Friday, August 7, 2009

Amygdala re-training

I have recently started a CFS treatment programme that is based on a hypothesis that CFS is of neurological origin. Gupta Amygdala Retraining has been developed by a guy from London called Ashok Gupta. He is only young, and is not a medical doctor. He got CFS about 10 years ago. In the process of researching the condition, he struck on something that worked and got himself better. He then went on to open a clinic and has successfully treated a number of patients. His treatment programme is now available to buy as a set of DVDs.

When I first came across Gupta, I was fairly suspicious, because there are always cure merchants out there. But I encountered a few people who were trying it, and there seemed to be a fairly positive vibe coming from people in forums. He was also at the most recent International Association for CFS/ME conference in Reno, where he presented a poster, and has been seeking support to do a more comprehensive trial of his treatment. So I think he is kosher, and I have bought his DVD treatment programme.

He has done a clinical study of 33 patients. After one year, 92% improved, and 67% made a full (or very nearly full) recovery. Those are pretty encouraging numbers!

So what is Gupta's hypothesis? At the root of it is a part of the brain called the amygdala. As he explains it, the amygdala is responsible for generating emotional responses due to sensory stimuli. An example might be if you are in the bush and think you see a snake. The sensory input from your eyes enters the amygdala from the thalamus. The amygdala recognises the stimuli as looking like a snake. It then activates the sympathetic nervous system (i.e the stress response) via the hypothalamus, and makes you feel scared and anxious. All this happens before your conscious mind has had a chance to even form the thought "snake!"

The amygdala is capable of learning. So if there is indeed a snake, then your conscious recognition of that fact reinforces the response of the amygdala. If there wasn't a snake, then your amygdala would learn to not overreact to sticks on the ground.

How does this relate to CFS? Gupta proposes that the amygdala is highly sensitised in CFS sufferers. This results in a nasty vicious cycle:
  • Sensory stimuli relating to CFS symptons (tiredness, pain, etc.) arrive at the amygdala.
  • The amygdala, because it is over-sensitised, recognises these stimuli as bad.
  • It kicks off the stress response, which, because of this cycle, is chronic.
  • It also generates fear/anxiety in the concious mind.
  • The conscious mind recognises the symptoms, and agrees with the amygdala: "Yeah, that sucks, I really am tired!"
  • The amygdala learns that it has done the right thing, and becomes even more sensitised to the symptoms.
  • The chronic stress response actually is the cause of the CFS symptoms, and so we are back at the start of the cycle, and it continues onwards.
So it's all in the head? Well, not quite. The symptoms are real. But they continue because of the over-sensitised amygdala. Additionally, this is not a conscious process. Rather it is sub-conscious. So it is not a psychological problem, but rather a neurological one.

How does someone get stuck in this feedback loop to start with? Gupta contends that it is a combination of stress and infection. Someone might be in a particularly stressful period of their lives. They get an infection or virus. They get over the initial symptoms in a week or two, but then they never seem to quite get completely better. They have post-viral fatigue. As this drags on, they become increasingly aware of their symptoms, and angry and frustrated by them. This, then, trains the amygdala to treat the symptoms as a threat, and to trigger the stress response. And so the cycle begins.

This hypothesis has been published in the journal Medical Hypotheses, and is available online. Gupta has also made available some of his DVD sessions. Those where he explains the hypothesis begin here. He gives an overview of the treatment programme beginning here. And there are some testimonials starting here (the one with Rebecca is the best). Note that all up he has put about 3 hours worth of video up on youtube. On the plus side, he is really quite good at presenting it.

How does Gupta treat this? Well, I would be breaking his intellectual property to tell you, but it boils down to this. The only part in the cycle we can control is the part where the conscious mind reaffirms the actions of the amygdala. The key is to break the cycle there, and then gradually the amygdala will desensitise, the chronic stress response will diminish, and the body return to normal.

As I watched his DVDs, everything he said made sense, and I could relate to intimately. It really struck a chord with me, and I could look into the past and see how events and my behaviour had triggered various episodes. But more than anything, he knew exactly what was going on in my head, and why that was keeping me sick.

I've been applying Gupta's technique for nearly two weeks now. Is it helping? I think, yes. The last two weeks have been my best since about November. I have been more able, more energetic and more enthusiastic about life. Will it last? Only time will tell, but I feel positive that it will. I feel like I have the tools to deal with any dips, and the knowledge to recognise undesirable behaviour.

Is it hard to do? Yes and no. Persistence and awareness would be better descriptions of what is required. When I first understood the full consequences of the technique, and what it would demand of me, I had a "Holy Shit!" moment. He was asking me to completely turn around the way my brain had been operating! But after a few days of absorbing the concept, I found that my thinking had already started to adapt, and that I was naturally shying away from my old unhealthy thinking. It's like this understanding he has given me has flicked a switch in my head, and my brain has seen the light and is getting to work in this new direction.

Having said that, it's possible that I'm not really doing it properly, and that I need to be more diligent to get the long-term improvements.

One unanswered question I have, is that if the symptoms are due to a chronic stress response, shouldn't that be detectable in the levels of hormones etc. in the blood?

I should outline the other factors that may have led to my recent improvements in health. I was already on an up before starting Gupta, but I am quite confident that Gupta has enabled me to at least maintain that improvement, if not better it. Other things that have changed recently is that I have shifted towards a low-carb, paleo-diet, and that I am taking a bunch of supplements. I think they are both important contributing factors. In combination, I am hopeful that they will be enough to get me better again.

Fingers crossed!

Sunday, August 2, 2009

Eco-tarian meat eating

I've started eating more meat lately, and have been juggling the environment consequences of that.

To begin with, I bought some sausages from the local butcher. I did this because I can walk there and it's convenient. By contrast, to get kangaroo sausages, I need to drive to the markets. So, I wondered, is driving 14km to get a dozen roo sausages worse than walking to get a dozen beef sausages?

According to the Garnaut Report, emissions for production of meat are as follows (expressed in kg CO2-e/kg meat):
  • Beef: 24.0
  • Lamb: 16.8
  • Pork: 4.1
  • Poultry: 0.8
  • Kangaroo: let's assume 0.
Let's say a dozen sausages weighs a kilo. Then the beef sausages emit 24kg of CO2. To drive 14km, even in my old Magna, would produce only 4.1kg of CO2. That means I could drive about 80km to get my roo meat, and come out even. Wow!

At Coles the other day I noticed that they now have a "game meat" section. Not only was there kangaroo, but also wild goat sausages, vension steaks, and a bunch of other things. All of these animals are hunted in the wild, and are feral pest species. This is fantastic! So by eating this meat, I can help reduce the number of ferals animals causing all sorts of environmental degradation, and reduce greenhouse emissions. With kangaroos, I only avoid emissions. Who'd have thought you could do better than roo?

My housemate tells me that they are hunting feral camels for meat in NT and WA. Camels produce a lot of methane, and there is something like a million of them out there. The camel hunters are hoping to get emission credits for the emissions the camels would have produced if allowed to live!