in day and darkness at nightComputer/TV @ night (blue light/amber glasses)ISRT Interpersonal Social Rhythm Therapy

  • Sleeping mouse flushing her brain

  • Lifestyle treatment of depressionExerciseSuperoxide Dismutase (SOD)Brain derived neurotrophic factor (BDNF)Tiredness to help sleepBetter insulin sensitivity, energy and weight controlEndorphins for moodDietOmega-3/omega-6 ratio of 1:1 in paleolithic hunter gatherersOmega-3 building blocks for resolvins & neuroprotectinSugar, metabolic syndrome and inflammationNutrients, including antioxidants, and protein lean meat, vegetables, fruit, berries, nuts

  • Sparking Life (Dr John Ratey)

  • Brain Food

  • Obesity primarily a sugar/carb metabolism problem.

    World Obesity Federation annual conference, Berlin 2015

  • Junk food shrinks brain

  • Lifestyle treatment of depressionNatural environmentsNature Deficit DisorderMobile fractal patterns vs linear regularityKorean CBT in forest study 5.21.61, hrv, salivary cortisol.Human touchEvolved from apes who endlessly groomed eachotherAndaman islandersMassage therapiesAttachment and socialisingFriendships face-to-faceTalking therapies

  • Nature Deficit DisorderEcotherapy

  • Our Primate Legacy. neurological immaturity at birth..slow development.. in relationship to prolonged breast feeding and physical contact with adults

    Slide courtesy Prof J McKennaOrang-Utan

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  • Consider the physical intimacy of the maternal-infant relationship

    Slide courtesy Prof J McKennasocially and medicallyobscured by western cultureBalineseMother and infant

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  • Parent child holding The Welsh Shawl

    Tradition of long holding and carrying of infants was in West too.

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  • The Tribe:Main Focus of Human Evolution

  • Paradigm shiftIntegrative PsychiatryAncestral HealthTruly holistic and developmental in broader evolutionary perspectiveEvolutionary perspective niche & nurture that is required by our natureBiopsychosocioculturoevolutionary model !!!

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