Carl Jung argued that sometimes what seems like mental illness is in actuality an effective coping mechanism. He advised against treating the coping mechanism as the problem without understanding what it is a response to. The problem itself could be made worse. Some people have found a careful balance that allows them to function in the world, no matter how dysfunctional it may seem to others, from addiction to dissociation. We need to have respect and compassion for how humans cope with difficulties.
There is something similar in physical health. Consider obesity. Is it always the cause of health problems? Or might it be the body’s way of protecting against other health problems? That is what was explored in a recent study mentioned by Gabor Erdosi. It is Friendly Fat Theory – Explaining the Paradox of Diabetes and Obesity by Rajiv Singla et al. The authors write:
“Obesity has been called the mother of all diseases and, historically, has been strongly linked to diabetes. However, there are still some paradoxes that exist in diabetes epidemiology and obesity and no unifying hypothesis has been proposed to explain these paradoxical phenomena. Despite the ever-increasing prevalence of both obesity and diabetes, differential relationships exist between diabetes and the extent of obesity in various different ethnic groups. In addition, people with a higher body mass index have been shown to have an improved survival advantage in terms of chronic diabetes complications, especially cardiovascular complications. This narrative review attempts to explain these paradoxical and complex relationships with a single unifying theory. We propose that adipocytes are actually friends of the human body to prevent the occurrence of diabetes and also help in mitigating the complications of diabetes. Adipose tissue actually acts as a reservoir of free fatty acids, responsible for insulin resistance, and prevents their overflow into insulin-sensitive tissues and, therefore, friendly fat theory.”
L. Amber O’Hearn responded, “Wait, are you saying the body is actually trying to be healthy and that many symptoms we see in connection with disease are functionally protective coping mechanisms? Yes, indeed.” Following that, someone else mentioned that this perspective was argued by Dr. Jason Fung in an interview with Peter Attia, podcast #59. I’m sure many others have said similar things. It’s not difficult to understand for anyone familiar with some of the science.
For example, inflammation causes many problems, but inflammation itself isn’t the fundamental cause since it is a protective response itself to something else. Or as yet another example, there is the theory that cholesterol plaque in arteries doesn’t cause the problem but is a response to it, as the cholesterol is essentially forming a scab in seeking to heal injury. Pointing at cholesterol would be like making accusations about firefighters being present at fires. One could look to numerous other things, as the basic principal is widely applicable. The body is always seeking the healthiest balance under any conditions, even if less than optimal. So, in seeking greater health, we must realize that the body-mind of an individual is a system that is part of larger systems. To get different results, the totality of the situation needs to be shifted into a new balance. That is why something like ketosis can dramatically improve so many health issues, as it completely alters the functioning of gut health, metabolism, immune response, neurocognition, and on and on. That diet could have that kind of impact should not be hard to understand. Think about the multiple links, direct and indirect, between the gut and the brain — multiply that by hundreds of other major connections within our biology.
The failing of conventional medicine is that it has usually been a symptoms-based approach. Diagnosis is determined by patterns of symptoms. Too often that then is used to choose a medication or surgical intervention to treat those symptoms. Underlying causes are rarely understood or even considered. Partly, that is because of a lack of knowledge and the related low quality of many medical studies. But more problematic is that the dominant paradigm constrains thought, shuts down the ability to imagine other ways of doing medicine. The above study, however, suggests that we should understand what purpose something is serving. Obesity isn’t merely too much fat. Instead of being the problem itself, obesity might be the body’s best possible solution under those conditions.
What if so many of our supposed problems operate in a similar manner? What if instead of constantly fighting against what we deem as bad we sought understanding first about what purpose is being served and then sought some other means of accomplishing that end? Think about the short-term thinking that has been observed under conditions of poverty and high inequality. Instead of judging people as inferior, we could realize that short-term thinking makes perfect sense in evolutionary terms, as extreme stress indicates that immediate problems must be dealt with first. Rather than blaming the symptom or scapegoating the victim, we should look at the entire context of what is going on. If we don’t like the results we are getting as individuals and as a society, we better change the factors that lead to those results. It’s a simple and typically overlooked insight.
We aren’t isolated individuals. We are an inseparable aspect of a larger world. Every system within our bodies and minds, every system in society and the environment is integral to our holistic functioning as human beings. Everything is connected in various ways. Change one thing and it will ripple outward.
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To return to the topic at hand, the notion of food as medicine, a premise of the paleo diet, also goes back to the ancient Greeks — in fact, originates with the founder of modern medicine, Hippocrates (he also is ascribed as saying that, “All disease begins in the gut,” a slight exaggeration of a common view about the importance of gut health, a key area of connection between the paleo diet and alternative medicine). What we now call functional medicine, treating people holistically, used to be standard practice of family doctors for centuries and probably millennia, going back to medicine men and women. But this caring attitude and practice went by the wayside because it took time to spend with patients and insurance companies wouldn’t pay for it. Traditional healthcare that we now think of as alternative is maybe not possible with a for-profit model, but I’d say that is more of a criticism of the for-profit model than a criticism of traditional healthcare.
Related to diet, Pezeshki does bring up the issue of inflammation. As I originally came around to my present diet from a paleo viewpoint, I became familiar with the approach of functional medicine that puts inflammation as a central factor (Essentialism On the Decline). Inflammation is a bridge between the physiological and the psychological, the individual and the social. Where and how inflammation erupts within the individual determines how a disease condition or rather a confluence of symptoms gets labeled and treated, even if the fundamental cause originated elsewhere, maybe in the ‘external’ world (socioeconomic stress, transgenerational trauma, environmental toxins, parasites because of lack of public sanitation, etc. Inflammation is linked to leaky gut, leaky brain, arthritis, autoimmune disorders, mood disorders, ADHD, autism, schizophrenia, impulsivity, short-term thinking, addiction, aggression, etc — and such problems increase under high inequality.
There are specific examples to point to. Diabetes and mood disorders co-occur. There is the connection of depression and anhedonia, involving the reward circuit and pleasure, which in turn can be affected by inflammation. Also, inflammation can lead to changes in glutamate in depression, similar to the glutamate alterations in autism from diet and microbes, and that is significant considering that glutamate is not only a major neurotransmitter but also a common food additive. Dr. Roger McIntyre writes that, “MRI scans have shown that if you make someone immune activated, the hypervigilance center is activated, activity in the motoric region is reduced, and the person becomes withdrawn and hypervigilant. And that’s what depression is. What’s the classic presentation of depression? People are anxious, agitated, and experience a lack of spontaneous activity and increased emotional withdrawal” (Inflammation, Mood Disorders, and Disease Model Convergence). Inflammation is a serious condition and, in the modern world, quite pervasive. The implications of this are not to be dismissed.
In reading about paleolithic diets and traditional foods, a recurring theme is inflammation, specifically as it relates to the health of the gut-brain network and immune system.
The paradigm change this signifies is that seemingly separate diseases with different diagnostic labels often have underlying commonalities. They share overlapping sets of causal and contributing factors, biological processes and symptoms. This is why simple dietary changes can have a profound effect on numerous health conditions. For some, the diseased state expresses as mood disorders and for others as autoimmune disorders and for still others something entirely else, but there are immense commonalities between them all. The differences have more to do with how dysbiosis and dysfunction happens to develop, where it takes hold in the body, and so what symptoms are experienced.
From a paleo diet perspective in treating both patients and her own multiple sclerosis, Terry Wahls gets at this point in a straightforward manner (p. 47): “In a very real sense, we all have the same disease because all disease begins with broken, incorrect biochemistry and disordered communication within and between our cells. […] Inside, the distinction between these autoimmune diseases is, frankly, fairly arbitrary”. In How Emotions Are Made, Lisa Feldman Barrett wrote (Kindle Locations 3834-3850):
“Inflammation has been a game-changer for our understanding of mental illness. For many years, scientists and clinicians held a classical view of mental illnesses like chronic stress, chronic pain, anxiety, and depression. Each ailment was believed to have a biological fingerprint that distinguished it from all others. Researchers would ask essentialist questions that assume each disorder is distinct: “How does depression impact your body? How does emotion influence pain? Why do anxiety and depression frequently co-occur?” 9
“More recently, the dividing lines between these illnesses have been evaporating. People who are diagnosed with the same-named disorder may have greatly diverse symptoms— variation is the norm. At the same time, different disorders overlap: they share symptoms, they cause atrophy in the same brain regions, their sufferers exhibit low emotional granularity, and some of the same medications are prescribed as effective.
“As a result of these findings, researchers are moving away from a classical view of different illnesses with distinct essences. They instead focus on a set of common ingredients that leave people vulnerable to these various disorders, such as genetic factors, insomnia, and damage to the interoceptive network or key hubs in the brain (chapter 6). If these areas become damaged, the brain is in big trouble: depression, panic disorder, schizophrenia, autism, dyslexia, chronic pain, dementia, Parkinson’s disease, and attention deficit hyperactivity disorder are all associated with hub damage. 10
“My view is that some major illnesses considered distinct and “mental” are all rooted in a chronically unbalanced body budget and unbridled inflammation. We categorize and name them as different disorders, based on context, much like we categorize and name the same bodily changes as different emotions. If I’m correct, then questions like, “Why do anxiety and depression frequently co-occur?” are no longer mysteries because, like emotions, these illnesses do not have firm boundaries in nature.”
What jumped out at me was the conventional view of disease as essentialist, and hence the related essentialism in biology and psychology.